sodium-hypochlorite and Dental-Pulp-Diseases

This paper reviews current concepts of root canal infection and the consequences for endodontic treatment strategies and practices. In particular, root canal disinfection by chemical and mechanical means is discussed, as are the possibilities and limitations of proposed methods to reduce the time necessary to obtain a disinfected canal.

Topics: Bacterial Infections; Calcium Hydroxide; Dental Caries; Dental Pulp Diseases; Disinfection; Focal Infection, Dental; Humans; Periapical Periodontitis; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Time Factors

This overview was put together to update the endodontic knowledge of the general practitioners. Several treatment methods sometimes with contradicting principles are applied in Hungary using a wide range of endodontic medicines. The aim of the paper was not only to clarify the basic therapeutic principles but also to provide practical information about the relevant endodontic products for the everyday use.

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Anti-Infective Agents; Calcium Hydroxide; Chloramphenicol; Dental Pulp; Dental Pulp Diseases; Disinfectants; Edetic Acid; Formaldehyde; Gangrene; Humans; Metronidazole; Penicillins; Phenol; Polymers; Root Canal Therapy; Sodium Hypochlorite; Tetracyclines

Periradicular lesions are diseases either primarily or secondarily caused by microorganisms and therefore they must be prevented or treated accordingly. If the professional is well-versed in both preventing and eliminating the root canal infection, the success rate of endodontic therapy may exceed 90 percent. The present paper discusses theoretical and practical aspects of effective antimicrobial endodontic therapy and delineates strategies to effectively control root canal infections.

Topics: Anti-Bacterial Agents; Bacterial Infections; Calcium Hydroxide; Dental Pulp Diseases; Humans; Laser Therapy; Periapical Periodontitis; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Calcium Hydroxide; Dental Pulp Diseases; Humans; Root Canal Irrigants; Sodium Hypochlorite

This clinical study was conducted to compare the effectiveness of single-file reciprocating systems and rotary systems in removing endotoxins and cultivable bacteria from primarily infected root canals.. Forty-eight primarily infected root canals were selected and randomly divided into 4 groups: WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) (n = 12); Reciproc (VDW, Munich, Germany) (n = 12), ProTaper (Dentsply Maillefer) (n = 12), and Mtwo (VDW) (n = 12). Samples were collected before and after chemomechanical preparation. The irrigation was performed by using 2.5% sodium hypochlorite. A chromogenic limulus amebocyte lysate assay test was used to quantify endotoxins. Culture techniques were used to determine bacterial colony-forming unit counts.. In the baseline samples (ie, samples collected before chemomechanical preparation), endotoxins and cultivable bacteria were recovered from 100% of the root canal samples. No differences were found in the median percentage values of endotoxin reduction achieved with reciprocating systems (ie, WaveOne [95.15%] and Reciproc [96.21%]) and with rotary systems (ie, ProTaper [97.98%] and Mtwo [96.34%]) (P < .05). Both single-file reciprocating systems (ie, WaveOne [99.45%] and Reciproc [99.93%]) and rotary systems (ProTaper [99.85%] and Mtwo [99.41%]) were effective in reducing the cultivable bacteria (all P < .05). Moreover, the culture analysis revealed no differences in bacterial load reduction (P > .05).. Both single-file reciprocating systems (ie, WaveOne and Reciproc instruments) and rotary systems (ie, ProTaper and Mtwo instruments) showed similar effectiveness in reducing endotoxins and cultivable bacteria from primarily infected root canals, but they were not able to eliminate them from all root canals analyzed.

Topics: Bacteria; Bacterial Load; Bacteriological Techniques; Dental Pulp Cavity; Dental Pulp Diseases; Endotoxins; Equipment Design; Humans; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Therapeutic Irrigation; Treatment Outcome

It was the aim of the present study to evaluate root canal samples for the presence and numbers of specific species as well as for total bacterial load in teeth with chronic apical periodontitis using quantitative real-time polymerase chain reaction (PCR).. Forty adult patients with one radiographically documented periapical lesion were included. Twenty teeth presented with primary infections and 20 with secondary infections, requiring retreatment. After removal of necrotic pulp tissue or root canal filling, a first bacterial sample was obtained. Following chemo-mechanical root canal preparation a second sample was taken and a third sample was obtained after 14 days of intracanal dressing with calcium hydroxide. Analysis by real-time PCR enabled the quantification of total bacterial counts and of nine selected species.. Root canals with primary infections harbored significantly more bacteria (by total bacterial count) than teeth with secondary infections (P < 0.05). Mean total bacterial count in the retreatment group was 2.1 x 10(6) and was significantly reduced following root canal preparation (3.6 x 10(4)) and intracanal dressing (1.4 x 10(5)). Corresponding values for primary infections were: 4.6 x 10(7), 3.6 x 10(4), and 6.9 x 10(4). The numbers of the selected bacteria and their detection frequency were also significantly reduced.. Root canals with primary infections contained a higher bacterial load. Chemo-mechanical root canal preparation reduced bacterial counts by at least 95%.

