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Timponi Goes Cruz A, Antoniw Klemz A, Ribeiro Rosa EA, Soares Grecca F, Mattos B, Piasecki L, Machado R, Ignácio SA, da Silva Neto UX. Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods. Sci Rep 2024; 14:3795. [PMID: 38361036 PMCID: PMC10869831 DOI: 10.1038/s41598-024-53375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.
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Affiliation(s)
- Alessandra Timponi Goes Cruz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Adriane Antoniw Klemz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Biosciences, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Fabiana Soares Grecca
- Department of Endodontics, College of Dentistry, Federal University of Rio Grande do Sul-UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Mattos
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics & Endodontics, College of Dentistry, University at Buffalo, Buffalo, NY, USA
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Sérgio Aparecido Ignácio
- Department of Statistics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
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Bürklein S, Abdi I, Schäfer E, Appel C, Donnermeyer D. Influence of pulse energy, tip design and insertion depth during Er:YAG-activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro. Int Endod J 2024; 57:87-99. [PMID: 37947444 DOI: 10.1111/iej.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
AIM To investigate the influence of pulse energy, tip geometry and tip position in simulated 3D-printed root canals with multiple side canals at different levels in all directions on the cleaning performance of laser-activated irrigation (LAI) compared to sonic activation (EDDY) and conventional needle irrigation (NI). METHODOLOGY 3D-printed root canal models (25/.06, length 20 mm, curvature 60°, radius 5 mm) with side canals (diameter 0.2 mm) at 2, 5 and 8 mm from the apex were filled with coloured biofilm-mimicking hydrogel. LAI (Morita AdvErL Evo, Kyoto, Japan) was performed with six settings (n = 20; pulse-energy, pulses per second [PPS], tip position): LAI1 (50 mJ, 25 PPS, P400FL, canal entrance [CE]), LAI2 (same as LAI1, but insertion depth 9 mm before the apical endpoint [AE] [corresponding to 1 mm above the first lateral canals]), LAI3 (80 mJ, 25 PPS, P400FL, 9 mm before AE), LAI4 (same as LAI 3, but at CE) for 3 × 20 s each, LAI5 (50 mJ, 25 PPS, P400FL 2 × 20 s, CE & R200T (30 mJ, 25 PPS, 1 × 20 s, 9 mm before AE), LAI6 (30 mJ, 25 PPS, R200T, 9 mm before AE, 3 × 20 s). A continuous irrigation (3 mL/20 s) using distilled water accompanied the irrigation cycles. NI and EDDY (3 × 20 s each; 3 mL/20 s irrigation, insertion AE minus 1 mm, amplitude 4 mm) served as control groups. Biofilm-mimicking hydrogel removal (ImageJ, NIH) was assessed for the entire system, the central canal and the lateral canals using standardized photographs with a microscope (Expert DN, Müller-Optronic) and statistically analysed was performed using Kruskal-Wallis and Dunn tests (p = .05). Irrigant extrusion beyond the foramina was also recorded. RESULTS LAI2 (99.08%; interquartile range [IQR]: 96.85-100.00) and LAI3 (97.50%; 96.24-100.00) achieved the significantly best and LAI6 (80.08%; 73.41-84.69) the significantly worst removal of hydrogel from the entire root canal system amongst all LAI configurations (p < .05). There were no significant differences between LAI6, EDDY (72.89%; 67.49-76.22) and manual irrigation (54.39%; 51.01-56.94) (p > .05). R200T laser tip caused significantly more often irrigant extrusion than all other techniques (p < .05). CONCLUSION Tip design, energy settings, and the positioning of the laser tip below the canal entrance caused an improvement in cleaning performance of the LAI. However, the small R200T tip created significantly more procedural errors (irrigant extrusion) due to higher concentrated energy.
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Affiliation(s)
- Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Izzeddin Abdi
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Carsten Appel
- Private Practice, Endodontie am Venusberg, Bonn, Germany
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
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de Jesus Oliveira LS, de Figueiredo FED, Dantas JA, Ribeiro MAG, Estrela C, Sousa-Neto MD, Faria-E-Silva AL. Impact XP-endo finisher on the 1-year follow-up success of posterior root canal treatments: a randomized clinical trial. Clin Oral Investig 2023; 27:7595-7603. [PMID: 37867163 DOI: 10.1007/s00784-023-05349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. METHODS A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). RESULTS There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. CONCLUSIONS The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. CLINICAL TRIAL REGISTRATION The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).
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Affiliation(s)
- Ludmila Smith de Jesus Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Fabricio Eneas Diniz de Figueiredo
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Janaina Araújo Dantas
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Maria Amália Gonzaga Ribeiro
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Av. Universitária, s/n - Setor Leste Universitário, Goiânia, GO, 74605-020, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, SP, 14020-904, Brazil
| | - André Luis Faria-E-Silva
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Departamento de Odontologia, Campus da Saúde, Universidade Federal de Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
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Silva WO, Amoroso-Silva P, Olivares P, Alcalde MP, Alves FRF, Marceliano-Alves MF. Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation. Clin Oral Investig 2023; 27:7523-7529. [PMID: 37910237 DOI: 10.1007/s00784-023-05342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. MATERIALS AND METHODS Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. RESULTS Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). CONCLUSIONS Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). CLINICAL RELEVANCE None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.
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Affiliation(s)
- Warley Oliveira Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Federal University of Valley of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Patrícia Olivares
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Murilo Priori Alcalde
- Faculty of Dentistry of Bauru, Department of Dentistry, Endodontics and Dental Materials, University of São Paulo, Bauru, SP, Brazil
| | - Flávio Rodrigues Ferreira Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil
| | - Marília Fagury Marceliano-Alves
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil.
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Gioster-Ramos ML, Pivoto-João MMB, Pinto JC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Diamond-coated ultrasonic tip decreases debris and uninstrumented surface after preparation of curved canals with isthmus. Braz Oral Res 2023; 37:e102. [PMID: 38055520 DOI: 10.1590/1807-3107bor-2023.vol37.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/29/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this study was to evaluate root canal preparation with nickel titanium rotary instruments and complementary preparation with ultrasonic tip in curved canals of mandibular molars with isthmus. Twenty-eight mesial roots of mandibular molars with curvature between 20° and 40° and presence of isthmus throughout the entire extension of the root canals were prepared using ProDesign Logic CM (PDL) up to size 40.05, or HyFlex EDM (HFEDM) up to size 40.04. Complementary preparation was performed in the isthmus region using the ultrasonic insert E18D (Helse, Istmo Diamantada). The root canals were scanned using micro-CT (SkyScan 1176) at 9 µm voxel size before and after each preparation step. Transportation, percentage of increase in volume, debris and uninstrumented surface (UNS) were evaluated. Mann Whitney, Wilcoxon, paired and non-paired t-tests were used for statistical analysis (α = 0.05). The canals prepared with PDL and HFEDM obtained similar results for all the variables assessed before using E18D (p > 0.05). E18D significantly decreased the percentage of debris and UNS values in both Groups (p < 0.05). The complementary preparations with E18D caused a smaller quantity of debris in the isthmus of the canals previously prepared with PDL in comparison with HFEDM (p < 0.05). PDL and HFEDM provided similar root canal preparation. PDL promoted a smaller quantity of Debris in the isthmus than HFEDM after using E18D. E18D significantly improved cleaning, and reduced Debris and UNS.
