Contrast‐enhanced micro‐CT to assess dental pulp tissue debridement in root canals of extracted teeth: a series of cascading experiments towards method validation

De-Deus, G., Belladonna, F. G., Cavalcante, D. M., Simões‐Carvalho, M., Silva, E. J. N. L., Carvalhal, J. C. A., Zamolyi, R. Q., Lopes, R. T., Versiani, M. A., Dummer, P. M. H. ORCID: https://orcid.org/0000-0002-0726-7467 and Zehnder, M. 2021. Contrast‐enhanced micro‐CT to assess dental pulp tissue debridement in root canals of extracted teeth: a series of cascading experiments towards method validation. International Endodontic Journal 54 (2) , pp. 279-293. 10.1111/iej.13408

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Abstract

Aim To validate a new method for the evaluation of pulp tissue debridement in the root canals of extracted teeth using an impregnation protocol involving potassium triiodide, a radiocontrast solution known as Lugol’s, combined with micro‐computed tomographic (micro‐CT) imaging. Methodology The impact of NaOCl on the radiopacity of Lugol’s solution was assessed using a two‐fold dilution series of Lugol in distilled water and 5.25% NaOCl, which were then pipetted into transparent dishes and radiographed. To verify the influence of Lugol on the proteolytic effect of NaOCl, a dissolution test was performed using fresh bovine meat. Ten slices did not undergo any tissue processing, whilst twenty slices were fixed in formaldehyde for 24 h. After that, 10 of them were immersed in Lugol for another 24 h. Then, all specimens were placed in NaOCl and the time required for a complete tissue dissolution was recorded. For the last experiments (histological validation and micro‐CT assessment), 8 extracted mandibular premolars with formerly vital pulps were immersed in buffered formalin, scanned in a micro‐CT device, accessed, immersed in Lugol for 7 days and scanned again. Then, the root canals of 5 teeth were prepared and scanned, and the volume of remaining pulp tissue identified and quantified, whilst 3 teeth were histologically processed. The same specimens were subjected to histological assessment, and the images of the histologic sections were registered with the corresponding micro‐CT images to verify whether the pulp tissue in the histological sections matched its counterpart in the Lugol‐impregnated tissues identified in the micro‐CT slices. Results There was no discernible effect on radiopacity when NaOCl was mixed with Lugol’s solution. Tissue processing did not affect the time required for the complete dissolution of fresh bovine meat. Histological evaluation revealed a correlation between micro‐CT and histological images confirming the identification of Lugol‐impregnated pulp tissue in micro‐CT images. Conclusions The radiocontrast Lugol’s solution was unaffected by NaOCl and did not interfere with its soft tissue dissolution capability. The impregnation protocol using Lugol’s solution allowed the visualization of pulp tissue on the micro‐CT images and the identification of pulp remnants after chemical–mechanical canal procedures.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Dentistry
Publisher:	Wiley
ISSN:	0143-2885
Date of First Compliant Deposit:	26 October 2020
Date of Acceptance:	3 September 2020
Last Modified:	07 Nov 2023 01:09
URI:	https://orca.cardiff.ac.uk/id/eprint/135913

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