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Gunes B, Yeter KY, Altay Y. Impact of different activation procedures on sodium hypochlorite penetration into dentinal tubules after endodontic retreatment via confocal laser scanning microscopy. BMC Oral Health 2024; 24:1103. [PMID: 39289653 PMCID: PMC11409584 DOI: 10.1186/s12903-024-04891-6] [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: 07/18/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Infected dentinal tubules are a possible source of bacteria that are responsible for the failure of root canal treatment. Therefore, disinfection of dentinal tubules by increasing the penetration of the irrigation solution is important for success in retreatment cases. This study utilized confocal laser scanning microscopy (CLSM) to assess and compare the impact of XPR, ultrasonic irrigation (UI) and sonic activation (SA) on NaOCl penetration into dentinal tubules following endodontic retreatment. METHODS A total of forty mandibular premolars were enrolled in this investigation. Following root canal preparation up to ProTaper X3 file (30/0.07), root canals were obturated with gutta-percha and bioceramic root canal sealer with single cone technique. The root canal filling materials were removed using ProTaper nickel-titanium rotary retreatment files until the working length was reached. The retreatment procedure was finalized using the ProTaper Next X4 (40/0.06). The teeth were divided into four groups based on the irrigation activation technique: control (conventional needle irrigation), SA, UI and XPR. During the final irrigation procedure, Rhodamine B dye was introduced to 5% NaOCl for visualization via CLSM. Subsequent to image acquisition, the maximum penetration, penetration percentage, and penetration area were calculated. Data were statistically analyzed using the Kruskal-Wallis, Friedman, and Bonferroni Dunn multiple comparison tests through R software (p < 0.05). RESULTS In the middle third, UI yielded a significantly higher penetration percentage than the control group (p < 0.05). The UI and XPR groups showed increased penetration percentages in the coronal and middle thirds compared with the apical third (P < 0.05). Maximum penetration was notably reduced in the apical third than in comparison with the coronal and middle thirds in all groups (p < 0.05). In the control, SA and XP groups, the penetration area was ranked in descending order as coronal, middle and apical (p < 0.05). Conversely, in the ultrasonic group, the penetration area was significantly lower in the apical third than in the middle and coronal thirds (p < 0.05). CONCLUSIONS UI enhanced the penetration percentage in the middle third of the root compared with that in the control group. XPR and SA showed no significant effect on NaOCl penetration following retreatment.
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Affiliation(s)
- Betul Gunes
- Faculty of Dentistry, Department of Endodontics, Eskisehir Osmangazi University, Eskişehir, 26040, Turkey
| | - Kübra Yeşildal Yeter
- Faculty of Dentistry, Department of Endodontics, Eskisehir Osmangazi University, Eskişehir, 26040, Turkey.
| | - Yasin Altay
- Faculty of Agriculture, Department of Animal Science Biometry and Genetic, Eskisehir Osmangazi University, Eskişehir, Turkey
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Sarıyılmaz Ö, Uslu G, Sarıyılmaz E, Keskin NB. Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study. Clin Oral Investig 2024; 28:491. [PMID: 39155361 DOI: 10.1007/s00784-024-05878-x] [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: 05/09/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. MATERIALS AND METHODS 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2 mm in diameter and located 8 mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. RESULTS XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. CONCLUSIONS XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. CLINICAL RELEVANCE Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.
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Affiliation(s)
- Öznur Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Gülşah Uslu
- Private practice, Idadent Oral and Dental Health Clinic, Çanakkale, Turkey
| | - Evren Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Neslihan Büşra Keskin
- Faculty of Dentistry, Department of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Lyngdoh D, Alam S, Iftekhar H, Mishra SK. Evaluation of canal patency and cleanliness following retreatment of bioceramic sealer-obturated root canals using three different irrigant activation protocols. AUST ENDOD J 2024. [PMID: 38745548 DOI: 10.1111/aej.12855] [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: 04/04/2023] [Revised: 04/28/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
This study evaluated the effectiveness of three different irrigant activation techniques in cleaning and establishing patency during retreatment of root canals obturated with gutta-percha and bioceramic sealer. 60 extracted premolars with oval-shaped canals were instrumented and obturated with gutta-percha and EndosequenceBC sealer using the 'warm hydraulic condensation' technique. The teeth were retreated using Protaper Universal Retreatment and XP-Endo Shaper system and divided into four groups according to the irrigant activation protocol used: control, passive ultrasonic irrigation (PUI), Endovac irrigation (EVI) and XP-Endo Finisher R (XPFR). Apical patency was achieved in all the samples of the XPFR group (100%), which showed a significantly higher success rate compared with the control (73.3%) and EVI groups (73.3%) (p < 0.05). The scanning electron microscopic evaluation revealed significantly cleaner middle and apical third root canals in the PUI and XPFR groups compared with the control group (p < 0.05). These findings suggest that XPFR effectively cleans and establishes patency in root canals filled with bioceramic sealers.