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Affiliation(s)
- Maria Luiza Gioster-Ramos
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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González Sánchez JA, Munill Ferrer M, Suresh N, Nagendrababu V, Dummer PMH, Garcia-Font M, Abella Sans F. Successful Root Canal Treatment of an Atypical Mandibular Canine with a Boomerang-shaped Root and Canal System with a Large Periapical lesion-A Case Report with 9-year Follow-up. J Endod 2023; 49:1369-1375. [PMID: 37468060 DOI: 10.1016/j.joen.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
AIM This report describes an atypical mandibular canine with a single boomerang-shaped root and root canal system with a large periapical lesion managed by root canal treatment. METHODS The chief complaint of a 16-year-old male was acute pain and an abnormal sensation in the right mandibular canine (tooth #27). The clinical examination revealed that tooth #27 had an unusual coronal morphology. The buccal aspect of the tooth resembled that of a normal canine but was significantly broader than expected. On the lingual aspect of the crown; however, there was an unusual cusp-like structure with ridges that was slightly less prominent than the buccal incisal tip. The intraoral periapical radiographs revealed a complex root with an obvious cow horn-shaped canal mesially and distally, but with the suggestion of a root structure joining the mesial and distal extensions. A large periapical lesion was present. Computed tomography revealed the presence of a single root and canal system shaped like a boomerang. Root canal treatment was performed and the patient was followed-up for 9 years. RESULTS Following root canal treatment, the patient had no symptoms, no mobility, no periodontal pockets, or root resorption. At 9 years, the cone beam computed tomography images confirmed that satisfactory healing of the periapical tissues had occurred. CONCLUSION The mandibular right canine had a unique boomerang-shaped root and canal system. Effective shaping and cleaning of the complex canal shape plus thermoplastic root filling aided the successful healing of the periapical lesion.
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Affiliation(s)
| | | | - Nandini Suresh
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (MAHER), TamilNadu, India
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, University of Sharjah, College of Dental Medicine, Sharjah, United Arab Emirates
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Marc Garcia-Font
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain
| | - Francesc Abella Sans
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain.
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Xu X, Li Z, Jiang P, Zheng C, Dou L. Effect of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo finisher in removing intracanal Vitapex paste. AUST ENDOD J 2023; 49 Suppl 1:374-380. [PMID: 36939113 DOI: 10.1111/aej.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
To compare the efficiency of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo Finisher in removing Vitapex paste from root canals. The root canals of human single-rooted teeth were prepared and obturated with Vitapex paste. After 2 weeks, the 48 teeth were randomly allocated into four groups: conventional needle irrigation (CNI) group, passive ultrasonic irrigation (PUI) group, sonic irrigation (SI) group and XP-endo Finisher (XP) group. The specimens of four groups were scanned using a micro-computed tomography after the Vitapex pastes was removed. The results showed that more residual paste was left in the CNI group than in the other three groups (p < 0.05). There was no significant difference among the PUI, SI and XP group (p > 0.05). And, the majority of the residual Vitapex was found in the apical third, with a small amount in the middle third after using any of the three agitated irrigation techniques.
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Affiliation(s)
- Xiaoqi Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zheng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Peiru Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chengxiang Zheng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lei Dou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Hepsenoglu YE, Ersahan S. Is XP-endo Finisher a better treatment option for its efficacy against intracanal bacteria for post-treatment apical periodontitis cases than EndoActivator? AUST ENDOD J 2023; 49 Suppl 1:399-412. [PMID: 37026533 DOI: 10.1111/aej.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
To investigate the efficacy of the supplementary use of a rotary agitation method [XP-endo Finisher (XPF)] and sonically-activated irrigation [EndoActivator (EA)], using droplet digital PCR (ddPCR) on reducing the bacterial load in previously root canal treated teeth with apical periodontitis. Twenty patients with post-treatment apical periodontitis were allocated into two groups according to the irrigation activation method used: XPF and EA group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation, and after final irrigation activation (S3) by means of ddPCR. The bacterial copy numbers were compared between groups using the Friedman test (Nonparametric Repeated Measures ANOVA). When the groups were examined in terms of gender, age, number of root canals, periapical index score, sterility control total bacteria (SCTB), S1- and S2-total bacteria copy number, it was found that there was no statistical difference between the XPF group and the EA group (p > 0.05). Subsequent activation (S3) resulted in a significant microbial reduction in both XPF and EA groups, both of which reduced significantly more bacteria than chemomechanical instrumentation (S2) (p < 0.0001). On the contrary, S3-total bacteria copy number of the EA group was lower than the XPF group (p < 0.0147). There was no statistical difference between the XPF group and the EA group in terms of E. faecalis copy number (p > 0.05). Although both the XPF and the EA optimised the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis, a lower total bacterial copy number was achieved with the EA application than the XPF application.
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Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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Coşkun Başoğlu E, Koçak S, Özdemir O, Koçak MM, Sağlam BC. Efficacy of various activation techniques on tubule penetration of resin-based and bioceramic root canal sealers: An in vitro confocal microscopy study. AUST ENDOD J 2023; 49 Suppl 1:381-389. [PMID: 36971332 DOI: 10.1111/aej.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/30/2023] [Accepted: 03/16/2023] [Indexed: 09/17/2023]
Abstract
To compare the penetration of Ah Plus and MTA Fillapex after irrigation activation with sonic, passive ultrasonic, SWEEPS and XP-Endo Finisher using confocal microscopy. Instrumented root canals of 160 mandibular premolar teeth were allocated randomly to four groups (n = 40/group) and eight subgroups according to the activation techniques and canal sealers (n = 20/subgroup). After the obturation, three sections at 1-2, 5-6 and 9-10 mm levels from the apex were examined. Penetration area and maximum penetration depth values were represented as mean and standard deviation, and results below 0.05 were considered statistically significant. For penetration area and maximum penetration depth, the statistical difference was found in terms of material, device and region (Maximum penetration depth: p = 0.006, p < 0.001, p < 0.001; Penetration area: p = 0.004, p < 0.001, p < 0.001). SWEEPS was found to be relatively higher than other groups. Sealers presented similar results when evaluated independently of the region. The use of SWEEPS for irrigation activation is promising in terms of tubule penetration.
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Affiliation(s)
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Olcay Özdemir
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Poly A, Marques F, Lee J, Setzer FC, Karabucak B. XP-endo Finisher effectively reduces hard-tissue debris accumulated in root canals with isthmus after preparation with a reciprocating file system. AUST ENDOD J 2023; 49:279-286. [PMID: 35980742 PMCID: PMC10091117 DOI: 10.1111/aej.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
This study compared the accumulated hard-tissue debris (AHTD) after preparation with WaveOne Gold (WOG) to XP-endo Shaper (XPS), without and with a supplementary step using XP-endo Finisher (XPF) using clinically applicable irrigation. Twenty-four mesial roots with two canals and single foramen were micro-CT-scanned and matched. Scans were also taken after preparation with WOG or XPS, and after XPF. Irrigation with 2.5% NaOCl (total: 17 ml per canal) and 17% EDTA (2.5 ml per canal) was performed using a 30ga Max-I-Probe needle placed up to the working length. Morphological parameters were calculated and compared within and among groups. XPF significantly reduced unprepared area within XPS and WOG groups, and AHTD within WOG (p < 0.05). There were no significant differences between WOG and XPS after preparation and after XPF (p > 0.05). In conclusion, WOG and XPS produced a similar volume of AHTD, but the supplementary step with XPF decreased the AHTD in the WOG group.
