Skip to main content
Erschienen in: Lasers in Dental Science 4/2018

27.11.2018 | Original Article

Efficacy of ultrasonic and Er:YAG laser activated EDTA irrigation in removing bacteria from ex vivo root canal system

verfasst von: Sharonit Sahar-Helft, Ayşe Sena Kabaş Sarp, Murat Gulsoy, Idan Redenski, Adam Stabholtz, David Keinan, Doron Steinberg

Erschienen in: Lasers in Dental Science | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Due to the limited effectiveness of irrigation to reduce the bacterial load inside root canals, the efficacy of activated irrigation techniques was evaluated.

Methods

Sixty endodontically prepared single-rooted human teeth were sterilized, infected with Enterococcus faecalis, and divided into six groups: (A) endodontic treatment positive control, (B) irrigation with EDTA 17%, (C) Er:YAG laser activated irrigation with tip 1 mm from working length, (D) Er:YAG laser to the coronal third, (E) ultrasonic irrigation applied 1 mm from working length, (F) US irrigation to the coronal third.

Results

The positive control group had significantly more bacteria than all other groups. EDTA irrigation had low efficiency. US irrigation 1 mm from the working length was significantly more effective than controls. Laser treatment to the coronal third was the most efficient.

Conclusions

Laser activated irrigation caused the greatest bacterial reductions.
Literatur
1.
Zurück zum Zitat Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed
2.
Zurück zum Zitat Sjogren U, Figdor D, Persson S, Sundqvist G (1997) Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 30:297–306CrossRefPubMed Sjogren U, Figdor D, Persson S, Sundqvist G (1997) Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 30:297–306CrossRefPubMed
3.
Zurück zum Zitat Peters LB, Wesselink PR (2002) Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms. Int Endod J 35:660–667CrossRefPubMed Peters LB, Wesselink PR (2002) Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms. Int Endod J 35:660–667CrossRefPubMed
4.
Zurück zum Zitat Weiger R, Rosendahl R, Lost C (2000) Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions. Int Endod J 33:219–226CrossRefPubMed Weiger R, Rosendahl R, Lost C (2000) Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions. Int Endod J 33:219–226CrossRefPubMed
5.
Zurück zum Zitat Peters OA, Schonenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34:221–230CrossRefPubMed Peters OA, Schonenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34:221–230CrossRefPubMed
6.
Zurück zum Zitat Senna RA, Spohr AR, Gastmann AH, Pappen FG, Lima RKP, Morgental RD (2018) The effect of EDTA on the antibacterial activity of sodium hypochlorite. Gen Dent 66:74–78PubMed Senna RA, Spohr AR, Gastmann AH, Pappen FG, Lima RKP, Morgental RD (2018) The effect of EDTA on the antibacterial activity of sodium hypochlorite. Gen Dent 66:74–78PubMed
7.
Zurück zum Zitat Molander A, Reit C, Dahlen G (1999) The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide. Endod Dent Traumatol 15:205–209CrossRefPubMed Molander A, Reit C, Dahlen G (1999) The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide. Endod Dent Traumatol 15:205–209CrossRefPubMed
8.
Zurück zum Zitat Bystrom A, Sundqvist G (1983) Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy. Oral Surg Oral Med Oral Pathol 55:307–312CrossRefPubMed Bystrom A, Sundqvist G (1983) Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy. Oral Surg Oral Med Oral Pathol 55:307–312CrossRefPubMed
9.
Zurück zum Zitat Torabinejad M, Handysides R, Khademi AA, Bakland LK (2002) Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:658–666CrossRefPubMed Torabinejad M, Handysides R, Khademi AA, Bakland LK (2002) Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:658–666CrossRefPubMed
