nach oben

Clinical Oral Investigations

Erschienen in:

26.07.2017 | Original Article

Comparison of sodium hypochlorite extrusion by five irrigation systems using an artificial root socket model and a quantitative chemical method

verfasst von: Adham A. Azim, Hacer Aksel, M. Margaret Jefferson, George T.-J. Huang

Erschienen in: Clinical Oral Investigations | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

This is to compare the volumes of irrigant apically extruded by five irrigation systems in an artificial socket model simulating clinical conditions.

Materials and methods

Twenty extracted human single-rooted teeth were enlarged to size 40/04 and then embedded in silicone impression material. The root canal space was irrigated with nominal 3% sodium hypochlorite (NaOCl) using standard needle irrigation (SNI) with a 30-gauge notched needle, EndoActivator (EA), XP Endo Finisher (XP Endo), EndoVac (EV), and photon-induced photoacoustic streaming (PIPS). Extruded NaOCl was collected, reacted with taurine to form taurine-monochloramine, and absorbance of taurine-monochloramine was measured at 252 nm using a spectrophotometer. The five irrigation systems were compared with repeated measures ANOVA and pairwise comparisons.

Results

The EV group had very low extrusion (mean ± SD = 0.12 ± 0.2 μL) and differed significantly from the other four groups (P ≤ 0.001). Larger volumes of irrigant were extruded in the other irrigation groups. There were no significant differences in the extruded volumes among the SNI (7.4 ± 3.4 μL), EA (7.0 ± 6.1 μL), and XP Endo (7.8 ± 4.1 μL) groups (P = 1). The PIPS group had the highest mean extruded volume (12.9 ± 6.8 μL) and differed significantly from SNI (P = 0.030), EV (P < 0.0005), and EA (P = 0.02), but not XP Endo (P = 0.154).

Conclusion

Under the in vitro conditions of this study, irrigant extrusion appears unavoidable unless negative pressure irrigation such as EV is used. PIPS extrudes more irrigant than other systems, while SNI, EA, and XP Endo extrude similar volumes of irrigant.

Clinical relevance

The findings help clinicians select the optimal irrigation system to avoid irrigant extrusion.

Nur mit Berechtigung zugänglich

Shuping GB, Orstavik D, Sigurdsson A et al (2000) Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod 26:751–755CrossRefPubMed

Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 44:583–609CrossRefPubMed

Dutner J, Mines P, Anderson A (2012) Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod 38:37–40CrossRefPubMed

Psimma Z, Boutsioukis C, Kastrinakis E et al (2013) Effect of needle insertion depth and root canal curvature on irrigant extrusion ex vivo. J Endod 39:521–524CrossRefPubMed

Sedgley CM, Nagel AC, Hall D et al (2005) Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 38:97–104CrossRefPubMed

Hulsmann M, Hahn W (2000) Complications during root canal irrigation—literature review and case reports. Int Endod J 33:186–193CrossRefPubMed

Gernhardt CR, Eppendorf K, Kozlowski A et al (2004) Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant. Int Endod J 37:272–280CrossRefPubMed

Pashley EL, Birdsong NL, Bowman K et al (1985) Cytotoxic effects of NaOCl on vital tissue. J Endod 11:525–528CrossRefPubMed

Ehrich DG, Brian JD, Walker WA (1993) Sodium hypochlorite accident: inadvertent injection into the maxillary sinus. J Endod 19:180–182CrossRefPubMed

10.

Koch JD, Jaramillo DE, DiVito E et al (2016) Irrigant flow during photon-induced photoacoustic streaming (PIPS) using particle image Velocimetry (PIV). Clin Oral Investig 20:381–386

11.

Mathew J, Emil J, Paulaian B et al (2014) Viability and antibacterial efficacy of four root canal disinfection techniques evaluated using confocal laser scanning microscopy. J Conserv Dent 17:444–448CrossRefPubMedPubMedCentral

12.

Al Shahrani M, DiVito E, Hughes CV et al (2014) Enhanced removal of enterococcus faecalis biofilms in the root canal using sodium hypochlorite plus photon-induced photoacoustic streaming: an in vitro study. Photomed Laser Surg 32:260–266CrossRefPubMedPubMedCentral

13.