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Affiliation(s)
- Ane Poly
- Proclin Department, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Endodontics, College of Dentistry, Texas A&M University, Dallas, TX, USA
| | - Fernando Marques
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Josh Lee
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Frank C. Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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11
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Ashraf A, Hussein W, Hashem A, Soliman A. The Effect of Passive Ultrasonic Irrigation and XP-Endo Finisher on Post-operative Pain after Endodontic Retreatment on Patients (Randomized Controlled Clinical Trial). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To evaluate the effect of passive ultrasonic irrigation or XP-Endo Finisher on postoperative pain in patients with underextended filling in previously endodontically treated mandibular first molar teeth requiring endodontic retreatment using visual analog scale (VAS) scale at 6, 12, 24, 48, 72 h, and 7 daytime intervals.
METHODS: Seventy-eight patients with mandibular first molars which need endodontic retreatment were randomly allocated into one of three separate groups (n = 26); NaviTip group (control), XP-Endo Finisher group, or Ultra X group. Data were statistically analyzed with a significance level of p ≤ 0.05.
RESULTS: XP-Endo Finisher agitation and ultrasonic agitation as a final irrigation protocol showed significantly lower pain values than the control group, but there was no significant difference in pain values between the experimental groups.
CONCLUSION: Within the limitation of this study, it can be concluded that agitation techniques used during endodontic retreatment decreased the incidence and intensity of post-operative pain.
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12
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Alfirdous RA, Alquiria TA, Jacinto RC, Martinho FC. A modified dentin infection model with Fluorescent Lipopolysaccharide and
LPS
sampling technique to compare
XP‐Endo
finisher and passive ultrasonic irrigation. Int Endod J 2022; 55:1081-1090. [DOI: 10.1111/iej.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - T. A. Alquiria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - R. C. Jacinto
- Division of Endodontics, Department of preventive and restorative dentistry School of Dentistry, Aracatuba São Paulo SP Brazil
| | - F. C. Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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13
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Impact of agitation/activation strategies on the antibiofilm potential of sodium hypochlorite/etidronate mixture in vitro. BMC Oral Health 2022; 22:201. [PMID: 35606751 PMCID: PMC9125931 DOI: 10.1186/s12903-022-02222-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background To investigate the effect of a rotary agitation method or ultrasonically activated irrigation on the antibiofilm effect of a mixture of sodium hypochlorite (NaOCl) and etidronate (1-hydroxyethylidene-1,1-bisphosphonate, HEBP) using a dual-species biofilm model in root canal system. Methods Mature dual-species biofilms of Enterococcus faecalis and Streptococcus gordonii were formed in root canals of mandibular premolars. Teeth were randomly allotted (n = 12) to group 1, XP-endo Finisher (XPF); group 2, ultrasonically activated irrigation (UAI); group 3, syringe-and-needle irrigation (SNI). In all groups, canals were instrumented with a rotary instrument (XP-endo Shaper) prior to irrigant agitation/activation. A mixture containing 2.5% NaOCl and 9% HEBP was used throughout the experiment. Bacterial counts from the canal were determined using qPCR before preparation (S1), after preparation (S2), and after final irrigation agitation/activation (S3). Bacterial viability within the dentinal tubules in the coronal, middle and apical root-thirds was quantified using confocal microscopy after Live/Dead staining. The bacterial counts and viability were compared between groups using one-way ANOVA and post-hoc Tukey’s tests. Paired t-test was used to compare the bacterial counts within groups. Results Instrumentation alone could significantly reduce the microbial counts in all the groups (P < 0.0001). Subsequent agitation/activation resulted in significant microbial reduction only in XPF and UAI (P < 0.05), both of which reduced significantly more microbial counts than SNI (P < 0.05). Live/Dead staining revealed that XPF and UAI showed significantly greater percentage of dead bacteria within the dentinal tubules than SNI in the coronal third (P < 0.05); UAI resulted in the significantly highest percentage of dead bacteria in the middle third (P < 0.05); while there was no significant difference between the groups in the apical third (P > 0.05). Conclusions When using the sodium hypochlorite/etidronate mixture for irrigation, final irrigant agitation/activation with XP-endo Finisher or ultrasonic can improve disinfection of the main root canal space and the dentinal tubules in the coronal third, while ultrasonically activated irrigation appears to exhibit better disinfection within dentinal tubules in the middle third. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02222-1.
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14
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Chang JWW, Manigandan K, Samaranayake L, NandhaKumar C, AdhityaVasun P, Diji J, PradeepKumar AR. Morphotypes of the apical constriction of maxillary molars: a micro-computed tomographic evaluation. Restor Dent Endod 2022; 47:e19. [PMID: 35692230 PMCID: PMC9160759 DOI: 10.5395/rde.2022.47.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/10/2021] [Accepted: 08/21/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this study was to evaluate and compare the apical constriction (AC) and apical canal morphology of maxillary first and second molars, using micro-computed tomography (micro-CT). Materials and Methods The anatomical features of 313 root canals from 41 maxillary first molars and 57 maxillary second molars of patients with known age and sex were evaluated using micro-CT, with a resolution of 26.7 µm. The factors evaluated were the presence or absence of AC, the morphotypes, bucco-lingual dimension, mesio-distal dimension, and the profile (shape) of AC and the apical root canal. The apical root canal dimensions, location of the apical foramen (AF), AC to AF distance, and presence of accessory canals in the apical 5 mm were also assessed. Descriptive and analytical statistics were used for data evaluation. Results AC was present in all 313 root canals. Patients’ age and sex did not significantly impact either AC or the apical canal dimensions. The most common AC morphotype detected was the traditional (single) constriction (52%), followed by the parallel (29%) morphotype. The mean AC dimensions in maxillary first molars were not significantly different from those in maxillary second molars. Sixty percent of AF were located within 0.5 mm from the anatomic apex. Conclusions The most common morphotype of AC detected was the traditional constriction. Neither patients’ age nor sex had a significant impact on the dimensions of the AC or the apical root canal. The majority of AF (60%) were located within 0.5 mm from the anatomic apex.
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Affiliation(s)
| | - Kuzhanchinathan Manigandan
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, TN, India
| | | | - Chellapandian NandhaKumar
- Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM University (Deemed to be University) Ramapuram, Chennai, TN, India
| | | | - Johny Diji
- Adhish Multispeciality Dental Clinic, Chennai, TN, India
| | - Angambakkam Rajasekharan PradeepKumar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, TN, India
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15
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Elsaka S, Hussein W, Hashem A, Soliman A. The Effect of Passive Ultrasonic Irrigation or XP-Endo Finisher on Post-Operative Pain in Patients with Necrotic Teeth with Apical Periodontitis (Randomized Controlled Clinical Trial). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To evaluate the effect of passive ultrasonic irrigation or XP-Endo Finisher on post-operative pain in patients with necrotic teeth with apical periodontitis using (VAS) scale at 6, 12, 24, 48, 72 hours, and 7 day time intervals.
