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Adl A, Razavian A, Eskandari F. The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study. BMC Oral Health 2022; 22:564. [DOI: 10.1186/s12903-022-02626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
This study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls.
Methods
The root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal–Wallis, Dunn’s post hoc, and Friedman tests. P < 0.05 was considered to be statistically significant.
Results
No statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023).
Conclusion
Within the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.
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Coaguila-Llerena H, Gaeta E, Faria G. Outcomes of the GentleWave system on root canal treatment: a narrative review. Restor Dent Endod 2022; 47:e11. [PMID: 35284323 PMCID: PMC8891464 DOI: 10.5395/rde.2022.47.e11] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Eduarda Gaeta
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
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Alhussain BS, Alshehri AM, Alrasheed MA, Algadhi SK, Alahmad FA. Endodontics Retreatment and Successful Removal of Endodontic Sealers Using Lasers: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/ekiqcpebrz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kirmizi D, Aksoy U, Orhan K. Efficacy of Laser-Activated Irrigation and Conventional Techniques in Calcium Hydroxide Removal from Simulated Internal Resorption Cavities: Micro-CT Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:674-681. [PMID: 34662526 DOI: 10.1089/photob.2021.0001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: This study aimed to evaluate the effectiveness of different irrigant-activation techniques for eliminating calcium hydroxide from an internal root canal resorption cavity by using microcomputed tomography (micro-CT). Background: Several techniques and irrigants are inadequate for the complete removal of calcium hydroxide from an internal root resorption cavity. Recently, a few studies have investigated the effectiveness of various methods, but there has been no micro-CT study that compares the effectiveness of photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) techniques. Methods: Seventy single-canal mandibular premolar teeth were selected and divided into seven groups (n = 10) according to the techniques to be used: syringe irrigation (SI), passive ultrasonic irrigation (PUI), EndoActivator (EA), XP-Endo finisher file (XP), Er,Cr:YSGG laser-activated irrigation, PIPS, and SWEEPS. The root canals were instrumented using a rotary system and divided vertically. Internal resorption cavities were created and standardized through diamond burs. Calcium hydroxide was placed into the root canal space. All specimens were evaluated using micro-CT in two different periods. The initial and residual calcium hydroxide volumes in the simulated cavities were calculated. Data were analyzed using a Kruskal-Wallis H test. Results: SWEEPS and PIPS were significantly more effective than EA, Er,Cr:YSGG, PUI, XP, and SI (p < 0.05). There was no significant difference between the SWEEPS and PIPS groups (p > 0.05). SI and XP showed the least effective activity (p < 0.05). Conclusions: The SWEEPS and PIPS techniques were superior to the EA, Er,Cr:YSGG, PUI, XP, and SI techniques. None of the techniques used entirely removed the calcium hydroxide from the resorption cavities.
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Affiliation(s)
- Dilan Kirmizi
- Department of Endodontics, Near East University Faculty of Dentistry, Mersin, Turkey
| | - Umut Aksoy
- Department of Endodontics, Near East University Faculty of Dentistry, Mersin, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Faculty of Dentistry, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Teves A, Blanco D, Casaretto M, Torres J, Alvarado DE, Coaguila-Llerena H, Faria G, Jaramillo DE. Multispecies biofilm removal by XP-endo Finisher and passive ultrasonic irrigation: A scanning electron microscopy study. AUST ENDOD J 2021; 48:91-97. [PMID: 34310795 DOI: 10.1111/aej.12549] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/18/2021] [Indexed: 12/21/2022]
Abstract
The aim was to assess the effect of XP-endo Finisher (XPF) on multispecies biofilm removal, in comparison with passive ultrasonic irrigation (PUI) and conventional syringe irrigation (CSI), by scanning electron microscope (SEM). Fifty mandibular first premolars were instrumented, longitudinally sectioned. The split halves were incubated for 4 days with a broth obtained from three bacteria strains: Enterococcus faecalis, Eikenella corrodens and Streptococcus anginosus. Subsequently, the re-approximated split halves were irrigated with 4% sodium hypochlorite (NaOCl) or water using CSI, and the final irrigation protocols were CSI with 4% NaOCl (CSI+4%NaOCl), PUI+4%NaOCl, XPF+4%NaOCl and CSI+water. The analysis of biofilm removal was performed using SEM images. There were no differences between PUI and XPF (P > 0.05), and both groups promoted higher biofilm removal than CSI+4%NaOCl and CSI+water groups (P < 0.05). It can be concluded the multispecies biofilm removal was significantly improved using XPF and PUI when compared to CSI.
