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Alessi RS, Jitumori RT, Bittencourt BF, Gomes GM, Gomes JC. Effect of irrigation protocols on smear layer removal, bond strength and nanoleakage of fiber posts using a self-adhesive resin cement. Restor Dent Endod 2023; 48:e28. [PMID: 37675450 PMCID: PMC10477426 DOI: 10.5395/rde.2023.48.e28] [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: 03/04/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives This study aimed to investigate the effect of the application method of 2% chlorhexidine (CHX) and its influence on the adhesion of fiberglass posts cemented with a self-adhesive resin cement. Materials and Methods Sixty human mandibular premolars were endodontically treated and divided into 5 groups (n = 12), according to the canal irrigant and its application method: 2 groups with conventional syringe irrigation (CSI)-2.5% sodium hypochlorite (NaOCl) (control) and 2% CHX- and 3 groups with 2% CHX irrigation/activation-by passive ultrasonic irrigation (PUI), Easy Clean file, and XP-Endo Finisher file. Two roots per group were evaluated for smear layer (SL) removal by scanning electron microscopy. For other roots, fiber posts were luted using a self-adhesive resin cement. The roots were sectioned into 6 slices for push-out bond strength (BS) (7/group) and nanoleakage (NL) (3/group). Data from SL removal were submitted to Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). Data from BS and NL were evaluated by 2-way analysis of variance and Tukey's test (α = 0.05). Results For SL removal and BS, the CHX irrigation/activation promoted better values than CSI with CHX (p < 0.05), but it was not significantly different from CSI with NaOCl (p > 0.05). For NL, the lowest values were obtained by the chlorhexidine irrigation/activation groups (p < 0.05). Conclusions Active 2% CHX irrigation can be used to improve the post space cleaning and adhesion before fiber post cementation with self-adhesive resin cements.
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Affiliation(s)
- Rodrigo Stadler Alessi
- Department of Restorative Dentistry, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
| | - Renata Terumi Jitumori
- Department of Restorative Dentistry, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
| | - Bruna Fortes Bittencourt
- Department of Restorative Dentistry, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
| | - Giovana Mongruel Gomes
- Department of Restorative Dentistry, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
| | - João Carlos Gomes
- Department of Restorative Dentistry, State University of Ponta Grossa (UEPG), Ponta Grossa, PR, Brazil
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Tong J, Liu L, Du J, Gao Y, Song D, Huang D. Effect of photon-induced photoacoustic streaming and shock-wave enhanced emission photoacoustic streaming technique on the removal of the smear layer after root canal preparation in curved root canals. J Dent Sci 2023; 18:157-164. [PMID: 36643274 PMCID: PMC9831787 DOI: 10.1016/j.jds.2022.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/21/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The efficiency of root canal irrigation has an important impact on the prognosis of root canal treatment. Photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) are the special modality of Er: YAG laser, whether can they improve the efficiency of root canal irrigation remains to be studied. Materials and methods Fifty human teeth with curved root canals were collected and stored in the thymol solution until used in the study. After traditional endodontic cavities preparation, root canals were prepared to size #35 with a 0.04 taper. The final irrigating techniques were as follows: (I) manual dynamic activation (MDA), (II) ultrasonically activated irrigation (UAI), (III) sonically activated irrigation (SAI), (IV) PIPS, and (V) SWEEPS. Fifty teeth were randomly divided into five groups mentioned above. After root canal preparation, the roots were cleaved longitudinally. The dentine surfaces were photographed from the coronal, middle, and apical third of the root by scanning electron microscopy operated at a low vacuum. Two examiners separately graded each image according to the remained smear layer situations. Results PIPS and SWEEPS groups showed fewer smear layers remaining than the others in the middle and the apical third (P < 0.05) of the root canal. In contrast, in the coronal third, five groups showed no significant difference (P > 0.05). Conclusion PIPS and SWEEPS showed superior smear layer clearing efficiency than traditional irrigating techniques in curved root canals.
