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Title: Assessment of the use of ozone in root canal treatment
Author: Alawadi, Jameela Mohammed Ali Senkais
ISNI:       0000 0001 3409 8649
Awarding Body: Queen's University of Belfast
Current Institution: Queen's University Belfast
Date of Award: 2008
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Healing and non-healing in the periapical region after endodontic treatment in humans was first studied radiographically by Strindberg (1956). Subsequent reports (Bergenhoitz et af.1979, Ehnevid et af. 1993, Caliskan & Sen 1996, Waltimo et af. 2001, Huumonen et af. 2003) have published radiographic studies of the periapical healing process. They all report a high percentage of failures after endodontic treatment. Furthermore, in a bacteriological and radiographic study, Engstrom (1964) found a higher healing rate after endodontic treatment when bacteriological samples from the root canal showed no traces of bacteria before root filling. Therefore,the use of antiseptic irrigation is an important part of chemomechanical root canal preparation. It enhances elimination of microbiota and facilitates removal of necrotic tissue and dentine debris from the root canal system. Based on its unique capacity to dissolve necrotic tissue remnants, NaOCI remains the most widely recommended irrigating solution in endodontics (Zehnder 2006). A novel concept for the treatment of dental caries using ozone gas, as a potent microbicide, has recently been introduced (Baysan et af. 2000, Baysan & Lynch 2004, 2006, 2007). A number of studies have been undertaken on the effects of ozone on treating dental caries and the reduction of oral microorganisms (Holmes 2003, Abu-Salem 2004, Nagayoshi et af. 2004a, b, Huth et af. 2005, Huth et af. 2006, Huth et af. 2007, Estrela et af. 2007, Baysan & Beighton 2007). Previous data had suggested that ozone delivered as a gas on root carious lesions or as ozonatcd water to bacteria in vitro (Baysan et af. 2000) was extremely bactericidal. Such effects would also be expected if the gaseous ozone became dissoived in water since ozonated water is well established as an antimicrobial in many industrial situations (Kim et af.. 1999). Aims: The study aims at the following: to investigate the quality of the first and second root canal fillings performed by undergraduate dental students at the School of Dentistry, Belfast, UK; to investigate the efficacy of ozone for removal of the smear layer and to kil1 microorganisms including E. faecalis in-vitro; to examine clinically the ability of ozone to reduce the number ofbacteria in root canals and its effect on postoperative pain after root canal therapy in an in-vivo study and to assess radiographic the effect ofthc use of ozone into NaOCI on periapical radiolucencies after 6 months recall. I\Iaterials and Methods: 230 postoperative periapical radiographs were assessed. All the radiographs were interpreted using strict criteria. EntercocclIs faecalis microorganisms and 80 extracted single rooted tceth were used to assess the ability ofozone to remove the smear layer as well as to kill microorganisms in an in-vitro study. One hundred patients were enrolled and subjected to clinical examination of the root treated tooth and a periapical radiograph and a sample was taken for microbiological analysis and the postoperative pain scores were quantified (no pain to severe). Eighty periapical x-ray where examined at the baseline and at 6 months recall using strict criteria. Results: There was no statistically significant difference between the quality of the first and second root canal fillings performed by undergraduate dental students. The application of ozone for 40s, 60s or 120s was able to kill all the E. faecalis in an in-vitro study. The irrigation of ozonated NaOCI and Sterilox with ozone significantly improved the removal of the smear layer in-vitro. The application of ozone for a period of lOs at each stage was capable of reducing the number of colony forming units in-vivo with no adverse side effects. The ozone delivery system was easy to use. Conclusions: Radiographic examination of endodontically treated teeth demonstrated that there was no statistically significant difference in the first and second root canal fillings performed by undergraduate dental students. From the obtained data, it can be concluded that the introduction of ozone in routine root canal disinfection when used with NaOCI and with Sterilox in-vitro helped to removc thc smear layer. Ozone gas~kill more E. faecalis in vitro than NaOCI with air. The use ofozone is capable of reducing microorganisms with~for less postoperative pain in one session RCT using ozone. Two cases, which were treated with NaOCI and air, got worse and both cases had x-ray scores of one at baseline and were two at 6 months, whilst in the ozonated NaOCI group no case got worse. Supplied by The British Library - 'The world's knowledge'
Supervisor: Not available Sponsor: Not available
Qualification Name: Queen's University of Belfast, 2008 Qualification Level: Doctoral
EThOS ID:  DOI: Not available