Methods Seventy-eight patients diagnosed with necrotic mandibular first molar with symptomatic apical periodontitis were randomly allocated into 1 of 3 separate groups (n=26); Navitip group (control), XP-Endo Finisher group, or Ultra X group. After a single visit root canal treatment and a specific method of agitation, depending on each group, the patients were given a questionnaire on which the patient would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48, 72 hours and 7 days post-obturation. Data were statistically analyzed with a significance level of P ≤ 0.05.
Results Ultrasonic agitation and XP-Endo Finisher agitation as a final irrigation protocol showed significantly lower pain values than the control group, but there was no significant difference in pain values between the experimental groups.
Conclusion There was significantly less pain associated with ultrasonic and XP-Endo Finisher agitation compared to Navitip irrigation.
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16
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Chinchiyanont P, Yanpiset K, Banomyong D, Thongbai-On N. Shaping ability of non-adaptive and adaptive core nickel-titanium single-file systems with supplementary file in ribbon-shaped canals analysed by micro-computed tomography. AUST ENDOD J 2022; 49:38-47. [PMID: 35255157 DOI: 10.1111/aej.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
Abstract
This study compared shaping ability between two single-file systems and before/after using supplementary file in untouched area, volume of removed dentin, maximum cut depth (the highest cut depth by main file) and remaining thinnest dentin (the thinnest root dentin after preparation). Ribbon-shaped distal canals of mandibular molars were prepared with non-adaptive core (WaveOne Gold) or adaptive core (XP-endo Shaper) files (n = 15/group) and additionally prepared with a supplementary file (XP-endo Finisher), and the shaping ability was investigated using micro-computed tomography. XP-endo Shaper group demonstrated significantly less overall untouched area than WaveOne Gold group (38.21 ± 6.98% vs. 47.68 ± 9.16%) (p < 0.05). No significant difference was detected between XP-endo Shaper and WaveOne Gold groups in volume of removed dentin (1.85 ± 0.53 vs. 1.66 ± 0.33 mm3 ), maximum cut depth (0.10-0.28 vs. 0.10-0.29 mm) and remaining thinnest dentin (0.66-0.80 vs. 0.78-0.88 mm). Supplementary XP-endo Finisher treatment significantly decreased untouched area (11%-23% reduction) (p < 0.05) with minimally cut root dentin (0.01-0.02 mm).
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Affiliation(s)
- Parichat Chinchiyanont
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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17
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Galvani LD, Costa JLDSG, Besegato JF, Zaniboni JF, Escalante-Otárola WG, Kuga MC. Influence of agitation methods of irrigants after methylene blue-mediated PDT on the bonding interface of a fiber post cementation system. Photodiagnosis Photodyn Ther 2022; 37:102708. [PMID: 34971820 DOI: 10.1016/j.pdpdt.2021.102708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/09/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study evaluated the effects of final agitation methods of irrigants to remove methylene blue and sodium hypochlorite residues after PDT-assisted endodontic treatment on the bond strength of fiber posts cemented with etch-and-rinse adhesive and conventional resin cement. METHODS Ninety bovine teeth were endodontically treated. In sequence, post space preparation followed by methylene blue-mediated PDT and sodium hypochlorite (NaOCl) irrigation were performed. Six final irrigations protocols for dye and NaOCl removal were performed prior to cementation with etch-and-rinse adhesive (Adper Scocthbond Multipurpose) and conventional dual resin cement (RelyX ARC): Conventional endodontic irrigation (CEI), passive ultrasonic irrigation (PUI), mechanical agitation with XP Endo Finisher (XPF), XP Clean (XPC) or Easy Clean (ECL) and distilled water (NCO - control). After fiber post cementation, push-out bond strength test was performed at different thirds of the post space. Failure mode was also analyzed. ANOVA and Tukey's post-hoc test was used for data analysis (α=5%). RESULTS PUI, XPF e XPC protocols showed the highest bond strength values with no difference among them (p > 0.05), although they were similar to NCO, regardless of the post space third. CEI e ECL showed similar bond strength values, regardless of the third (p > 0.05). Adhesive failure was the most incident for CEI and ECL, while mixed and cohesive failures were predominant in PUI, XPF, XPC and NCO groups. CONCLUSIONS Mechanical agitation of distilled water with XPF, XPC and PUI after methylene blue-mediated PDT and irrigation with 2.5% sodium hypochlorite promoted bond strength of the resin cementation system in post space dentin comparable to control group.
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Affiliation(s)
- Lucas David Galvani
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | | | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
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18
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De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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19
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Yargici VH, Kaptan RF. Evaluation of Debris Removal Efficacy of Conventional Syringe, Irrisafe, XP-endo Finisher File, and Photon-Induced Photoacoustic-Streaming Methods in Teeth with Artificial Internal Resorption Using Two Different Methodologies. Photobiomodul Photomed Laser Surg 2022; 40:25-32. [DOI: 10.1089/photob.2021.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Vahide Hazal Yargici
- Department of Endodontics, Yeditepe University Dentistry Faculty, İstanbul, Turkey
| | - Rabia Figen Kaptan
- Department of Endodontics, Yeditepe University Dentistry Faculty, İstanbul, Turkey
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20
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Tavares KIMC, Pinto JC, Santos-Junior AO, Esteves Torres FF, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals. Restor Dent Endod 2021; 46:e56. [PMID: 34909420 PMCID: PMC8636074 DOI: 10.5395/rde.2021.46.e56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.
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Affiliation(s)
| | - Jáder Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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21
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Barbosa AFA, Lima COD, Sassone LM, Fares RD, Fidalgo TKDS, Silva EJNL. Effect of passive ultrasonic irrigation on hard tissue debris removal: a systematic review and meta-analysis. Braz Oral Res 2021; 35:e123. [PMID: 34878078 DOI: 10.1590/1807-3107bor-2021.vol35.0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/15/2021] [Indexed: 12/22/2022] Open
Abstract
Accumulated hard tissue debris (AHTD) in root canal irregularities may negatively impact adequate root canal disinfection. In light of this, the efficacy of passive ultrasonic irrigation (PUI) to reduce AHTD has been largely studied in in vitro studies, which have adopted different analytic methods of varying accuracy to determine the extent of AHTD more correctly. Therefore, the aim of this study was to compare how well PUI and non-activated irrigation (NAI) systems perform in reducing AHTD during final irrigation protocols, based exclusively on studies whose analyses used microCT scanning. A systematic search of the studies published up to April 2020 was performed using MeSH terms and free terms, in the following databases: PubMed, Scopus, Web of Science, BVS (Lilacs and BBO) and Embase. The inclusion criteria consisted of laboratory studies that evaluated the amount of AHTD, and compared PUI with NAI protocols using microCT analysis. The risk of bias in the selected studies was assessed critically by two reviewers. A meta-analysis was performed using the RevMan software program (P<0.05), and included studies providing the standardized mean difference (SMD), using a fixed effect model, and adopting a confidence interval of 95%. In all, 3495 studies were identified, three of which met the inclusion criteria. All three were considered as having a low risk of bias. The meta-analysis comparing the ability of PUI and NAI protocols to remove hard tissue debris showed a higher percentage of AHTD reduction (P<0.01) for PUI, with a confidence interval of 1.41 [0.79, 2.02]. The heterogeneity among the studies was 82% (I2). Considering the limitations of the present study, this systematic review and meta-analysis showed that PUI was more effective than NAI in removing hard tissue debris, based exclusively on studies that used microCT scanning to provide a more precise analysis of the two techniques used. The findings presented in the present study reinforce the concept that PUI can increase residue removal and improve the cleanliness of the root canal in endodontic treatments.
