Transcript

0393-974X (2019)Copyright © by BIOLIFE, s.a.s.

This publication and/or article is for individual use only and may not be further

reproduced without written permission from the copyright holder.

DISCLOSURE: ALL AUTHORS REPORT NO CONFLICTS OF

INTEREST RELEVANT TO THIS ARTICLE.1

JOURNAL OF BIOLOGICAL REGULATORS & HOMEOSTATIC AGENTS Vol. 33, no. 3 (S1), 1-9 (2019)

material to the root canal’s walls, is agreed by everyone

can induce a bleeding in the canal that can sometimes

more than one session.

blood comes from the canal system and often needs

causes of bleeding can be due to iatrogenic factors

anatomical factors, such as minor or ignored canals

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics;

this may result in apical microleakage. The purpose of this investigation was to observe and evaluate

EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping.

A prospective study was designed with 2 randomized parallel groups: decontaminant material

(experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

sodium hypochlorite 5% in 30 patients (control group). T-test showed that the percentage change in

millimeters of blood detected in the root canal was statistically greater for experimental group [mean

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

the results of this study.

Key words: calcium hydroxide, endodontic treatment, root canal bleeding, root canal exudation

Corresponding author:

Dr. Luca Di Nasso,

e-mail: [email protected]

THE EFFECTS OF A NEW DECONTAMINANT SOLUTION ON ROOT CANAL BLEEDING

DURING ENDODONTIC TREATMENT: A RANDOMIZED CONTROLLED STUDY

R. PACE1 1 2, L. TAURO1,1 1

1Department of Endodontics, University of Florence, Florence, Italy; 2Department of biostatistics,

University of Milan, Milan, Italy

material to the root canal’s walls, is agreed by everyone

can induce a bleeding in the canal that can sometimes

more than one session.

blood comes from the canal system and often needs

causes of bleeding can be due to iatrogenic factors

anatomical factors, such as minor or ignored canals

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics;

this may result in apical microleakage. The purpose of this investigation was to observe and evaluate

EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping.

A prospective study was designed with 2 randomized parallel groups: decontaminant material

(experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

sodium hypochlorite 5% in 30 patients (control group). st showed that the percentage change in

millimeters of blood detected in the root canal was statistically greater for experimental group [mean

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

the results of this study.

Key words: calcium hydroxide, endodontic treatment, root canal bleeding, root canal exudation

DURING ENDODONTIC TREATMENT: A RANDOMIZED CONTROLLED STUDY

R. PACE1 1 2, L. TAURO1,1 1

1Department of Endodontics, University of Florence, Florence, Italy; 2Department of biostatistics, 2

University of Milan, Milan, Italy

EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping.

A prospective study was designed with 2 randomized parallel groups: decontaminant material

(experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

sodium hypochlorite 5% in 30 patients (control group).

millimeters of blood detected in the root canal was statistically greater for experimental group [mean

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics;

st showed that the percentage change in

EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping.

A prospective study was designed with 2 randomized parallel groups: decontaminant material

(experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

sodium hypochlorite 5% in 30 patients (control group).

millimeters of blood detected in the root canal was statistically greater for experimental group [mean

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics;

Department of Endodontics, University of Florence, Florence, Italy;

University of Milan, Milan, Italy

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

sodium hypochlorite 5% in 30 patients (control group).

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced

in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study

(experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics; Blood contamination of the canal during preparation and obturation can be a problem in Endodontics;

in the canal that can sometimes

blood comes from the can

causes of bleeding can be

anatomical factors, such a

calcium hydroxide, endodontic treatment, root canal bleeding, root

anal’s walls, is agreed by everyone

g prep

ge. The purpose of this investigation was

ith necrotic pulp and unstoppablble e bleeding a

gngneded w witith h 2 2 rarararararandndomomizizeded p pararalallelel l grgroups:

odododiuiuiuium m m hyhyhypopochchlololoririririririririririritetetetetetetetetetetetete 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5% % % % % % % % % % (c(contrtrolol g g grorororoupupupupupupupup).).). The ana

%,%,%,%,%, b b b by y y y mememememeasasurururinininining g g thththe e mimimillllllimimimeteteteteterers s ofofof b b blololoodododod o o o o on n a sterile

atientnts s wiwiwiwithth necrorotitic c c c c c c c pupupupupupupupulplplplp a a a a andndndndndnd u unstoppppabablele bleleeding we

into 2 grgrououps: decontntamamininanant t t mamateterial in 30 patients

5% in 30 patients (c(cononontrtrtrolol g g groroupupup).). T-test showed that thTT

detected in the r roooot cacanananananal wawas s ststatatistically greater for ex

0.66-0.82); p<0.000101].]. T Thehe h h h hemememosostatatic properties were be

udy.