10.
Zurück zum Zitat Brannstrom M (1984) Smear layer: pathological and treatment considerations. Oper Dent Suppl 3:35–42PubMed Brannstrom M (1984) Smear layer: pathological and treatment considerations. Oper Dent Suppl 3:35–42PubMed
11.
Zurück zum Zitat Haapasalo M, Orstavik D (1987) In vitro infection and disinfection of dentinal tubules. J Dent Res 66:1375–1379CrossRefPubMed Haapasalo M, Orstavik D (1987) In vitro infection and disinfection of dentinal tubules. J Dent Res 66:1375–1379CrossRefPubMed
12.
Zurück zum Zitat Pashley DH (1984) Smear layer: physiological considerations. Oper Dent Suppl 3:13–29PubMed Pashley DH (1984) Smear layer: physiological considerations. Oper Dent Suppl 3:13–29PubMed
13.
Zurück zum Zitat Paster BJ, Olsen I, Aas JA, Dewhirst FE (2006) The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000 42:80–87CrossRefPubMed Paster BJ, Olsen I, Aas JA, Dewhirst FE (2006) The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000 42:80–87CrossRefPubMed
14.
Zurück zum Zitat Love RM (2001) Enterococcus faecalis - a mechanism of its role in endodontic failure. Int Endod J 34:399–405CrossRefPubMed Love RM (2001) Enterococcus faecalis - a mechanism of its role in endodontic failure. Int Endod J 34:399–405CrossRefPubMed
15.
Zurück zum Zitat Nielsen BA, Baumgartner JC (2007) Comparison of the EndoVac system to needle irrigation of root canals. J Endod 33:611–615CrossRefPubMed Nielsen BA, Baumgartner JC (2007) Comparison of the EndoVac system to needle irrigation of root canals. J Endod 33:611–615CrossRefPubMed
16.
Zurück zum Zitat de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36:1216–1221CrossRefPubMed de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36:1216–1221CrossRefPubMed
17.
Zurück zum Zitat Pedulla E, Genovese C, Campagna E, Tempera G, Rapisarda E (2012) Decontamination efficacy of photon-initiated photoacoustic streaming (PIPS) of irrigants using low-energy laser settings: an ex vivo study. Int Endod J 45:865–870CrossRefPubMed Pedulla E, Genovese C, Campagna E, Tempera G, Rapisarda E (2012) Decontamination efficacy of photon-initiated photoacoustic streaming (PIPS) of irrigants using low-energy laser settings: an ex vivo study. Int Endod J 45:865–870CrossRefPubMed
18.
Zurück zum Zitat Adcock JM, Sidow SJ, Looney SW Liu Y, McNally K, Lindsey K, Tay FR (2011) Histologic evaluation of canal and isthmus debridement efficacies of two different irrigant delivery techniques in a closed system. J Endod 37:544–548CrossRefPubMed Adcock JM, Sidow SJ, Looney SW Liu Y, McNally K, Lindsey K, Tay FR (2011) Histologic evaluation of canal and isthmus debridement efficacies of two different irrigant delivery techniques in a closed system. J Endod 37:544–548CrossRefPubMed
19.
Zurück zum Zitat Jiang LM, Verhaagen B, Versluis M, Langedijk J, Wesselink P, van der Sluis LW (2011) The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. J Endod 37:688–692CrossRefPubMed Jiang LM, Verhaagen B, Versluis M, Langedijk J, Wesselink P, van der Sluis LW (2011) The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. J Endod 37:688–692CrossRefPubMed
20.
Zurück zum Zitat Deleu E, Meire MA, De Moor RJ (2015) Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci 30:831–835CrossRefPubMed Deleu E, Meire MA, De Moor RJ (2015) Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci 30:831–835CrossRefPubMed
21.
Zurück zum Zitat Green J, Weiss A, Stern A (2011) Lasers and radiofrequency devices in dentistry. Dent Clin N Am 55:585–597 ix–x CrossRefPubMed Green J, Weiss A, Stern A (2011) Lasers and radiofrequency devices in dentistry. Dent Clin N Am 55:585–597 ix–x CrossRefPubMed
22.