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Affiliation(s)
- Jiaru Tong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Elsayed M. Multiparameter image analysis to evaluate dentinal tubules patency after using different irrigation protocols. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_109_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Raj S, Dhingra A, Jha P, Nikhil V, Ravinder R, Mishra P. To compare the continuous and intermittent irrigation method on the removal of dentin debris from root canals and to evaluate the dynamics of irrigant flow using computational fluid dynamics. J Conserv Dent 2021; 24:94-99. [PMID: 34475688 PMCID: PMC8378498 DOI: 10.4103/jcd.jcd_636_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/24/2021] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
Aim: This study aimed to compare the efficiency of continuous and intermittent irrigating methods on the removal of dentin debris from the simulated grooves and to evaluate the dynamics of irrigant using computational fluid dynamics (CFD). Methodology: Seventy-five extracted human permanent maxillary canines were selected. Access cavities were made, working length was determined, and canals were prepared by crown down technique. The teeth were split longitudinally and standard groove 2.0 mm in length was made in split halves and each groove was filled with dentin debris and the images were taken under a microscope (E200). The halves were re-assembled and divided into five groups based on different irrigation methods. Group 1: ultrasonic Irrigation with continuous flow for 3.0 min; Group 2: ultrasonic irrigation with continuous flow for 1.5 min; Group 3: ultrasonic irrigation with intermittent flow for 3.0 min; Group 4: ultrasonic irrigation with the intermittent flow for 1.5 min; and Group 5: syringe irrigation for 1 min. The root halves were again separated and re-evaluated for debris elimination after the irrigation protocol for all the groups separately. The effect of time and method of passive ultrasonic irrigation were compared. For the computational fluid analysis, a GAMBIT 2.2 (Ansys) software was used for mesh construction. FLUENT 6.2 (Ansys) software was used to set the boundary conditions and reconstruction of the canal; flow patterns and turbulence were graphically constructed. Results: The continuous irrigation methods were better at debris removal than intermittent irrigation flow methods. The CFD showed that the turbulence of flow of irrigant was dependent on the inlet velocity and pressure of the irrigant. Conclusion: Debris removal from the simulated grooves was better with continuous irrigation compared with intermittent irrigation. CFD study revealed that the turbulence that was affected by the velocity and pressure of the irrigant introduced and is a variable entity.
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Affiliation(s)
- Shalya Raj
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Anil Dhingra
- Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Padmanabh Jha
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Rohit Ravinder
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Preeti Mishra
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
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Srivastava I, Srivastava S, Grover R, Paliwal A. Comparative Evaluation of Efficacy of Different Irrigating Needles and Devices in Removal of Debris from Apical Third of Root Canal: An In-vitro SEM Study. Contemp Clin Dent 2021; 12:222-229. [PMID: 34759677 PMCID: PMC8525803 DOI: 10.4103/ccd.ccd_468_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: 05/30/2020] [Revised: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Irrigants were required to eliminate the microbes and debris from the intraradicular space and must have direct contact with the entire root canal wall. Therefore, different irrigation methods have been proposed to deliver the irrigant as close as possible to the remote areas of the root canal. AIM The aim of the present study is to evaluate the cleaning efficacy of single-beveled needle, side-vented needle, endovac, and endo-irrigator plus in the removal of debris from apical third of root canal by Scanning Electron Microscope. MATERIALS AND METHODS Forty single-rooted freshly extracted human permanent mandibular premolars were collected. Root canals were cleaned and instrumented till X2 (25/06) with rotary Protaper Next at working length 1 mm short of the apex. Teeth were randomly divided into four equal groups: Group 1 (n = 10): Endovac, Group 2 (n = 10): Endo irrigator plus, Group 3 (n = 10): Side-vented needle, and Group 4 (n = 10): Single-beveled needle. Irrigation was done with 5.25% NaOCl, followed by 17% ethylenediaminetetraacetic acid. Samples were sectioned and examined under SEM at apical levels. STATISTICAL ANALYSIS Analysis of variance followed by Tukey's post hoc test was performed. RESULTS The level of debris removal efficacy is as follows: Endovac > Endo-irrigator plus > Side-vented needle ~ Single-beveled needle. CONCLUSION Endovac showed the maximum number of debris removal and has better cleaning efficacy in the apical areas of the root canal, followed by Endo irrigator plus, Side-vented needle and Single-beveled needle.