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Affiliation(s)
- Abel Teves
- Stomatological research and training center, Lima, Peru
| | - Daniel Blanco
- Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia - UPCH, Lima, Peru
| | - Mario Casaretto
- Department of Endodontics, Universidad Nacional Mayor de San Marcos - UNMSM. Lima, Peru
| | - John Torres
- Department of Endodontics, Universidad Privada San Juan Bautista - UPSJB, Lima, Peru
| | - Débora E Alvarado
- Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos - UNMSM, Lima, Peru
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - David E Jaramillo
- Department of Endodontics, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Effect of calcium hydroxide mixed with lidocaine hydrochloride on postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis: a preliminary randomized controlled prospective clinical trial. Clin Oral Investig 2020; 25:203-210. [PMID: 32462277 DOI: 10.1007/s00784-020-03354-w] [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: 07/24/2019] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate the effect of calcium hydroxide mixed with lidocaine HCl on postoperative spontaneous pain. MATERIALS AND METHODS Sixty patients having irreversible pulpitis and symptomatic apical periodontitis with a preoperative spontaneous pain and percussion pain which was more than 50 on a visual analogue scale (100 mm VAS) were included in this study. After the preparation of the root canals, the patients were randomly distributed into two groups according to the calcium hydroxide vehicle, control group (mixed with saline) and calcium hydroxide mixed with lidocaine HCl (n = 30). Postoperative spontaneous pain scores were recorded by a VAS every day for a week. Data were analysed using one-way analysis of variance, chi-squared test and Mann-Whitney U tests (p = 0.05). RESULTS The calcium hydroxide mixed with lidocaine HCl group resulted in significantly less pain compared with the calcium hydroxide mixed with saline group during days 1 to 4 (p < 0.05). There were no significant differences between the groups in terms of postoperative percussion pain levels (p > 0.05). CONCLUSION Within the limitations of this study, it can be concluded that the calcium hydroxide mixed with lidocaine HCl can be beneficial in reducing postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis. CLINICAL RELEVANCE The calcium hydroxide mixed with lidocaine HCl can be beneficial in reducing postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis. CLINICAL REGISTRATION NUMBER TCTR20181121003.
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Küçükkaya Eren S, Uzunoğlu Özyürek E. Influence of cavity design on calcium hydroxide removal from root canal irregularities. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.605699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Parikh M, Kishan KV, Solanki NP, Parikh M, Savaliya K, Bindu VH, Devika TD. Efficacy of Removal of Calcium Hydroxide Medicament from Root Canals by Endoactivator and Endovac Irrigation Techniques: A Systematic Review of In vitro Studies. Contemp Clin Dent 2019; 10:135-142. [PMID: 32015656 PMCID: PMC6974993 DOI: 10.4103/ccd.ccd_335_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: The aim of this systematic review was to systematically evaluate and summarize the outcomes of in vitro studies comparing Endoactivator irrigation and Endovac irrigation techniques for removing calcium hydroxide (Ca[OH]2) medicament from the root canals. Materials and Methods: The research question was developed according to the population, intervention, comparison, and outcome strategy. A computerized literature search was conducted in Medline, PubMed, Google Scholar, and Embase. A hand search of the reference lists of identified articles was performed to separate relevant articles. Two reviewers critically assessed the studies that fulfilled the inclusion criteria and processed. Evaluation of the risk of bias of the studies was performed independently by the two reviewers. Results: After study selection, 61 were assessed for eligibility. Of these, 13 met the inclusion criteria and were included in the systematic review. Since significant heterogeneity was found in the methodologies, it was not possible to conduct a meta-analysis. Conclusions: On the basis of available evidence, we determined that Endoactivator irrigation technique showed better performance in removing Ca(OH)2 intracanal medicaments from middle third and coronal third area of the root canals and Endovac irrigation technique showed better performance from the apical third area of the root canals. Due to the limitations, small sample sizes, and low number of included studies, further research is needed to confirm our results.