Zurück zum Zitat Sahar-Helft S, Stabholtz A, Moshonov J, Gutkin V, Redenski I, Steinberg D (2013) Effect of Er:YAG laser-activated irrigation solution on enterococcus faecalis biofilm in an ex-vivo root canal model. Photomed Laser Surg 31:334–341CrossRefPubMed Sahar-Helft S, Stabholtz A, Moshonov J, Gutkin V, Redenski I, Steinberg D (2013) Effect of Er:YAG laser-activated irrigation solution on enterococcus faecalis biofilm in an ex-vivo root canal model. Photomed Laser Surg 31:334–341CrossRefPubMed
23.
Zurück zum Zitat de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW (2009) Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 42:1077–1083CrossRefPubMed de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW (2009) Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 42:1077–1083CrossRefPubMed
24.
Zurück zum Zitat Blanken J, De Moor RJ, Meire M, Verdaasdonk R (2009) Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study. Lasers Surg Med 41:514–519CrossRefPubMed Blanken J, De Moor RJ, Meire M, Verdaasdonk R (2009) Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study. Lasers Surg Med 41:514–519CrossRefPubMed
25.
Zurück zum Zitat De Moor RJ, Blanken J, Meire M, Verdaasdonk R (2009) Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: evaluation of the efficacy. Lasers Surg Med 41:520–523CrossRefPubMed De Moor RJ, Blanken J, Meire M, Verdaasdonk R (2009) Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: evaluation of the efficacy. Lasers Surg Med 41:520–523CrossRefPubMed
26.
Zurück zum Zitat George R, Meyers IA, Walsh LJ (2008) Laser activation of endodontic irrigants with improved conical laser fiber tips for removing smear layer in the apical third of the root canal. J Endod 34:1524–1527CrossRefPubMed George R, Meyers IA, Walsh LJ (2008) Laser activation of endodontic irrigants with improved conical laser fiber tips for removing smear layer in the apical third of the root canal. J Endod 34:1524–1527CrossRefPubMed
27.
Zurück zum Zitat 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 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
28.
Zurück zum Zitat Nakamura VC, Cai S, Candeiro GT, Ferrari PH, Caldeira CL (2013) Gavini. Int Endod 46:217–224CrossRef Nakamura VC, Cai S, Candeiro GT, Ferrari PH, Caldeira CL (2013) Gavini. Int Endod 46:217–224CrossRef
29.
Zurück zum Zitat van der Waal SV, Oonk CA, Nieman SH, Wesselink PR, de Soet JJ, Crielaard W (2015) Additional disinfection with a modified salt solution in a root canal model. J Dent 43:1280–1284CrossRefPubMed van der Waal SV, Oonk CA, Nieman SH, Wesselink PR, de Soet JJ, Crielaard W (2015) Additional disinfection with a modified salt solution in a root canal model. J Dent 43:1280–1284CrossRefPubMed
30.
Zurück zum Zitat Siqueira JF Jr (2001) Strategies to treat infected root canals. J Calif Dent Assoc 29:825–837PubMed Siqueira JF Jr (2001) Strategies to treat infected root canals. J Calif Dent Assoc 29:825–837PubMed
31.
Zurück zum Zitat Wu MK, van der Sluis LWM, Wesselink PR (2003) The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals. Int Endod J 36:218–224CrossRefPubMed Wu MK, van der Sluis LWM, Wesselink PR (2003) The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals. Int Endod J 36:218–224CrossRefPubMed
32.
Zurück zum Zitat Johnson WT, Noblett WC (2009) Cleaning and shaping in: endodontics: principles and practice, 4th edn. Saunders, Philadelphia, PA Johnson WT, Noblett WC (2009) Cleaning and shaping in: endodontics: principles and practice, 4th edn. Saunders, Philadelphia, PA
33.
Zurück zum Zitat Goswami M, Chhabra N, Kumar G, Verma M, Chhabra A (2014) Sodium hypochlorite dental accidents. Paediatr Int Child Health 34:66–69CrossRefPubMed Goswami M, Chhabra N, Kumar G, Verma M, Chhabra A (2014) Sodium hypochlorite dental accidents. Paediatr Int Child Health 34:66–69CrossRefPubMed
34.