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Affiliation(s)
- Isha Srivastava
- Department of Conservative Dentistry and Endodontics, All India Institute of Medical Sciences, Gorakhpur, India
| | - Sanjeev Srivastava
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India
| | - Rohit Grover
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India
| | - Ajay Paliwal
- Department of Conservative Dentistry and Endodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Zancan RF, Di Maio A, Tomson PL, Duarte MAH, Camilleri J. The presence of smear layer affects the antimicrobial action of root canal sealers. Int Endod J 2021; 54:1369-1382. [PMID: 33763882 DOI: 10.1111/iej.13522] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
AIM To assess the chemical and microstructural characteristics of dentine after the use of two irrigation protocols and correlate this with the antimicrobial properties of hydraulic calcium silicate cement (HCSC) sealers and changes to the dentine structure/chemistry after sealer placement. METHODOLOGY Two irrigation protocols - Protocol A using 2% NaOCl used 5 mL/5 min and Protocol B with 2% NaOCl (5 mL/5 min) followed by 17% EDTA (5 mL/3 min) - were used to prepare dentine. The chemical and microstructural changes following irrigation were assessed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy (n = 5) on dentine obtained from the mid-root and coronal parts of extracted human teeth. Four sealers (AH Plus, BioRoot, MTA Fillapex, TotalFill) were characterized by SEM/EDS (n = 3). The ability of the sealers to eradicate intratubular Enterococcus faecalis biofilms was assessed by live/dead dye and confocal laser scanning microscopy to measure the percentage of living cells. The effect of combined irrigation and root filling on dentine was assessed by SEM and EDS analysis (n = 5). Statistical analysis was undertaken using one-way anova and a number of post hoc tests to detect intergroup differences. The F-test was used for comparison of variances in the microbiology testing. RESULTS The use of NaOCl alone left the smear layer intact, with traces of chlorine remaining on dentine. The use of BioRoot sealer restored the calcium levels of dentine which had been depleted by the irrigation with EDTA. BioRoot exhibited antimicrobial properties against intratubular bacteria even in the presence of smear layer (Protocol A). Smear layer removal improved the bactericidal effect of all sealers and Ca2+ leaching. The use of a chelating agent was important for the intratubular sealer penetration for AH Plus but not the other sealers. CONCLUSION The removal of smear layer was necessary for penetration of AH Plus into the dentinal tubules. BioRoot was a more effective sealer in reducing the bacterial load in the dentinal tubules than the other materials tested and the presence of smear layer did not affect its activity.
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Affiliation(s)
- R F Zancan
- Department of Restorative Dentistry, Dental Materials and Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - A Di Maio
- School of Biosciences, University of Birmingham, Birmingham, UK
| | - P L Tomson
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M A H Duarte
- Department of Restorative Dentistry, Dental Materials and Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - J Camilleri
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Damade Y, Kabir R, Gaddalay S, Deshpande S, Gite S, Bambale S, Dubey N. Root canal debridement efficacy of heated sodium hypochlorite in conjunction with passive ultrasonic agitation: An ex vivo study. J Dent Res Dent Clin Dent Prospects 2021; 14:235-238. [PMID: 33575013 PMCID: PMC7867682 DOI: 10.34172/joddd.2020.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/23/2020] [Indexed: 11/09/2022] Open
Abstract
Background. This study aimed to investigate the endodontic debridement efficacy of different sodium hypochlorite (NaOCl) irrigation regimens with and without ultrasonic agitation, followed by ethylenediaminetetraacetic acid (EDTA) via scanning electron microscopy (SEM) after using a rotary instrumentation system.
Methods. Mandibular premolars (n=50) were randomly divided into five experimental groups (n=10) for root canal instrumentation with ProTaper Universal rotary system up to F3. The root canal system was treated with intracanal-heated NaOCl (100°C) or preheated NaOCl (55°C), followed by ultrasonic agitation and EDTA treatment. Samples irrigated with conventional needle irrigation (CNI) using normal saline solution were used as controls. Debridement efficacy was analyzed by SEM. A five-point scale was used to estimate the presence/absence of debris for each canal segment (coronal, middle, and apical). The results were analyzed using one-way ANOVA and post hoc Tukey tests (P<0.05).
Results. The experimental groups exhibited less debris compared to CNI with saline (P<0.05). The amount of debris decreased significantly for the group with NaOCl intracanal heating compared to extraoral heating. Ultrasonic agitation further enhanced the root canal debridement efficacy of NaOCl.
Conclusion. In summary, intracanal heating of NaOCl with and without ultrasonic agitation followed by EDTA appears to be a promising method to flush debris from the root canal system.