Topics: Adult; Aged; Bacteroides; Calcium Hydroxide; Chlorhexidine; Colony Count, Microbial; Dental Pulp Cavity; Dental Pulp Diseases; Dental Pulp Necrosis; Female; Follow-Up Studies; Fusobacterium nucleatum; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Middle Aged; Peptostreptococcus; Periapical Periodontitis; Polymerase Chain Reaction; Porphyromonas endodontalis; Retreatment; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite

Topics: Cracked Tooth Syndrome; Decision Making; Dental Leakage; Dental Pulp Calcification; Dental Pulp Cavity; Dental Pulp Diseases; Edetic Acid; Esthetics, Dental; Humans; Patient Care Planning; Patient Care Team; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Smear Layer; Sodium Hypochlorite; Tooth Root

Recently, two new clinical concepts have emerged for the management of endodontically compromised immature permanent teeth. One involves a revitalization approach to achieve tissue generation and regeneration in the root canal system. In this method, new living tissue is expected to form in the cleaned canal space allowing continued root development in terms of both length and thickness. The other is the active pursuit of pulp/dentine regeneration via tissue engineering technology to implant or re-grow pulps. Although the technology is still at its infancy, it has potential to benefit immature pulpless teeth by allowing continued growth and maturation. Evidence has shown that using dental stem cells, pulp and dentin can be regenerated in the root canal space. It is foreseeable that a decade or two from now, regenerative endodontics is likely to be an alternative treatment modality for clinical endodontics. It is therefore important for us to understand stem cells and tissue regeneration and be prepared for this clinical practice.

Topics: Animals; Anti-Bacterial Agents; Apexification; Dental Pulp; Dental Pulp Cavity; Dental Pulp Diseases; Dentin; Guided Tissue Regeneration; Humans; Odontogenesis; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Stem Cells; Tooth, Deciduous; Treatment Outcome

To determine the antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in human root canals infected by Enterococcus faecalis.. Thirty human maxillary anterior teeth were prepared and inoculated with E. faecalis for 60 days. Eppendorf tubes were connected to the coronal portion of the teeth. Urethane hoses were attached to the tubes and to the entrance of a peristaltic pump. The exit of the apparatus corresponded to the apical portion of the root canals. The test irrigating solutions were ozonated water, gaseous ozone, 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine that circulated at a constant flow of 50 mL min(-1) for 20 min. Samples from the root canals were collected and immersed in 7 mL Letheen Broth (LB), followed by incubation at 37 degrees C for 48 h. Bacterial growth was analysed by turbidity of the culture medium and subculture on a specific nutrient broth. A 0.1 mL inoculum obtained from LB was transferred to 7 mL of brain heart infusion and incubated at 37 degrees C for 48 h. Bacterial growth was checked by turbidity of the culture medium carried out in triplicate.. No solution used as an irrigant over a 20-min contact time demonstrated an antimicrobial effect against E. faecalis.. The irrigation of infected human root canals with ozonated water, 2.5% NaOCl, 2% chlorhexidine and the application of gaseous ozone for 20 min was not sufficient to inactivate E. faecalis.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Colony Count, Microbial; Dental Pulp Diseases; Enterococcus faecalis; Humans; Microbial Sensitivity Tests; Nephelometry and Turbidimetry; Oxidants, Photochemical; Ozone; Root Canal Irrigants; Sodium Hypochlorite; Water

