The Effectiveness of Three Irrigation Systems in the Enterococcus faecalis Reduction after Instrumentation with a Reciprocating Instrument

Karina Gonzalez Camara Fernandes; Bruno Barciela da Silva; Nilton César Boer; Danilo Rodrigues Mandarini; Lucieni Cristina Trovati Moreti; Augusto Shoji Kato; Carlos Eduardo da Silveira  Bueno; Ana Grasiela da Silva Limoeiro; Sergio Luiz Pinheiro; Alexandre Sigrist De Martin; Carlos Eduardo Fontana

doi:10.1055/s-0040-1714760

European Journal of Dentistry, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(04): 539-543
DOI: 10.1055/s-0040-1714760

Original Article

The Effectiveness of Three Irrigation Systems in the Enterococcus faecalis Reduction after Instrumentation with a Reciprocating Instrument

Karina Gonzalez Camara Fernandes

¹Department of Endodontics, Universidade Brasil, Brazil

,

Bruno Barciela da Silva

¹Department of Endodontics, Universidade Brasil, Brazil

,

Nilton César Boer

¹Department of Endodontics, Universidade Brasil, Brazil

,

Danilo Rodrigues Mandarini

¹Department of Endodontics, Universidade Brasil, Brazil

,

Lucieni Cristina Trovati Moreti

¹Department of Endodontics, Universidade Brasil, Brazil

,

Augusto Shoji Kato

²Department of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil

,

Carlos Eduardo da Silveira Bueno

²Department of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil

,

Ana Grasiela da Silva Limoeiro

³Department of Endodontics, Faculdade de Ilhéus Bahia, Brazil

,

Sergio Luiz Pinheiro

⁴Department of Endodontics, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil

,

Alexandre Sigrist De Martin

²Department of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil

,

Carlos Eduardo Fontana

⁴Department of Endodontics, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil

› Institutsangaben

Abstract

Objective This study aimed to analyze the effectiveness of three irrigation systems: EndoActivator, passive ultrasonic irrigation (PUI), and Easy Clean in the reduction of Enterococcus faecalis, after instrumentation with the reciprocating system, through microbiological collection and culture method.

Materials and Methods A total of 60 extracted human lower premolars were used and standardized at 16 mm in length. The teeth were accessed, contaminated with E. faecalis, and incubated for 21 days at 37°C. Initial collections (S1) were made with an absorbent paper cone to confirm the contamination; subsequently, instrumentation was performed with WaveOne Primary. The teeth were divided into four groups according to the final irrigation protocol (n = 15): group 1. EndoActivator; group 2, PUI; group 3, Easy Clean; and group 4, control group irrigated with saline solution sterile and without agitation. In the final irrigation, the agitation of the 17% ethylene amine tetra-acetic acid (EDTA) solutions was used, then 2.5% sodium hypochlorite (NaOCl); in both for this, three cycles of 20 seconds each. After the chemical–mechanical preparation and agitation of the irrigating solutions, the final collections (S2) for counting the colony-forming units (CFU/mL) occurred.

Results The Kruskal–Wallis test revealed that all the agitation systems reduced by 100% and the control group by 65.7%.

Conclusion The control group presented a significantly higher amount of CFU/mL after the chemical–mechanical preparation than the other groups, which were similar to each other (p > 0.05).