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Affiliation(s)
- Daiasharailang Lyngdoh
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Sharique Alam
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Huma Iftekhar
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Surendra Kumar Mishra
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
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Alves LS, Ormiga F, de Lima CO, Lopes RT, Gusman H. Root canal dentin wear during final irrigation in endodontic retreatment with passive ultrasonic irrigation and easy clean instruments. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:246-251. [PMID: 38634025 PMCID: PMC11019816 DOI: 10.4103/jcde.jcde_137_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/29/2023] [Accepted: 01/05/2024] [Indexed: 04/19/2024]
Abstract
Context Complementary procedures have been proposed to improve the endodontic retreatments. Aim The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment. Methods Thirty-six mesial roots of the lower first molars were divided into four groups (n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group. Results Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers (P < 0.05). Conclusion Both complementary cleaning procedures promoted dentin wear and must be used cautiously.
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Affiliation(s)
- Louise Schmitt Alves
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ricardo Tadeu Lopes
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Düzgün S, Topçuoğlu HS, Kahraman Ö, Eminsoy AT. Efficacy of different irrigation agitation systems in the removal of root canal sealers from artificial standardised grooves. AUST ENDOD J 2023; 49 Suppl 1:339-344. [PMID: 36810934 DOI: 10.1111/aej.12741] [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: 09/10/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
The present study aims to assess the efficacy of different irrigation agitation systems in removing calcium silicate-based sealers from artificial standardised apical grooves. After the root canal instrumentation of 96 teeth, artificial apical grooves were created in half of each root. The samples were divided into two main groups according to the sealer type (AH Plus Jet [APJ] and Sure-Seal Root™ [SSR]) (n = 48). The root halves were then reassembled and divided into four experimental groups based on the final irrigation technique used: Conventional Syringe Irrigation (CSI), Ultrasonic Irrigant Agitation (UIA), Sonic Agitation (SA) and Manual Dynamic Agitation (MDA). The roots were then dissembled to assess the amount of root canal sealer. UIA significantly removed more of SSR sealer than CSI, MDA and SA while there was no statistical difference between CSI, MDA, SA and UIA groups in the APJ group. None of the irrigation agitation systems used had completely removed the APJ and SSR sealers. However, UIA was more effective in removing SSR sealer from the standardised apical groove than were CSI, MDA and SA.
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Affiliation(s)
- Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Ömür Kahraman
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ayşe Tuğba Eminsoy
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Tandon J, Yadav RK, Tikku AP, Shakya VK, Singh SK. Comparative evaluation of different irrigating and irrigant activation system in removal of gutta-percha/sealer during retreatment: An in vitro Micro-CT study. J Oral Biol Craniofac Res 2022; 12:444-448. [PMID: 35664952 PMCID: PMC9160468 DOI: 10.1016/j.jobcr.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background The aim of the study was to compare the efficacy of different irrigation and irrigant activation system used as an adjuvant to retreatment rotary files in removal of gutta-percha and sealer from endodontic retreatment using Micro-CT. Method 64 extracted permanent maxillary central incisor teeth with single canal, were collected and decoronated to standard length of 16 mm. Instrumentation was done using rotary files and obturation was performed using GuttaCore and AH plus sealer. After setting of sealer, initial removal of filling material was performed using ProTaper universal retreatment files (D1, D2, D3). All 64 sample were randomised into four groups (n = 16) Group1: Endodontic syringe irrigation, Group 2: Passive Ultasonic Irrigation (PUI), Group 3: EndoActivator, and Group 4: EndoVac. Micro-CT scanning was performed after obturation, initial removal of filling material by retreatment file and after using experimental protocols of each group, and volume of remaining filling material was calculated using Dolphin software. Statistical analysis performed with one-way ANOVA followed by Tukey's post hoc. Results A significant reduction in the volume of residual obturation material were found between each group. PUI was superior to the sonic (EndoActivator), negative pressure irrigation technique (EndoVac) and positive pressure irrigation at the coronal, middle third and apical third of the root canal. However, none of the supplementary techniques were able to completely remove the residual obturation material. Conclusion PUI and EndoActivator were found better in remaining filling material removal, demonstrating clinically useful as supplementary technique in removing remaining obturation material during endodontic retreatment.
