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The Journal of Contemporary Dental... Apr 2024The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. (Comparative Study)
Comparative Study
AIM
The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques.
MATERIALS AND METHODS
In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of < 0.05.
RESULTS
At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels ( < 0.001).
CONCLUSION
In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group.
CLINICAL SIGNIFICANCE
With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, . Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.
Topics: Root Canal Irrigants; Smear Layer; Humans; Therapeutic Irrigation; Root Canal Preparation; Microscopy, Electron, Scanning; Bicuspid; Dental Pulp Cavity; In Vitro Techniques
PubMed: 38956847
DOI: 10.5005/jp-journals-10024-3626 -
JPMA. the Journal of the Pakistan... Jun 2024Musculoskeletal (MSK) disorders encompass various conditions impacting bones, muscles, tendons, ligaments, and nerves. An estimated 1.71 billion individuals globally... (Review)
Review
Musculoskeletal (MSK) disorders encompass various conditions impacting bones, muscles, tendons, ligaments, and nerves. An estimated 1.71 billion individuals globally have MSK disorders, causing disability and reduced quality of life. Literature contradicts the notion that musculoskeletal pain and disability solely arise from physical impairments; psychological, behavioural, and social factors contribute significantly. These facets influence pain perception and chronic impairment development. Common interventions-medication, exercise, manual and hydrotherapy, electro-thermal modalities, behavioural and alternative therapies-address pain individually, yet lack the comprehensive response required. In contrast, a multimodal approach combines diverse therapies tailored to individual needs. It ensures lasting symptom relief, prevents recurrence, and improves function. Although proven effective, clinical implementation of this approach remains limited. This mini-review discusses the reasons behind this gap, underscores multimodal approach importance, and enlightens rehabilitation professionals on its potential for managing chronic musculoskeletal issues.
Topics: Humans; Musculoskeletal Diseases; Combined Modality Therapy; Musculoskeletal Pain; Chronic Disease; Exercise Therapy
PubMed: 38949004
DOI: 10.47391/JPMA.24-44 -
Journal of Clinical Medicine Jun 2024Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has...
Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. : This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epidural analgesia, and maternal and neonatal outcomes during labor. : A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a therapeutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. : Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a significantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no significant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neonatal unit admissions. : Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is associated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both methods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor duration and maternal outcomes.
PubMed: 38930046
DOI: 10.3390/jcm13123517 -
Biological Research For Nursing Jun 2024This study aimed to investigate the impacts of water exercise training on functional and hemodynamic responses in HF patients. A systematic review and meta-analysis... (Review)
Review
This study aimed to investigate the impacts of water exercise training on functional and hemodynamic responses in HF patients. A systematic review and meta-analysis were conducted until February 15, 2024, using multiple databases. Mean difference (MD) with corresponding 95% confidence intervals (CIs) were calculated. Sixteen studies, comprising 349 participants with HF, were included. Water exercise led to enhancements in peak VO (MD, 2.85 mL/kg/min; 95% CI, 1.89 to 3.80; < .00001) and resting heart rate (MD, -4.16 bm; 95% CI, -6.85 to -1.46; = .002) compared to no exercising controls. Water plus land exercise reduced resting heart rate (MD, -1.41 bm; 95% CI, -2.13 to -0.69; = .0001) compared to land exercise alone. Furthermore, acute water exercises decreased resting heart rate (MD, -3.85 bm; 95% CI, -6.49 to -1.21; = .004) and increased stroke volume (MD, 14.68 mL/beat; 95% CI, 8.57 to 20.79; < .00001) and cardiac output (MD, 0.5 L/min; 95% CI, 0.27 to 0.73; < .00001) compared to baseline. These findings suggest that water exercise holds promise as an effective intervention for enhancing functional capacity and hemodynamic parameters in individuals with HF, highlighting the importance of further research to optimize its implementation and elucidate long-term benefits.