This study evaluated the biologic ability of sodium hypochlorite to control hemorrhage via chemical amputation of the coagulum, to remove dentin chips, to assist healing, and to facilitate formation of a dentinal bridge under two adhesive systems.. Ninety Class V cavities with mechanical pulpal exposures were placed in the teeth of five adult monkeys and histologically observed. All exposures were prepared with a No. 330 bur, and hemorrhage was controlled with 3% sodium hypochlorite. Twenty-two exposures were capped with All-Bond 2 and AElitefil, and 26 exposures were capped with One-Step (OS) and Resinomer (RS). Two pulps were excluded from the final data. Forty-two exposures were capped with calcium hydroxide and amalgam as controls. At 7, 27, and 90 days, tissues were obtained by perfusion fixation, demineralized, sectioned, stained, and histologically graded according to published qualitative criteria.. For both adhesives, at 7 days, 12 of 16 pulps showed no coagulum remnants or dentin chips at the material interface. No necrotic pulps were observed. At 27 and 97 days, 26 of 30 capped pulps had dentinal bridges at the adhesive interface. Reparative dentin was present in 28 pulps. Four 97-day pulps exhibited necrosis associated with stained bacteria. One 97-day pulp contained dentin chips throughout the pulp and demonstrated no healing, no reparative dentin, and no stained bacterial profiles.. Normal soft tissue reorganization and dentinal bridge formation were observed in 86% of pulps treated with sodium hypochlorite and either adhesive system.

Topics: Animals; Bisphenol A-Glycidyl Methacrylate; Calcium Hydroxide; Composite Resins; Dental Amalgam; Dental Pulp Capping; Dental Pulp Diseases; Dental Pulp Exposure; Dental Pulp Necrosis; Dental Restoration, Permanent; Dentin-Bonding Agents; Dentin, Secondary; Hemorrhage; Hemostatics; Macaca mulatta; Methacrylates; Resin Cements; Root Canal Irrigants; Silanes; Silicon Dioxide; Sodium Hypochlorite; Time Factors; Wound Healing

The effectiveness of 4.0% sodium hypochlorite (NaOCl) used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal was tested in vitro. Root canals contaminated with E. faecalis were treated as follows: (i) irrigation with 2 mL of NaOCl solution and agitation with hand files; (ii) irrigation with 2 mL of NaOCl solution and ultrasonic agitation; (iii) irrigation with NaOCl alternated with hydrogen peroxide. Contaminated canals irrigated with sterile saline solution served as the control. Paper points used to sample bacteria from the root canals were transferred to tubes containing 5 mL of brain heart infusion (BHI) broth. Tubes were incubated and the appearance of broth turbidity was indicative of bacteria remaining in the root canal. There were no statistically significant differences between the experimental groups. However, NaOCl applied by the three methods tested, was significantly more effective than the saline solution (control group) in disinfecting the root canal.

Topics: Chi-Square Distribution; Cuspid; Dental Disinfectants; Dental Pulp Cavity; Dental Pulp Diseases; Drug Evaluation, Preclinical; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Root Canal Therapy; Sodium Hypochlorite; Therapeutic Irrigation

Topics: Citrates; Dental Pulp Diseases; Dentin; Edetic Acid; Humans; Periodontal Diseases; Root Canal Irrigants; Sodium Hypochlorite; Ultrasonic Therapy

Topics: Animals; Dental Pulp Diseases; Hydrogen Peroxide; Root Canal Irrigants; Sodium Hypochlorite

The Authors, after having underlined the importance of the endodontic discipline, that allows to obtain a reliable rehabilitation, illustrate the Schilder technique, used by them at the Odontoiatric Clinic, University of Brescia. The AA. take into consideration and face the problem of the reintervention on channels already treated, as well as the periapical infections complication. They conclude saying that endodoncy is an extremely difficult discipline, because it implies a lot of experience, practical ability and a constant application.

Topics: Dental Pulp Diseases; Endodontics; Humans; Hydrogen Peroxide; Inflammation; Root Canal Therapy; Sodium Hypochlorite

Topics: Dental Pulp Diseases; Dental Pulp Necrosis; Humans; Hydrogen Peroxide; Root Canal Therapy; Sodium Hypochlorite

Topics: Administration, Topical; Calcium Hydroxide; Camphor; Dental Pulp Diseases; Disinfectants; Formaldehyde; Humans; Phenols; Pulpectomy; Sodium Hypochlorite; Therapeutic Irrigation; Thymol; Time Factors

Topics: Chloramines; Cresols; Debridement; Dental Pulp Diseases; Eugenol; Humans; Hydrogen Peroxide; Phenols; Root Canal Therapy; Sodium Hypochlorite; Sterilization; Sulfathiazoles; Therapeutic Irrigation