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Affiliation(s)
- Ana Flávia Almeida Barbosa
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Luciana Moura Sassone
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Raissa Dias Fares
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil
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22
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Macedo LMDD, Silva-Sousa YTC, Olivato Junior O, Baltazar AF, Rached-Junior FJA. Different biomechanical preparation protocols on the penetration and bond strength of the filling material to dentin. Braz Dent J 2021; 32:12-22. [PMID: 34877974 DOI: 10.1590/0103-6440202104472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the influence of different instruments and mechanisms of agitation of the irrigating solution on the penetration by confocal laser scanning microscopy (CLSM), and the bond strength (BS) of the filling material to the dentin by push-out test. Human premolars were distributed in two experimental groups (n=30), according to the instrumentation system: ProTaper Next (PN) or XP-endo Shaper (XS) and three irrigation protocol (n=10): NaviTip (Nv), XP-endo Finisher (XF), passive ultrasonic irrigation/ XP-endo Finisher (PUIXF). The 2.5% NaOCl and 17% EDTA were the irrigating solutions used. The filling was performed using a lateral condensation technique, with AH Plus added to 0.1% rodhamine B. The roots were sectioned, obtaining 2 slices for each third of the root. The first slice was submitted to the sealer penetration analysis and the push-out test. The second slice was submitted to qualitative analysis (SEM) of the union interface. For the penetration (%) Tukey showed that PNXF (82.38±13.48), PNPUIXF (82.48± 12.02), XSXF (82.24±11.28) and XSPUIXP (86.23±10.45) presented the highest values, different (p<0.05) from PNNv (68.29±15.12) and XSNv (71.41±16.50). The BS (MPa) test evidenced that in the cervical third, PNPF (4.92±1.04) and XPSPF (5.03±0.70) obtained the highest values differing from the others groups (p<0.05). CSLM and SEM showed greater penetration of the sealer on the entire length of the root canal when the irrigation solution was stirred. In conclusion that the association PUI and XP-endo Finisher favored the penetration and bond strength of the filling material to the root dentin.
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23
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Pedrinha VF, Cardenas Cuellar MR, Velásquez-Espedilla EG, Duarte MAH, Andrade FBD, Rodrigues PDA. Impact of irrigation protocols with some chelators and mechanical agitation on intratubular decontamination. Braz Oral Res 2021; 35:e127. [PMID: 34878082 DOI: 10.1590/1807-3107bor-2021.vol35.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This study evaluated main canal and intratubular decontamination using different irrigation solutions followed by adjunctive agitation steps for infected root canals. Sixty-eight lower incisors were contaminated with Enterococcus faecalis and allocated to groups according to canal treatment (n = 10): G1, NaOCl followed by ethylenediaminetetraacetic acid (EDTA); G2, a mixture of NaOCl with hydroxyethylidene bisphosphonate (HEBP); and G3, NaOCl followed by EDTA-T (EDTA with sodium lauryl ether sulfate). All three groups of teeth were agitated with passive ultrasonic irrigation (PUI) using saline solution, whereby G4, G5, and G6 were prepared as above, and agitation was performed using an XP-Endo Finisher instrument. Microbiological samples were collected from the root canals with paper points at three times: before and after chemomechanical preparation and after agitation. The colony-forming units (CFU)/mL count was determined, and bacterial intratubular viability was analyzed via confocal laser scanning microscopy using Live/Dead staining. Statistical analysis was performed using a Kruskal-Wallis test followed by Dunn tests. A Friedman test was applied for colony-counting data (α = 0.05). CFU/mL counting indicated equally effective decontamination in the experimental groups (p > 0.05). According to microscopy images, the use of irrigation solutions followed by agitation with the XP-Endo Finisher yielded better results. Moreover, NaOCl+EDTA-T followed by XP-Endo Finisher resulted in significantly lower viability than in the PUI-activated groups (p < 0.05). The cervical and medium thirds of the specimens presented similar results. Overall, NaOCl+EDTA-T exhibited the best intratubular antibacterial activity, mainly for canals that were subsequently agitated using XP-Endo Finisher.
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Affiliation(s)
- Victor Feliz Pedrinha
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| | - Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
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Perminio DJ, Rodrigues DM, Vianna KC, Machado A, Lopes R, Barboza EP. Micro-tomographic analysis of the root trunk and pre-furcation area of the first mandibular molars. Odontology 2021; 110:120-126. [PMID: 34387774 DOI: 10.1007/s10266-021-00645-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
This study analyzed the root trunk (RT) and the pre-furcation area (PFA) of mandibular first molars. Thirty lower first mandibular molars extracted due to advanced periodontal disease were evaluated in a high-energy spiral computerized micro-tomography. Two gutta-percha markings on the cementoenamel junction (CEJ) and at the furcation entrance (FE) at buccal and lingual surfaces served as reference points for measurements of RT length, and PFA width and depth, at the levels of CEJ, 1 mm apical to CEJ, 2 mm apical to CEJ, and at the FE. The mean RT length was 2.49 mm at buccal and 3.18 mm at lingual sides. The mean widths of the PFA at CEJ, at 1 and 2 mm apical to CEJ, and at FE were 2.9, 3.4, 3.9 and 4.3 mm, respectively, while the mean depths were 0.19, 0.32, 0.57 and 1.1 mm, respectively. The PFA coincided with CEJ in 10 buccal and 10 lingual surfaces, representing 33.33% of the sample. There was a negative correlation between RT length and PFA dimensions. This study concludes that the RT length was smaller than previous studies. From the CEJ up to the furcation entrance, the PFA showed a progressive increase in width and depth. The coincidence of the PFA area beginning at the CEJ in 1/3, and the negative correlation between RT length and PFA dimensions may represent greater risk factor for the early development of furcation lesions.
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Affiliation(s)
- Dyego Jhony Perminio
- Postgraduate program, Federal Fluminense University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | | | - Katia Costa Vianna
- Postgraduate program, Federal Fluminense University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | - Alessandra Machado
- Nuclear Instrumentation Laboratory PEN, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Lopes
- Nuclear Instrumentation Laboratory PEN, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliane Porto Barboza
- Department of Dental Clinic, Federal Fluminense University School of Dentistry, Niterói, Rio de Janeiro, Brazil.