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Affiliation(s)
- Jyoti Tandon
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Rakesh Kumar Yadav
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Aseem Prakash Tikku
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Vijay Kumar Shakya
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Satyendra Kumar Singh
- Stem Cell and Cell Culture Unit, Centre For Advanced Research (CFAR), King George's Medical University, U.P, Lucknow, India
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Kaloustian MK, Hachem CE, Zogheib C, Nehme W, Hardan L, Rached P, Kharouf N, Haikel Y, Mancino D. Effectiveness of the REvision System and Sonic Irrigation in the Removal of Root Canal Filling Material from Oval Canals: An In Vitro Study. Bioengineering (Basel) 2022; 9:bioengineering9060260. [PMID: 35735503 PMCID: PMC9219995 DOI: 10.3390/bioengineering9060260] [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: 05/17/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the effectiveness of the Endostar REvision system (Poldent, Warsaw, Poland) in the removal of filling materials from oval root canals using sonic irrigation as an additional cleaning method. Thirty human-extracted mandibular premolars with oval canals were prepared using the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland) up to instrument F1 (20/.07), and then filled by the continuous wave vertical compaction technique using pulp canal sealer EWT (Sybron Dental Specialties, Orange, CA, USA). The teeth were randomly divided into two groups (n = 15) according to the instrumentation system and the additional cleaning method, as follows: REvision (30/.08, 25/.06) with EQ-S sonic activation (Meta Biomed, Chungcheongbuk-do, Korea), REvision (30/.08, 25/.06) without additional activation. All specimens were sectioned longitudinally at 3 and 7 mm from the apex, and analyzed using digital microscopy (KEYENCE, Osaka, Japan) to measure the total area of the residual obturation materials, followed by SEM analysis. The data on the percentage of remaining filling material were analyzed by Kruskal−Wallis one-way Analysis of Variance on ranks. None of the retreatment protocols completely removed the filling material from the root canals (p > 0.05); the retreatment technique using sonic activation showed statistically less residual filling materials than the retreatment technique using irrigants without activation at the coronal third (p < 0.05), whilst no significant difference was found between both tested groups at the apical and middle thirds (p > 0.05). The REvision system showed promising results in the removal of filling materials from oval canals.
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Affiliation(s)
- Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Walid Nehme
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon;
| | - Pamela Rached
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.:+33-66752-2841
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
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Lee T, Kahm SH, Kim K, Yang S. The Retrievability of Calcium Silicate-Based Sealer during Retreatment and the Effectiveness of Additional Passive Ultrasonic Irrigation: A Microcomputed Tomographic Study. SCANNING 2022; 2022:3933305. [PMID: 35136463 PMCID: PMC8803455 DOI: 10.1155/2022/3933305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/08/2022] [Indexed: 06/10/2023]
Abstract
This study investigated the retreatability of EndoSeal MTA (Maruch, Wonju, Korea) according to the presence or absence of a canal isthmus and the additional use of passive ultrasonic irrigation (PUI) through microcomputed tomography (micro-CT) imaging. An epoxy resin sealer (AH Plus (Dentsply DeTrey, Konstanz, Germany)) was used as a reference for comparison. Forty-five artificial mandibular molars (TRUETOOTH #19, DELABS, Santa Barbara, CA) with a mesial canal with an isthmus and a distal canal without an isthmus were obturated using gutta-percha and one of the following sealers (n = 15 each): AH Plus, EndoSeal MTA, and EndoSeal MTA + PUI. Micro-CT scanning was performed to assess the void volume (as a percentage) at three root levels. After the root fillings were removed, second micro-CT scanning was conducted to evaluate the amount of remaining root filling material. The Kruskal-Wallis H test and post hoc analysis were used for between-group comparisons. The Mann-Whitney U test was used for comparisons between canals with and without an isthmus (p < 0.05). In the EndoSeal MTA group, the void volume and remaining filling materials were higher irrespective of the presence or absence of an isthmus. In apical lesions in the EndoSeal MTA group, the void ratio was significantly lower, and there was a significantly higher amount of remaining filling material. Regardless of the presence of an isthmus, the amount of remaining filling material of the EndoSeal + PUI group was reduced to a similar degree as the AH plus group. When performing retreatment for root canals filled with EndoSeal MTA, removal of the filling material can be more difficult in the apical region. The additional use of PUI can improve the efficacy of removal.
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Affiliation(s)
- TaeYeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Se Hoon Kahm
- Department of Dentistry, Eunpyeong St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | | | - SungEun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Sinsareekul C, Hiran-Us S. Comparison of the efficacy of three different supplementary cleaning protocols in root-filled teeth with a bioceramic sealer after retreatment-a micro-computed tomographic study. Clin Oral Investig 2021; 26:3515-3521. [PMID: 34854988 DOI: 10.1007/s00784-021-04320-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study evaluated the efficacy of three different supplementary cleaning protocols on the removal of bioceramic-based root canal filling materials from oval-shaped canals. MATERIALS AND METHODS A total of 36 human mandibular premolars were instrumented and obturated with gutta-percha and iRoot SP using the single-cone technique. Retreatment was performed with ProTaper Universal retreatment files. The samples were randomly divided into the following supplementary cleaning protocols: conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher R (XPR). The samples underwent micro-CT scanning to quantify the amount of residual filling materials after retreatment and after performing the cleaning protocols. The volume of filling material removal was analyzed by one-way analysis of variance and post hoc Bonferroni and Games-Howell tests (P < 0.05). RESULTS There were significant differences in the amount of root canal filling material removal in every comparison group (P < 0.05). The XPR removed significantly more residual filling materials (P < 0.01) followed by PUI and CSI (P < 0.05). Similar efficacy was found in the total root canal and all root thirds. CONCLUSIONS The additional use of XP-endo Finisher R and passive ultrasonic irrigation effectively removed the bioceramic-obturated root filling materials from the oval-shaped canals. However, none of the techniques completely removed the filling materials. CLINICAL RELEVANCE The XP-endo Finisher R and passive ultrasonic irrigation exhibited greater efficacy compared with syringe irrigation in the reduction of residual filling materials after retreatment in root-filled teeth with a bioceramic sealer.
