Advertisement

In Vivo Antibacterial Efficacy of Ultrasound after Hand and Rotary Instrumentation in Human Mandibular Molars

      Abstract

      The purpose of this prospective, randomized, single-blind study was to compare the in vivo antibacterial efficacy of a hand/rotary technique versus a hand/rotary/ultrasound technique in mesial root canals of necrotic mandibular molars. The hand/rotary group consisted of 16 mesial roots prepared with a hand/rotary technique. The hand/rotary/ultrasound group consisted of 15 mesial roots prepared similarly, followed by 1 minute of ultrasonic irrigation per canal with an ultrasonic needle in a MiniEndo unit and 15 mL/canal of 6.0% sodium hypochlorite. Canals were sampled before and after instrumentation and after 1 minute of ultrasonic irrigation. Samples were incubated anaerobically on reduced blood agar for 7 days at 37°C, and colony-forming units (CFUs) were counted. The addition of 1 minute of ultrasonic irrigation resulted in significant (p = .0006) reduction in CFU count and positive cultures (p = .0047). Logistic regression analysis indicated the addition of ultrasonic irrigation was 7 times more likely to yield a negative culture.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Weller R.N.
        • Brady J.M.
        • Bernier W.E.
        Efficacy of ultrasonic cleaning.
        J Endod. 1980; 6: 740-743
        • Goodman A.
        • Reader A.
        • Beck F.
        • Melfi R.
        • Meyers W.
        An in vitro comparison of the efficacy of the step-back technique versus a step-back ultrasonic technique in human mandibular molars.
        J Endod. 1985; 11: 249-256
        • Lev R.
        • Reader A.
        • Beck M.
        • Meyers W.
        An in vitro comparison of the step-back technique versus a step-back/ultrasound technique for one and three minutes.
        J Endod. 1987; 13: 523-530
        • Haidet J.
        • Reader A.
        • Beck M.
        • Meyers W.
        An in vivo comparison of the step-back technique versus a step-back/ultrasonic technique in human mandibular molars.
        J Endod. 1989; 15: 195-199
        • Metzler R.S.
        • Montgomery S.
        The effectiveness of ultrasonics and calcium hydroxide for the debridement of human mandibular molars.
        J Endod. 1989; 15: 373-378
        • Mayer B.E.
        • Peters O.A.
        • Barbakow F.
        Effects of rotary instruments and ultrasonic irrigation on debris and smear layer scores: a scanning electron microscopic study.
        Int Endod J. 2002; 35: 582-589
        • Schafer E.
        • Zapke K.
        A comparative scanning electron microscopic investigation of the efficacy of manual and automated instrumentation of root canals.
        J Endod. 2000; 26: 660-664
        • Hulsmann M.
        • Schade M.
        • Schafers F.
        A comparative study of root canal preparation with HERO 642 and Quantec SC rotary Ni-Ti instruments.
        Int Endod J. 2001; 34: 538-546
        • Versumer J.
        • Hulsmann M.
        • Schafers F.
        A comparative study of root canal preparation using Profile .04 and Lightspeed rotary Ni-Ti instruments.
        Int Endod J. 2002; 35: 37-46
        • Tan B.T.
        • Messer H.H.
        The quality of apical canal preparation using hand and rotary instruments with specific criteria for enlargement based on initial apical file size.
        J Endod. 2002; 28: 658-664
        • Archer R.
        • Reader A.
        • Nist R.
        • Beck M.
        • Meyers W.J.
        An in vivo evaluation of the efficacy of ultrasound after step-back preparation in mandibular molars.
        J Endod. 1992; 18: 549-552
        • Gutarts R.
        • Nusstein J.
        • Reader A.
        • Beck M.
        In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars.
        J Endod. 2005; 31: 166-170
        • Dalton B.
        • Ørstavik D.
        • Phillips C.
        • Pettiette M.
        • Trope M.
        Bacterial reduction with nickel-titanium rotary instruments.
        J Endod. 1998; 24: 763-767
        • Shuping G.
        • Ørstavik D.
        • Sigurdsson A.
        • Trope M.
        Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications.
        J Endod. 2000; 26: 751-755
        • Siqueira J.
        • Lima K.
        • Magalhaes F.
        • Lopes H.
        • de Uzeda M.
        Mechanical reduction of the bacterial population in the root canal of three instrumentation techniques.