cal microleakage

sed in teeth with

y was dedededededesisisisisigngn

p) and sododododododiuiu

rite 5%,%,

ixty pat

ed int

e 5%

p)

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%,

atat

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ixty

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and

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s

teeeethth

microlea

th

s

blood comes from the canal system and often needs

st showed that the percentage change in

and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or

st showed that the percentage change in

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

st showed that the percentage change in

millimeters of blood detected in the root canal was statistically greater for experimental group [mean

difference: 0.74 (IC: 0.66-0.82); p<0.0001]. The hemostatic properties were better in the experimental

decontaminant device in cases of teeth with necrotic

canals. The ability of the decontaminant device to

was to test the reduction of root canal bleeding in

Study population

able and willing to sign a consent form, single-

diseases, using anticoagulants, antibiotics, or anti-

They also received information on the duration of

suggestions can be found, mainly about hemostatic

This device has been successfully used in

demonstrated the effectiveness of the oral tissue

decontaminant material in the treatment of clinical

use of systemic or local antibiotics. Similar favorable

R. PACE ET AL.

decontaminant device in cases of teeth with necrotic

canals. The ability of the decontaminant device to

was to test the reduction of root canal bleeding in

able and willing to sign a consent form, single-

diseases, using anticoagulants, antibiotics, or anti-

suggestions can be found, mainly about hemostatic

This device has been successfully used in

demonstrated the effectiveness of the oral tissue

decontaminant material in the treatment of clinical

use of systemic or local antibiotics. Similar favorable

suggestions can be found, mainly about hemostatic suggestions can be found, mainly about hemostatic suggestions can be found, mainly about hemostatic suggestions can be found, mainly about hemostatic suggestions can be found, mainly about hemostatic

able and willing to sign

diseases, using anticoagulan

been successfully used in

ffectiveness of the oral tissue

al in the treatment of clinical

al antibiotics. Similar favorable

was to test the reduction

StStStudududy y popopopopupulation

mamaininininlylyly a a a a a aboboboututut h h hemememosososososostatatatatatatatitic ound, mamaound

Study population

Journal of Biological Regulators & Homeostatic Agents

were measured.

millimeters of blood within the root canal were

a priori

the ordinary endodontic treatment was carried out.

in a consecutive order, assigning the tooth to either the

Experimental Group

The decontaminant material was introduced

Finally, the canal was rinsed with sterile water using a

The millimeters of blood inside the root canal were

Control Group

the canal.

Finally, the canal was rinsed with sterile water

Treatment

was standardized

and limited to one

After each instrument, the root canals were rinsed

instruments were driven with an endodontic motor

as suggested by the manufacturer.

area. To avoid this inconvenience, a

were measured.

millimeters of blood within the root canal were

a priori

the ordinary endodontic treatment was carried out.

in a consecutive order, assigning the tooth to either the

The decontaminant material was introduced

Finally, the canal was rinsed with sterile water using a

he millimeters of blood inside the root canal were

Treatment

and limited to one

After each instrument, the root canals were rinsed

instruments were driven with an endodontic motor

as suggested by the manufacturer.

and limited to one and limited to one

The millimeters of blood

Control Group

ument, the root canals were rinsed

riven with an endodontic motor

manufacturer.

inin a c cononsesecucucutitititititititiveveveveveveve order, assi

ExExpeperimental Group

The decontaminant

FiFinanalllly,y, the canal was rinse

was standardized

the cFinally, the canal was rinsed with sterile water using a Finally, the canal was rinsed with sterile water using a

The decontaminant material was introduced

Experimental Group

RESULTS

canal bleeding after instrumentation were enrolled

according to the intervention used in order to control

the bleeding:

blood detected in the root canal at baseline and after

relevant differences in terms of root canal bleeding

of variances for the measured variable calculated for the

in millimeters of blood detected in the root canal was

the millimeters of blood

inside the root canal were measured again according

Sample Size Estimation

terms of root canal bleeding based on the following

Statistical Analysis

Total HybenX Control

Gender

Age

Smoking habit

Arch

Position

Table I. Demographic and baseline characteristics.

R. PACE ET AL.

RESULTS

canal bleeding after instrumentation were enrolled

according to the intervention used in order to control

blood detected in the root canal at baseline and after

relevant differences in terms of root canal bleeding

for the measured variable calculated for the

in millimeters of blood detected in the root canal was

the millimeters of blood

inside the root canal were measured again according

Sample Size Estimation

terms of root canal bleeding based on the following

Statistical Analysis

Table I. Demographic and baseline characteristics.

as

in millimeters of blood

Total HybenX Control

Gender

Age

Smoking habit

hic and baseline characteristics.

