Root Canal Irrigation Practice Among General Dental Practitioners in Misurata-Libya: A cross Sectional Study
Keywords:
Root canal irrigation, Irrigation practice , Surveying, dental practitionersAbstract
Objective: The aim of this survey was to evaluate the current trends in the practice of general dental practitioners regarding the root canal irrigation during endodontic treatment in private and governmental dental clinics in Misurata- Libya.
Materials and Methods: A descriptive questionnaire survey was circulated among 220 general dental practitioners in private and governmental dental clinics in Misurata-Libya. The analysis of data was performed using SPSS. The descriptive statistics were used for determination of the frequency and percentage of the participant's responses. Chi-Square test was used to assess the impact of work sector and professional experience on the responses (P < 0.05).
Results: A total of 186 completed the survey questionnaire, giving a response rate of 84.5%. Around 99% of respondents used sodium hypochlorite in irrigation protocol while EDTA was included by 42%. 60% of respondents used full strength sodium hypochlorite (5.25%). 83.3% of respondents used smaller needle gauge (25 and 27). 68% of respondents used syringe capacity ˃5.0 ml. Only 45% of respondents used irrigation adjuncts and 89% agitate the irrigation solution manually. Around 38% of respondents insert the irrigation needle 2-3 mm from the apex. The majority of respondents irrigate the root canals ˂ 10 minutes and do not change their primary irrigation solution according to the pulpal or periapical status. No significant impact observed for either the working sector or professional experience on the responses.
Conclusion: General dental practitioners in Misurata should be encouraged to introduce various techniques and adjuncts to improve the efficacy of endodontic irrigants.
References
Siqueira Junior JF, das Neves Rôças I, Marceliano-Alves MF, Pérez, AR, Ricucci, D. Unprepared root canal surface areas: Causes, clinical implications, and therapeutic strategies. Braz. Oral Res. 2018; 32: e65.
https://pubmed.ncbi.nlm.nih.gov/30365606/
Zehnder M: Root canal irrigants. J Endod. 2006; 32:389-98.
https://pubmed.ncbi.nlm.nih.gov/16631834/
Ricucci D, Siqueira, JF, Bate, AL, Pitt Ford TR. Histologic investigation of root canal-treated teeth with apical periodontitis: A retrospective study from twenty-four patients. J. Endod. 2009; 35:493–502.
https://pubmed.ncbi.nlm.nih.gov/19345793/
Vera J, Siqueira JF, Ricucci D, Loghin S, Fernández N, Flores B, Cruz AG. One- versus two-visit endodontic treatment of teeth with apical periodontitis: A histobacteriologic study. J Endod. 2012;38:1040–1052.
https://pubmed.ncbi.nlm.nih.gov/22794203/
Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello, S. Irrigating solutions and activation methods used in clinical endodontics: A systematic review. Front. Oral Health 2022; 3: 838043
https://pubmed.ncbi.nlm.nih.gov/35174355/
Carr GB, Schwartz RS, Schaudinn C, Gorur A, Costerton JW. Ultrastructural examination of failed molar retreatment with secondary apical periodontitis: an examination of endodontic biofilms in an endodontic retreatment failure. J Endod. 2009;35:1303-1309.
https://pubmed.ncbi.nlm.nih.gov/19720237/
Siqueira JF, Rôças IN. Clinical Implications and microbiology of bacterial persistence after treatment procedures. J Endod 2008; 34, 1291–1301.
https://pubmed.ncbi.nlm.nih.gov/18928835/
Violich DR, Chandler NP. The smear layer in endodontics A Review. Int Endod J. 2010; 43, 2–15.
https://pubmed.ncbi.nlm.nih.gov/20002799/
Mohammadi, Z, Shalavi S, Yaripour S, Kinoshita JI, Manabe A, Kobayashi M, Giardino L, Palazzi F, Sharifi F, Jafarzadeh H. Smear layer removing ability of root canal irrigation solutions: A Review J Contemp Dent Pract. 2019; 20, 395–402.
https://pubmed.ncbi.nlm.nih.gov/31204334/
Parente JM, Loushine RJ, Susin L, et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J. 2010;43(11):1001-12.
