O objetivo desse estudo in vivo foi avaliar a intensidade de expressão de moléculas indicadoras da diferenciação celular com fenótipo mineralizador em dentes de cães com rizogênese incompleta e lesão periapical induzida experimentalmente submetidos à irrigação dos canais radiculares por pressão apical negativa (EndoVac®) e à irrigação por pressão apical positiva (irrigação convencional). Foram utilizados 30 dentes (60 raízes), divididos em 3 grupos: Grupo EndoVac® Irrigação com pressão apical negativa (n=20), Grupo Convencional Irrigação com pressão apical positiva (n=20); e Grupo Controle com Lesão Periapical (n=20). Após indução de lesões periapicais, os canais radiculares dos grupos Endovac e Convencional foram instrumentados com limas manuais, empregando o sistema de irrigação correspondente. Decorridos 90 dias, os animais foram eutanasiados e os espécimes submetidos ao processamento histotécnico. Cortes representativos de cada grupo foram corados com hematoxilina e eosina (HE), para descrição histopatológica das regiões apical e periapical. Os cortes foram submetidos à para marcação de osteopontina (OPN), fosfatase alcalina (ALP) e fator de transcrição RUNX2 nas regiões apical e periapical das raízes. Para avaliação da intensidade da expressão desses marcadores foi realizada uma análise semi-quantitativa por meio de um sistema de escores. Os dados foram analisados estatisticamente pelo teste não-paramétrico de Kruskal-Wallis e pós-teste de Dunn e o nível de significância adotado foi de 5%. Com relação à descrição histopatológica, achados distintos foram observados em cada grupo. Resumidamente, o grupo Endovac demonstrou um tecido conjuntivo bem organizado, invaginando-se para o interior do canal radicular, e exibiu um processo de reparo mais avançado, com relação aos demais grupos. A avaliação das imunomarcações para RUNX2 revelou que no grupo Endovac® houve marcação significantemente mais intensa (p=0,03), em comparação ao grupo controle. Com relação à expressão de OPN, não foi possível encontrar diferença estatisticamente significante entre os grupos (p=0,15). Após análise das imunomarcações para ALP, observou-se diferença estatisticamente significante entre os grupos (p=0,0021), sendo que o grupo Endovac® apresentou marcação significantemente mais intensa com relação ao grupo controle. Os resultados do presente estudo in vivo permitiram concluir que a irrigação por pressão apical negativa (EndoVac®) apresentou potencial mineralizador, indicando ser o melhor sistema de irrigação para dentes com ápice incompleto e lesão periapical / The objective of this in vivo study was to evaluate the expression intensity of molecules indicating cell differentiation with mineralizing phenotype in immature dogs teeth with experimentally induced apical periodontitis subjected to irrigation of root canals using negative apical pressure (EndoVac®) and positive apical pressure (conventional irrigation). Thirty teeth (60 roots) were divided into 3 groups: EndoVac® Group - negative apical pressure irrigation (n=20), Conventional Group - positive apical pressure irrigation (n=20); and Control Group with apical periodontitis (n=20). After induction of periapical lesions, the root canals of the EndoVac ® and Conventional groups were instrumented with hand files, using the corresponding irrigation system. After 90 days, the animals were euthanized and the specimens were submitted to histotechnical processing. Representative sections of each group were stained with hematoxylin and eosin (HE) for histopathological description of the apical and periapical regions. The sections were submitted to osteopontin (OPN), alkaline phosphatase (ALP) and RUNX2 transcription factor Immunostaining in the apical and periapical regions of the roots. A semi-quantitative analysis was performed to evaluate the expression intensity of these markers, using a score system. Data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. Regarding the histopathological description, different findings were observed in each group. Briefly, the EndoVac® group demonstrated a well-organized connective tissue, invaginating into the root canal, and exhibited a more advanced repair process in relation to the other groups. RUNX2 immunostaining revealed that in the EndoVac® group there was a significantly stronger (p=0.03) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to find a statistically significant difference between the groups (p=0.15). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p=0.0021), and the EndoVac® group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation (EndoVac®) presented mineralizing potential, indicating that it is the best irrigation system for teeth with an open apex and apical periodontitis