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Herce-Ros N, Álvarez-Sagües A, Álvarez-Losa L, Nistal-Villan E, Amador U, Presa J, Azabal M. Antibacterial Ability of Sodium Hypochlorite Activated with PUI vs. XPF File against Bacteria Growth on Enterococcus faecalis Mature Biofilm. Dent J (Basel) 2021; 9:dj9060067. [PMID: 34200637 PMCID: PMC8228713 DOI: 10.3390/dj9060067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
The objectives of the present study were to assess the antibacterial effectiveness of two sodium hypochlorite (NaOCl) concentrations (2.5% and 5.25%) activated by means of two techniques, passive ultrasonic irrigation (PUI) and XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) (XPF) against bacteria growth in intracanal mature biofilm. Our aim was to determine if the effect of heating up NaOCl at body temperature (BT) contributed to an improvement of the efficacy of XPF. Sixty-two single-canal human roots previously instrumented were infected with E. faecalis inoculum at 0.5 McFarland and incubated at 37 °C for two weeks. Twelve specimens were randomly selected as positive control, and the remaining fifty were divided into five experimental groups (n = 10). The first two were irrigated with 2.5 vs. 5.25% NaOCl at room temperature (RT), activated with PUI, and the other three were irrigated with XPF. Of these three, two were irrigated using 2.5 vs. 5.25% NaOCl at RT and one was irrigated with 5.25% NaOCl at BT. Our results showed that NaOCl was effective in biofilm removal for all experimental groups (p > 0.05), especially in the groups irrigated with 5.25% NaOCl at room temperature (RT) activated with PUI and the group treated with 5.25% NaOCl at BT with XPF. These groups were the most successful ones (p < 0.001). NaOCl, activated with XPF, was as effective as PUI in biofilm removal from the apical third of the canal when it was used at higher concentration and heated up. This study indicates that XPF only reached the efficacy of PUI when NaOCl was heated up.
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Affiliation(s)
- Nerea Herce-Ros
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Alejandro Álvarez-Sagües
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
| | - Laura Álvarez-Losa
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Estanislao Nistal-Villan
- Microbiology Section, Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Ulises Amador
- Department of Chemistry and Biochemistry, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Jesús Presa
- Independent Researcher, 28003 Madrid, Spain;
| | - Magdalena Azabal
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
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Zhou J, Liu T, Guo L. Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis. BMC Oral Health 2021; 21:294. [PMID: 34107959 PMCID: PMC8191128 DOI: 10.1186/s12903-021-01644-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01644-7.
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Affiliation(s)
- Jiani Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Tingjun Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Lihong Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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Magni E, Jäggi M, Eggmann F, Weiger R, Connert T. Apical pressures generated by several canal irrigation methods: A laboratory study in a maxillary central incisor with an open apex. Int Endod J 2021; 54:1937-1947. [PMID: 34022070 PMCID: PMC8518727 DOI: 10.1111/iej.13575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/19/2021] [Indexed: 01/13/2023]
Abstract
Aim A laboratory study to determine the apical pressure generated by seven canal irrigation methods in an anterior tooth with an open apex. Methodology Canal irrigation was performed on a 3D‐printed central maxillary incisor with an open apex (maximum diameter of 2.1 mm). Ultrasonically activated irrigation (UAI), sonic activation (EDDY), negative pressure irrigation (EndoVac), the self‐adjusting file (SAF) and the XP‐endo Finisher were employed at tooth length (TL), TL—1 mm, TL—2 mm and TL—3 mm. UAI was tested at three intensity levels additionally. Hydrodynamic irrigation with RinsEndo was performed in the pulp chamber, at the canal orifice, the coronal third, the middle of the canal and at TL. Er:YAG laser activation, at four frequency settings, was performed in the pulp chamber and at the orifice of the canal. The pressure of the fluid towards the canal terminus generated by activation was directly transferred to a pressure sensor with a range of 0 to 120 mmHg and a response time of ≤0.5 ms. The critical threshold for apical extrusion of the irrigant was set at 5.73 mmHg (lower limit of the central venous pressure: 5.88 ± 0.15 mmHg). Each experiment was repeated ten times. The tests were followed by descriptive analyses (maximum, mean, standard deviation, 95% confidence interval). Results EndoVac, the SAF, the XP‐endo Finisher, and UAI never exceeded the critical threshold at any insertion depth or intensity level. Er:YAG laser activation exceeded the critical threshold exclusively at frequency settings that varied from the manufacturer's recommendation. EDDY at TL and RinsEndo at any insertion depth exceeded the critical threshold in 100% of the measurements. EDDY at TL—1,—2, and—3 mm crossed the critical threshold in 30%, 10%, and 20% of the measurements, respectively. Conclusions In a simulated maxillary central incisor with an open apex, irrigation with EndoVac, Er:YAG laser activation, UAI, the SAF, and the XP‐endo Finisher generated apical pressures below the critical threshold of 5.73 mmHg. By contrast, using EDDY and RinsEndo for irrigation produced higher apical pressures that exceeded the critical threshold.
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Affiliation(s)
- Eva Magni
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Marco Jäggi
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
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da Silva EJNL, de Moura SG, de Lima CO, Barbosa AFA, Misael WF, Lacerda MFLS, Sassone LM. Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study. Restor Dent Endod 2021; 46:e16. [PMID: 34123752 PMCID: PMC8170380 DOI: 10.5395/rde.2021.46.e16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/05/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.
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Affiliation(s)
- Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Sara Gomes de Moura
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Waleska Florentino Misael
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
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29
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Machado R, da Silva I, Comparin D, de Mattos BAM, Alberton LR, da Silva Neto UX. Smear layer removal by passive ultrasonic irrigation and 2 new mechanical methods for activation of the chelating solution. Restor Dent Endod 2021; 46:e11. [PMID: 33680900 PMCID: PMC7906843 DOI: 10.5395/rde.2021.46.e11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 02/04/2023] Open
Abstract
Objectives The aim of this study was to compare smear layer removal by conventional application (CA), passive ultrasonic irrigation (PUI), EasyClean (EC), and XP-Endo Finisher (XPF), using 17% ethylenediaminetetraacetic acid (EDTA) after chemomechanical preparation, as evaluated with scanning electron microscopy (SEM). Materials and Methods Forty-five single-rooted human mandibular premolars were selected for this study. After chemomechanical preparation, the teeth were randomly divided into 5 groups according to the protocol for smear layer removal, as follows: G1 (control): CA of distilled water; G2 (CA): CA of 17% EDTA; G3 (PUI): 17% EDTA activated by PUI; G4 (EC): 17% EDTA activated by EC; and G5 (XPF): 17% EDTA activated by XPF. SEM images (×1,000) were obtained from each root third and scored by 3 examiners. Data were evaluated using the Kruskal-Wallis and Dunn tests (p < 0.05). Results In the apical third, there were no statistically significant differences among the groups (p > 0.05). In the cervical and middle thirds, the experimental groups performed better than the control group (p < 0.05); however, G2 presented better results than G3, G4, and G5 (p < 0.05), which showed no differences among one another (p > 0.05). Conclusions No irrigation method was able to completely remove the smear layer, especially in the apical third. Using CA for the chelating solution performed better than any form of activation.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, Pontifical Catholic University of Paraná - PUCPR, Curitiba, Paraná, Brazil
| | - Isadora da Silva
- Department of Endodontics, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | | | - Luiz Rômulo Alberton
- Department of Veterinary Medicine, Paranaense University- UNIPAR, Umuarama, Paraná, Brazil
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30
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Pinto JC, Torres FFE, Santos Junior AO, Tavares KIMC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Influence of voxel size on micro-CT analysis of debris after root canal preparation. Braz Oral Res 2020; 35:e008. [PMID: 33206781 DOI: 10.1590/1807-3107bor-2021.vol35.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on the evaluation of debris accumulation after passive ultrasonic irrigation (PUI) in curved root canals prepared with rotary nickel-titanium files. Mesial root canals (n = 24) of mandibular molars with curvature between 25° and 35° were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM). PUI was performed after root canal preparation of all root canals. The specimens were scanned using high-resolution (5 μm voxel size) micro-CT imaging before and after experimental procedures. The percentage of debris was analyzed in the middle and apical thirds using images with 5, 10 and 20 μm voxel sizes. Data were compared using unpaired and paired Student's t-test, ANOVA and Tukey's statistical tests (α = 0.05). There were no differences among the debris analyses performed at different voxel sizes (5, 10 and 20 μm) (p > 0.05). The percentage of debris was similar between the root canals prepared by PDL and HEDM before and after PUI (p > 0.05). In both groups, the percentage of debris decreased in the middle third after PUI (p < 0.05). Within the limitations of this ex vivo study, it can be concluded that the voxel sizes evaluated did not have a significant impact on the analysis of accumulated debris. However, the results showed a tendency for detection of more debris in the analysis performed using a lower voxel size. PUI decreased the debris accumulation in the middle third of curved root canals.
