Analysis of the efficiency of sound impact on the system of canals of the tooth root: A laboratory study

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Abstract

BACKGROUND: The treatment of chronic apical periodontitis is directly related to the successful impact on the biofilm in the root canal system. Despite recent advances in understanding the effects of bacterial biofilm, there are still many questions concerning bacterial inactivation, and more research in these areas is needed.

AIM: To investigate approaches to improve the effectiveness of treating chronic apical periodontitis by combining an antimicrobial drug with sound activation.

MATERIALS AND METHODS: The biological material of 40 teeth was obtained as a result of removal according to guidelines to create a model of the process of obturation of a tooth’s root canal with a calcium hydroxide paste. In the main group, we used the EndoActivator (Dentsply Sirona, USA) system intracanally after introducing the resultant paste with the help of canal filler. The root canal filling was performed using canal filler in the comparison control group. The filling was assessed using a radiovisiograph (Schick Technologies Inc., USA), and the filling of macrocanal and microcanal of the tooth root was examined using a scanning electron microscope.

RESULTS: The average score per tooth in the main group was 0.5 points/tooth. The average score per tooth in the control group was 2.05 points/tooth, which was significantly higher than in the main group (p <0.001). A comparison of the proportions of teeth with a certain number of points recorded in the compared groups revealed that teeth with a score of “0” (80%) predominated in the main group, whereas the proportion of such teeth in the control group was 15%; the differences are statistically significant (p <0.001). The data showed that the effectiveness of the root canal filling method with the canal filler and activation of the EndoActivator system resulted in the least complications.

CONCLUSION: The use of sonic vibrations of the EndoActivator system causes a dynamic movement of the material in the root canal, aimed at improving its flow and distribution into the dentinal tubules, and contributes to the uniform homogeneity of the filling material in the lumen of the root canal and the absence of voids between the root filling and the walls of the root canal of the tooth.

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About the authors

Anatolii A. Adamchik

Kuban State Medical University

Email: adamchik1@mail.ru
ORCID iD: 0000-0002-2861-0260

md, dr. sci. (med.), assistant professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Valerii V. Tairov

Kuban State Medical University

Email: tairovvaleriy@mail.ru
ORCID iD: 0000-0003-0379-5964

md, cand. sci. (med.), assistant professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Irina O. Kamyshnikova

Kuban State Medical University

Email: ir.kamishnikova2013@yandex.ru
ORCID iD: 0000-0002-0665-043X

md, cand. sci. (med.), assistant professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Ekaterina S. Zaporozhskaya-Abramova

Kuban State Medical University, Krasnodar

Email: dr.katerina_abramova@mail.ru
ORCID iD: 0000-0003-0675-6581

md, cand. sci. (med.), assistant professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Zhanna V. Solovyeva

Kuban State Medical University, Krasnodar

Email: janna_soul@mail.ru
ORCID iD: 0000-0001-6591-395X

md, cand. sci. (med.), assistant

Russian Federation, 4 Sedina street, 350063 Krasnodar

Viktoria A. Ivashchenko

Kuban State Medical University, Krasnodar

Email: vikato777@mail.ru
ORCID iD: 0000-0002-9946-9700

md, cand. sci. (med.), assistant

Russian Federation, 4 Sedina street, 350063 Krasnodar

Natalia V. Lapina

Kuban State Medical University

Email: kgma74@yandex.ru
ORCID iD: 0000-0003-1835-8898

md, dr. sci. (med.), professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Armenak V. Arutyunov

Kuban State Medical University

Email: armenak@mail.ru
ORCID iD: 0000-0001-8823-1409

md, dr. sci. (med.), assistant professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Olga N. Risovannaya

Kuban State Medical University

Email: dentrosa@mail.ru
ORCID iD: 0000-0001-9585-4444

md, dr. sci. (med.), professor

Russian Federation, 4 Sedina street, 350063 Krasnodar

Ksenia D. Kirsch

Kuban State Medical University

Email: kdkirsh@mail.ru
ORCID iD: 0000-0002-6786-9347

assistant

Russian Federation, 4 Sedina street, 350063 Krasnodar

Valeria D. Golubina

Kuban State Medical University

Author for correspondence.
Email: adamchik1@mail.ru
ORCID iD: 0000-0003-2579-4903
Russian Federation, 4 Sedina street, 350063 Krasnodar