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Affiliation(s)
- Margi Parikh
- Department of Conservative Dentistry and Endodontics, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Karkala Venkappa Kishan
- Department of Conservative Dentistry and Endodontics, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Nidhi P Solanki
- Department of Conservative Dentistry and Endodontics, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Maitry Parikh
- Department of Orthodontics and Dentofacial Orthopaedic, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Krushn Savaliya
- Department of Conservative Dentistry and Endodontics, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Vinukonda Hima Bindu
- Department of Conservative Dentistry and Endodontics, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - T Das Devika
- Department of Oral and Maxillofacial Surgery K.M.Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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CRESPO MP, PEREIRA KDF, KUGA MC, PORTO TS, ARMADA L. Alkalizing potential and calcium release of residues from intracanal dressing containing calcium hydroxide. REVISTA DE ODONTOLOGIA DA UNESP 2018. [DOI: 10.1590/1807-2577.11018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction If the restoration, that seal the root canal from oral environment, failed or solubilize, the intracanal dressing could be partially removed, decreasing the efficiency of calcium hydroxide (CH). Objective To evaluate the alkalizing potential and calcium ions release of intracanal residues from different medications, in different periods. Materials and method Human incisors were endodontically instrumented and randomly divided (n=10). The root canals were filled with: G1⎯Calcium hydroxide (CH); G2⎯CH with 0.4% chlorhexidine digluconate (CHC); G3⎯CH with camphorated paramonochlorophenol and glycerin (HPG); G4⎯CH was maintained during all experiment, as positive control group (PC) and G5⎯ No medication was performed in the negative control group (NC). The specimens were immersed in distilled water for 7 days. The intracanal dressing was removed from the experimental groups using F1 instrument (Protaper). The teeth were stored in distilled water for 24 hours, 7, 14 and 28 days. pH value and calcium ions released were evaluated and the data were submitted to ANOVA one-way and Tukey tests. Result All experimental groups presented lower alkalizing potential and calcium ions release than PC (P<0.05). No significant difference was found among the experimental groups, regardless of the period (P>0.05). Conclusion The alkalizing potential and calcium ions release of residues from different intracanal dressing, in different periods, were similar and lower than the positive control group, that the medication was maintained inside the root canal, encouraging the replacement of intracanal dressing when the restoration fail.
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Coaguila-Llerena H, Stefanini da Silva V, Tanomaru-Filho M, Guerreiro Tanomaru JM, Faria G. Cleaning capacity of octenidine as root canal irrigant: A scanning electron microscopy study. Microsc Res Tech 2018; 81:523-527. [DOI: 10.1002/jemt.23007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Hernán Coaguila-Llerena
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Virgínia Stefanini da Silva
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Mario Tanomaru-Filho
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | | | - Gisele Faria
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
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Efficacy and Safety of Photon Induced Photoacoustic Streaming for Removal of Calcium Hydroxide in Endodontic Treatment. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2845705. [PMID: 29850498 PMCID: PMC5937569 DOI: 10.1155/2018/2845705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/21/2018] [Accepted: 03/19/2018] [Indexed: 11/25/2022]
Abstract
Calcium hydroxide removal from the root canal by photon induced photoacoustic streaming (PIPS) compared to needle irrigation and irrigation using sonic activation was investigated. Additionally, safety issues regarding apical extrusion were addressed. In endodontic treatment temporary intracanal medication like calcium hydroxide should be completely removed for long term success. For analysis, 60 artificial teeth were prepared, filled with calcium hydroxide, and divided into four groups. The teeth were assigned to needle irrigation, irrigation using a sonic device, PIPS with a lower energy setting (10 mJ, 15 Hz), or PIPS with a higher energy setting (25 mJ/40 Hz). For comparison the weight of each tooth was measured before and after calcium hydroxide incorporation, as well as after removing calcium hydroxide using the four different methods. Regarding safety issues another 24 samples were filled with stained calcium hydroxide and embedded in 0.4% agarose gel. Color changes in the agarose gel due to apical extrusion were digitally analysed using Photoshop. No significant differences were found for calcium hydroxide removal between the two laser groups. Sonic assisted removal and needle irrigation resulted in significant less calcium hydroxide removal than both laser groups, with significantly more calcium hydroxide removal in the ultrasonic group than in the needle irrigation group. For apical extrusion the higher laser (25 mJ/40 Hz) group resulted in significant higher color changes of the periapical gel than all other groups. PIPS with the setting of 10 mJ/15 Hz achieved almost complete removal of calcium hydroxide without increasing apical extrusion of the irrigation solution.