Azim AA, Aksel H, Zhuang T et al (2016) Efficacy of 4 irrigation protocols in killing bacteria colonized in dentinal tubules examined by a novel confocal laser scanning microscope analysis. J Endod 42:928–934

14.

Mitchell RP, Baumgartner JC, Sedgley CM (2011) Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod 37:1677–1681CrossRefPubMed

15.

Mitchell RP, Yang SE, Baumgartner JC (2010) Comparison of apical extrusion of NaOCl using the EndoVac or needle irrigation of root canals. J Endod 36:338–341CrossRefPubMed

16.

George R, Walsh LJ (2008) Apical extrusion of root canal irrigants when using Er:YAG and Er,Cr:YSGG lasers with optical fibers: an in vitro dye study. J Endod 34:706–708CrossRefPubMed

17.

Yost RA, Bergeron BE, Kirkpatrick TC et al (2015) Evaluation of 4 different irrigating systems for apical extrusion of sodium hypochlorite. J Endod 41:1530–1534CrossRefPubMed

18.

Desai P, Himel V (2009) Comparative safety of various intracanal irrigation systems. J Endod 35:545–549CrossRefPubMed

19.

Beeson TJ, Hartwell GR, Thornton JD et al (1998) Comparison of debris extruded apically in straight canals: conventional filing versus profile .04 Taper series 29. J Endod 24:18–22CrossRefPubMed

20.

Ghivari SB, Kubasad GC, Chandak MG et al (2011) Apical extrusion of debris and irrigant using hand and rotary systems: a comparative study. J Conserv Dent 14:187–190CrossRefPubMedPubMedCentral

21.

Rodriguez-Figueroa C, McClanahan SB, Bowles WR (2014) Spectrophotometric determination of irrigant extrusion using passive ultrasonic irrigation, EndoActivator, or syringe irrigation. J Endod 40:1622–1626CrossRefPubMed

22.

Thomas EL, Grisham MB, Jefferson MM (1986) Preparation and characterization of chloramines. Methods Enzymol 132:569–585CrossRefPubMed

23.

King CC, Jefferson MM, Thomas EL (1997) Secretion and inactivation of myeloperoxidase by isolated neutrophils. J Leukoc Biol 61:293–302CrossRefPubMed

24.

Jamani K, Harrington E, Wilson H (1989) Rigidity of elastomeric impression materials. J Oral Rehabil 16:241–248CrossRefPubMed

25.

Yoshida N, Koga Y, Peng C-L et al (2001) In vivo measurement of the elastic modulus of the human periodontal ligament. Med Eng Phys 23:567–572CrossRefPubMed

26.

Tasdemir T, Er K, Celik D et al (2008) Effect of passive ultrasonic irrigation on apical extrusion of irrigating solution. Eur J Dent 2:198–203PubMedPubMedCentral

27.

İriboz E, Bayraktar K, Türkaydın D et al (2015) Comparison of apical extrusion of sodium hypochlorite using 4 different root canal irrigation techniques. J Endod 41:380–384CrossRefPubMed

28.

Charara K, Friedman S, Sherman A et al (2016) Assessment of apical extrusion during root canal irrigation with the novel GentleWave system in a simulated apical environment. J Endod 42:135–139CrossRefPubMed

29.

Ferraz CC, Gomes NV, Gomes BP et al (2001) Apical extrusion of debris and irrigants using two hand and three engine-driven instrumentation techniques. Int Endod J 34:354–358CrossRefPubMed

30.

Flanders DH (2002) Endodontic patency. How to get it. How to keep it. Why it is so important. N Y State Dent J 68:30–32PubMed

31.

Vera J, Hernandez EM, Romero M et al (2012) Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study. J Endod 38:1340–1343CrossRefPubMed

32.

Tinaz AC, Alacam T, Uzun O et al (2005) The effect of disruption of apical constriction on periapical extrusion. J Endod 31:533–535CrossRefPubMed

33.

Kustarci A, Akdemir N, Siso SH et al (2008) Apical extrusion of intracanal debris using two engine driven and step-back instrumentation techniques: an in-vitro study. Eur J Dent 2:233–239PubMedPubMedCentral

34.

Thomas EL, Grisham MB, Jefferson MM (1983) Myeloperoxidase-dependent effect of amines on functions of isolated neutrophils. J Clin Invest 72:441–454CrossRefPubMedPubMedCentral

35.

