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2. The comparative effectiveness and safety of three activated irrigation techniques in the isthmus area using a transparent tooth model

Author

Malentacca, A, Uccioli, U, Mannocci, F, Bhuva, B, Zangari, D, Pulella, C, Lajolo, Carlo, Lajolo, C (ORCID:0000-0003-4663-9734), Malentacca, A, Uccioli, U, Mannocci, F, Bhuva, B, Zangari, D, Pulella, C, Lajolo, Carlo, and Lajolo, C (ORCID:0000-0003-4663-9734)

Abstract

Aim To compare the effectiveness and safety of three activated irrigation techniques when removing pulp tissue from the isthmus of a transparent tooth model. The three techniques assessed were: the EndoVac (EV), passive ultrasonic irrigation (PUI) and ultrasonic wave aspiration (TUWA). Conventional syringe irrigation (CSI) was used as a control. Methodology A transparent tooth model was created using the mesial root of an extracted mandibular first molar that had an isthmus and two independent mesial canals. An artificial 0.3-mL cylindrical chamber was created below the apical foramen. The tooth was then cleared. After preparation, the root canals were filled with fuchsine-stained bovine pulp tissue. The irrigation protocols were compared in respect of their effectiveness at removing pulp tissue from the isthmus and their safety with regard to irrigantextrusion. For all four groups, 5.25% sodium hypochlorite solution was used as the irrigant. Photographs were taken and analysed using an imaging software. A Kruskal–Wallis test was used to detect the differences between groups (statistical significance was set at P < 0.05). Results No group was associated with extrusion of irrigant beyond the apex. Significant differences were observed between the groups: TUWA was the most effective technique at removing pulp tissue from the isthmus (3.39 mm2; standard deviation (SD) = 0.67; range = 1.25–3.69), followed by PUI (2.16 mm2; SD = 0.38; range = 1.37–2.96), EV (0.73 mm2; SD = 0.14; range = 0.49–0.98) and CSI (0.27 mm2; SD = 0.01; range = 0.26–0.28). Conclusion Ultrasonic wave aspiration was the most effective technique at removing artificial pulp tissue from the isthmus of a transparent tooth model. None of the techniques extruded irrigant. Keywords: efficacy, negative pressure irrigation, safety, sodium hypochlorite, ultrasonic irrigation, ultrasonic needle.

Published
2018

4. Efficacy and safety of various active irrigation devices when used with either positive or negative pressure: an in vitro study

Author

Malentacca, A, Uccioli, U, Zangari, D, Lajolo, Carlo, Fabiani, C., Lajolo, Carlo (ORCID:0000-0003-4663-9734), Malentacca, A, Uccioli, U, Zangari, D, Lajolo, Carlo, Fabiani, C., and Lajolo, Carlo (ORCID:0000-0003-4663-9734)

Abstract

The purpose of this in vitro study was to evaluate and compare the efficacy and safety of different devices available for canal cleansing.

Published
2012

5. A divergent Pseudomonas aeruginosa palmitoyltransferase essential for cystic fibrosis-specific lipid A.

Author

Thaipisuttikul I, Hittle LE, Chandra R, Zangari D, Dixon CL, Garrett TA, Rasko DA, Dasgupta N, Moskowitz SM, Malmström L, Goodlett DR, Miller SI, Bishop RE, and Ernst RK

Subjects
Acidic Glycosphingolipids, Acyltransferases chemistry, Amino Acid Motifs, Amino Acid Sequence, Antimicrobial Cationic Peptides immunology, Antimicrobial Cationic Peptides metabolism, Bacterial Proteins chemistry, Catalytic Domain, Cystic Fibrosis metabolism, Cystic Fibrosis microbiology, Cytokines metabolism, Drug Resistance, Bacterial, Escherichia coli Proteins chemistry, Escherichia coli Proteins genetics, Escherichia coli Proteins metabolism, Humans, Immunity, Innate, Lipid A immunology, Lipoylation, Models, Molecular, Molecular Sequence Data, Mutation, Phylogeny, Polymyxin B pharmacology, Protein Conformation, Protein Structure, Tertiary, Pseudomonas aeruginosa chemistry, Pseudomonas aeruginosa drug effects, Pseudomonas aeruginosa immunology, Pseudomonas aeruginosa metabolism, Acyltransferases genetics, Acyltransferases metabolism, Bacterial Proteins genetics, Bacterial Proteins metabolism, Cystic Fibrosis immunology, Lipid A metabolism, Palmitates metabolism
Abstract

