Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals

Eduardo A. Bortoluzzi, Daniel Carlon, Mohamed M. Meghil, Ahmed R. El-Awady, Lina Niu, Brian Edward Bergeron, Lisiane Susin, Christopher W Cutler, David H. Pashley, Franklin Chi Meng Tay

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives To evaluate the effectiveness of TRUShape® 3D Conforming Files, compared with Twisted Files, in reducing bacteria load from root canal walls, in the presence or absence of irrigant agitation. Methods Extracted human premolars with single oval-shaped canals were infected with Enterococcus faecalis. Teeth in Group I (N = 10; NaOCl and QMix® 2in1 as respective initial and final irrigants) were subdivided into 4 subgroups: (A) TRUShape® instrumentation without irrigant activation; (B) TRUShape® instrumentation with sonic irrigant agitation; (C) Twisted Files without irrigant agitation; (D) Twisted Files with sonic irrigant agitation. To remove confounding factor (antimicrobial irrigants), teeth in Group II (N = 10) were irrigated with sterile saline, using the same subgroup designations. Specimens before and after chemomechanical débridement were cultured for quantification of colony-forming units (CFUs). Data from each group were analyzed separately using two-factor ANOVA and Holm-Sidak multiple comparison (α = 0.05). Canal wall bacteria were qualitatively examined using scanning electron microscopy (SEM) and light microscopy of Taylor-modified Brown and Brenn-stained demineralised sections. Results CFUs from subgroups in Group I were not significantly different (P = 0.935). For Group II, both file type (P < 0.001) and irrigant agitation (P < 0.001) significantly affected log-reduction in CFU concentrations. The interaction of these two factors was not significant (P = 0.601). Although SEM showed reduced canal wall bacteria, bacteria were present within dentinal tubules after rotary instrumentation, as revealed by light microscopy of longitudinal root sections. Conclusions TRUShape® files removed significantly more canal wall bacteria than Twisted Files when used without an antibacterial irrigant; the latter is required to decontaminate dentinal tubules. Clinical significance Root canal disinfection should not be focused only on a mechanistic approach. Rather, the rational choice of a rotary instrumentation system should be combined with the use of well-tested antimicrobial irrigants and delivery/agitation techniques to establish a clinically realistic chemomechanical débridement protocol.

Original languageEnglish (US)
Pages (from-to)597-604
Number of pages8
JournalJournal of Dentistry
Volume43
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Dental Pulp Cavity
Bacteria
Stem Cells
Electron Scanning Microscopy
Microscopy
Tooth
Light
Enterococcus faecalis
Disinfection
Bicuspid
Analysis of Variance
nitinol

Keywords

  • Canal conforming
  • Dentine conservation
  • E. faecalis
  • Nickel titanium
  • Rotary instrumentation
  • Sonic agitation

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals. / Bortoluzzi, Eduardo A.; Carlon, Daniel; Meghil, Mohamed M.; El-Awady, Ahmed R.; Niu, Lina; Bergeron, Brian Edward; Susin, Lisiane; Cutler, Christopher W; Pashley, David H.; Tay, Franklin Chi Meng.

In: Journal of Dentistry, Vol. 43, No. 5, 01.05.2015, p. 597-604.

Research output: Contribution to journalArticle

Bortoluzzi, Eduardo A. ; Carlon, Daniel ; Meghil, Mohamed M. ; El-Awady, Ahmed R. ; Niu, Lina ; Bergeron, Brian Edward ; Susin, Lisiane ; Cutler, Christopher W ; Pashley, David H. ; Tay, Franklin Chi Meng. / Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals. In: Journal of Dentistry. 2015 ; Vol. 43, No. 5. pp. 597-604.
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abstract = "Objectives To evaluate the effectiveness of TRUShape{\circledR} 3D Conforming Files, compared with Twisted Files, in reducing bacteria load from root canal walls, in the presence or absence of irrigant agitation. Methods Extracted human premolars with single oval-shaped canals were infected with Enterococcus faecalis. Teeth in Group I (N = 10; NaOCl and QMix{\circledR} 2in1 as respective initial and final irrigants) were subdivided into 4 subgroups: (A) TRUShape{\circledR} instrumentation without irrigant activation; (B) TRUShape{\circledR} instrumentation with sonic irrigant agitation; (C) Twisted Files without irrigant agitation; (D) Twisted Files with sonic irrigant agitation. To remove confounding factor (antimicrobial irrigants), teeth in Group II (N = 10) were irrigated with sterile saline, using the same subgroup designations. Specimens before and after chemomechanical d{\'e}bridement were cultured for quantification of colony-forming units (CFUs). Data from each group were analyzed separately using two-factor ANOVA and Holm-Sidak multiple comparison (α = 0.05). Canal wall bacteria were qualitatively examined using scanning electron microscopy (SEM) and light microscopy of Taylor-modified Brown and Brenn-stained demineralised sections. Results CFUs from subgroups in Group I were not significantly different (P = 0.935). For Group II, both file type (P < 0.001) and irrigant agitation (P < 0.001) significantly affected log-reduction in CFU concentrations. The interaction of these two factors was not significant (P = 0.601). Although SEM showed reduced canal wall bacteria, bacteria were present within dentinal tubules after rotary instrumentation, as revealed by light microscopy of longitudinal root sections. Conclusions TRUShape{\circledR} files removed significantly more canal wall bacteria than Twisted Files when used without an antibacterial irrigant; the latter is required to decontaminate dentinal tubules. Clinical significance Root canal disinfection should not be focused only on a mechanistic approach. Rather, the rational choice of a rotary instrumentation system should be combined with the use of well-tested antimicrobial irrigants and delivery/agitation techniques to establish a clinically realistic chemomechanical d{\'e}bridement protocol.",
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T1 - Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals

AU - Bortoluzzi, Eduardo A.