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Affiliation(s)
- Yogesh Damade
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Ramchandra Kabir
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Sunanda Gaddalay
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Sharvaree Deshpande
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Sonali Gite
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Sandip Bambale
- Department of Conservative Dentistry & Endodontics, Maharashtra Institute of Dental Sciences & Research Dental College, Latur, India
| | - Nileshkumar Dubey
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Khoshroo K, Shah B, Johnson A, Baeten J, Barry K, Tahriri M, Ibrahim MS, Tayebi L. A new phantom to evaluate the tissue dissolution ability of endodontic irrigants and activating devices. Restor Dent Endod 2020; 45:e45. [PMID: 33294410 PMCID: PMC7691255 DOI: 10.5395/rde.2020.45.e45] [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: 11/16/2019] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to introduce a gelatin/bovine serum albumin (BSA) tissue standard, which provides dissolution properties identical to those of biological tissues. Further, the study evaluated whether the utilization of endodontic activating devices led to enhanced phantom dissolution rates. MATERIALS AND METHODS Bovine pulp tissue was obtained to determine a benchmark of tissue dissolution. The surface area and mass of samples were held constant while the ratio of gelatin and BSA were varied, ranging from 7.5% to 10% gelatin and 5% BSA. Each sample was placed in an individual test tube that was filled with an appropriate sodium hypochlorite solution for 1, 3, and 5 minutes, and then removed from the solution, blotted dry, and weighed again. The remaining tissue was calculated as the percent of initial tissue to determine the tissue dissolution rate. A radiopaque agent (sodium diatrizoate) and a fluorescent dye (methylene blue) were added to the phantom to allow easy quantification of phantom dissolution in a canal block model when activated using ultrasonic (EndoUltra) or sonic (EndoActivator) energy. RESULTS The 9% gelatin + 5% BSA phantom showed statistically equivalent dissolution to bovine pulp tissue at all time intervals. Furthermore, the EndoUltra yielded significantly more phantom dissolution in the canal block than the EndoActivator or syringe irrigation. CONCLUSIONS Our phantom is comparable to biological tissue in terms of tissue dissolution and could be utilized for in vitro tests due to its injectability and detectability.
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Affiliation(s)
- Kimia Khoshroo
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Brinda Shah
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | | | | | | | - Mohamed S. Ibrahim
- Marquette University School of Dentistry, Milwaukee, WI, USA.,Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
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Rubio J, Zarzosa JI, Pallarés A. A Comparative Study of Cyclic Fatigue of 10 Different Types of Endodontic Instruments: an in Vitro Study. Acta Stomatol Croat 2019; 53:28-36. [PMID: 31118530 PMCID: PMC6508929 DOI: 10.15644/asc53/1/3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study was designed to test the null hypothesis that there were no significant differences between size 25 files F360, F6 SkyTaper, Hyflex EDM, iRace, Neoniti, One Shape Protaper Next, Reciproc, Revo-S and Wave One Gold in terms of resistance to cyclic fatigue and length of broken fragments. Material and methods 300 new size 25 files of the systems studied were selected (n=30). The instruments were mechanized with a X-Smart Plus endo motor at the speed and torque recommended by the manufacturer, holding the instruments steady with a clamping mechanism, with passive adjustment and without pressure in a stainless-steel block. The time was calculated in seconds until fracture. The number of fatigue cycles was calculated as (Resistance (s) x Speed)/60. The separated fragment lengths were measured with a digital Vernier calliper. A statistical analysis was performed with the SPSS 18 programme at a 95% confidence level, using the Levene´s Test to compare variances, the Welch’s Test to compare means, and the Games-Howell´s Test to reveal differences between groups. Results The Levene’s Test showed no equal variances (P<0.05). The Welch’s Test (P<0.05) showed significant differences in cyclic fatigue and separated fragment lengths. The Games-Howell test (P<0.05) exhibited significant differences in multiple comparisons, (P<0.05). Conclusions The systems with CM-Wire (Hyflex EDM and Neoniti) were superior in resistance to the other systems for cyclic fatigue. For separated fragment lengths, F360 (conventional NiTi) and Reciproc (M-Wire) were better significantly better in terms of resistance.
