Flatsonic Ultrasonic Tip Optimizes the Removal of Remaining Filling Material in Flattened Root Canals: A Micro-computed Tomographic Analysis

INTRODUCTION

The aim of this study was to evaluate the effectiveness of the XP-endo Finisher R (XPFR; FKG Dentaire, La Chaux-de-Fonds, Switzerland) or the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) in removing remaining filling material after the retreatment of flattened root canals using micro-computed tomographic imaging.

METHODS

Twenty-four flattened distal root canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were prepared with Reciproc Blue (RB) R40 (VDW GmbH, Munich, Germany) and filled using the Tagger hybrid technique. All canals were retreated with RB R40, and apical enlargement was performed with RB R50 (VDW GmbH). The specimens were randomly distributed into 2 groups: XPFR or Flatsonic (n = 12). The percentage of remaining filling material after retreatment and centralization ability was evaluated. Data were submitted to Mann-Whitney, Wilcoxon, and unpaired t tests (α = 5%).

RESULTS

Greater capacity to remove remaining filling material in the entire canal and the cervical and middle thirds was observed for the Flatsonic compared with the XPFR (P < .05). However, both supplementary cleaning techniques showed a similar percentage of residual filling material in the apical third (P > .05). No difference was observed in the centralization ability between the techniques (P > .05).

CONCLUSIONS

The Flatsonic promotes greater removal of remaining filling material than the XPFR in the retreatment of flattened root canals. However, both supplementary cleaning approaches were similar in the apical third. The XPFR and Flatsonic were able to maintain root canal centralization.

The Effect of Combined Ultrasonic Tip and Mechanized Instrumentation on the Reduction of the Percentage of Non-Instrumented Surfaces in Oval/Flat Root Canals: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to evaluate the effectiveness of the ultrasonic tip associated with mechanized instrumentation in reducing the percentage of non-instrumented surfaces of human teeth with oval or flattened root canals. The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Pubmed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, Embase, Web of Science, and Cochrane Library were searched for literature published till October 2022. Only in vitrostudies were included, which compared conventional mechanized endodontic treatment alone against conventional endodontic treatment in association with ultrasonic tips, evaluating the reduction in the percentage of non-instrumented walls (computed microtomography). Four studies were eligible for qualitative and quantitative analysis. The majority of the studies scored low for risk of bias. The meta-analysis comparing protocols demonstrated a reduced percentage of non-instrumented walls in groups using ultrasonic tips after the conventional mechanized technique (p<0.01) with a confidence interval of 1.04 (95%CI: 0.59, 1.50). The ultrasonic tip associated with mechanized instrumentation demonstrates a significant reduction in the percentage of non-instrumented surfaces in oval or flattened canals.