https://pubmed.ncbi.nlm.nih.gov/20722753/
Haapasalo M, Shen Y, Qian W, et al. Irrigation in endodontics. Dent Clinics 2010; 54:291-312.
https://pubmed.ncbi.nlm.nih.gov/20433979/
Ghivari SB, Bhattacharya H, Bhat KG, Pujar MA. Antimicrobial activity of root canal irrigants against biofilm forming pathogens- An in vitro study. J Conserv Dent. 2017;20(3):147-151.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706312/
Luddin N, Ahmed HM. The antibacterial activity of sodium hypochlorite and chlorhexidine against Enterococcus faecalis: A review on agar diffusion and direct contact methods. J Conserv Dent. 2013;16:9–16.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548356/
Taneja S, Mishra N, Malik S. Comparative evaluation of human pulp tissue dissolution by different concentrations of chlorine dioxide, calcium hypochlorite and sodium hypochlorite: An in vitro study. J Cons Dent. 2014;17:541–545.
https://pubmed.ncbi.nlm.nih.gov/25506141/
Mohammadi Z. Sodium hypochlorite in endodontics: An update review. Int Dent J. 2008;58:329–341.
https://pubmed.ncbi.nlm.nih.gov/19145794/
Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:658-666.
https://pubmed.ncbi.nlm.nih.gov/12464887/
Cai X, Wang X, Santarcangelo F, Schoeffel GJ, Bergeron BE, Tay FR, Niu L. Effect of simulated intraosseous sinusoidal pressure on NaOCl extrusion. J Dent. 2018; 78:46–50.
https://pubmed.ncbi.nlm.nih.gov/12464887/
Giardino L, Pedullà E, Cavani F, Bisciotti F, Giannetti L, Checchi V, Angerame D, Consolo U, Generali L. Comparative evaluation of the penetration depth into dentinal tubules of three endodontic irrigants. Materials 2021;14:5853.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510083/
Hülsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J. 2003;36: 810-830.
https://pubmed.ncbi.nlm.nih.gov/14641420/
Ballal NV,Mala K, Bhat KS. Effect of maleic acid and ethylenediaminetetraacetic acid on the dissolution of human pulp tissue–an in vitro study Int Endod J. 2011;44:353-356.
https://pubmed.ncbi.nlm.nih.gov/21219363/
Rocas IN, Siqueira JF. Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: A molecular microbiology study. J Endod. 2011;37:143–150
https://pubmed.ncbi.nlm.nih.gov/21238793/
Bernardi A, Teixeira CS. The properties of chlorhexidine and undesired effects of its use in endodontics. Quintessence Int. 2015;46:575–582.
https://pubmed.ncbi.nlm.nih.gov/25918757/
Klein U, Kleier DJ. Sodium hypochlorite accident in a pediatric patient. Pediatr. Dent. 2013;35: 534–538.
https://pubmed.ncbi.nlm.nih.gov/24553278/
Topbas C, Adiguzel O: Endodontic irrigation solutions: a review. Int dent res. 2017;7:54-61.
https://www.dental-research.com/idr/article/view/102
Haapasalo M, Shen Y, Wang Z, Gao Y: Irrigation in endodontics. Br Dent J. 2014; 216:299-303.
https://pubmed.ncbi.nlm.nih.gov/24651335/
Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello S. Irrigating solutions and activation methods used in clinical endodontics: A Systematic Review. Front Oral Health. 2022; 31;3:838043.
https://pubmed.ncbi.nlm.nih.gov/35174355/
Susila A, Minu J. Activated Irrigation vs. Conventional non-activated irrigation in endodontics - A Systematic Review. Eur Endod J. 2019;4:96-110.
https://pubmed.ncbi.nlm.nih.gov/32161895/
Weise M, Roggendorf MJ, Ebert J, Petschelt A, et al.. Four methods for cleaning simulated lateral extensions of curved root canals-a SEM evaluation. Int Endod J. 2007;40:979–1007.
https://www.researchgate.net/publication/285912517
Eggmann F, Vokac Y, Eick S, Neuhaus KW. Sonic irrigant activation for root canal disinfection: Power modes matter. . BMC Oral Health. 2020;20:102.
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Copyright (c) 2023 Idris Mohamed Mehdawi، Jamal Mustafa El-Swiah، Walid Mohamed Elmahdi
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