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Affiliation(s)
- Chanakarn Sinsareekul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirawut Hiran-Us
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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Rajda M, Miletić I, Baršić G, Krmek SJ, Šnjarić D, Baraba A. Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis. MATERIALS 2021; 14:ma14216670. [PMID: 34772195 PMCID: PMC8587586 DOI: 10.3390/ma14216670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/27/2022]
Abstract
The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann-Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm3, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm3) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.
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Affiliation(s)
- Marko Rajda
- Dental Health Center—Center, Runjaninova 4, 10000 Zagreb, Croatia;
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Gorana Baršić
- Department for Quality, Department for Measurement and Control, Faculty of Mechanical Engineering and Naval Architecture, IvanaLučića 5, 10002 Zagreb, Croatia;
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Damir Šnjarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
- Correspondence:
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Ajina MA, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J 2021; 55 Suppl 1:119-152. [PMID: 34674279 DOI: 10.1111/iej.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Despite enjoying high favourable outcome rates, root canal treatment is not always successful. Root canal retreatment is a widely practised option for managing a non-healing root treated tooth. A basic distinction between retreatment and initial treatment is the requirement to remove the existing root filling material occupying the root canal space. Only then, can the technical deficiencies and possible causes of failure be addressed. Hence, the successful removal of the root filling material is critical to achieving the objectives of retreatment. Many different materials and techniques have been used for root canal filling, which have been documented in a plethora of studies; these are mainly laboratory studies investigating the removal of root filling materials. To help guide future research, which may then better inform clinical practice in relation to retreatment procedures, the focus of this narrative review is on the research methods and experimental models employed to study the removal of root filling materials. The current available literature demonstrates great variation in the research methodologies used to study the removal of root filling material, including direct visualization by splitting tooth samples or clearing, three-dimensional radiographic imaging including using microcomputed tomography or cone-beam computed tomography, and a combination of these techniques. Depending on the research method employed, variation also exists in quantification of root filling material removal; these include measurements of surface area, volume or weight, and criteria-based (semi-quantitative) assessment. Experimental models, using human teeth or resin models, differ with respect to standardization techniques and replication of the clinical scenario including initial sample preparation, canal filling, allocation and technical aspects of retreatment procedures. Future models should replicate, as closely as possible, the clinical scenario. Currently, microcomputed tomography provides a highly detailed, non-invasive and non-destructive method of objectively assessing and quantifying root filling removal.
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Affiliation(s)
- Mahdi A Ajina
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Shah
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Bun San Chong
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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de Souza DS, S Silva AS, Ormiga F, Lopes RT, Gusman H. The effectiveness of passive ultrasonic irrigation and the easy-clean instrument for removing remnants of filling material. J Conserv Dent 2021; 24:57-62. [PMID: 34475681 PMCID: PMC8378483 DOI: 10.4103/jcd.jcd_590_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 02/03/2023] Open
Abstract
Objective This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) and the easy clean instrument by micro-computed tomography (CT) for removing remnant filling materials during endodontic retreatment. Materials and Methods Forty mesial roots of mandibular molars were divided into four groups (n = 10) according to the agitation system and sealer used: Group 1: PUI/AH Plus; Group 2: PUI/TotalFill; Group 3: Easy Clean/AH Plus; and Group 4: Easy Clean/TotalFill. The groups were compared by micro-CT analysis according to the volumes of the obturation and the remaining material before and after the agitation systems were used. Results There was no difference between the groups for total filling volume and initial and final remaining filling volume (P > 0.05). Conclusions Both the PUI and easy-clean instrument are effective for removing remnants of filling material with no difference between the groups.
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Affiliation(s)
| | - Aline S S Silva
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Ricardo T Lopes
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
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Alsubait S, Alhathlol N, Alqedairi A, Alfawaz H. A micro-computed tomographic evaluation of retreatability of BioRoot RCS in comparison with AH Plus. AUST ENDOD J 2021; 47:222-227. [PMID: 33119208 DOI: 10.1111/aej.12456] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/28/2022]
Abstract
This study compared the retreatability of filling material from canals filled with BioRoot RCS (Septodont, Saint-Maur-des-Fosses, France) and AH Plus (Dentsply DeTrey, Konstanz, Germany) combined with gutta-percha using micro-computed tomography for evaluation. Thirty-four mandibular premolars were divided into two groups according to the sealer used. Thirty days after obturation, canals were retreated with a ProTaper Universal retreatment system (Dentsply Maillefer, Ballaigues, Switzerland) followed by passive ultrasonic irrigation (PUI). The time taken for retreatment was recorded. The roots were scanned after obturation, after retreatment and after PUI. Data were analysed using the Mann-Whitney and Wilcoxon tests. Canals filled with BioRoot RCS exhibited significantly less remaining filling material than canals filled with AH Plus (P < 0.05). The addition of PUI resulted in a significant decrease in the residual material in both groups (P < 0.05). A significantly shorter retreatment time was reported for the AH Plus group than the BioRoot RCS group (P < 0.05).
