Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
권호 표지
DOI QR코드

DOI QR Code

Enhanced visualization of the root canal morphology using a chitosan-based endo-radiopaque solution

  • Shashirekha Govind (Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University) ;
  • Amit Jena (Department of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University) ;
  • Satabdi Pattanaik (Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University) ;
  • Mahaprasad Anarasi (Department of Conservative Dentistry and Endodontics, Hi-Tech Dental College & Hospital, Utkal University) ;
  • Satyajit Mohapatra (Department of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University) ;
  • Vinay Shivagange (Adult Restorative Dentistry - Endodontics, Oman Dental College, University Complutense of Madrid)
  • Received : 2020.08.26
  • Accepted : 2020.12.09
  • Published : 2021.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy. Materials and Methods: In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01). Results: In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions: CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

Keywords

Acknowledgement

The authors would like to thank Professor Sushant Kumar Kamila, Department of Physics ITER, Siksha 'O' Anusandhan Deemed to be University, Odisha India and, Professor Uma Sankar Mishra, Faculty of Management Sciences, Siksha 'O' Anusandhan Deemed to be University, Odisha India.

References

  1. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005;10:3-29. https://doi.org/10.1111/j.1601-1546.2005.00129.x
  2. Cleghorn BM, Christie WH, Dong CC. The root and root canal morphology of the human mandibular first premolar: a literature review. J Endod 2007;33:509-516. https://doi.org/10.1016/j.joen.2006.12.004
  3. Sachdeva GS, Ballal S, Gopikrishna V, Kandaswamy D. Endodontic management of a mandibular second premolar with four roots and four root canals with the aid of spiral computed tomography: a case report. J Endod 2008;34:104-107. https://doi.org/10.1016/j.joen.2007.10.004
  4. Barker BC, Parsons KC, Mills PR, Williams GL. Anatomy of root canals. I. Permanent incisors, canines and premolars. Aust Dent J 1973;18:320-327. https://doi.org/10.1111/j.1834-7819.1973.tb03493.x
  5. Hession RW. Endodontic morphology. I. An alternative method of study. Oral Surg Oral Med Oral Pathol 1977;44:456-462. https://doi.org/10.1016/0030-4220(77)90416-9
  6. Lowman JV, Burke RS, Pelleu GB. Patent accessory canals: incidence in molar furcation region. Oral Surg Oral Med Oral Pathol 1973;36:580-584. https://doi.org/10.1016/0030-4220(73)90316-2
  7. Mahale US, Hegde MN, Shetty A, Patil A. Iopamidol in comparison with meglumine sodium diatrizoate in different concentrations as contrast media in clinical endodontics - in vivo study. Indian J Appl Res 2013;3:410-413.
  8. Ahmed HM. Guidelines to enhance the interpretation of two-dimensional periapical radiographic images in endodontics. Eur J Gen Dent 2015;4:106.
  9. Del Carpio-Perochena A, Bramante CM, Duarte MA, de Moura MR, Aouada FA, Kishen A. Chelating and antibacterial properties of chitosan nanoparticles on dentin. Restor Dent Endod 2015;40:195-201. https://doi.org/10.5395/rde.2015.40.3.195
  10. Goy RC, Britto DD, Assis OB. A review of the antimicrobial activity of chitosan. Polimeros 2009;19:241-247. https://doi.org/10.1590/S0104-14282009000300013
  11. Rabea EI, Badawy ME, Stevens CV, Smagghe G, Steurbaut W. Chitosan as antimicrobial agent: applications and mode of action. Biomacromolecules 2003;4:1457-1465. https://doi.org/10.1021/bm034130m
  12. Fatimi A, Chabrot P, Berrahmoune S, Coutu JM, Soulez G, Lerouge S. A new injectable radiopaque chitosanbased sclerosing embolizing hydrogel for endovascular therapies. Acta Biomater 2012;8:2712-2721. https://doi.org/10.1016/j.actbio.2012.04.006