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Affiliation(s)
- Jorge Rubio
- Department of Endodontics and Restorative Dentistry, Catholic University of Valencia, Spain
| | - José Ignacio Zarzosa
- Department of Endodontics and Restorative Dentistry, Catholic University of Valencia, Spain
| | - Antonio Pallarés
- Department of Endodontics and Restorative Dentistry, Catholic University of Valencia, Spain
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Shalan LA, Al-Huwaizi HF. Cleaning Efficiency of Root Canal after Irrigation with New Irrigation Technique: A Scanning Electron Microscopic Study. IRANIAN ENDODONTIC JOURNAL 2018; 13:102-107. [PMID: 29692844 PMCID: PMC5800450 DOI: 10.22037/iej.v13i1.17285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to evaluate the ability of pressurized water irrigation technique (AquaPick Device) as an intra-canal irrigation technique and compare it with sonic irrigation device (Endoactivator) for their ability to remove smear layer from canals. Methods and Materials: Total number of 80 single rooted teeth (premolars) were prepared, divided into eight main groups, Group 1: Aquapick with apically vented needle/18 mm depth, Group 2: Aquapick with apically vented needle/15 mm depth, Group 3: Endoactivator device/18 mm depth, Group 4: Endoactivator device/15 mm depth, Group5: Aquapick with 2 side vented needle/18 mm depth, Group 6: Aquapick with 2 side vented needle/15 mm depth and two control groups. Then all samples were tested by SEM in 3, 6 and 9-mm distances from the apical foramen. The data were statistically analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: There was a high significant difference among the tested groups with the best removal of smear layer by the use of pressurized water irrigation device with apical vented needle especially at the 3 mm area. Conclusion: Pressurized water irrigation technique could be used as intra-canal irrigation technique with good results.
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Affiliation(s)
- Linz A Shalan
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Hussain F Al-Huwaizi
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2017; 51:605-621. [PMID: 29178166 DOI: 10.1111/iej.12877] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022]
Abstract
AIMS To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). METHODOLOGY Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1 mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis. RESULTS From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57 / SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53 / SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62 / SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1 mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. CONCLUSIONS IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.
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Affiliation(s)
- S S Virdee
- Department of Restorative Dentistry, Birmingham Dental Hospital, Birmingham, UK
| | - D W Seymour
- Department of Restorative Dentistry, York Hospital, York, UK
| | - D Farnell
- Department of Dentistry, Cardiff University School of Dentistry, Cardiff, UK
| | - G Bhamra
- Department of Restorative Dentistry, Cardiff University Dental Hospital, Cardiff, UK
| | - S Bhakta
- Department of Restorative Dentistry, Leeds Dental Institute, Leeds, UK
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Prado MC, Leal F, Gusman H, Simão RA, Prado M. Effects of auxiliary device use on smear layer removal. J Oral Sci 2016; 58:561-567. [PMID: 28025441 DOI: 10.2334/josnusd.16-0216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study evaluated the effects of different auxiliary irrigation devices on smear layer removal with a chelating solution (QMix). Fifty single-rooted permanent human teeth were shaped with a sequence of nickel-titanium instruments. A 2% chlorhexidine gel was used as a chemical auxiliary substance during preparation. Samples were assigned to five groups (n = 10 each) according to final irrigation protocol, namely, distilled water (control group), QMix 1 min, QMix + passive ultrasonic irrigation (PUI), QMix + plastic endodontic finishing file (EC), and QMix 3 min. Teeth were prepared and evaluated by scanning electron microscopy, and three photomicrographs (magnification, 1,000×) were obtained for each root third. Two blinded and precalibrated evaluators analyzed and scored the images, and the data were statistically analyzed by the Kruskal-Wallis and Dunn tests (P < 0.05). Groups were ranked according to the extent of smear layer removal. The total area of the root canal walls and apical root thirds was calculated, and the groups ranked PUI > EC = QMix 3 min > QMix 1 min > control. QMix 1 min was effective for smear layer removal only when used with auxiliary devices, and QMix + passive ultrasonic irrigation yielded the best results, particularly for the apical third.(J Oral Sci 58, 561-567, 2016).
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Affiliation(s)
- Marina C Prado
- Proclin Department, School of Dentistry, Rio de Janeiro State University
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Jadhav GR, Mittal P, Kulkarni A, Syed S, Bagul R, Elahi S, Kalra D. Comparative evaluation of canal cleaning ability of various rotary endodontic filesin apical third: A scanning electron microscopic study. Dent Res J (Isfahan) 2016; 13:508-514. [PMID: 28182065 PMCID: PMC5256014 DOI: 10.4103/1735-3327.197031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the canal cleaning ability of three novel endodontic rotary instruments and compare with ProTaper files as a control in apical third of root canals under scanning electron microscopy (SEM). MATERIALS AND METHODS Eighty freshly extracted mandibular premolars were selected according to inclusion criteria. Buccal cusp tips were ground to ensure having a flat coronal reference point with a total tooth length of 16 mm for all samples. Teeth were divided equally into four groups: Group I (ProTaper group), Group II (ProTaper next group), Group III (variable taper group), and Group IV (self-adjusting file [SAF] group). Using SEM, the dentinal surfaces were observed and rated at apical thirds with a magnification of ×1000 for the presence/absence of smear layer and debris. Descriptive analysis was performed, and analysis of variance with Bonferroni post hoc test was carried out for comparison between the groups, at a significance level of 0.05. RESULTS There was statistically significant difference between Group II and Group IV for debris (P = 0.047) and smear layer (P = 0.037). CONCLUSION In apical third of root canal, SAF showed statistically significant canal cleaning ability due to combined effect of continuous streaming irrigation with effectively replacing the irrigant from the apical portion of the root canal, irrigants activation through the creation of turbulence, and its self-adapting design to root canal anatomy with a scrubbing motion on the canal walls.