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Affiliation(s)
- Sara Alsubait
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nuha Alhathlol
- Endodontic Residency Program, Saudi Commission for Health Specialist, Riyadh, Saudi Arabia
- Department of Clinical Dental Sciences, College of Dentistry, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdullah Alqedairi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hussam Alfawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Comparison of the efficacy of laser-activated and ultrasonic-activated techniques for the removal of tricalcium silicate-based sealers and gutta-percha in root canal retreatment: a microtomography and scanning electron microscopy study. BMC Oral Health 2021; 21:275. [PMID: 34022868 PMCID: PMC8141189 DOI: 10.1186/s12903-021-01638-5] [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: 11/10/2020] [Accepted: 05/18/2021] [Indexed: 12/02/2022] Open
Abstract
Tricalcium silicate-based sealers have been usually indicated for the single-cone technique and result in more residual filling materials in root canal retreatment. Passive ultrasonic irrigation and photon-initiated photoacoustic streaming have been reported to improve the removal efficacy of root canal filling materials. However, the abilities of both techniques combined with NiTi re-instrumentation to remove residual tricalcium silicate-based sealer and gutta-percha have not been compared. The aim of this study was to evaluate the efficacy of laser-activated and ultrasonic-activated techniques in vitro for the removal of the tricalcium silicate-based sealer iRoot SP and gutta-percha after standard canal retreatment procedures with the use of nickel-titanium (NiTi) rotary instruments.
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Comparative Analysis of Root Canal Filling Debris and Smear Layer Removal Efficacy Using Various Root Canal Activation Systems during Endodontic Retreatment. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:medicina56110615. [PMID: 33207656 PMCID: PMC7698200 DOI: 10.3390/medicina56110615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/28/2022]
Abstract
Background and objectives: The complete removal of obturation material can be a challenge in nonsurgical root canal retreatment. The insufficient removal of obturation material is a reason for root canal retreatment failure. Materials and Methods: The purpose of this study was to assess the efficacy of different final root canal irrigation activation methods in removing debris and smear layers in the apical and middle portions of root canals during retreatment. Sixty-six distal roots of freshly extracted molars were randomly divided into six groups: (1) primary root canal treatment with no obturation (negative control); (2) retreatment with only conventional instrumentation and irrigation (positive control); (3) retreatment with additional ultrasonic irrigation using the Piezon Master 700; (4) ultrasonic irrigation with the ENDOSONIC Blue; (5) sonic irrigation with the EDDY; and (6) multisonic irrigation with the GentleWave system. Roots were split and prepared for scanning electron microscopic (SEM) evaluation. Acquired images were assessed to quantify the amount of debris and smear remaining. Results: Among the treatment groups, Group 6 had a significantly lower debris score than Group 2 (positive control) in both the middle and apical regions (p = 0.004, p = 0.012). All treatment groups showed significantly lower smear scores than Group 2 in the middle and apical regions (p < 0.05). Conclusions: The GentleWave multisonic System showed a more optimal cleaning efficacy of the root canal debris but did not differ significantly with the tested passive ultrasonic or sonic irrigation method.
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Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, Silva ASDS, Bueno CEDS. Micro-computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod 2020; 46:1901-1906. [PMID: 32961214 DOI: 10.1016/j.joen.2020.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study was to conduct a micro-computed tomographic assessment of the effectiveness of 3 supplementary cleaning techniques in reducing the residual volume of gutta-percha and a bioceramic sealer after performing endodontic retreatment procedures in teeth with oval canals. METHODS Thirty-six mandibular premolars were instrumented with the ProTaper Next system (instruments X1-X3; Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and Bio-C Sealer (Angelus, Londrina, PR, Brazil) using the single-cone technique. The teeth were reinstrumented with the Reciproc R40 instrument (VDW, Munich, Germany) and divided into 3 groups according to the supplementary cleaning technique used (n = 12): ultrasonic-assisted irrigation (UAI), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) irrigation (EAI), or the XP-endo Finisher R system (XPR; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Micro-computed tomographic imaging was used to quantify the residual volume of filling material. One-way analysis of variance complemented by the Tukey test was used to perform the statistical analysis (P < .05). RESULTS Significant reductions were obtained in the residual filling material after supplementary cleaning (P < .05). XPR (47.5%) led to significantly greater (P < .05) filling material removal than UAI (16.6%) or EAI (22.6%). The removal values of the 2 latter systems were not significantly different. CONCLUSIONS XPR was more effective than UAI and EAI in removing filling material in mandibular premolars with oval canals. None of the tested supplementary cleaning techniques completely removed the residual filling material.