        J Endod. 1999; 25: 232-235
        • Siqueira J.
        • Rôças I.
        • Favieri A.
        • Lima K.
        Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite.
        J Endod. 2000; 26: 331-334
        • Siqueira J.
        • Rôças I.
        • Santos S.
        • Lima K.
        • Magalhaes F.
        • de Uzeda M.
        Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals.
        J Endod. 2002; 28: 181-184
        • Peters L.
        • van Winkelhoff A.
        • Buijs J.
        • Wesselink P.
        Effects of instrumentation, irrigation, and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions.
        Int Endod J. 2002; 35: 13-21
        • Card S.
        • Sigurdsson A.
        • Ørstavik D.
        • Trope M.
        The effectiveness of increased apical enlargement in reducing intracanal bacteria.
        J Endod. 2002; 28: 779-783
        • Ørstavik D.
        • Kerekes K.
        • Molven O.
        Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis.
        Int Endod J. 1991; 24: 1-7
        • Rollison S.
        • Barnett F.
        • Stevens R.
        Efficacy of bacterial removal from instrumented root canals in vitro related to instrumentation technique and size.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 366-371
        • Shabahang S.
        • Torabinejad M.
        Effect of MTAD™ on Enterococcus faecalis-contaminated root canals of extracted human teeth.
        J Endod. 2003; 29: 576-579
        • DeNunzio M.
        • Hicks M.
        • Pelleu G.
        • Kingman A.
        • Sauber J.
        A bacteriological comparison of ultrasonic and hand instrumentation of root canals in dogs.
        J Endod. 1989; 14: 290-293
        • Ahmad M.
        Effect of ultrasonic instrumentation on Bacteroides intermedius.
        Endod Dent Traumatol. 1989; 5: 83-86
        • Siqueira J.
        • Machado A.
        • Siveira R.
        • Lopes H.
        • de Uzeda M.
        Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal, in vitro.
        Int Endod J. 1997; 30: 279-282
        • Weber C.
        • McClanahan S.
        • Miller G.
        • Diener-West M.
        • Johnson J.
        The effect of passive ultrasonic activation of 2% chlorhexidine or 5.25% sodium hypochlorite irrigant on residual antimicrobial activity in root canals.
        J Endod. 2003; 29: 562-564
        • Spoleti P.
        • Siragusa M.
        • Spoleti M.
        Bacteriological evaluation of passive ultrasonic activation.
        J Endod. 2003; 29: 12-14
        • Schneider S.W.
        A comparison of canal preparations in straight and curved root canals.
        Oral Surg. 1971; 32: 271-275
        • Farbicius L.
        • Dahlen G.
        • Sunqvist G.
        • Happonen R.
        • Moller A.
        Influence of residual bacteria on periapical healing after chemomechanical treatment and root filling of experimentally infected monkey teeth.
        Eur J Oral Sci. 2006; 114: 278-285
        • Stumpf P.
        • Green D.
        • Smith F.
        Ultrasonic disintegration as a method of extraction of bacterial enzymes.
        J Bacteriol. 1946; 59: 487-491
        • Yumita N.
        • Nishigaki R.
        • Umemura K.
        • et al.
        Sonochemical activation of hematoporphyrin: an ESR study.
        Radiat Res. 1994; 138: 171-176
        • Pitt W.
        • McBride M.
        • Lunceford J.
        • Roper R.
        • Sagers R.
        Ultrasonic enhancement of antibiotic action on Gram-negative bacteria.
        Antimicrob Agents Chemother. 1994; 38: 2577-2582
        • Qian Z.
        • Sagers R.
        • Pitt W.
        Investigation of the mechanism of the bioacoustic effect.
        J Biomed Mater Res. 1999; 44: 198-205
        • Ahmad M.
        Effect of ultrasonic instrumentation on Bacteroides intermedius.
        Endod Dent Traumatol. 1989; 5: 83-86
        • Joyce E.
        • Phull S.
        • Lorimer J.
        • Mason T.
        The development and evaluation of ultrasound for the treatment of bacterial suspensions: a study of frequency, power, and sonication time on cultured Bacillus species.
        Ultrason Sonochem. 2003; 10: 231-234
        • Ahmad M.
        • Pitt Ford T.R.
        • Crum L.A.
        Ultrasonic debridement of root canals: an insight into the mechanisms involved.
        J Endod. 1987; 13: 93-101