Mechanical and chemical debridement plays an important role in reducing intracanal microorganisms. Effective root canal irrigation depends on both the root canal irrigant and irrigation system. The objective of this study was to evaluate the debridement efficiency of four root canal irrigation systems, Endovac®, PiezoFlow™, EndoActivator® and traditional needle irrigation using saline as an irrigant. Seventy-five, single canal, extracted, mature teeth were selected. Teeth were standardized to canal lengths of 15 mm and instrumented to Master Apical File size #40 with 4% taper. Teeth were mounted in a centrifuge tube using PVS impression material. Teeth were randomly divided into four experimental groups (n=15) and one control group (n=15). The root canals were inoculated with 24-hour culture of Streptococcus mutans and incubated for 72 hours. Saline was delivered via each of the irrigation systems at the rate of 7 ml/min using a precision syringe pump. Immediately following the treatment, samples were collected from the untreated control and the experimental groups and plated on agar plates. Results were analyzed using repeated measures ANOVA and Tukey’s HSD multiple comparison tests. All the experimental groups were significantly better than the control group (p<0.0001). Among the experimental groups, Endovac® and PiezoFlow™ were significantly better in reducing microorganisms compared to needle and EndoActivator® groups (p<0.05). There was no statistical difference between Endovac® and PiezoFlow™. Debridement efficiency of Endovac® and PiezoFlow™ is better than needle and EndoActivator® irrigation systems using saline as an irrigant. Funded by Alexander Fellowship, VCU School of Dentistry.

O presente estudo teve por objetivo avaliar in vivo a eficácia do preparo de canais radiculares na redução bacteriana em dentes portadores de periodontite apical primária, com auxílio do sistema EndoVac de irrigação e aspiração. Foram coletadas amostras dos canais radiculares de 20 pacientes, antes (S1) e após (S2) o preparo com instrumentos rotatórios Protaper, variando somente a técnica utilizada para irrigação e aspiração: Grupo A (irrigação convencional n=10) e Grupo B (irrigação com auxílio do sistema EndoVac n=10). Após a extração do DNA presente nas amostras, este foi quantificado através da reação de PCR em tempo real, pelo método SYBR Green, identificando o número de cópias do gene 16SrRNA. Em todas as amostras, com exceção de uma pós-preparo com EndoVac, foram identificadas cópias do gene alvo. A média para todos os casos foi de 1,6 X 108 e 8,8 X 105 cópias do 16SrRNA, antes e após o preparo, respectivamente. Para os grupos isoladamente, os mesmos valores foram: 2,0 X 108 e 5,5 X 105 (convencional), e 1,1 X 108 e 1,2 X 106 (EndoVac). O percentual médio de redução foi de 97,52% (97,02% para convencional e 98,04% para o EndoVac). O teste de Mann-Whitney permitiu concluir que ambas as técnicas reduziram significativamente os microrganismos presentes antes do preparo (p<0,0001), sem haver diferença entre as mesmas (p=0,9705). Nenhuma das técnicas foi efetiva na eliminação completa de bactérias sob a metodologia utilizada. A eficácia antibacteriana do sistema EndoVac, sob esta metodologia, foi semelhante a obtida com a irrigação e aspiração convencional. / The present study aimed to analyze in vivo the effectiveness of root canal preparation on bacterial reduction in patientss teeth with primary apical periodontitis. Samples were collected from 20 patients before (S1) and after (S2) preparation with ProTaper rotary files, varying only the technique used for irrigation and aspiration: Group A (conventional irrigation - n = 10) and Group B (with the aid of EndoVac system - n = 10). After extraction, the DNA present in the samples was quantified by real-time PCR with the SYBR Green method, identifying the number of 16SrRNA gene copies. In all samples, except for a post-preparation case with EndoVac, copies of the target gene were identified. Average for all cases was 1,6 X 108 and 8,8 X 105 copies of the 16SrRNA, before and after preparation, respectively. For the groups separately, the same values were 2,0 X 108 and 5,5 X 105 (conventional) and 1,1 X 108 and 1,2 X 106 (EndoVac). The mean percentage of reduction was 97.52% (97.02% for the conventional and 98.04% for the EndoVac). The Mann-Whitney test concluded that both techniques significantly reduced the microrganisms after preparation (p<0,0001), with no differences between them (p=0,9705). None of the techniques were effective in the complete elimination of bacteria under this methodology. The antibacterial efficacy of the EndoVac system under this methodology was similar to that obtained with conventional irrigation and aspiration.