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Affiliation(s)
- Ganesh Ranganath Jadhav
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Priya Mittal
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, New Delhi, India
| | - Anish Kulkarni
- Department of Conservative Dentistry and Endodontics, Pune, Maharashtra, India
| | - Shibli Syed
- Department of Orthodontics, Pune, Maharashtra, India
| | | | - Saina Elahi
- Department of Periodontology, Pune, Maharashtra, India
| | - Dheeraj Kalra
- Department of Public Health Dentistry, YMT Dental College, Mumbai, Maharashtra, India
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Alsilani R, Jadu F, Bogari DF, Jan AM, Alhazzazi TY. Single file reciprocating systems: A systematic review and meta-analysis of the literature: Comparison of reciproc and WaveOne. J Int Soc Prev Community Dent 2016; 6:402-409. [PMID: 27891305 PMCID: PMC5109853 DOI: 10.4103/2231-0762.192945] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 09/29/2016] [Indexed: 12/05/2022] Open
Abstract
The introduction of single-file nickel-titanium (NiTi) reciprocating systems has been a major breakthrough in the field of endodontics. Thus, the aim of this study was to compare the available reciprocating systems, Reciproc and WaveOne, using a meta-analysis with different parameters. A comprehensive electronic literature search for Reciproc and WaveOne using PubMed and Google scholar was initially conducted in September 2014 and updated in September 2016. Inclusion and exclusion criteria were then established. Twenty-six studies were qualified for the systematic review, and only three studies were considered for the meta-analysis using cyclic fatigue resistance as the main parameter. The time to fracture for the Reciproc and WaveOne systems ranged from 119.7 sec to 156.4 sec and 74.8 sec to 99.6 sec, respectively. The pooled difference in mean time to fracture was longer for the Reciproc system by 45.6 sec. This difference was statistically significantly at P value < 0.001. In conclusion, our study supports the finding that Reciproc is more resistant to cyclic fatigue than WaveOne. However, with regard to other parameters, mixed results were obtained. Well-designed randomized clinical trials comparing both systems under the same experimental conditions should be done in future studies.
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Affiliation(s)
- Rana Alsilani
- Department of Dental, Batterjee Medical School, Jeddah, Saudi Arabia
| | - Fatima Jadu
- Department of Diagnostic Oral Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Dania F Bogari
- Department of Endodontics, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Ahmed M Jan
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Turki Y Alhazzazi
- Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
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Retsas A, Koursoumis A, Tzimpoulas N, Boutsioukis C. Uncontrolled Removal of Dentin during In Vitro Ultrasonic Irrigant Activation in Curved Root Canals. J Endod 2016; 42:1545-9. [DOI: 10.1016/j.joen.2016.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/28/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
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Boutsioukis C, Tzimpoulas N. Uncontrolled Removal of Dentin during In Vitro Ultrasonic Irrigant Activation. J Endod 2016; 42:289-93. [DOI: 10.1016/j.joen.2015.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/27/2015] [Accepted: 09/28/2015] [Indexed: 12/21/2022]
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Ertuğrul İF, Maden M, Orhan EO, Özkorucuklu SP. The effect of micro-electric current and other activation techniques on dissolution abilities of sodium hypochlorite in bovine tissues. BMC Oral Health 2015; 15:161. [PMID: 26681346 PMCID: PMC4683763 DOI: 10.1186/s12903-015-0152-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/14/2015] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the study was to evaluate the effects of micro-electric current on sodium hypochlorite’s (NaOCl’s) tissue-dissolution abilities, compared with other activation methods, including sonic, ultrasonic, pipetting, and temperature. Methods Bovine muscle tissues (n = 154) with standard sizes and weights were prepared and divided into two temperature groups: room temperature and 45 °C. Each temperature group was divided into seven sub-groups by activation methods: D = distilled water (−control); NaOCl = 5.25 % passive NaOCl (+ control); P = 5.25 % NaOCl with pipetting; SA = 5.25 % NaOCl with sonic activation; UA = 5.25 % NaOCl with ultrasonic activation; E-NaOCl = 5.25 % NaOCl with micro-electric current; and E-NaOCl + P = 5.25 % NaOCl with micro-electric current and pipetting. Specimens were weighed before and after treatment. Average, standard deviation, minimum, maximum, and median were calculated for each group. Resulting data were analyzed statistically using multi-way ANOVA and Tukey HSD tests. The level of the alpha-type error was set at < 0.05. Results At room temperature, the E-NaOCl + P group dissolved the highest amount of tissue (p < 0.05), and the UA, SA, and P groups dissolved significantly higher amounts of tissue than did the positive control or E-NaOCl groups (p < 0.05). At 45 °C, there was no significant difference between the SA and E-NaOCl groups (p > 0.05), and the E-NaOCl + P group dissolved a higher amount of tissue than any other group (p < 0.05). Conclusions Using NaOCl with micro-electric current can improve the tissue-dissolving ability of the solution. In addition, this method can be combined with additional techniques, such as heating and/or pipetting, to achieve a synergistic effect of NaOCl on tissue dissolution.
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Affiliation(s)
| | - Murat Maden
- Department of Endodontics, Ağız Diş Sağlığı Merkezi, Aydın, Turkey.
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Osmangazi University, Eskişehir, Turkey.
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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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da Costa Lima GA, Aguiar CM, Câmara AC, Alves LC, dos Santos FAB, do Nascimento AE. Comparison of Smear Layer Removal Using the Nd:YAG Laser, Ultrasound, ProTaper Universal System, and CanalBrush Methods: An In Vitro Study. J Endod 2015; 41:400-4. [DOI: 10.1016/j.joen.2014.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/31/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
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Metzger Z. The self-adjusting file (SAF) system: An evidence-based update. J Conserv Dent 2014; 17:401-19. [PMID: 25298639 PMCID: PMC4174698 DOI: 10.4103/0972-0707.139820] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 11/04/2022] Open
Abstract
Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics.
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Affiliation(s)
- Zvi Metzger
- Department of Endodontology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Martins Justo A, Abreu da Rosa R, Santini MF, Cardoso Ferreira MB, Pereira JR, Húngaro Duarte MA, Reis Só MV. Effectiveness of final irrigant protocols for debris removal from simulated canal irregularities. J Endod 2014; 40:2009-14. [PMID: 25266470 DOI: 10.1016/j.joen.2014.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 08/12/2014] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aim of this in vitro study was to compare the effectiveness of saline, 2.5% sodium hypochlorite, and 2% chlorhexidine, with or without passive ultrasonic irrigation (PUI), in debris removal from simulated canal irregularities within prepared root canals. METHODS Ninety bovine lateral incisors were randomly divided into 3 main groups (n = 30) based on the irrigant and prepared with hand files attached to an oscillating handpiece (NSK, Tokyo, Japan) up to a size #80 K-file. Next, the teeth were split longitudinally, and a standardized groove was prepared into the apical third and filled with dentin debris. After the halves were reassembled, they were placed in a muffle. Each main group was randomly subdivided into 2 groups (n = 14) and was treated with different final irrigation protocols. In the sodium hypochlorite/PUI, chlorhexidine/PUI, and saline/PUI groups, the solution was ultrasonically activated 3 times for 20 seconds. In the remaining groups, PUI was not performed. Specimens were scored for debris removal and analyzed under a scanning electron microscope. RESULTS An association was observed between the score of debris removal and protocols using PUI (P < .05). No association was observed between the scores of debris removal and the irrigants (P = .87). CONCLUSIONS Final irrigation protocols that used PUI were more effective in removing debris from simulated canal irregularities into the apical third than those that did not use it.
