Apical extrusion of irrigants in immature teeth using different negative pressure irrigation devices
DOI:
https://doi.org/10.22456/2177-0018.135470Keywords:
Endodontics, Root canal irrigants, Regenerative endodonticsAbstract
Aim: The aim of this study was to evaluate the apical extrusion of irrigants in simulated immature teeh, comparing convencional irrigation with other negative pressure irrigation devices. Materials and methods: 48 samples of simulated immature teeth were set up in an adapted model to contain the extravasated irrigant and evenly distributed into 4 groups (n=12) according to the device used: Convencional Irrigation Group (CI), EndoVac Group (EV), Pulp Sucker Group (PS) and Ivac Group (IV). The samples were irrigated with 15mL of irrigant solution, consisting of 10mL NaOCl 2,5% and 5mL EDTA 17%, in na alternating sequence. The samples’ weights were measured using a precision scale before and after the irrigation procedures, with the difference between de final and initial weights considered the volume of extravasated irrigant. Data were collected and statistically analyzed by Kruskal-wallis and Fisher exact tests. Results: The groups that used negative pressure devices significantly promoted a lower volume of extruded irrigant than the CI group (p<0,05), with no significant differences between the negative pressure groups (p>0,05). There were signficant differences in the association between the groups and irrigant extrusion, with the PS group showing significantly less association with irrigant extrusion (p<0,005). Discussion: Previous studies have indicated that negative pressure devices are safe alternatives to convencional irrigation when considering irrigant extrusion. Conclusion: Conventional irrigation promoted a significantly greater volume of irrigant extrusion when compared to negative pressure irrigation devices. The PulpSucker system showed irrigant extravasation in significantly fewer samples.
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Sjögren U, Hägglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod [Internet]. 1990 [cited 2023 July 14];16(10):498-504. Available from: https://pubmed.ncbi.nlm.nih.gov/2084204/.
Ricucci D, Siqueira JF. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod [Internet]. 2010 Aug [cited 2019 June 10];36(8):1277-88. Available from: http://.ncbi.nlm.nih.gov/pubmed/20647081.
Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, et al. Influence of the apical preparation size and the irrigant type on bacterial reduction in root canal-treated teeth with apical periodontitis. J Endod [Internet]. 2017 July 1 [cited 2021 Dec 6];43(7):1058–63. Available from: https://pubmed.ncbi.nlm.nih.gov/28483164/.
Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002 [cited 2023 July 28];18(3):134–7. Available from: https://pubmed.ncbi.nlm.nih.gov/12110105/.
Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Dent Traumatol [Internet]. 1992 Apr 1 [cited 2023 June 14];8(2):45–55. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-9657.1992.tb00228.x.
Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod [Internet]. 2004 [cited 2023 June 10];30(4):196–200. Available from: https://pubmed.ncbi.nlm.nih.gov/15085044/.
Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, et al. European society of endodontology position statement: revitalization procedures. Int Endod J [Internet]. 2016 Aug 1 [cited 2023 June 14];49(8):717–23. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/iej.12629.
Wei X, Yang M, Yue L, Huang D, Zhou X, Wang X, et al. Expert consensus on regenerative endodontic procedures. Int J Oral Sci [Internet]. 2022 Dec 1 [cited 2023 June 14];14(1). Available from: https://pubmed.ncbi.nlm.nih.gov/36450715/.
Trevino EG, Patwardhan AN, Henry MA, Perry G, Dybdal-Hargreaves N, Hargreaves KM, et al. Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips. J Endod [Internet]. 2011 Aug [cited 2023 June 14];37(8):1109–15. Available from: https://pubmed.ncbi.nlm.nih.gov/21763903/.
Velmurugan N, Sooriaprakas C, Jain P. Apical extrusion of irrigants in immature permanent teeth by using endovac and needle irrigation: an in vitro study. J Dent (Tehran) [Internet]. 2014 [cited 2022 Apr 22];11(4):433. Available from: https://www.scielo.br/j/jaos/a/JHzTR58C8c9frfDNqyZ9VXS/?lang=en.
Jamleh A, Fukumoto Y, Takatomo Y, Kobayashi C, Suda H, Adorno CG. A comparison between two negative pressure irrigation techniques in simulated immature tooth: an ex vivo study. Clin Oral Investig [Internet]. 2016 Jan 1 [cited 2023 June 14];20(1):125–31. Available from: https://pubmed.ncbi.nlm.nih.gov/25963721/.
Magni E, Jäggi M, Eggmann F, Weiger R, Connert T. Apical pressures generated by several canal irrigation methods: a laboratory study in a maxillary central incisor with an open apex. Int Endod J [Internet]. 2021 Oct 1 [cited 2022 Apr 26];54(10):1937–47. Available from: https://pubmed.ncbi.nlm.nih.gov/34022070/.
Erdfelder E, Paul F, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009 [cited 2022 Aug 1];41(4):1149–60. Available from: https://pubmed.ncbi.nlm.nih.gov/19897823/.
Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod [Internet]. 1991 [cited 2022 May 2];17(6):275–9. Available from: https://pubmed.ncbi.nlm.nih.gov/1940753/.
Wang HJ, Chen YHM, Chen KL. Conservative treatment of immature teeth with apical periodontitis using triple antibiotic paste disinfection. J Dent Sci [Internet]. 2016 June 1 [cited 2022 July 19];11(2):196–201. Available from: https://pubmed.ncbi.nlm.nih.gov/30894971/.
Lovelace TW, Henry MA, Hargreaves KM, Diogenes A. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. J Endod [Internet]. 2011 Feb [cited 23 June 16];37(2):133–8. Available from: https://pubmed.ncbi.nlm.nih.gov/21238791/.
Sonoyama W, Liu Y, Yamaza T, Tuan RS, Wang S, Shi S, et al. Characterization of the apical papilla and its residing stem cells from human immature permanent teeth: a pilot study. J Endod [Internet]. 2008 Feb [cited 2023 June 16];34(2):166–71. Available from: https://pubmed.ncbi.nlm.nih.gov/18215674/.
Mitchell RP, Yang SE, Baumgartner JC. Comparison of apical extrusion of NaOCl using the endovac or needle irrigation of root canals. J Endod [Internet]. 2010 [cited 2022 May 23];36(2):338–41. Available from: http://dx.doi.org/10.1016/j.joen.2009.10.003.
Sharma R, Kumar V, Logani A, Chawla A, Sharma S, Koli B. Effect of gravity on periapical extrusion of irrigating solution with different irrigation protocols in immature anterior teeth. Eur Endod J. 2020 [cited 2022 May 23];5(2):150–4. Available from: https://pubmed.ncbi.nlm.nih.gov/32766527/.
Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod [Internet]. 2009 Apr [cited 2023 July 4];35(4):545–9. Available from: https://pubmed.ncbi.nlm.nih.gov/19345802/.
Fairbourn DR, McWalter GM, Montgomery S. The effect of four preparation techniques on the amount of apically extruded debris. J Endod [Internet]. 1987 [cited 2022 May 2];13(3):102–8. Available from: https://pubmed.ncbi.nlm.nih.gov/3471831/.
Charara K, Friedman S, Sherman A, Kishen A, Malkhassian G, Khakpour M, et al. Assessment of apical extrusion during root canal irrigation with the novel gentlewave system in a simulated apical environment. J Endod. 2016 [cited 2023 July 14];42(1):135–9. Available from: https://pubmed.ncbi.nlm.nih.gov/26547720/.
Hachmeister DR, Schindler WG, Walker WA, Thomas DD. The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification. J Endod. 2002 [cited 2023 Feb 21];28(5):386–90. Available from: https://pubmed.ncbi.nlm.nih.gov/12033201/.
Fukumoto Y, Kikuchi I, Yoshioka T, Kobayashi C, Suda H. An ex vivo evaluation of a new root canal irrigation technique with intracanal aspiration. Int Endod J [Internet]. 2006 Feb [cited 2023 Apr 8];39(2):93–9. Available from: https://pubmed.ncbi.nlm.nih.gov/16454788/.
Cohenca N, Heilborn C, Johnson JD, Flores DSH, Ito IY, da Silva LAB. Apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing on root canal disinfection in dog teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod [Internet]. 2010 Jan 1 [cited 2023 July 17];109(1). Available from: https://pubmed.ncbi.nlm.nih.gov/20123368/.
Nakamura VC, Pinheiro ET, Prado LC, Silveira AC, Carvalho APL, Mayer MPA, et al. Effect of ultrasonic activation on the reduction of bacteria and endotoxins in root canals: a randomized clinical trial. Int Endod J [Internet]. 2018 Jan [cited 2019 May 9];51:e12–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28439928.
Gupta J, Nikhil V, Jha P. Corelation between machines assisted endodontic irrigant agitation and apical extrusion of debris and irrigant: a laboratory study. Sci World J. 2014 Oct 16 [cited 2023 Feb 21]; 346184. Available from: https://pubmed.ncbi.nlm.nih.gov/25386593/.
Brizuela C, Huang GTJ, Diogenes A, Botero T, Khoury M. The four pillars for successful regenerative therapy in endodontics: stem cells, biomaterials, growth factors, and their synergistic interactions. Stem Cells Int [Internet]. 2022 [cited 2023 July 17];2022. Available from: https://pubmed.ncbi.nlm.nih.gov/36193253/.
Verma P, Nosrat A, Kim JR, Price JB, Wang P, Bair E, et al. Effect of residual bacteria on the outcome of pulp regeneration in vivo. J Dent Res [Internet]. 2017 Jan 1 [cited 2023 July 17];96(1):100–6. Available from: https://pubmed.ncbi.nlm.nih.gov/27694153/.
Cohen S, Burns R, Keiser K. Pathways of the pulp. 1998 [cited 2023 May 22]. Available from: https://www.uacj.mx/icb/dest/documentos/est0015-endodoncia i.pdf.
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Copyright (c) 2023 Gabriela Milani, Hermano Camelo Paiva, Eduardo Akisue, Elaine Faga Iglecias, Carmo Antonio Aun, Érica Mina Miyazima Nunes, Giulio Gavini
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