Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Research ArticleVolume 6 Issue 9

Comparative Evaluation of the Efficacy of Different Irrigation Systems for Removal of Triple Antibiotic Paste from Root Canals - An In Vitro Study

Aayushi Sharma*, Shraddha Chokshi, Zarana Sanghvi and Setu Bavaria

Ahmedabad Dental College and Hospital, India

*Corresponding Author: Aayushi Sharma, Ahmedabad Dental College and Hospital, India.

Received: August 8, 2022; Published: August 25, 2022

Abstract

The main goal of endodontics is the complete elimination of bacteria from the root canal system [1]. Because of the complex root canal anatomy that includes the presence of apical deltas, oval extensions, accessary canals and isthumus, with the routine endodontic procedures followed, it is difficult to shape and clean the root canal completely [2,3]. The success of root canal therapy depends on the complete elimination of these diverse varieties of pathologic micro-organisms. While mechanical preparation of the root canal serves as a primary mechanism for the elimination of the bacteria, irrigants and intra canal medicaments serve as a valuable adjunct. The irrigants can enhance the mechanical debridement by aiding in removal of smear layer, manual flushing of the debris out of the root canal, dissolving the necrotic and vital pulp tissues which serve as a harbour of micro-organisms and by having an effective anti-microbial activity. Various irrigants have varied action to aid in debridement of the root canal space. Even though irrigation plays a vital role in elimination of bacteria from the root canal system, the wide spectrum of micro-organisms demands additional antibiotic agents for their complete elimination. The use of systemic antibiotics is considered invaluable for use in teeth undergoing root canal treatment, hence use of local delivery of antibiotics is suggested [4]. Thus, the combination of instrumentation associated with irrigation and intracanal medicament has been proposed to be effective against the polymicrobial flora of the root canal. The introduction of triple antibiotic paste was aimed at providing a combination that could possibly be effective against all of the micro-organisms in the root canal pathology. With this background, the aim of the study was to evaluate the effectiveness of few irrigation techniques and irrigating solutions for the removal of the most commonly used intracanal medicament TAP from root canal system of single rooted teeth.