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Affiliation(s)
- Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Airton Oliveira Santos Junior
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | | | - Mario Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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31
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Silva EJNL, Guerreiro MYR, Belladonna FG, Monteiro LPB, Lima CO, Brandão JMS. Response to the letter to the editor‐ Is EDTA the protagonist for the enhancement of accumulated hard tissue debris removal from root canals? Int Endod J 2020; 53:1456-1457. [DOI: 10.1111/iej.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E. J. N. L. Silva
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
- Department of Endodontics State University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
- Department of Endodontics Grande Rio University Duque de Caxias Rio de JaneiroBrazil
| | | | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | | | - C. O Lima
- Department of Endodontics State University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
| | - J. M. S. Brandão
- Department of Endodontics Federal University of Pará Belém Brazil
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32
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Augusto CM, Barbosa AFA, Guimarães CC, Lima CO, Ferreira CM, Sassone LM, Silva EJNL. A laboratory study of the impact of ultraconservative access cavities and minimal root canal tapers on the ability to shape canals in extracted mandibular molars and their fracture resistance. Int Endod J 2020; 53:1516-1529. [DOI: 10.1111/iej.13369] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 01/15/2023]
Affiliation(s)
- C. M. Augusto
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - C. C. Guimarães
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - C. M. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de Janeiro RJBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro RJ Brazil
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33
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Barbosa AFA, Silva EJNL, Coelho BP, Ferreira CMA, Lima CO, Sassone LM. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars. Int Endod J 2020; 53:1666-1679. [DOI: 10.1111/iej.13383] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 12/17/2022]
Affiliation(s)
- A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro Brazil
| | - B. P. Coelho
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. M. A. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
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Alakshar A, Saleh ARM, Gorduysus MO. Debris and Smear Layer Removal from Oval Root Canals Comparing XP-Endo Finisher, EndoActivator, and Manual Irrigation: A SEM Evaluation. Eur J Dent 2020; 14:626-633. [PMID: 32777834 PMCID: PMC7535965 DOI: 10.1055/s-0040-1714762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective
This study aimed to assess and compare XP-Endo Finisher (XP) cleaning efficiency with respect to the amount of remaining debris and smear layer versus Max-I-Probe needle (CI), EndoActivator device (EA), and combination of XP-Endo Finisher file with EndoActivator device (XP+EA) in oval root canals.
Materials and Methods
This
in vitro
study was performed on 36 extracted single root/canal mandibular premolars. Radiographic images were taken in buccolingual and mesiodistal projections to evaluate the shape of the root canal and determine whether it met exclusion criteria. All teeth were decoronated and prepared using Reciproc (R40). The samples were divided randomly into four groups: CI, EA, XP, and XP + EA. The root canals were irrigated with 5 mL of 17% EDTA and 2.5% NaOCl, respectively. Apart from the CI group, both solutions were activated by using the tested techniques for 1 minute.
The teeth were split longitudinally, and the best visible identified sections of the roots were used as the representing samples for scanning electron microscope (SEM) evaluation. Each half was divided into the following three parts: 1 mm from the anatomic apex and a standardized photomicrograph with 500x and 1500x magnifications for debris and smear layer were obtained. A five-grade scoring system was utilized to quantify the results at the coronal, middle, and apical regions. Statistical analysis was performed by using the Kruskal–Wallis and Mann–Whitney U tests. Results
Group differences in debris and smear layer scores were found statistically significant for all locations as well as for overall assessment, except for the coronal third. Intragroup comparison of debris and smear layer in CI, EA, and XP had the minimum score at the middle third, with no significant difference compared with the coronal and apical thirds. XP + EA had less debris and smear layer score at the coronal third, significantly different from apical third.
CI and EA had less debris and smear layer compared with XP and XP + EA at all locations with a significant difference at the middle and apical third (
p
< 0.05).
Conclusion
EA and CI showed less debris and smear layer than XP and XP + EA in the middle and apical third. The use of the XP in conjunction with the present irrigation protocol failed to have debris-free dentin surface in the apical portion of most of the root canals.
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Affiliation(s)
- Asmaa Alakshar
- Department of Restorative Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Mehmet Omer Gorduysus
- Preventive and Restorative Dentistry Department, College of Dental Medicine, University of Sharjah, United Arab Emirates
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Guerreiro MYR, Belladonna FG, Monteiro LPB, Lima CO, Silva EJNL, Brandão JMS. The influence of the addition of surfactants to sodium hypochlorite on the removal of hard tissue debris. Int Endod J 2020; 53:1131-1139. [PMID: 32294253 DOI: 10.1111/iej.13307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the effect of the addition of surfactants to sodium hypochlorite (NaOCl) on the removal of accumulated hard tissue debris (AHTD), before and after final irrigation with 17% EDTA, from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis. METHODOLOGY Thirty moderately curved mandibular mesial roots with Vertucci type II canal configuration were selected and scanned in a micro-CT device at an isotropic resolution of 22.9 μm. The specimens were assigned to three groups (n = 10) with respect to the root length, degree of curvature of the mesial root, volume and 3D anatomy of the root canals according to the irrigating solution used during root canal preparation: 2.5% NaOCl and 0.1% Benzalkonium Chloride, 2.5% NaOCl and 0.1% Tween 80 and 2.5% NaOCl without additives. The root canals were instrumented up to Reciproc R25 instrument. Then, the specimens were scanned again after canal preparation and after final irrigation with 17% EDTA, and the registered data sets were examined to evaluate the percentage of AHTD. For comparison between the different groups before and after using 17% EDTA, the Kruskal-Wallis test was used with a significance level of 5%. For comparison between the same groups before and after using 17% EDTA, the Wilcoxon test was used with a significance level of 5%. RESULTS None of the irrigant solutions tested was able to completely eliminate hard tissue debris from mesial canals of mandibular molars. There were no significant differences in the percentage of AHTD amongst the different irrigation solutions (P > 0.05). Final irrigation with 17% EDTA significantly reduced the percentage of AHTD (P < 0.05), without differences amongst the groups (P > 0.05). CONCLUSIONS The addition of surfactants to NaOCl did not affect the removal of AHTD from mesial canals of extracted mandibular molars. Final irrigation with 17% EDTA significantly improved AHTD removal.