canal bleeding after i

acaccocordrdining g totototo t thehe interve

ththe e blbleeeeeedidididingngngngngngngng: : : :

blblood detected in the ro

rerelelevavant differences in

ofvariancesfor the meas

ed on the following

is

bleeding basednal bl ededl bleeding b

ancesfor the measofvavarianvarianofvariofvariances

relevant differences in terms of root canal bleeding relevant differences in terms of root canal bleeding

blood detected in the root canal at baseline and after blood detected in the root canal at baseline and after

Journal of Biological Regulators & Homeostatic Agents

antibacterial activity of commonly used disinfectant

There are no clinical studies that analyze how

and changes it into a more basic condition that is

of a decontaminat device on the ability to dry the

in case of over-instrumentation, a serosanguineous

Methacrylate-based Endodontic Sealers are used, the

root canal walls must have a slight degree of humidity

Baseline (mm) 30 3.40

After treatment (mm) 30 0.26

% Change 30 0.95

Baseline (mm) 30 3.73

After treatment (mm) 30 3.03

% Change 30 0.21

Table II. Descriptive statistics.

antibacterial activity of commonly used disinfectant

There are no clinical studies that analyze how

and changes it into a more basic condition that is

of a decontaminat device on the ability to dry the

in case of over-instrumentation, a serosanguineous

Methacrylate-based Endodontic Sealers are used, the

root canal walls must have a slight degree of humidity

Table II. Descriptive statistics.

in case of over-instrumentation, a serosanguineous

Methacrylate-based Endodontic Sealers are used, the

root canal walls must have a slight degree of humidity

of a decontaminat device on the ability to dry the

in case of over-instrumentation, a serosanguineous

Methacrylate-based Endodontic Sealers are used, the

root canal walls must have a slight degree of humidity

of a decontaminat device on the ability to dry the of a decontaminat device on the ability to dry the

Ba li (mm) 30 3.40

statistics.

and changes it into a mo

a serosanguineous

Endodontic Sealers s arare ususededededed, ththe e

t have a slight degree o of f huhumimidididitytytyty

rumentation, a

E

ru a

E

rumentntatatioio

and changes it into a more basic condition that is and changes it into a more basic condition that is and changes it into a more basic condition that is

outcome, the authors were interested in evaluating the

during endodontic treatment.

it for 20 sec. The sulfonic/sulfuric acid solution is an

aqueous solution, and thus it can be removed easily

all the factors interacting in the endodontic success

vs

the surface of the walls covered with the calcium

root canals allowed irrigation needles to reach most

The study revealed that considerable amounts of

microbiological study, using a decontaminant

bleeding after using the material. Therefore, due to this

Table III. T-Test on percentage change as (baseline - after treatment) x 100/baseline.

R. PACE ET AL.

outcome, the authors were interested in evaluating the

during endodontic treatment.

it for 20 sec. The sulfonic/sulfuric acid solution is an

aqueous solution, and thus it can be removed easily

all the factors interacting in the endodontic success

vs

the surface of the walls covered with the calcium

root canals allowed irrigation needles to reach most

The study revealed that considerable amounts of

microbiological study, using a decontaminant

bleeding after using the material. Therefore, due to this

Table III. T-Test on percentage change as (baseline - after treatment) x 100/baseline.

The study revealed that considerable amounts of

the surface of the walls covered with the calcium

The study revealed that considerable amounts of

the surface of the walls covered with the calcium the surface of the walls covered with the calcium

y, using a decontaminant

material. Therefore, due to this

entage change as (baseline - after treatment) x 100/baseline.

alall l ththe e factors interacting in

o reach most

able amounts of

gation needles to re

that consididerab

rigati o o re

abab

gati

hat cons

on

consns

on needles

all the factors interacting in the endodontic success all the factors interacting in the endodontic success

Journal of Biological Regulators & Homeostatic Agents

.

ACKNOWLEDGMENTS

This study is registered on clinicaltrials.gov

REFERENCES

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.

ACKNOWLEDGMENTS

This study is registered on clinicaltrials.gov

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Pini-Prato G, Magnani C, Rotundo R. Treatment

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debris. This could lead to coagulation in the vascular

not tied to conventional blood factor hemostasis

chemistry.

the root surface and facilitating root instrumentation

there was no clinician blinding. Another limitation

the measurement of the millimeters of blood in this

the surface of the water molecule is attracted to the

of debris at the damaged vascular bed interface

molecularly remove bound water from the detritus at

this interface causing instant denaturation of the tissue

debris. This could lead to coagulation in the vascular

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molecularly remove bound water from the detritus at

this interface causing instant denaturation of the tissue

debris. This could lead to coagulation in the vascular

on the outside surface. The combination between

molecularly remove bound water from the detritus at

of debris at the damaged vascular bed interface of debris at the damaged vascular bed interface

on the outside surface. The combination between

Pini-Prato G, Magnani

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an blinding. Another limitation

the millimeters of blood in this

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e e isis a attttraractcteded t to o ththththththe e

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