An in vitro study on the influence of laser-activated irrigation on infiltration and leakage of a dual curing-resin cement as an endodontic sealer

Authors

  • Laurine Marger Division of Cariology and Endodontology, CUMD – University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva Geneva, Switzerland
  • Marwa Abdelaziz Division of Cariology and Endodontology, CUMD – University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva Geneva, Switzerland
  • Enrico di Bella Division of Cariology and Endodontology, CUMD – University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva Geneva, Switzerland
  • Ivo Krejci Division of Cariology and Endodontology, CUMD – University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva Geneva, Switzerland
  • Clara Isabel Anton y Otero Division of Cariology and Endodontology, CUMD – University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva Geneva, Switzerland

DOI:

https://doi.org/10.2340/biid.v11.41098

Keywords:

Composite resin, adhesion, sealing, microleakage, confocal microscopy

Abstract

Objectives: The study aims to investigate the effects of laser-activated irrigation on infiltration and microleakage of a dual-curing resin cement applied as a root canal sealer.

Methods: Thirty-eight extracted upper molars were attributed to four experimental groups. Roots were mechanically enlarged and disinfected (NaOCl). Control samples (n = 11) were irrigated with conventional needles and three different lasers were used to activate the irrigant in the other groups (n = 9): 2.94 µm Er:YAG laser, 9,300 µm CO2 laser and 808 nm diode laser with a modified black coated laser tip. Final irrigation was performed in each group with ethylenediaminetetraacetic acid (EDTA),  sodium hypochlorite (NaOCl) and sodium chloride (NaCl) activated with lasers and in the control without activation.
Dentin tubules were then labeled with a red fluorophore (Rhodamine B) and the root canals were sealed with a dual-curing resin cement (Paracore). The cement fixed the dye on the sealed and infiltrated dentin parts. To remove the Rhodamine not fixed by the cement, roots were then sectioned horizontally and immersed in hydrogen peroxide (H2O2). The empty dentin tubules spaces were then labeled with a green fluorophore (Fluorescein) allowing the visualization of infiltration and microleakage by confocal microscopy.

Results: Percentages of infiltration were significantly higher in the middle root third of the control and Er:YAG laser-activated samples compared to CO2 or diode laser groups. Microleakage was present in all experimental groups but significantly less after CO2 laser activation.

Conclusion: Laser-activated irrigation impacted resin cement infiltration and microleakage dependent on the applied wavelength. Er:YAG laser activation led to higher values of infiltration and microleakage compared to CO2 and diode lasers.

Downloads

Download data is not yet available.

References

Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340–9. https://doi.org/10.1016/0030-4220(65)90166-0 DOI: https://doi.org/10.1016/0030-4220(65)90166-0

Tibúrcio-Machado CS, et al. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J. 2021;54(5):712–35. https://doi.org/10.1111/iej.13467 DOI: https://doi.org/10.1111/iej.13467

Siqueira JF, Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34(1):1–10. https://doi.org/10.1046/j.1365-2591.2001.00396.x DOI: https://doi.org/10.1046/j.1365-2591.2001.00396.x

Tabassum S, Khan FR. Failure of endodontic treatment: the usual suspects. Eur J Dent. 2016;10(1):144–7. https://doi.org/10.4103/1305-7456.175682 DOI: https://doi.org/10.4103/1305-7456.175682

Verma A, et al. A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis. J Clin Exp Dent. 2020;12(9):e821–9. https://doi.org/10.4317/jced.56368 DOI: https://doi.org/10.4317/jced.56368

Ando N, Hoshino E. Predominant obligate anaerobes invading the deep layers of root canal dentin. Int Endod J. 1990;23(1):20–7. https://doi.org/10.1111/j.1365-2591.1990.tb00798.x DOI: https://doi.org/10.1111/j.1365-2591.1990.tb00798.x

Agarwal A, et al., Evaluation of apical capor lock formation and comparative evaluation of its elimination using three different techniques: an in vitro Study. J Contemp Dent Pract. 2017;18(9):790–4. https://doi.org/10.5005/jp-journals-10024-2128 DOI: https://doi.org/10.5005/jp-journals-10024-2128

Tay FR, et al. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010;36(4):745–50. https://doi.org/10.1016/j.joen.2009.11.022 DOI: https://doi.org/10.1016/j.joen.2009.11.022

Susila A, Minu J. Activated irrigation vs. conventional non-activated irrigation in endodontics – a systematic review. Eur Endod J. 2019;4(3):96–110. https://doi.org/10.14744/eej.2019.80774 DOI: https://doi.org/10.14744/eej.2019.80774

Anton y Otero CI, Marger L, di Bella E, Feilzer A, Krejci I, Abdelaziz M. An in-vitro study on effects of laser activation on dye penetration in human root dentin. Biomater Investig Dent. 2024;11:40311. https://doi.org/10.2340/biid.v11.40311 DOI: https://doi.org/10.2340/biid.v11.40311

Zhu X, et al. Comparison of the antibacterial effect and smear layer removal using photon-initiated photoacoustic streaming aided irrigation versus a conventional irrigation in single-rooted canals: an in vitro study. Photomed Laser Surg. 2013;31(8):371–7. https://doi.org/10.1089/pho.2013.3515 DOI: https://doi.org/10.1089/pho.2013.3515

Mancini M, et al. FESEM evaluation of smear layer removal from conservatively shaped canals: laser activated irrigation (PIPS and SWEEPS) compared to sonic and passive ultrasonic activation-an ex vivo study. BMC Oral Health. 2021;21(1):81. https://doi.org/10.1186/s12903-021-01427-0 DOI: https://doi.org/10.1186/s12903-021-01427-0

Anton y Otero CI, et al. Micromorphology of root canal walls after laser activated irrigation. Eur J Prosthodont Restorat Dent. 2023;32(1):109–19.