PubMed: 38904085
DOI: 10.1177/10998004241263943 -
Clinics (Sao Paulo, Brazil) 2024The objective of this study is to describe the rehabilitation of individuals with Congenital Malformations (CMF) during the use of an External Fixator (EF) in Aquatic...
OBJECTIVES
The objective of this study is to describe the rehabilitation of individuals with Congenital Malformations (CMF) during the use of an External Fixator (EF) in Aquatic Therapy (AT) and to analyze the association between diagnosis, EF type and location with rehabilitation process outcomes, surgical intervention, and adverse effects.
METHODS
This retrospective study included 29 medical records from which the personal and rehabilitation data of the patient were collected. The AT used was described and the outcome variables were associated. The medical records were selected by screening the database of the CMF clinic at the AACD. The inclusion criteria were participants with CMF who used EF treated between 2011 and 2019 of both genders and without age restriction. The exclusion criteria were incomplete medical record data or not undergoing AT while using EF. The extracted data included diagnosis, gender, age, EF type and location, objective of the surgery, adverse events, surgical interventions, time of rehabilitation in AT, physiotherapeutic objectives, and rehabilitation process outcomes in AT.
RESULTS
The mean age of the participants was 12.1 ± 3.99 years, with male predominance (55 %) and hemimelia cases (37 %). The most used EF was circular (51 %), located in the femur (37 %), and the main objective of surgery was bone lengthening (52 %). The most recurrent adverse effect was infection (62 %) and 76 % completed AT. There was no association between the variables analyzed.
CONCLUSIONS
It was possible to describe CMF rehabilitation with EF in AT. There was no association between the variables analyzed.
Topics: Humans; Female; Male; Retrospective Studies; External Fixators; Child; Adolescent; Bone Lengthening; Treatment Outcome; Hydrotherapy; Young Adult; Child, Preschool
PubMed: 38897100
DOI: 10.1016/j.clinsp.2024.100416 -
Journal of Clinical Medicine May 2024: the benefits of water are significant during the birth process. Improved maternal experience of labor, less use of epidurals, better pain management, shorter labor,... (Review)
Review
: the benefits of water are significant during the birth process. Improved maternal experience of labor, less use of epidurals, better pain management, shorter labor, and a greater sense of control are observed during the birth process. : This report aims to determine the benefits of hydrotherapy in clinical childbirth approaches and its applicability in pain control. A meta-analysis of randomized clinical trials selected from various databases with no publication date limits was conducted, comparing groups that did not use hydrotherapy with groups that did during labor. Seven articles met the inclusion criteria, with five articles using hot water immersion and two using hot water shower as hydrotherapy treatments. This study identified 840 participants, with the intervention groups including 417 term pregnant women and the control groups including 423 pregnant women. The effect size of hydrotherapy on pain was calculated using the visual analog scale in five articles and analgesic use in the other two articles. Hydrotherapy significantly reduced pain during labor with a mean difference of -0.97 (95% CI: -1.91 to -0.03; I = 97.32%, < 0.001). The duration of the first stage of labor was not significantly affected, with a mean difference of -0.17 h (95% CI: -0.55 to 0.21; I = 56.75%, = 0.059). Additionally, hydrotherapy did not significantly impact the newborns' Apgar scores at 5 min, with a mean difference of 0.18 (95% CI: -0.48 to 0.85; I = 2.15%, = 0.939). Hydrotherapy is beneficial for pain control in the first stage of labor and does not increase its duration or negatively affect the Apgar score of newborns.
PubMed: 38892969
DOI: 10.3390/jcm13113260 -
International Ophthalmology Jun 2024Intraocular irrigating solution is extensively applied in cataract surgery. This paper explored the difference and relationship between optical coherence tomography... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Intraocular irrigating solution is extensively applied in cataract surgery. This paper explored the difference and relationship between optical coherence tomography (OCT) and optical quality analysis system (OQAS) parameters induced by compound electrolyte intraocular irrigating solution (CEIIS) or Ringer lactate (RL) solution during uncomplicated cataract surgery.
