Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2019, vol. 56, nr 2, April-June, p. 149–153

doi: 10.17219/dmp/103911

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Evaluation of the apical extrusion of sodium hypochlorite gel in immature permanent teeth: An in vitro study

Ocena przepchnięcia wierzchołkowego żelu z podchlorynem sodu w niedojrzałych zębach stałych – badanie in vitro

Salma Fuad Al Nesser1,B,C,D, Nada George Bshara1,A,E,F

1 Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Syria

Abstract

Background. Sodium hypochlorite (NaOCl) gel has been suggested as a safer substitute in open apices as compared to solution, with the same antimicrobial effect.
Objectives. This study aimed to compare the amount of the apical extrusion of NaOCl gel and solution in immature permanent teeth.
Material and Methods. A crossover in vitro study was conducted at the Department of Pediatric Dentistry, Faculty of Dentistry of Damascus University, Syria. Thirty freshly extracted immature single-rooted human premolars were decoronated and the cavity was then accessed. The teeth were radiographed to determine the mesiodistal dimension of the apex. In addition, the surface area of the apical foramen was calculated with Adobe Photoshop® to evaluate the amount of extrusion from the whole surface of the apex. The teeth were divided into 2 groups according to the size of the apex: ≤2.5 mm (group A) and >2.5 mm (group B); each group was irrigated with 5 mL of NaOCl solution and 2 different commercial types of NaOCl gel for 60 s, and then the extruded irrigant was measured in a plastic vial.
Results. The data was analyzed using the Kruskal–Wallis analysis. Based on the observed results, a statistically significant difference was noted (p = 0) between NaOCl solution and gel when the apical diameter was ≤2.5 mm, while there was no significant difference between the 2 types of NaOCl gel. No statistically significant difference was observed (p = 0.2) between NaOCl solution and gel when the apical diameter was >2.5 mm.
Conclusion. Sodium hypochlorite gel is safer than solution when irrigating immature teeth with the apical diameter ≤2.5 mm.

Key words

sodium hypochlorite, apical extrusion, immature teeth

Słowa kluczowe

podchloryn sodu, przepchnięcie wierzchołkowe, niedojrzałe zęby

References (22)

  1. Wright PP, Walsh LJ. Optimizing antimicrobial agents in endodontics. In: Kumavath RN, ed. Antimicrobial Agents. Croatia: InTech; 2017:87–107.
  2. Rahimi S, Janani M, Lotfi M, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014;9(3):161–168.
  3. Mohammadi Z. Sodium hypochlorite in endodontics: An update review. Int Dent J. 2008;58(6):329–341.
  4. Guivarc’h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. Sodium hypochlorite accident: A systematic review. J Endod. 2017;43(1):16–24.
  5. Kleier DJ, Averbach RE, Mehdipour O. The sodium hypochlorite accident: Experience of diplomates of the American Board of Endo­dontics. J Endod. 2008;34(11):1346–1350.
  6. Mathew ST. Risks and management of sodium hypochlorite in endo­dontics. J Oral Hyg Heal. 2015;3(3):3–7.
  7. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: A treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod. 2013;39(3):319–326.
  8. da Silva Limoeiro AG, dos Santos AHB, Kato AS, Freire LG, da Silveira Bueno CE. Pulp revascularization: A case report [in Portuguese]. Dent Press Endod. 2015;5(2):74–77.
  9. Saeki K, Fujita Y, Shiono Y, Morimoto Y, Maki K. Pulp revascularization in immature permanent tooth with apical periodontitis using mineral trioxide aggregate. Case Rep Med. 2014;2014:564908.
  10. Namour M, Theys S. Pulp revascularization of immature permanent teeth: A review of the literature and a proposal of a new clinical protocol. ScientificWorldJournal. 2014;2014:737503.
  11. He L, Zhong J, Gong Q, et al. Treatment of necrotic teeth by apical revascularization: Meta-analysis. Sci Rep. 2017;7(1):13941.
  12. Martin DE, de Almeida JF, Henry MA, et al. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod. 2014;40(1):51–55.
  13. Balani P, Niazi F, Rashid H. A brief review of the methods used to determine the curvature of root canals. J Res Dent. 2015;3:57–63.
  14. Nielsen BA, Craig Baumgartner J. Comparison of the EndoVac System to needle irrigation of root canals. J Endod. 2007;33(5):611–615.
  15. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and canal master techniques. J Endod. 1991;17(6):275–279.
  16. Aksel H, Askerbeyli S, Cigdem C, Serper A. Effect of needle insertion depth and apical diameter on irrigant extrusion in simulated immature permanent teeth. Braz Oral Res. 2014;28(1):1–6.
  17. Velmurugan N, Sooriaprakas C, Jain P. Apical extrusion of irrigants in immature permanent teeth by using EndoVac and needle irrigation: An in vitro study. J Dent (Tehran). 2014;11(4):433–439.
  18. Al-Sudani DA, Al Omar HA. Evaluation of sodium hypochlorite (NaOCl) gel as an endodontic irrigant. J Biomater Tissue Eng. 2011;1(2):215–218.
  19. Zand V, Lotfi M, Soroush MH, Abdollahi AA, Sadeghi M, Mojadadi A. Antibacterial efficacy of different concentrations of sodium hypochlorite gel and solution on Enterococcus faecalis biofilm. Iran Endod J. 2016;11(4):315–319.
  20. Nejad Shamsi P, Atash Biz Yeganeh L, Vadiati Saberi B, Forghan Parast K, Taghavi Kashan A. Antibacterial effect of sodium hypochlorite gel and solution on Enterococcus faecalis. 3DJ. 2017;6(1):27–30.
  21. Arora S, Tewari S. The morphology of the apical foramen in posterior teeth in a North Indian population. Int Endod J. 2009:42(10):930–939.
  22. Jena A, Sahoo SK, Govind S. Root canal irrigants: A review of their interactions, benefits, and limitations. Compend Contin Educ Dent. 2015;36(4):256–261.