Keywords: Endodontics; Triple Antibiotic Paste (TAP); Irrigation

Bibliography

  1. Ricucci D and Bergenholtz G. “Bacterial status in root-filled teeth exposed to the oral environment by loss of restoration and fracture or caries - a histobacteriological study of treated cases”. International Endodontic Journal 36 (2005): 787-797.
  2. Peters OA. “Current challenges and concepts in the preparation of root canal systems: a review”. Journal of Endodontics 30 (2004): 559-567.
  3. Naı¨r PNR., et al. “Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after one visit endodontic treatment”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 99 (2005): 231-252.
  4. Mohammadi Z and Abbott PV. “On the local applications of antibiotics and antibioticbased agents in endodontics and dental traumatology”. International Endodontic Journal7 (2009): 55567.
  5. Chong BS and Pitt Ford TR. “The role of intracanal medicaments in root canal treatment”. International Endodontic Journal2 (1992): 97-106.
  6. Iwaku M., et al. “Lesion sterilization and tissue repair (LSTR) therapy: new pulpal treatment. How to conserve infected pulps”. Tokyo, Japan: Nihon-Shika Hyoron (1996).
  7. Hoshino E., et al. “In vitro antibacterial susceptibility of bacteria from infected root dentin to a mixture of ciprofloxacin, metronidazole and minocycline”. International Endodontic Journal 29 (1996): 125-130.
  8. Sain S., et al. “Lesion Sterilization and Tissue repair-Current Concepts and Practices”. International Journal of Clinical Pediatric Dentistry5 (2018): 446-450.
  9. Lima KC., et al. “Susceptibilities of Enterococcus faecalis biofilms to some antimicrobial medications”. Journal of Endodontics10 (2001): 616-619.
  10. Abbott PV. “Selective and intelligent use of antibiotics in endodontics”. Australian Endodontic Journal1 (2000): 30.
  11. Kim JH., et al. “Tooth discoloration of immature permanent sincisor associated with triple antibiotic therapy: a case report”. Journal of Endodontics 36 (2010): 1086-1091.
  12. Van der Sluis LW., et al. “The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies”. International Endodontic Journal1 (2007): 52-57.
  13. Taşdemir T., et al. “Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals”. International Endodontic Journal6 (2011): 505-509.
  14. Ahmetoğlu F., et al. “Efficacy of self-adjusting file and passive ultrasonic irrigation on removing calcium hydroxide from root canals”. Dental Material Journal6 (2013): 1005-1010.
  15. Chou K., et al. “Effectiveness of different intracanal irrigation techniques in removing intracanal paste medicaments”. Australian Endodontic Journal1 (2014): 21-25.
  16. SA Türker., et al. “Comparison of calcium hydroxide removal by self-adjusting file, EndoVac, and CanalBrush agitation techniques: An in vitro study”. Journal of Conservative Dentistry: JCD5 (2013): 439.
  17. Adl A., et al. “A Comparison between the Antimicrobial Effects of Triple Antibiotic Paste and Calcium Hydroxide against Entrococcus Faecalis”. Iranian Endodontic Journal3 (2012): 149-155.
  18. Arslan H., et al. “Efficacy of Needle Irrigation, EndoActivator, and Photon-initiated Photoacoustic Streaming Technique on Removal of Double and Triple Antibiotic Pastes”. Journal of Endodontics 9 (2014): 1439-1442.
  19. Berkhoff JA., et al. “Evaluation of triple antibiotic paste removal by different irrigation procedures”. Journal of Endodontics8 (2014): 1172-1177.
  20. Capar ID., et al. “Effect of Different Final Irrigation Methods on the Removal of Calcium Hydroxide from an Artificial Standardized Groove in the Apical Third of Root Canals”. Journal of Endodontics 3 (2014): 451.
  21. , et al. “Antifungal effectiveness of various intracanal medicaments against Candida albicans: an ex-vivo study”. BMC Oral Health 14 (2014): 53.
  22. Arslan H., et al. “Efficacy of various irrigation protocols on the removal of triple antibiotic paste”. International Endodontic Journal6 (2014): 594-599.
  23. Shaik J., et al. “Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and calcium hydroxide using chitosan as carrier against Candida albicans and Enterococcus faecalis: An in vitro study”. Journal of Conservative Dentistry 17 (2014): 335-339.
  24. Silva LJ., et al. “Micro-CT evaluation of calcium hydroxide removal through passive ultrasonic irrigation associated with or without an additional instrument”. International Endodontic Journal8 (2016): 768-773.
  25. Topçuoğlu HS., et al. “Effectiveness of conventional syringe irrigation, vibringe, and passive ultrasonic irrigation performed with different irrigation regimes in removing triple antibiotic paste from simulated root canal irregularities”. Journal of Conservative Dentistry4 (2014): 323-327.
  26. Khademi AA., et al. “Removal efficiency of calcium hydroxide intracanal medicament with RinsEndo system in comparison with passive ultrasonic irrigation, an in vitro study”. Dental Research Journal (Isfahan)2 (2015): 157-160.
  27. Alturaiki S., et al. “Efficacy of 3 Different Irrigation Systems on Removal of Calcium Hydroxide from the Root Canal: A Scanning Electron Microscopic Study”. Journal of Endodontics1 (2015): 97-101.
  28. Ok E., et al. “Effectiveness of Different Irrigation Solutions on Triple Antibiotic Paste Removal From Simulated Immature Root Canal”. Scanning 6 (2015): 409-413.
  29. Abbas Ali k., et al. “Removal efficiency of calcium hydroxide intracanal medicament with RinsEndo system in comparison with passive ultrasonic irrigation, an in vitro study”. Dental Research Journal (Isfahan) 12.2 (2015): 157-160.
  30. Akman M., et al. “Comparison of different irrigation activation regimens and conventional irrigation techniques for the removal of modified triple antibiotic paste from root canals”. Journal of Endodontics5 (2015): 720-724.
  31. Thakur DA., et al. “Comparative scanning electron microscopy evaluation of Canal Brushing technique, sonic activation, and master apical file for the removal of triple antibiotic paste from root canal (in vitro study)”. Contemporary Clinical Dentistry4 (2015): 517-521.