Weiss SJ, Klein R, Slivka A et al (1982) Chlorination of taurine by human neutrophils. Evidence for hypochlorous acid generation. J Clin Invest 70:598–607CrossRefPubMedPubMedCentral

36.

Lampert MB, Weiss SJ (1983) The chlorinating potential of the human monocyte. Blood 62:645–651PubMed

37.

Grisham MB, Jefferson MM, Melton DF et al (1984) Chlorination of endogenous amines by isolated neutrophils. Ammonia-dependent bactericidal, cytotoxic, and cytolytic activities of the chloramines. J Biol Chem 259:10404–10413PubMed

38.

Boutsioukis C, Psimma Z, Kastrinakis E (2014) The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J 47:487–496CrossRefPubMed

39.

Boutsioukis C, Lambrianidis T, Kastrinakis E (2009) Irrigant flow within a prepared root canal using various flow rates: a computational fluid dynamics study. Int Endod J 42:144–155CrossRefPubMed

40.

Shen Y, Gao Y, Qian W et al (2010) Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod 36:884–889CrossRefPubMed

41.

Fukumoto Y, Kikuchi I, Yoshioka T et al (2006) An ex vivo evaluation of a new root canal irrigation technique with intracanal aspiration. Int Endod J 39:93–99CrossRefPubMed

42.

Arslan H, Akcay M, Ertas H et al (2015) Effect of PIPS technique at different power settings on irrigating solution extrusion. Lasers Med Sci 30:1641–1645CrossRefPubMed

Titel: Comparison of sodium hypochlorite extrusion by five irrigation systems using an artificial root socket model and a quantitative chemical method
verfasst von: Adham A. Azim
Hacer Aksel
M. Margaret Jefferson
George T.-J. Huang
Publikationsdatum: 26.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 2/2018
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-017-2187-y

Neu im Fachgebiet Zahnmedizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

19.04.2024 Vorhofflimmern Nachrichten

Werden Personen mit Vorhofflimmern in der Blanking-Periode nach einer Katheterablation gegen eine bestehende Parodontitis behandelt, verbessert dies die Erfolgsaussichten. Dafür sprechen die Resultate einer prospektiven Untersuchung.

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

11.04.2024 Endokarditis Nachrichten

Bei welchen Personen eine Antibiotikaprophylaxe zur Prävention einer infektiösen Endokarditis nach invasiven zahnärztlichen Eingriffen sinnvoll ist, wird diskutiert. Neue Daten stehen im Einklang mit den europäischen Leitlinienempfehlungen.

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

08.04.2024 Zahnmedizin Nachrichten

Der Aufbau von Geweben und Organen während der Embryonalentwicklung wird von den Zellen bemerkenswert choreografiert. Für diesen Prozess braucht es spezielle sogenannte „Organisatoren“. In einer aktuellen Veröffentlichung im Fachjournal Nature Cell Biology berichten Forschende durch welchen Vorgang diese Organisatoren im Gewebe entstehen und wie sie dann die Bildung von Zähnen orchestrieren.

Die Oralprophylaxe & Kinderzahnheilkunde umbenannt

11.03.2024 Kinderzahnmedizin Nachrichten

Infolge der Umbenennung der Deutschen Gesellschaft für Kinderzahnheilkunde in Deutsche Gesellschaft für Kinderzahnmedizin (DGKiZ) wird deren Mitgliederzeitschrift Oralprophylaxe & Kinderzahnheilkunde in Oralprophylaxe & Kinderzahnmedizin umbenannt. Aus diesem Grunde trägt die erste Ausgabe in 2024 erstmalig den neuen Titel.

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2018

Soft tissue profile changes after Functional Mandibular Advancer or Herbst appliance treatment in class II patients

Micro-CT and FE-SEM enamel analyses of calcium-based agent application after bleaching

The effect of saliva on the fate of nanoparticles

Bonding of composite resins to PEEK: the influence of adhesive systems and air-abrasion parameters

Approximal morphology as predictor of approximal caries in primary molar teeth

Evaluation of cortical mandibular bone in patients with oral squamous cell carcinoma

Neu im Fachgebiet Zahnmedizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

Die Oralprophylaxe & Kinderzahnheilkunde umbenannt

Newsletter