AU - Carlon, Daniel

AU - Meghil, Mohamed M.

AU - El-Awady, Ahmed R.

AU - Niu, Lina

AU - Bergeron, Brian Edward

AU - Susin, Lisiane

AU - Cutler, Christopher W

AU - Pashley, David H.

AU - Tay, Franklin Chi Meng

PY - 2015/5/1

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N2 - Objectives To evaluate the effectiveness of TRUShape® 3D Conforming Files, compared with Twisted Files, in reducing bacteria load from root canal walls, in the presence or absence of irrigant agitation. Methods Extracted human premolars with single oval-shaped canals were infected with Enterococcus faecalis. Teeth in Group I (N = 10; NaOCl and QMix® 2in1 as respective initial and final irrigants) were subdivided into 4 subgroups: (A) TRUShape® instrumentation without irrigant activation; (B) TRUShape® instrumentation with sonic irrigant agitation; (C) Twisted Files without irrigant agitation; (D) Twisted Files with sonic irrigant agitation. To remove confounding factor (antimicrobial irrigants), teeth in Group II (N = 10) were irrigated with sterile saline, using the same subgroup designations. Specimens before and after chemomechanical débridement were cultured for quantification of colony-forming units (CFUs). Data from each group were analyzed separately using two-factor ANOVA and Holm-Sidak multiple comparison (α = 0.05). Canal wall bacteria were qualitatively examined using scanning electron microscopy (SEM) and light microscopy of Taylor-modified Brown and Brenn-stained demineralised sections. Results CFUs from subgroups in Group I were not significantly different (P = 0.935). For Group II, both file type (P < 0.001) and irrigant agitation (P < 0.001) significantly affected log-reduction in CFU concentrations. The interaction of these two factors was not significant (P = 0.601). Although SEM showed reduced canal wall bacteria, bacteria were present within dentinal tubules after rotary instrumentation, as revealed by light microscopy of longitudinal root sections. Conclusions TRUShape® files removed significantly more canal wall bacteria than Twisted Files when used without an antibacterial irrigant; the latter is required to decontaminate dentinal tubules. Clinical significance Root canal disinfection should not be focused only on a mechanistic approach. Rather, the rational choice of a rotary instrumentation system should be combined with the use of well-tested antimicrobial irrigants and delivery/agitation techniques to establish a clinically realistic chemomechanical débridement protocol.

AB - Objectives To evaluate the effectiveness of TRUShape® 3D Conforming Files, compared with Twisted Files, in reducing bacteria load from root canal walls, in the presence or absence of irrigant agitation. Methods Extracted human premolars with single oval-shaped canals were infected with Enterococcus faecalis. Teeth in Group I (N = 10; NaOCl and QMix® 2in1 as respective initial and final irrigants) were subdivided into 4 subgroups: (A) TRUShape® instrumentation without irrigant activation; (B) TRUShape® instrumentation with sonic irrigant agitation; (C) Twisted Files without irrigant agitation; (D) Twisted Files with sonic irrigant agitation. To remove confounding factor (antimicrobial irrigants), teeth in Group II (N = 10) were irrigated with sterile saline, using the same subgroup designations. Specimens before and after chemomechanical débridement were cultured for quantification of colony-forming units (CFUs). Data from each group were analyzed separately using two-factor ANOVA and Holm-Sidak multiple comparison (α = 0.05). Canal wall bacteria were qualitatively examined using scanning electron microscopy (SEM) and light microscopy of Taylor-modified Brown and Brenn-stained demineralised sections. Results CFUs from subgroups in Group I were not significantly different (P = 0.935). For Group II, both file type (P < 0.001) and irrigant agitation (P < 0.001) significantly affected log-reduction in CFU concentrations. The interaction of these two factors was not significant (P = 0.601). Although SEM showed reduced canal wall bacteria, bacteria were present within dentinal tubules after rotary instrumentation, as revealed by light microscopy of longitudinal root sections. Conclusions TRUShape® files removed significantly more canal wall bacteria than Twisted Files when used without an antibacterial irrigant; the latter is required to decontaminate dentinal tubules. Clinical significance Root canal disinfection should not be focused only on a mechanistic approach. Rather, the rational choice of a rotary instrumentation system should be combined with the use of well-tested antimicrobial irrigants and delivery/agitation techniques to establish a clinically realistic chemomechanical débridement protocol.

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