O presente estudo teve por objetivo avaliar in vivo a eficácia do preparo de canais radiculares na redução bacteriana em dentes portadores de periodontite apical primária, com auxílio do sistema EndoVac de irrigação e aspiração. Foram coletadas amostras dos canais radiculares de 20 pacientes, antes (S1) e após (S2) o preparo com instrumentos rotatórios Protaper, variando somente a técnica utilizada para irrigação e aspiração: Grupo A (irrigação convencional n=10) e Grupo B (irrigação com auxílio do sistema EndoVac n=10). Após a extração do DNA presente nas amostras, este foi quantificado através da reação de PCR em tempo real, pelo método SYBR Green, identificando o número de cópias do gene 16SrRNA. Em todas as amostras, com exceção de uma pós-preparo com EndoVac, foram identificadas cópias do gene alvo. A média para todos os casos foi de 1,6 X 108 e 8,8 X 105 cópias do 16SrRNA, antes e após o preparo, respectivamente. Para os grupos isoladamente, os mesmos valores foram: 2,0 X 108 e 5,5 X 105 (convencional), e 1,1 X 108 e 1,2 X 106 (EndoVac). O percentual médio de redução foi de 97,52% (97,02% para convencional e 98,04% para o EndoVac). O teste de Mann-Whitney permitiu concluir que ambas as técnicas reduziram significativamente os microrganismos presentes antes do preparo (p<0,0001), sem haver diferença entre as mesmas (p=0,9705). Nenhuma das técnicas foi efetiva na eliminação completa de bactérias sob a metodologia utilizada. A eficácia antibacteriana do sistema EndoVac, sob esta metodologia, foi semelhante a obtida com a irrigação e aspiração convencional. / The present study aimed to analyze in vivo the effectiveness of root canal preparation on bacterial reduction in patientss teeth with primary apical periodontitis. Samples were collected from 20 patients before (S1) and after (S2) preparation with ProTaper rotary files, varying only the technique used for irrigation and aspiration: Group A (conventional irrigation - n = 10) and Group B (with the aid of EndoVac system - n = 10). After extraction, the DNA present in the samples was quantified by real-time PCR with the SYBR Green method, identifying the number of 16SrRNA gene copies. In all samples, except for a post-preparation case with EndoVac, copies of the target gene were identified. Average for all cases was 1,6 X 108 and 8,8 X 105 copies of the 16SrRNA, before and after preparation, respectively. For the groups separately, the same values were 2,0 X 108 and 5,5 X 105 (conventional) and 1,1 X 108 and 1,2 X 106 (EndoVac). The mean percentage of reduction was 97.52% (97.02% for the conventional and 98.04% for the EndoVac). The Mann-Whitney test concluded that both techniques significantly reduced the microrganisms after preparation (p<0,0001), with no differences between them (p=0,9705). None of the techniques were effective in the complete elimination of bacteria under this methodology. The antibacterial efficacy of the EndoVac system under this methodology was similar to that obtained with conventional irrigation and aspiration.

No description available.

Indiana University School of Dentistry located on the campus of Indiana University-Purdue University Indianapolis (IUPUI) / This in-vitro, prospective, randomized study microscopically compared the debridement efficacy of negative pressure irrigation with the EndoVac (Discus Dental, Culver City, CA) versus the Canal CleanMax (Maximum Dental, Inc., Secaucus, NJ). Sixty extracted human canines were instrumented using a combination of hand-instrumentation with Lexicon K-type files and rotary instrumentation with ProTaper files. All canals were irrigated with 6.0-percent sodium hypochlorite and 17- percent ethylenediaminetetraacetic acid (EDTA). However, the irrigation/aspiration techniques differed among three groups of 20 randomly selected teeth. Group one (control) was irrigated with only a 12-ml Monoject syringe via 30-gauge side-vented, closed-end needle. Group two was irrigated with the EndoVac system. Group three was irrigated similar to group one, but with the adjunct of the Canal CleanMax system. All teeth were sectioned longitudinally, and the more intact sections were divided into coronal, middle, and apical thirds. Each portion of the canal was photographed with a scanning electron microscope (SEM). The photographs were scored by two independent examiners according to relative amount of debris and/or smear layer present, as well as relative number of patent dentinal tubules. These scores were statistically analyzed using a Krustal-Wallis test and Wilcoxon Rank Sum tests to determine differences between groups. The coronal aspect of root canal walls irrigated with the EndoVac system exhibited significantly less debris and/or smear layer present when compared to the coronal aspect of root canals irrigated with only a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle (control). There were no other significant differences in scores between any groups at any location. For all locations combined, the EndoVac system produced significantly cleaner root canal walls as compared to the control. No significant differences were seen between the Canal CleanMax and Control or Canal CleanMax and EndoVac. This study suggested negative pressure irrigation delivery with the EndoVac system during and after hand-rotary instrumentation is more effective in removal of debris and smear layer from the coronal third and combined thirds of root canal walls compared to irrigation with a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle.