Effect of ultrasonic activation on the reduction of bacteria and endotoxins in root canals: a randomized clinical trial.

Autor: Nakamura VC; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil., Pinheiro ET; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil., Prado LC; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil., Silveira AC; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil., Carvalho APL; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil., Mayer MPA; Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil., Gavini G; Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: International endodontic journal [Int Endod J] 2018 Jan; Vol. 51 Suppl 1, pp. e12-e22. Date of Electronic Publication: 2017 May 23.
DOI: 10.1111/iej.12783
Abstrakt: Aim: This randomized clinical trial aimed to compare the effectiveness of ultrasonic activation with that of nonactivated irrigation on the removal of bacteria and endotoxin from root canals.
Methodology: Fifty patients with necrotic pulps and asymptomatic apical periodontitis were randomly allocated into two groups according to the final irrigation protocol after root canal preparation: Group UI - ultrasonic irrigation (n = 25) and Group NI - needle irrigation (n = 25). The root canals were medicated with calcium hydroxide for 14 days. Microbiological sampling was performed before (S1) and after the root canal preparation (S2), after the irrigation protocols (S3) and after the removal of the intracanal medication (S4). Total bacteria counts were determined by qPCR and the endotoxin levels by the limulus amebocyte lysate assay. Intragroup analyses were performed using the Wilcoxon test for related samples, whereas intergroup analyses were performed using the Mann-Whitney U-test (P < 0.05).
Results: All S1 samples were positive for bacteria, with median numbers of 1.49 × 10 6 and 8.55 × 10 5 bacterial cells for the UI and NI groups, respectively. This number significantly decreased in S2 samples (UI: 1.41 × 10 4 ; NI: 3.53 × 10 4 ; both with P < 0.001). After final irrigation protocols, there was a significant decrease in bacterial load from S2 to S3 samples in both groups (UI: 4.29 × 10 3 ; NI: 1.08 × 10 4 ; P < 0.01). Intergroup analysis revealed a significant difference between irrigation methods regarding bacterial counts in S3 samples (P < 0.05). In contrast, no significant differences were observed between groups for endotoxin levels (P > 0.05).
Conclusions: Ultrasonic activation was more effective than nonactivated irrigation for reducing the number of bacteria but not the endotoxin levels in root canals of teeth with apical periodontitis.
(© 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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