References

  1. Adamchik AA, Arutyunov AV, Sirak SV, Ovsyannikova AA. Regeneration of bone tissue when conservative treatment of destructive forms of periodontitis. The Dental Institute. 2016;(1):39–41. (In Russ).
  2. Koshel’ IV, Adamchik AA, Kobylkina TL. Justification of the choice of the drug for temporary canal filling in the treatment of destructive forms of chronic periodontitis. Russian Journal of Dentistry. 2016;20(6):320–323. (In Russ). doi: 10.18821/1728-28022016;20(6)320-323
  3. Sirak SV, Adamchik AA, Kobylkina TL, et al. Comparative characteristics of preparations for temporary root canal filling in treatment apical periodontitis. Endodontija Today. 2016;(4):25–28. (In Russ).
  4. Sirak SV, Adamchik AA, Kobylkina TL, et al. Experimental evaluation of the regenerative potential of periodontal tissues. Parodontologiya. 2016;21(3):15–18. (In Russ).
  5. Tsarev VN, Mitronin АV, Podporin MS. Microbial biofilm root canals and new approaches to the diagnosis and treatment of the chronic forms of pulpitis using a photoactivatable disinfection and ultrasonic treatment. Endodontija Today. 2016;(3):19–23. (In Russ).
  6. Adl A, Razavian A, Eskandari F. The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study. BMC Oral Health. 2022;22(1):564. doi: 10.1186/s12903-022-02626-z
  7. Coaguila-Llerena H, Gaeta E, Faria G. Outcomes of the GentleWave system on root canal treatment: a narrative review. Restor Dent Endod. 2022;47(1):e11. doi: 10.5395/rde.2022.47.e11
  8. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921–930. doi: 10.1111/j.1365-2591.2006.01180.x
  9. American Association of Endodontists [Internet]. Colleagues for Excellence Newsletter, 2009. Available from: www.aae.org/colleagues
  10. Paqué F, Balmer M, Attin T, Peters OA. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. J Endod. 2010;36(4):703–707. doi: 10.1016/j.joen.2009.12.020
  11. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30(8):559–567. doi: 10.1097/01.DON.0000129039.59003.9D
  12. Zapata RO, Bramante CM, de Moraes IG, et al. Confocal laser scanning microscopy is appropriate to detect viability of Enterococcus faecalis in infected dentin. J Endod. 2008;34(10):1198–1201. doi: 10.1016/j.joen.2008.07.001

Supplementary files

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2. Fig. 1. Radiograph of a 3.5 tooth with a formed root canal.

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3. Fig. 2. Radiograph of tooth 3.5, uniform and compact distribution of paste in the root canal with subsequent activation by the Endo- Activator device: 1 — absence of pores throughout the root canal, tight fit to the walls of the root canal; 2 — filling of the lateral canal; 3 — filling the apical part of the root canal.

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4. Fig. 3. Radiograph of tooth 3.5 with filling of the root canal system of the tooth in the traditional way using a canal filler: 1 — pores throughout the root canal of the tooth.

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5. Fig. 4. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate (scanning electron microscope, LEI mode, ×500 magnification).

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6. Fig. 5. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate (scanning electron microscope, LEI mode, ×1000 magnification).

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7. Fig. 6. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate (scanning electron microscope, LEI mode, ×2000 magnification).

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8. Fig. 7. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — filling of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, LEI mode, ×2000 magnification).

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9. Fig. 8. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — filling of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, LEI mode, ×2000 magnification).

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10. Fig. 9. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — penetration of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, COMPO mode, ×500 magnification).

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11. Fig. 10. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — penetration of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, COMPO mode, ×1000 magnification).

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12. Fig. 11. Micrograph of a tooth root fragment, the middle part of the tooth root: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — filling of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, COMPO mode, ×2000 magnification).

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13. Fig. 12. Micrograph of a fragment of the root of the tooth, median part of the root of the tooth: 1 — dentin of the root of the tooth with dentine tubules; 2 — a paste of calcium hydroxide mixed with basic bismuth nitrate; 3 — filling of dentine tubules with calcium hydroxide paste mixed with basic bismuth nitrate to different depths (scanning electron microscope, COMPO mode, ×5000 magnification).

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