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Zorzin J, Wießner J, Wießner T, Lohbauer U, Petschelt A, Ebert J. Removal of Radioactively Marked Calcium Hydroxide from the Root Canal: Influence of Volume of Irrigation and Activation. J Endod 2016; 42:637-40. [DOI: 10.1016/j.joen.2016.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 11/25/2022]
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Tanomaru-Filho M, Miano LM, Chávez-Andrade GM, Torres FFE, Leonardo RDT, Guerreiro-Tanomaru JM. Cleaning of Root Canal System by Different Irrigation Methods. J Contemp Dent Pract 2015; 16:859-63. [PMID: 26718291 DOI: 10.5005/jp-journals-10024-1771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare the cleaning of main and lateral canals using the irrigation methods: negative pressure irrigation (EndoVac system), passive ultrasonic irrigation (PUI) and manual irrigation (MI). MATERIALS AND METHODS Resin teeth were used. After root canal preparation, four lateral canals were made at 2 and 7 mm from the apex. Root canals were filled with contrast solution and radiographed pre- and post-irrigation using digital radiographic system [radiovisiography (RVG)]. The irrigation protocols were: MI1-manual irrigation [22 G needle at 5 mm short of working length-WL]; MI2-manual irrigation (30G needle at 2 mm short of WL); PUI; EV1-EndoVac (microcannula at 1 mm short of WL); EV2-Endovac (microcannula at 3 mm short of WL). The obtained images, initial (filled with contrast solution) and final (after irrigation) were analyzed by using image tool 3.0 software. Statistical analysis was performed by analysis of variance (ANOVA) and Tukey tests (5% significance level). RESULTS EV1 and EV2, followed by PUI showed better cleaning capacity than manual irrigation (MI1 and MI2) (p < 0.05). CONCLUSION Negative pressure irrigation and PUI promoted better cleaning of main and simulated lateral canals. CLINICAL SIGNIFICANCE Conventional manual irrigation technique may promote less root canal cleaning in the apical third. For this reason, the search for other irrigation protocols is important, and EndoVac and PUI are alternatives to contribute to irrigation effectiveness.
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Affiliation(s)
- Mário Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, , Rua Humaita 1680 Centro CEP 14801-903, Araraquara, Sao Paulo, Brazil Phone: +55-16-3301-6390, e-mail:
| | - Lucas Martinati Miano
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
| | | | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
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Ethem Yaylali I, Kececi AD, Ureyen Kaya B. Ultrasonically Activated Irrigation to Remove Calcium Hydroxide from Apical Third of Human Root Canal System: A Systematic Review of In Vitro Studies. J Endod 2015; 41:1589-99. [DOI: 10.1016/j.joen.2015.06.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/11/2015] [Accepted: 06/15/2015] [Indexed: 11/29/2022]
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Li D, Jiang S, Yin X, Chang JWW, Ke J, Zhang C. Efficacy of Needle, Ultrasonic, and Endoactivator Irrigation and Photon-Induced Photoacoustic Streaming in Removing Calcium Hydroxide from the Main Canal and Isthmus: An In Vitro Micro-Computed Tomography and Scanning Electron Microscopy Study. Photomed Laser Surg 2015; 33:330-7. [PMID: 26067942 DOI: 10.1089/pho.2015.3903] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this in vitro study was to use high-resolution micro-computed tomography (micro-CT) and scanning electron microscopy (SEM) to compare the efficacy of four irrigation techniques [needle, ultrasonic, EndoActivator, and photon-induced photoacoustic streaming (PIPS)] in removing calcium hydroxide (Ca[OH]2) from the root canal and isthmus of maxillary premolars. METHODS Twenty-four maxillary first premolars were selected based on the presence of isthmus regions on micro-CT scans. Root canals were instrumented with an F2 file using ProTaper rotary instruments and filled with Ca(OH)2 paste. Samples were stored at 37°C and 100% humidity for 1 week and randomly divided into four groups (n=6 each), according to irrigation technique. Samples were scanned with micro-CT before instrumentation, after Ca(OH)2 filling, and after irrigation. Ca(OH)2 reduction in the coronal, middle, and apical thirds and in the isthmus were assessed with three-dimensional image analysis. Next, specimens were split longitudinally, and canal walls were examined with SEM for Ca(OH)2 residues. Data were statistically evaluated with the Kruskal-Wallis and Mann-Whitney tests (p=0.05). RESULTS The PIPS and ultrasonic groups showed greater Ca(OH)2 reduction in the apical third and higher cleanliness of the isthmus than the EndoActivator and needle irrigation groups (p<0.05). Ca(OH)2 residue scores in the PIPS and ultrasonic groups were significantly lower than those in the EndoActivator and needle groups in all regions of the root canals (p<0.05). There was no significant difference between PIPS and ultrasonic groups (p>0.05), or between EndoActivator and needle groups (p>0.05). CONCLUSIONS PIPS and ultrasonic irrigation more effectively removed Ca(OH)2 from the main canal and isthmus in maxillary premolars than did EndoActivator or needle irrigation.
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Affiliation(s)
- Dongxia Li
- 1 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China .,2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Shan Jiang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Xingzhe Yin
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China .,3 VIP Dental Service & Geriatric Dentistry, School and Hospital of Stomatology, Peking University , Haidian District, Beijing, China
| | - Jeffrey Wen Wei Chang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Jie Ke
- 1 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China
| | - Chengfei Zhang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
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