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Affiliation(s)
- Andrea Volponi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Saddock de Sá Silva
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Kumar S, Desai K, Palekar A, Biradar B, Chatterjee A, Kumari K. Comparison of the Efficacy of CanalBrush, EndoActivator, and Passive Ultrasonic Irrigation on the Removal of Triple Antibiotic Paste from Root Canal Walls: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:424-430. [PMID: 33042883 PMCID: PMC7523939 DOI: 10.4103/jispcd.jispcd_13_20] [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: 01/08/2020] [Accepted: 04/12/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The aim of this study was to compare the efficacy of CanalBrush (CB), EndoActivator (EA), and Passive Ultrasonic Irrigation (PUI) on the removal of triple antibiotic paste (TAP) from root canal walls. Materials and Methods: Thirty-six extracted human single-rooted teeth were prepared using ProTaper Universal rotary files (DentsplyMaillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with TAP, and after 21 days, roots were randomly assigned to three groups (n = 10) according to irrigation regimens used: CB, EA, and PUI. In three teeth, TAP was not removed (positive controls), and the other three teeth were not filled with TAP (negative controls). The roots were sectioned, and the amount of TAP remaining was evaluated at the mesial halves of each tooth at ×30 magnification under a stereomicroscope using a 4-grade scoring system. Data were evaluated using the Kruskal–Wallis and Mann–Whitney U tests. Results: There were significant differences among the experimental groups according to the different parts of the root canals (P < 0.05). At the apical and middle third, EA and PUI groups removed more TAP than CB group; however, there was a statistically significant difference only between CB and PUI groups (<0.01 at apical third and <0.05 at middle third). At the coronal third, there was no statistically significant difference between all the three groups (P > 0.05). Conclusion: PUI led to superior results compared to CB in the middle and apical thirds. There was no significant difference between EA and PUI techniques.
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Affiliation(s)
- Santosh Kumar
- Department of Conservative Dentistry and Endodontics, Patna Dental College & Hospital, Patna, Bihar, India
| | - Kavisha Desai
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Aparna Palekar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Baswaraj Biradar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Ananjan Chatterjee
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Khushboo Kumari
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
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Secondary Root Canal Treatment with Reciproc Blue and K-File: Radiographic and ESEM-EDX Analysis of Dentin and Root Canal Filling Remnants. J Clin Med 2020; 9:jcm9061902. [PMID: 32570806 PMCID: PMC7355850 DOI: 10.3390/jcm9061902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022] Open
Abstract
Secondary root canal treatment requires the complete removal of filling materials with different chemical-physical properties. A newly developed single-use NiTi instrument (Reciproc Blue, RB) may be more effective in root canal retreatment. The aim of the present study was to evaluate morphology and composition of remnants after retreatment with RB compared to traditional K-File technique, in canals obturated with Thermafil/AH Plus. Twenty-four single-rooted human teeth were shaped with NiTi obturated with AH-Plus/Thermafil and retreated using RB NiTi instruments or manual K-Files. Radiographs were taken to evaluate endodontic space and radiopacity of residual filling-material before/after procedures. After retreatment, samples were longitudinally split and observed by environmental scanning electron microscopy connected to energy dispersive X-Ray spectroscopy (ESEM-EDX) to analyze the debris/remnant position, microchemistry, and dentinal surface morphology. Time for retreatments was recorded and compared using one-way ANOVA (p-value = 0.05). Radiopaque filling residuals were found in both groups. RB system resulted statistically faster than manual K-File in retreatment procedure (p < 0.001). Root canal space radiographic appearance obtained after retreatment with RB was wider than K-File (p < 0.05). ESEM-EDX revealed 4 different morphological dentin area. Area-1: debris-free with typical Ca, P, and N composition of dentin and detected in 70% of the surface. Area-2: presence of deproteinized smear layer free from N and debris in 15% of the surface. Area-3: a thick packed smear layer N-free and with fine debris consisting of trace elements from sealer in 10% of the surface. Area-4: packed with debris and trace elements. No difference was observed between both instruments regarding root canal space appearance and ESEM-EDX analysis. Both systems were able to remove filling material but created a dentine morphology composed of packed debris and filling materials embedded into the smear layer. Dentin surface composition resulted in collagen depleted by irrigation procedures. The reciprocating system required less time to complete retreatment.
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Ballal NV, Ulusoy Öİ, Rao S, Gandhi P. The efficacy of different irrigation protocols in removing tricalcium silicate-based sealers from simulated root canal irregularities. Microsc Res Tech 2019; 82:1862-1868. [PMID: 31368166 DOI: 10.1002/jemt.23353] [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: 03/18/2019] [Revised: 05/11/2019] [Accepted: 07/16/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of different irrigation protocols in removing two tricalcium silicate-based sealers from simulated root canal irregularities and root canal walls. MATERIAL AND METHODS Root canals of 140 single-rooted teeth were instrumented. In one-half of each root, an apical groove was created. The samples were divided into two main groups (n = 70) based on the sealer used. In group 1, the grooves were filled with MTA Fillapex; in group 2, BioRoot RCS. The reassembled root halves were divided into six experimental and one control groups: 2.5% NaOCl-17% EDTA (Passive ultrasonic irrigation [PUI]), 5% NaOCl/9% DualRinse HEDP (PUI), 2.5% NaOCl-7% Maleic acid (PUI), 2.5% NaOCl-17% EDTA (Er:YAG laser activated irrigation [LAI]), 2.5% NaOCl/9% DualRinse HEDP (LAI), 2.5% NaOCl-7% Maleic acid (LAI), Distilled water (Control). Specimens were scored using SEM. The data were analysed using Kruskal-Wallis and Mann Whitney U tests. RESULTS Maleic acid and DualRinse HEDP removed higher amounts of MTA Fillapex from the grooves compared to EDTA, when used with both activation methods (p < .001). CONCLUSIONS Ultrasonically activated maleic acid or DualRinse HEDP can be an effective irrigation regimen in removing tricalcium silicate-based sealers.