METHODS
Totally 200 senior cataract patients were randomly divided into the CEIIS and RL groups (N = 100 patients/group). The anterior chamber was irrigated by CEIIS or RL during phacoemulsification. Patients were subdivided into diabetes mellitus (DM)+ and DM- groups. The central macular thickness (CMT), hyper reflective foci (HF), modulation transfer function cutoff frequency (MTF cutoff), Strehl ratio (SR), objective scatter index (OSI), and OQAS values (OVs) at 100%, 20%, and 9% contrast levels were measured preoperatively and 1 day and 1 week after operation using spectral-domain optical coherence tomography and OQAS II, respectively. Best-corrected visual acuity (BCVA) was assessed using the Snellen scale, followed by statistical analysis of its logarithm of the minimal angle of resolution.
RESULTS
There were no significant differences in clinical characteristics between the CEIIS and RL groups. Both groups exhibited notably increased postoperative CMT, MTF cutoff, SR, OV at 100%, 20%, and 9% contrast levels, and reduced OSI, indicating CEIIS and RL improved postoperative visual quality. CEIIS surpassed RL solution in improving postoperative visual quality, decelerating the increase of macular HF numbers and CMT in DM+ patients and postoperative BCVA. There was no difference between CEIIS and RL in long-term vision improvement.
CONCLUSION
CEIIS surpasses RL in postoperative visual recovery and retards increases of macular HF numbers and CMT in senior DM+ cataract patients.
Topics: Humans; Female; Male; Visual Acuity; Aged; Tomography, Optical Coherence; Ringer's Lactate; Phacoemulsification; Middle Aged; Therapeutic Irrigation; Electrolytes; Recovery of Function; Cataract; Prospective Studies; Ophthalmic Solutions
PubMed: 38886282
DOI: 10.1007/s10792-024-03131-8 -
Clinical and Experimental Dental... Jun 2024Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that... (Review)
Review
OBJECTIVES
Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps.
METHODS
The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting.
RESULTS
Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices.
CONCLUSIONS
Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.
Topics: Humans; Therapeutic Irrigation; Oral Hygiene; Oral Health; Dental Caries; Periodontal Diseases
PubMed: 38881230
DOI: 10.1002/cre2.912 -
Scientific Reports Jun 2024For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the...
For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue. 40 extracted bovine mandibular anterior teeth (n = 10) were used for the study. Bovine pulp pieces (25 ± 5 mg) were placed in 1.5 ml Eppendorf tubes. Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl, Group 3 with Irritrol, and Group 4 with Saline. Samples were left at room temperature for 30 min, then dried and reweighed. The efficacy of tissue dissolution ranked from highest to lowest was found to be NaOCl, Boric Acid, Irritrol, and saline (p < 0.05). It was observed that the decrease in the NaOCl group was greater than the decrease in the Irritrol and saline groups, and the decrease in the Boric acid group was significantly greater than the decrease in the saline group (p < 0.05). It also emphasizes the need for future studies to further investigate the effects of Irritrol and Boric Acid on tissue dissolution.
Topics: Animals; Cattle; Boric Acids; Root Canal Irrigants; Dental Pulp; Sodium Hypochlorite; Therapeutic Irrigation
PubMed: 38879635
DOI: 10.1038/s41598-024-64904-w -
Clinical Oral Investigations Jun 2024The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment.
MATERIALS AND METHODS
A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone-beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven's criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05.
RESULTS
In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were 'totally healed', and 39 teeth were 'reduced' on PA radiographs. No 'enlargement' was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05).
CONCLUSIONS
Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems.
CLINICAL RELEVANCE
In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.
Topics: Humans; Female; Therapeutic Irrigation; Male; Cone-Beam Computed Tomography; Wound Healing; Adult; Middle Aged; Treatment Outcome; Root Canal Irrigants; Root Canal Therapy; Periapical Diseases; Mandible
PubMed: 38878107
DOI: 10.1007/s00784-024-05758-4