  13. Zehtabi F, Dumont-Mackay V, Fatimi A, Bertrand-Grenier A, Heon H, Soulez G, Lerouge S. Chitosan-sodium tetradecyl sulfate hydrogel: characterization and preclinical evaluation of a novel sclerosing embolizing agent for the treatment of endoleaks. Cardiovasc Intervent Radiol 2017;40:576-584. https://doi.org/10.1007/s00270-016-1557-1
  14. Shashirekha G, Jena A, inventors; Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, assignee. Endo-radiopaque composition for visualizing the complex root canal anatomy. India patent IN 334776. 2020 Mar 16. 
  15. Aditya S, Mithra H, Divya T, Aum J, Darshana D. Study on the efficacy of Iodine based contrast media for interpretation of root canal anatomy. Int Res J Pharm 2013;4:207-210. https://doi.org/10.7897/2230-8407.04344
  16. Naoum HJ, Love RM, Chandler NP, Herbison P. Effect of X-ray beam angulation and intraradicular contrast medium on radiographic interpretation of lower first molar root canal anatomy. Int Endod J 2003;36:12-19. https://doi.org/10.1046/j.0143-2885.2003.00604.x
  17. Fournier PJ, Steinbrich W, Freitag P, Voegeli E. Evaluation of the clinical safety and efficacy of iobitridol (Xenetix) in intravenous urography. Eur J Radiol 1996;23:185-189. https://doi.org/10.1016/S0720-048X(96)01083-2
  18. Lefevre T, Funck F, Aliot E, Ethevenot B. Safety and efficacy of the new iodinated nonionic low-osmolality contrast medium Iobitridol (Xenetix) in coronary and ventricular angiography. Acta Radiol Suppl 1996;400:75-80. 
  19. Rossignol AM, Lusson JR, Chantepie A, Losay J. Safety and efficacy of Xenetix, a new iodinated contrast agent, in pediatric angiocardiography. Acta Radiol Suppl 1996;400:81-84.
  20. Jena A, Sahoo SK, Govind S. Root canal irrigants: a review of their interactions, benefits, and limitations. Compend Contin Educ Dent 2015;36:256-261.
  21. Pattanshetti N, Gaidhane M, Al Kandari AM. Root and canal morphology of the mesiobuccal and distal roots of permanent first molars in a Kuwait population--a clinical study. Int Endod J 2008;41:755-762. https://doi.org/10.1111/j.1365-2591.2008.01427.x
  22. Peiris HR, Pitakotuwage TN, Takahashi M, Sasaki K, Kanazawa E. Root canal morphology of mandibular permanent molars at different ages. Int Endod J 2008;41:828-835. https://doi.org/10.1111/j.1365-2591.2008.01428.x
  23. Reis AG, Grazziotin-Soares R, Barletta FB, Fontanella VR, Mahl CR. Second canal in mesiobuccal root of maxillary molars is correlated with root third and patient age: a cone-beam computed tomographic study. J Endod 2013;39:588-592. https://doi.org/10.1016/j.joen.2013.01.003
  24. Tang MP, Stock CJ. An in vitro method for comparing the effects of different root canal preparation techniques on the shape of curved root canals. Int Endod J 1989;22:49-54. https://doi.org/10.1111/j.1365-2591.1989.tb00506.x
  25. Silva PV, Guedes DF, Nakadi FV, Pecora JD, Cruz-Filho AM. Chitosan: a new solution for removal of smear layer after root canal instrumentation. Int Endod J 2013;46:332-338. https://doi.org/10.1111/j.1365-2591.2012.02119.x
  26. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the cleaning and shaping of root canals: a digital subtraction radiographic study. Int Endod J 2010;43:275-282. https://doi.org/10.1111/j.1365-2591.2009.01677.x
  27. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 2010;43:663-672. https://doi.org/10.1111/j.1365-2591.2010.01723.x
  28. Munoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod 2012;38:445-448. https://doi.org/10.1016/j.joen.2011.12.007
  29. Alonso-Ezpeleta LO, Gasco-Garcia C, Castellanos-Cosano L, Martin-Gonzalez J, Lopez-Frias FJ, Segura-Egea JJ. Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: comparison of three different obturation techniques. Med Oral Patol Oral Cir Bucal 2012;17:e721-e727.