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Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
| | - Özgür İlke Ulusoy
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sheetal Rao
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
| | - Poornika Gandhi
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
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Comparison of the Efficacy of Different Techniques for the Removal of Root Canal Filling Material in Artificial Teeth: A Micro-Computed Tomography Study. J Clin Med 2019; 8:jcm8070984. [PMID: 31284630 PMCID: PMC6678456 DOI: 10.3390/jcm8070984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the efficacy of canal filling material removal using three different techniques after filling with a Gutta-Percha (GP) cone and calcium silicate-based sealer, by measuring the percentage of volume debris of GP and sealer remaining intracanal with micro computed tomography (micro-CT). The filling material was removed from 30 plastic teeth by a nickel-titanium (Ni-Ti) rotary retreatment system. Final irrigation was performed with 2 mL of saline and 10 specimens were randomly allocated to a conventional group. In the passive ultrasonic irrigation (PUI) group, ultrasonic irrigation was added to the conventional group (n = 10). In the Gentlefile Brush (GF Brush) group, irrigation with GF Brush was added to the conventional group (n = 10). Remaining filling material was measured using micro-CT imaging analysis. The total mean volume of residual filling material after retreatment in the conventional group, PUI group and GF Brush group were 4.84896 mm3, 0.80702 mm3, and 0.05248 mm3, respectively. The percentage of filling material remaining intracanal was 6.76% in the conventional group, 1.12% in the PUI group and 0.07% in the GF Brush group. This study shows that the cleaning effect of the GF Brush system is superior to those of Ni-Ti retreatment files and the PUI system in the apical area.
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Bueno CRE, Cury MTS, Vasques AMV, Sarmiento JL, Trizzi JQ, Jacinto RC, Sivieri-Araujo G, Dezan Júnior E. Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study. Braz Oral Res 2019; 33:e017. [PMID: 30892412 DOI: 10.1590/1807-3107bor-2019.vol33.0017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/28/2019] [Indexed: 02/03/2023] Open
Abstract
In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.
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Affiliation(s)
| | - Marina Tolomei Sandoval Cury
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Ana Maria Veiga Vasques
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Jimena Lama Sarmiento
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Juliana Quintino Trizzi
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Rogério Castilho Jacinto
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Eloi Dezan Júnior
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
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Rodrigues CT, Duarte MAH, Guimarães BM, Vivan RR, Bernardineli N. Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment. Braz Oral Res 2017; 31:e113. [PMID: 29267674 DOI: 10.1590/1807-3107bor-2017.vol31.0113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/23/2017] [Indexed: 12/16/2022] Open
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Retreatability of three calcium silicate-containing sealers and one epoxy resin-based root canal sealer with four different root canal instruments. Clin Oral Investig 2017. [DOI: 10.1007/s00784-017-2156-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Bueno CEDS, Rios MDA, Coelho MS, Villela AM, de Martin AS, Kato AS, Alves VDO, Cunha RS. Influence of Passive Ultrasonic Irrigation on the Removal of Root Canal Filling Material in Straight Root Canals. Eur Endod J 2017; 2:1-5. [PMID: 33403342 PMCID: PMC7757959 DOI: 10.5152/eej.2017.16062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 12/28/2016] [Accepted: 01/26/2017] [Indexed: 11/22/2022] Open
Abstract
Objective This study evaluates the efficacy of passive ultrasonic irrigation (PUI) in removing root canal filling material from endodontically treated teeth after using one of two reciprocating systems, Reciproc (VDW, Munich, Germany) or WaveOne (Dentsply Maillefer, Ballaigues, Switzerland), or one nickel-titanium (NiTi) rotary system, ProTaper Universal Retreatment (Dentsply Maillefer). Methods One hundred and twenty straight root canals of extracted human maxillary incisors were instrumented and then obturated. The specimens were divided into six groups (n=20) as follows: Group R, Reciproc R25 instrument without PUI; Group W, WaveOne Primary instrument without PUI; Group PT, ProTaper Universal Retreatment system without PUI; Group R-PUI, Reciproc R25 with PUI; Group W-PUI, WaveOne Primary with PUI and Group PT-PUI, ProTaper Universal Retreatment system with PUI. After removing the filling material, the teeth were cleaved longitudinally and photographed. The total canal space and remaining material were quantified with the aid of an imaging software tool. The Kruskal-Wallis test was used to identify significant differences between the groups. Results No statistically significant differences (P>0.05) in residual filling material were observed between the groups. Conclusion The use of PUI did not improve the removal of filling material from the root canals, regardless of the previously used instrumentation system.