Keywords

endodontics - EndoActivator - Easy Clean - Enterococcus faecalis - PUI

Volltext

Referenzen

References
1 Chivatxaranukul P, Dashper SG, Messer HH. Dentinal tubule invasion and adherence by Enterococcus faecalis. Int Endod J 2008; 41 (10) 873-882
2 Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am 2010; 54 (02) 291-312
3 Machado ME, Sapia LA, Cai S, Martins GH, Nabeshima CK. Comparison of two rotary systems in root canal preparation regarding disinfection. J Endod 2010; 36 (07) 1238-1240
4 Martinho FC, de Rabello DG, Ferreira LL, Nascimento GG. Participation of endotoxin in root canal infections: A systematic review and meta-analysis. Eur J Dent 2017; 11 (03) 398-406
5 Dubey S, Saha SG, Rajkumar B, Dhole TK. Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection. Eur J Dent 2017; 11 (01) 12-16
6 Gomes BP, Pinheiro ET, Jacinto RC, Zaia AA, Ferraz CC, Souza-Filho FJ. Microbial analysis of canals of root-filled teeth with periapical lesions using polymerase chain reaction. J Endod 2008; 34 (05) 537-540
7 Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009; 35 (06) 791-804
8 Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: Different methods to improve efficacy and related problems. Eur J Dent 2018; 12 (03) 459-466
9 Podar R, Kulkarni GP, Dadu SS, Singh S, Singh SH. In vivo antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite as root canal irrigants. Eur J Dent 2015; 9 (04) 529-534
10 Pinheiro SL, Silva CC, Silva LAD. et al. Antimicrobial efficacy of 2.5% sodium hypochlorite, 2% chlorhexidine, and ozonated water as irrigants in mesiobuccal root canals with severe curvature of mandibular molars. Eur J Dent 2018; 12 (01) 94-99
11 Roy RA, Ahmad M, Crum LA. Physical mechanisms governing the hydrodynamic response of an oscillating ultrasonic file. Int Endod J 1994; 27 (04) 197-207
12 Al-Jadaa A, Paqué F, Attin T, Zehnder M. Acoustic hypochlorite activation in simulated curved canals. J Endod 2009; 35 (10) 1408-1411
13 Ruddle C. Endodontic disinfection - tsunami irrigation. Saudi Endod J 2015; 5: 1-12
14 Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod 2016; 42 (04) 659-663
15 Brito PRR, Souza LC, Machado de Oliveira JC. et al. Comparison of the effectiveness of three irrigation techniques in reducing intracanal Enterococcus faecalis populations: an in vitro study. J Endod 2009; 35 (10) 1422-1427
16 Siqueira Jr JF, Rôças IN, Santos SR, Lima KC, Magalhães FA, de Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod 2002; 28 (03) 181-184
17 Matos Neto M, Santos SS, Leão MV, Habitante SM, Rodrigues JR, Jorge AO. Effectiveness of three instrumentation systems to remove Enterococcus faecalis from root canals. Int Endod J 2012; 45 (05) 435-438
18 Gorduysus M, Nagas E, Torun OY, Gorduysus O. A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal. Aust Endod J 2011; 37 (03) 128-133
19 Aydin C, Tunca YM, Senses Z, Baysallar M, Kayaoglu G, Ørstavik D. Bacterial reduction by extensive versus conservative root canal instrumentation in vitro. Acta Odontol Scand 2007; 65 (03) 167-170
20 Paragliola R, Franco V, Fabiani C. et al. Final rinse optimization: influence of different agitation protocols. J Endod 2010; 36 (02) 282-285
21 Castelo-Baz P, Martín-Biedma B, Cantatore G. et al. In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod 2012; 38 (05) 688-691
22 Molander A, Reit C, Dahlén G, Kvist T. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J 1998; 31 (01) 1-7
23 Siqueira Jr JF, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev 2013; 26 (02) 255-273
24 White JM, Goodis HE, Marshall SJ, Marshall GW. Sterilization of teeth by gamma radiation. J Dent Res 1994; 73 (09) 1560-1567
25 Love RM. Invasion of dentinal tubules by root canal bacteria. Endod Topics 2004; 9: 52-65
26 Ran S, Wang J, Jiang W, Zhu C, Liang J. Assessment of dentinal tubule invasion capacity of Enterococcus faecalis under stress conditions ex vivo. Int Endod J 2015; 48 (04) 362-372
27 Tennert C, Fuhrmann M, Wittmer A. et al. New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings. J Endod 2014; 40 (05) 670-677
28 Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod 1999; 25 (11) 735-738
29 Duque JA, Duarte MA, Canali LC. et al. Comparative effectiveness of new mechanical irrigant agitating devices for debris removal from the canal and isthmus of mesial roots of mandibular molars. J Endod 2017; 43 (02) 326-331
30 Simezo AP, da Silveira Bueno CE, Cunha RS. et al. Comparative analysis of dentinal erosion after passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron study. J Endod 2017; 43 (01) 141-146
31 Huffaker SK, Safavi K, Spangberg LS, Kaufman B. Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod 2010; 36 (08) 1315-1318
32 van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR. Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 2010; 36 (04) 737-740
33 Andrade Jr. CV, Batista MR, Alves MM, Alves F, Silva JN. Efficacy of a new activation device in irrigant penetration into simulated lateral canals. Euro Endod J 2016; 3: 1-5