  32. Kuştarcı A., et al. “Efficacy of Laser Activated Irrigants in Calcium Hydroxide Removal from the Artificial Grooves in Root Canals: An Ex Vivo Study”. Photomedicine, and Laser Surgery 5 (2016): 205-210.
  33. Wigler R., et al. “Efficacy of XP-endo finisher files in the removal of calcium hydroxide paste from artificial standardized grooves in the apical third of oval root canals”. International Endodontic Journal7 (2017): 700-705.
  34. Görkem Can., et al. “Comparison of EndoVac, CanalBrush, EndoActivator and Syringe Irrigation on Removal of Triple Antibiotic Paste”. Journal of Dental and Medical Sciences12 (2017): 41-45.
  35. Vishal Pai Swathi., et al. “Effect of calcium hydroxide and triple antibiotic paste as intracanal medicaments on the incidence of inter-appointment flare-up in diabetic patients: An in vivo study”. Journal of Conservative Dentistry3 (2014).
  36. Amrita Chawla and Vijay Kumar. “Evaluating the efficacy of different techniques and irrigation solutions for removal of calcium hydroxide from the root canal system: A scanning electron microscope study”. Journal of Conservative Dentistry4 (2018): 394.
  37. Kfir A., et al. “Efficacy of self adjusting file, XP-endo finisher and passive ultrasonic irrigation on the removal of calcium hydroxide paste from an artificial standardized groove”. Australian Endodontic Journal1 (2018): 26-31.
  38. Santosh Kumar., et al. “Comparison of the efficacy of CanalBrush, EndoActivator, and Passive Ultrasonic Irrigation on the removal of triple antibiotic paste from root canal walls: An in vitro study”. International Journal of Preventive and Community Dentistry4 (2020): 424-430.
  39. Mehmet Adigüzel and Koray Yilmaz. “Comparison of the efficacy of sonic irrigation and conventional syringe irrigation in the removal of curcumin and triple antibiotic paste from root canals”. Journal of Dental Research, Dental Clinics, Dental Prospects3 (2021): 157-162.
  40. Sundqvist G., et al. “Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment”. Oral Surgery, Oral Medicine and Oral Pathology 85 (1998): 86-93.
  41. Hoshino E., et al. “In vitro antibacterial susceptibility of bacteria from infected root dentin to a mixture of ciprofloxacin, metronidazole and minocycline”. International Endodontic Journal 29 (1996): 125-130.
  42. Mozayeni MA., et al. “Antimicrobial effects of four intracanal medicaments on enterococcus faecalis: an in vitro study”. Iranian Endodontic Journal3 (2014): 195-198.
  43. Oktay EA., et al. “Effect of intracanal medicaments used in endodontic regeneration on the push-out bond strength of a calcium-phosphatesilicate-based cement to dentin”. Pakistan Journal of Medical Sciences2 (2018): 310-315.
  44. Galvão T., et al. “Efficacy of three methods for inserting calcium hydroxide-based paste in root canals”. Journal of Clinical and Experimental Dentistry6 (2017): e762-e766.
  45. Heilborn C., et al. “Cleaning efficacy of an apical negative pressure irrigation system at different exposure times”. Quintessence International 41 (2010): 759-767.
  46. Parente JM., et al. “Root canal debridement using manual dynamic agitation or the endovac for final irrigation in a closed system and an open system”. International Endodontic Journal 43 (2010): 1001-1012.
  47. Ghivari S and Kubasad G. “Root canal debris removal using different irrigating needles: an SEM study”. Indian Journal of Dental Research 5 (2011): 659-663.
  48. Velayutham Gopikrishna., et al. “An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate”. JCD2 (2016): 189193.
  49. Leighton TG. “The Acoustic Bubble, Chapters 1 and 2”. New York: Academic Press (1994).
  50. Manzur A., et al. “Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial”. Journal of Endodontics 33 (2007): 114.
  51. Okino LA., et al. “Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel”. International Endodontic Journal 37 (2004): 38-41.
  52. R Berdan. “Focus Stacking Comparing Photoshop, Helicon Focus and Zerene”. Motic America (2020).
  53. Schnitzler and K Zimmer. “Advances in Stereomicroscopy”. Optical Design and Engineering III edited by L. Mazuray et al. Proc. of SPIE Vol. 7100. 71000P-1. Leica Microsystems Heerbrugg, Switzerland (2008).
  54. Chow TW. “Mechanical effectiveness of root canal irrigation”. Journal of Endodontics 9 (1983): 475-479.
  55. Tay FR., et al. “Effect of vapor lock on root canal debridement by using a side-vented needle for positive pressure irrigant delivery”. Journal of Endodontics 36 (2010): 74550.
  56. Siqueira JF Jr., et al. “Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals”. Journal of Endodontics 23 (1977): 499-502.
  57. Rödig T., et al. “Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals”. International Endodontic Journal 12 (2011): 1155-1161.
  58. McGill S., et al. “The efficacy of dynamic irrigation using a commercially available system (Rinsendo) determined by removal of a collagen “biomolecular film” from an ex vivo model”. International Endodontic Journal 41 (2008): 602-608.
  59. Mitchell RP., et al. “Comparison of apical extrusion of NaOCl using the endovac or needle irrigation of root canals”. Journal of Endodontics 36 (2010): 338.
  60. Gu LS., et al. “Review of contemporary irrigant agitation techniques and devices”. Journal of Endodontics 35 (2009): 791-804.
  61. Okino LA., et al. “Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel”. International Endodontic Journal 37 (2004): 38-41.

Citation: Aayushi Sharma., et al. “Comparative Evaluation of the Efficacy of Different Irrigation Systems for Removal of Triple Antibiotic Paste from Root Canals - An In Vitro Study". Acta Scientific Dental Sciences 6.9 (2022): 71-78.

Copyright: © 2022 Aayushi Sharma., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US









ff

© 2024 Acta Scientific, All rights reserved.