Strains of Pseudomonas aeruginosa (PA) isolated from the airways of cystic fibrosis patients constitutively add palmitate to lipid A, the membrane anchor of lipopolysaccharide. The PhoPQ regulated enzyme PagP is responsible for the transfer of palmitate from outer membrane phospholipids to lipid A. This enzyme had previously been identified in many pathogenic Gram-negative bacteria, but in PA had remained elusive, despite abundant evidence that its lipid A contains palmitate. Using a combined genetic and biochemical approach, we identified PA1343 as the PA gene encoding PagP. Although PA1343 lacks obvious primary structural similarity with known PagP enzymes, the β-barrel tertiary structure with an interior hydrocarbon ruler appears to be conserved. PA PagP transfers palmitate to the 3' position of lipid A, in contrast to the 2 position seen with the enterobacterial PagP. Palmitoylated PA lipid A alters host innate immune responses, including increased resistance to some antimicrobial peptides and an elevated pro-inflammatory response, consistent with the synthesis of a hexa-acylated structure preferentially recognized by the TLR4/MD2 complex. Palmitoylation commonly confers resistance to cationic antimicrobial peptides, however, increased cytokine production resulting in inflammation is not seen with other palmitoylated lipid A, indicating a unique role for this modification in PA pathogenesis., (© 2013 John Wiley & Sons Ltd.)

Published
2014
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6. Efficacy and safety of various active irrigation devices when used with either positive or negative pressure: an in vitro study.

Author

Malentacca A, Uccioli U, Zangari D, Lajolo C, and Fabiani C

Subjects
Animals, Cattle, Coloring Agents, Dental Pulp anatomy & histology, Dental Pulp Cavity anatomy & histology, Efficiency, Injections instrumentation, Materials Testing, Models, Anatomic, Needles, Periapical Tissue anatomy & histology, Rosaniline Dyes, Safety, Sodium Hypochlorite administration & dosage, Suction instrumentation, Syringes, Tooth Apex anatomy & histology, Ultrasonics instrumentation, Root Canal Irrigants administration & dosage, Root Canal Preparation instrumentation, Therapeutic Irrigation instrumentation
Abstract

Introduction: The purpose of this in vitro study was to evaluate and compare the efficacy and safety of different devices available for canal cleansing., Methods: The following systems were tested: passive ultrasonic irrigation, EndoVac (Discus Dental, Culver City, CA), and the irrigation ultrasonic needle (ProUltra PiezoFlow Irrigation Ultrasonic Needle; Dentsply Tulsa Dental Specialties, Tulsa, OK) used in both the injection mode (IUNI) and the aspiration mode (IUNA). In the control group, traditional irrigation with a syringe and side-vented needle was used. A resin model was used with 4 lateral canals (respectively at 2, 5, 8, and 11 mm from the apical foramen) filled with bovine pulp stained with fuchsin. The model also included a 2-mm chamber in communication with the apex, again filled with bovine pulp, which enabled the measurement of the extrusion of NaOCl beyond the apex., Results: With regard to efficacy, the most effective systems were found to be those using the ultrasonic needle, either in aspiration or injection modes; EndoVac was the least effective. Conversely, IUNI was found to bring the highest risk with regard to the extrusion of sodium hypochlorite beyond the apex. EndoVac was the safest but only by a slight margin compared with IUNA and passive ultrasonic irrigation., Conclusions: Based on this study, the system that best reconciles efficacy and safety appears to be IUNA., (Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Published
2012
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