Zurück zum Zitat Mohammadi Z, Shalavi S, Giardino L, Palazzi F, Asgary S (2015) Impact of ultrasonic activation on the effectiveness of sodium hypochlorite: a review. Iran Endod J 10(4):216–220PubMedPubMedCentral Mohammadi Z, Shalavi S, Giardino L, Palazzi F, Asgary S (2015) Impact of ultrasonic activation on the effectiveness of sodium hypochlorite: a review. Iran Endod J 10(4):216–220PubMedPubMedCentral
35.
Zurück zum Zitat Sanchez F, Espana Tost AJ, Morenza JL (1997) ArF excimer laser irradiation of human dentin. Lasers Surg Med 21:474–479CrossRefPubMed Sanchez F, Espana Tost AJ, Morenza JL (1997) ArF excimer laser irradiation of human dentin. Lasers Surg Med 21:474–479CrossRefPubMed
36.
Zurück zum Zitat Kuah HG, Lui JN, Tseng PS, Chen NN (2009) The effect of EDTA with and without ultrasonics on removal of the smear layer. J Endod 35:393–396CrossRefPubMed Kuah HG, Lui JN, Tseng PS, Chen NN (2009) The effect of EDTA with and without ultrasonics on removal of the smear layer. J Endod 35:393–396CrossRefPubMed
37.
Zurück zum Zitat Sahar-Helft S, Sarp AS, Stabholtz A, Gutkin V, Redenski I, Steinberg D (2015) Comparison of positive-pressure, passive ultrasonic, and laser-activated irrigations on smear-layer removal from the root canal surface. Photomed Laser Surg 33:129–135CrossRefPubMed Sahar-Helft S, Sarp AS, Stabholtz A, Gutkin V, Redenski I, Steinberg D (2015) Comparison of positive-pressure, passive ultrasonic, and laser-activated irrigations on smear-layer removal from the root canal surface. Photomed Laser Surg 33:129–135CrossRefPubMed
38.
Zurück zum Zitat Meire MA, Havelaerts S, De Moor RJ (2016) Influence of lasing parameters on the cleaning efficacy of laser-activated irrigation with pulsed erbium lasers. Lasers Med Sci 31:653–658CrossRefPubMed Meire MA, Havelaerts S, De Moor RJ (2016) Influence of lasing parameters on the cleaning efficacy of laser-activated irrigation with pulsed erbium lasers. Lasers Med Sci 31:653–658CrossRefPubMed
39.
Zurück zum Zitat Lee SJ, Wu MK, Wesselink PR (2004) The effectiveness of syringe irrigation and ultrasonics to remove debris fromsimulated irregularities within prepared root canal walls. Int Endod J 37:672–678CrossRefPubMed Lee SJ, Wu MK, Wesselink PR (2004) The effectiveness of syringe irrigation and ultrasonics to remove debris fromsimulated irregularities within prepared root canal walls. Int Endod J 37:672–678CrossRefPubMed
40.
Zurück zum Zitat van Leeuwen TG, van de Veen MJ, Verdaasdonk RM, Borst C (1991) Non contact tissue ablation by holmium:YSGG laser pulses in blood. Lasers Surg Med 11:26–34CrossRefPubMed van Leeuwen TG, van de Veen MJ, Verdaasdonk RM, Borst C (1991) Non contact tissue ablation by holmium:YSGG laser pulses in blood. Lasers Surg Med 11:26–34CrossRefPubMed
41.
Zurück zum Zitat Lorencetti KT, Silva-Sousa YT, Nascimento GE, Messias DC, Colucci V, Rached-Junior FA (2014) Influence of apical enlargement in cleaning of curved canals using negative pressure system. Braz Dent J 25:430–434CrossRefPubMed Lorencetti KT, Silva-Sousa YT, Nascimento GE, Messias DC, Colucci V, Rached-Junior FA (2014) Influence of apical enlargement in cleaning of curved canals using negative pressure system. Braz Dent J 25:430–434CrossRefPubMed
Metadaten
Titel
Efficacy of ultrasonic and Er:YAG laser activated EDTA irrigation in removing bacteria from ex vivo root canal system
verfasst von
Sharonit Sahar-Helft
Ayşe Sena Kabaş Sarp
Murat Gulsoy
Idan Redenski
Adam Stabholtz
David Keinan
Doron Steinberg
Publikationsdatum
27.11.2018
Verlag
Springer International Publishing
Erschienen in
Lasers in Dental Science / Ausgabe 4/2018
Elektronische ISSN: 2367-2587
DOI
https://doi.org/10.1007/s41547-018-0046-z

Weitere Artikel der Ausgabe 4/2018

Lasers in Dental Science 4/2018 Zur Ausgabe

Newsletter

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