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Affiliation(s)
| | | | - Marcelo Santos Coelho
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, Brazil
| | | | | | - Augusto Shoji Kato
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, Brazil
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Gokturk H, Ozkocak I, Buyukgebiz F, Demir O. An in vitro evaluation of various irrigation techniques for the removal of double antibiotic paste from root canal surfaces. J Appl Oral Sci 2017; 24:568-574. [PMID: 28076461 PMCID: PMC5161255 DOI: 10.1590/1678-775720160286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/01/2016] [Indexed: 12/04/2022] Open
Abstract
Objective The aim of this study was to investigate the effectiveness of conventional syringe irrigations, passive ultrasonic irrigation (PUI), Vibringe, CanalBrush, XP-endo Finisher, and laser-activated irrigation (LAI) systems in removing double antibiotic paste (DAP) from root canals. Material and Methods One hundred five extracted single-rooted teeth were instrumented. The roots were split longitudinally. Three standard grooves were created and covered with DAP. The roots were distributed into seven groups: Group 1, beveled needle irrigation; Group 2, double side-vented needle irrigation; Group 3, CanalBrush; Group 4, XP-endo Finisher; Group 5, Vibringe; Group 6, PUI; Group 7, LAI. The amount of remaining DAP was scored under a stereomicroscope. Results Group 4, Group 6, and Group 7 removed significantly more DAP than the other protocols in the coronal region. Group 7 was more efficient in the middle region; however, no significant difference was found between Group 7 and Group 6. No differences were found between groups in the apical region either, except for the comparisons between groups 7 and 2, and groups 2 and 3. Conclusions None of the investigated protocols were able to completely remove the DAP from the grooves. The Vibringe and XP-endo Finisher systems showed results similar to those of conventional needle irrigation.
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Affiliation(s)
- Hakan Gokturk
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Ismail Ozkocak
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Fevzi Buyukgebiz
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Osman Demir
- - Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics, Tokat, Turkey
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MICHELON C, FRIGHETTO M, LANG PM, BELLO MDC, PILLAR R, SERPA GF, BIER CAS. Efficacy of passive ultrasonic irrigation in removing root filling material during endodontic retreatment. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.02814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. Objective To evaluate the efficacy of passive ultrasonic irrigation (PUI) in the removal of residual root filling material after removing the bulk of the root filling with nickel-titanium rotary instruments. Material and method Eighteen mesial isthmus-containing roots of human mandibular molars were prepared and filled. The root canal filling was removed with the ProTaper Retreatment system and K-files. The specimens were randomized into 2 groups (n = 9), both irrigated with 2.5% NaOCl and 17% EDTA. In the conventional group, an irrigation syringe was used. In the PUI group, the PUI technique was used. The roots were sectioned longitudinally and evaluated under stereomicroscopy. Student’s t test was used to compare groups and the general linear model was used to compare the apical, cervical, and middle root thirds within each group, in regard to the percentages of remaining residual filling material. Result There was no statistically significant intergroup difference, irrespective of which root third was evaluated (P > 0.05). In the PUI group, the apical third showed a significantly higher percentage of residual filling material, in comparison with the cervical (P = 0.038) and middle (P = 0.029) thirds. Conclusion The PUI technique was not more effective than the conventional irrigation technique in removing residual root filling material during endodontic retreatment in root canals with a complex anatomy.
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Rosa RAD, Santini MF, Cavenago BC, Pereira JR, Duarte MAH, Só MVR. Micro-CT Evaluation of Root Filling Removal after Three Stages of Retreatment Procedure. Braz Dent J 2015; 26:612-8. [DOI: 10.1590/0103-6440201300061] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 09/14/2015] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to quantify the residual filling material after filling removal, re-preparation with rotary or reciprocating files and passive ultrasonic irrigation (PUI). Twenty maxillary molars were prepared using ProTaper instruments up to F1. The teeth were filled with AH Plus and ProTaper gutta-percha points using the single-cone technique. Thereafter, the specimens were scanned using a micro-computed tomography system (Micro-CT #1). Then, the root canal filling was removed using ProTaper Retreatment files, and a new scan was performed (Micro-CT #2). The specimens were divided into two groups according to the instrument used for re-preparation: ProTaper rotary or WaveOne reciprocating files (Micro-CT #3). Finally, PUI was performed, and a new micro-CT scan was performed (Micro-CT #4). Intragroup and intergroup analyses were performed using Friedman and Dunn's post hoc test and the Kruskal-Wallis and Dunn post hoc tests, respectively. Palatal canal presented the highest volume of residual filling material in all stages of endodontic retreatment (p<0.05). The main reduction of filling volume was achieved after using ProTaper Retreament (p<0.05). The amount of remaining filling material after using ProTaper Retreatment was similar to that achieved with rotary and reciprocating files and after PUI (p>0.05). Rotary and reciprocating files achieved similar removal of the root canal filling (p>0.05). The greatest reduction in filling material was achieved after using ProTaper Retreatment files. Rotary and reciprocating instruments and PUI did not improve the removal of root canal filling materials.
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Tanomaru-FIlho M, Torres FFE, Chávez-Andrade GM, Miano LM, Guerreiro-Tanomaru JM. Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning. Clin Oral Investig 2015; 20:1541-6. [DOI: 10.1007/s00784-015-1645-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 10/26/2015] [Indexed: 12/01/2022]
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