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Affiliation(s)
- M Y R Guerreiro
- Department of Endodontics, Federal University of Pará, Belém, Brazil
| | - F G Belladonna
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - L P B Monteiro
- Department of Endodontics, Federal University of Pará, Belém, Brazil
| | - C O Lima
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil.,Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University, Duque de Caxias, Brazil
| | - J M S Brandão
- Department of Endodontics, Federal University of Pará, Belém, Brazil
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Amaral RR, Guimarães Oliveira AG, Braga T, Reher P, de Macêdo Farias L, Magalhães PP, Ferreira PG, Ilma de Souza Côrtes M. Quantitative Assessment of the Efficacy of Two Different Single-file Systems in Reducing the Bacterial load in Oval-Shaped Canals: A Clinical Study. J Endod 2020; 46:1228-1234. [PMID: 32653532 DOI: 10.1016/j.joen.2020.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This randomized clinical study compared the in vivo antibacterial efficacy of Reciproc Blue (RB), XP-endo Shaper (XP-S), and XP-endo Shaper associated with XP-endo Finisher (XP-F) systems in infected oval-shaped root canals with primary apical periodontitis. METHODS In this study, 28 human teeth with a single root and a single canal were randomly assigned to 2 groups according to the instrumentation technique: group 1, RB (n = 14) and group 2, XP-endo (XP-S and XP-F, n = 14). The single-rooted teeth were prepared by reciprocating and rotary nickel-titanium instruments with 5.25% sodium hypochlorite irrigation. Samples were collected from the canal at the baseline (S1), after chemomechanical preparation (S2), and after XP-F instrumentation (S3). The DNA extracts were subjected to quantitative analysis for total bacterial counts by quantitative real-time polymerase chain reaction. The data were analyzed using the analysis of variance test, and the level of significance was set at 5%. RESULTS All samples tested positive for the presence of bacteria at baseline, and the bacterial counts substantially reduced after treatment procedures (P < .01). The results showed no statistical difference between RB and XP-S instrumentation with respect to the bacterial reduction (P > .05). A marked bacterial reduction was observed after the use of the XP-F instrument (P < .01). CONCLUSIONS The XP-S and RB systems sharply reduced the bacterial load in oval-shaped root canals with primary apical periodontitis. XP-F used as a supplementary instrument to chemomechanical preparation promoted a significantly higher bacterial reduction.
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Affiliation(s)
- Rodrigo Rodrigues Amaral
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia; Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Anna Gabriella Guimarães Oliveira
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tiago Braga
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Peter Reher
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Luiz de Macêdo Farias
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula Prazeres Magalhães
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Gonçalves Ferreira
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Ilma de Souza Côrtes
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Evaluation of smear layer and debris removal by stepwise intraoperative activation (SIA) of sodium hypochlorite. Clin Oral Investig 2020; 25:237-245. [PMID: 32500405 DOI: 10.1007/s00784-020-03358-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a stepwise intraoperative activation (SIA) of irrigants during and after the instrumentation compared with that of a conventional activation (CA) performed only after the instrumentation to remove smear layer and debris using different activation devices. MATERIALS AND METHODS A total of 70 single-rooted teeth were divided into a control group (no activation, n = 10) and two different experimental groups according to the irrigant activation protocol used: group 1 (CA), in which sodium hypochlorite was activated only after the use of the last mechanical file, and group 2 (SIA), in which activation was performed during and after the instrumentation. The two groups were divided into 3 subgroups according to the activation device used (n = 10): passive ultrasonic irrigation (PUI, subgroup a), EndoActivator (EA, subgroup b), and EDDY (subgroup c). The roots were split longitudinally and observed using scanning electron microscopy (SEM) to evaluate the presence of debris and smear layer, and the results were statistically analyzed. RESULTS All activation protocols and devices were more effective than control group in removing smear layer and debris from all root canal thirds (P < 0.05), except for CA-EA (group 1b) in the apical third. In the apical third, SIA was found to be more effective than CA (P < 0.05) to remove smear layer and residual debris when PUI was used, to remove the smear layer when EA was used (P < 0.05), and to remove residual debris when EDDY was used (P < 0.05). PUI and EDDY removed statistically more smear layer and debris than EA in the apical third (P < 0.05). CONCLUSIONS The SIA technique improved the smear layer and debris removal from the apical third and debris removal from the coronal third, and PUI and EDDY were more effective than EA in the apical third. CLINICAL RELEVANCE The stepwise intraoperative activation (SIA) technique may increase smear layer and debris removal.
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Giardino L, Bidossi A, Del Fabbro M, Savadori P, Maddalone M, Ferrari L, Ballal NV, Das S, Rao BSS. Antimicrobial activity, toxicity and accumulated hard‐tissue debris (AHTD) removal efficacy of several chelating agents. Int Endod J 2020; 53:1093-1110. [DOI: 10.1111/iej.13314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 12/18/2022]
Affiliation(s)
- L. Giardino
- School of Dentistry University of Catanzaro Magna Graecia Catanzaro Italy
| | - A. Bidossi
- Laboratory of Clinical Chemistry and Microbiology IRCCS Orthopedic Institute Galeazzi Milano Italy
| | - M. Del Fabbro
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milano Italy
- IRCCS Orthopedic Institute Galeazzi Milano Italy
| | - P. Savadori
- IRCCS Orthopedic Institute Galeazzi Milano Italy
| | - M. Maddalone
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
| | - L. Ferrari
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
| | - N. V. Ballal
- Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences, Manipal Academy of Higher Education Manipal Karnataka India
| | - S. Das
- Department of Radiation Biology and Toxicology Manipal School of Life Sciences Manipal Academy of Higher Education Manipal Karnataka India
| | - B. S. S. Rao
- Department of Radiation Biology and Toxicology Manipal School of Life Sciences Manipal Academy of Higher Education Manipal Karnataka India
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Tüfenkçi P, Yılmaz K. The Effects of Different Endodontic Access Cavity Design and Using XP-endo Finisher on the Reduction of Enterococcus faecalis in the Root Canal System. J Endod 2020; 46:419-424. [DOI: 10.1016/j.joen.2019.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/16/2019] [Accepted: 11/23/2019] [Indexed: 12/16/2022]
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40
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Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9235001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction.
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De‐Deus G, Simões‐Carvalho M, Belladonna FG, Cavalcante DM, Portugal LS, Prado CG, Souza EM, Lopes RT, Silva EJNL. Arrowhead design ultrasonic tip as a supplementary tool for canal debridement. Int Endod J 2019; 53:410-420. [DOI: 10.1111/iej.13236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - L. S. Portugal
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - C. G. Prado
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Maranhão Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
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De-Deus G, Belladonna FG, Zuolo ADS, Cavalcante DM, Simões Carvalho M, Marinho A, Souza EM, Lopes RT, Silva EJNL. 3-dimensional Ability Assessment in Removing Root Filling Material from Pair-matched Oval-shaped Canals Using Thermal-treated Instruments. J Endod 2019; 45:1135-1141. [DOI: 10.1016/j.joen.2019.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/01/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
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