Duncan HF, et al. Treatment of pulpal and apical disease: the European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endodont J. 2023;56(S3):238–95. https://doi.org/10.1111/iej.13974 DOI: https://doi.org/10.1111/iej.13974

Aminoshariae A, Primus C, Kulild JC. Tricalcium silicate cement sealers: do the potential benefits of bioactivity justify the drawbacks? J Am Dent Assoc. 2022;153(8):750–60. https://doi.org/10.1016/j.adaj.2022.01.004 DOI: https://doi.org/10.1016/j.adaj.2022.01.004

Roggendorf MJ, et al. Influence of moisture on the apical seal of root canal fillings with five different types of sealer. J Endod. 2007;33(1):31–3. https://doi.org/10.1016/j.joen.2006.07.006 DOI: https://doi.org/10.1016/j.joen.2006.07.006

Burkovski A, Karl M. Lack of evidence for the necessity of root canal obturation. Quintessence Int, 2019;50(1):22–8.

Sabeti MA, et al. Healing of apical periodontitis after endodontic treatment with and without obturation in dogs. J Endodont. 2006;32(7):628–33. https://doi.org/10.1016/j.joen.2005.12.014 DOI: https://doi.org/10.1016/j.joen.2005.12.014

Anton y Otero CI, et al. Evaluating the use of self-conditioning adhesive combined with dual curing resin cement as an endodontic sealer: an in vitro study. Biomater Investig Dent. 2023;10(1):2282523. https://doi.org/10.1080/26415275.2023.2282523 DOI: https://doi.org/10.1080/26415275.2023.2282523

Anton Y Otero CI, et al. Activation of endodontic irrigants using a 9.3 µm CO₂ and diode lasers: A laboratory proof of concept model. Am J Dent. 2024;37(1):39-46. PMID: 38458982. https://doi.org/10.3389/fdmed.2022.1010916 DOI: https://doi.org/10.3389/fdmed.2022.1010916

Pirani C, et al. Does hybridization of intraradicular dentin really improve fiber post retention in endodontically treated teeth? J Endodont. 2005;31(12):891–4. https://doi.org/10.1097/01.don.0000164853.92310.e7 DOI: https://doi.org/10.1097/01.don.0000164853.92310.e7

Ekambaram M, Yiu CKY, Matinlinna JP. Bonding of adhesive resin to intraradicular dentine: a review of the literature. Int J Adhesion Adhesives. 2015;60:92–103. https://doi.org/10.1016/j.ijadhadh.2015.04.003 DOI: https://doi.org/10.1016/j.ijadhadh.2015.04.003

Feilzer AJ, De Gee AJ, Davidson C. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res. 1987;66(11):1636–9. https://doi.org/10.1177/00220345870660110601 DOI: https://doi.org/10.1177/00220345870660110601

Bouillaguet S, et al. Microtensile bond strength between adhesive cements and root canal dentin. Dent Mater. 2003;19(3):199–205. https://doi.org/10.1016/S0109-5641(02)00030-1 DOI: https://doi.org/10.1016/S0109-5641(02)00030-1

Tay FR, et al. Geometric factors affecting dentin bonding in root canals: a theoretical modeling approach. J Endodont. 2005;31(8):584–9. https://doi.org/10.1097/01.don.0000168891.23486.de DOI: https://doi.org/10.1097/01.don.0000168891.23486.de

Anton y Otero CI, et al. Activation of endodontic irrigants using a 9300nm CO2 and diode lasers: am in-vitro proof of concept model. Am J Dent. Under review.

Carrigan PJ, et al. A scanning electron microscopic evaluation of human dentinal tubules according to age and location. J Endod. 1984;10(8):359–63. https://doi.org/10.1016/S0099-2399(84)80155-7 DOI: https://doi.org/10.1016/S0099-2399(84)80155-7

Ricucci D, et al. A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(6):825–42. https://doi.org/10.1016/j.tripleo.2011.08.003 DOI: https://doi.org/10.1016/j.tripleo.2011.08.003

Fouad AF, Burleson J. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record. J Am Dent Assoc. 2003;134(1):43–51; quiz 117–8. https://doi.org/10.14219/jada.archive.2003.0016 DOI: https://doi.org/10.14219/jada.archive.2003.0016

Wen C, et al. Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers. BMC Oral Health. 2021;21(1):307. https://doi.org/10.1186/s12903-021-01671-4 DOI: https://doi.org/10.1186/s12903-021-01671-4

Published

2024-07-12