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Affiliation(s)
- Aline Martins Justo
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Manuela Favarin Santini
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Beatriz Cardoso Ferreira
- Department of Pharmacology Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jefferson Ricardo Pereira
- Department of Prosthodontics, Dental School, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | | | - Marcus Vinícius Reis Só
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Efficacy of Two Irrigants Used with Self-Adjusting File System on Smear Layer: A Scanning Electron Microscopy Study. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:289164. [PMID: 27355025 PMCID: PMC4897484 DOI: 10.1155/2014/289164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/03/2014] [Accepted: 07/07/2014] [Indexed: 11/17/2022]
Abstract
Mechanical instrumentation of root canals produces a smear layer that adversely affects the root canal seal. The aim of this study was to evaluate efficacy of MTAD and citric acid solutions used with self-adjusting file (SAF) system on smear layer. Twenty-three single-rooted human teeth were used for the study. Canals were instrumented manually up to a number 20 K file size. SAF was used to prepare the root canals. The following groups were studied: Group 1: MTAD + 5.25% NaOCl, Group 2: 20% citric acid + 5.25% NaOCl, and Group 3: Control (5.25% NaOCl). All roots were split longitudinally and subjected to scanning electron microscopy. The presence of smear layer in the coronal, middle, and apical thirds was evaluated using a five-score evaluation system. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. In the coronal third, Group 2 exhibited the best results and was statistically different froms the other groups (P < 0.05). There was not a significant difference among the three thirds of groups according to in-group comparisons (P > 0.05). The solutions used in Group 1 and 2 could effectively remove smear layer in most of the specimens. However, citric acid was more effective than MTAD in the three thirds of the canal.
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Guo X, Miao H, Li L, Zhang S, Zhou D, Lu Y, Wu L. Efficacy of four different irrigation techniques combined with 60 °C 3% sodium hypochlorite and 17% EDTA in smear layer removal. BMC Oral Health 2014; 14:114. [PMID: 25201549 PMCID: PMC4168203 DOI: 10.1186/1472-6831-14-114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Efforts to improve the efficacy of smear layer removal by applying irrigant activation at the final irrigation or by elevating the temperature of the irrigant have been reported. However, the combination of such activation protocols with 60 °C 3% sodium hypochlorite (NaOCl) has seldom been mentioned. The aim of this study was to compare the efficacy in smear layer removal of four different irrigation techniques combined with 60 °C 3% NaOCl and 17% EDTA. METHODS Fifty single-rooted teeth were randomly divided into five groups (n = 10) according to the irrigant agitation protocols used during chemomechanical preparation(Dentsply Maillefer, Ballaigues, Switzerland): a side-vented needle group, a ultrasonic irrigation (UI) group, a NaviTip FX group, an EndoActivator group, and a control group (no agitation). After each instrumentation, the root canals were irrigated with 1 mL of 3% NaOCl at 60 °C for 1 minute, and after the whole instrumentation, the root canals were rinsed with 1 mL of 17% EDTA for 1 minute. Both NaOCl and EDTA were activated with one of the five irrigation protocols. The efficacy of smear layer removal was scored at the apical, middle and coronal thirds. The Data were statistically analyzed using SAS version 9.2 for Windows (rank sum test for a randomised block design and ANOVA). RESULTS No significant differences among the NaviTip FX group, EndoActivator group and control groups, and each of these groups showed a lower score than that of UI group (P < 0.05). Within each group, all three thirds were ranked in the following order: coronal > middle > apical (P < 0.05). In the coronal third, the NaviTip FX group was better than UI group. In the middle and apical third, the differences were not significant among any of the groups. CONCLUSIONS Even without any activation, the combination of 60 °C 3% NaOCl and 17% EDTA could remove the smear layer effectively, similar to NaviTip FX or EndoActivator, and these three protocols were more effective than UI. However, regardless of different types of irrigation technique applied, complete removal of the smear layer was not achieved, particularly in the apical third.
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Affiliation(s)
| | | | | | | | | | | | - Ligeng Wu
- From the Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin 300070, PR China.
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Dua D, Dua A, Uppin VM. A Scanning electron microscopic evaluation of intracanal smear layer removal by two different final irrigation activation systems. Contemp Clin Dent 2014; 5:37-41. [PMID: 24808693 PMCID: PMC4012115 DOI: 10.4103/0976-237x.128661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The aim of this study was to compare smear layer removal at apical 1 mm level after final irrigation activation with an EndoVac system and Max-I probe. Materials and Methods: Fifty freshly extracted maxillary central incisors were randomly divided into two groups after completing cleaning and shaping with ProTaper rotary files. In one group, final irrigation was performed with an EndoVac system while in the other group final irrigation was performed with a 30 gauge Max-I probe. 3% sodium hypochlorite and 17% ethylenediaminetetracetic acid were used as final irrigants in all teeth. After instrumentation and irrigation, the teeth were sectioned longitudinally into buccal and palatal halves and viewed under a scanning electron microscope for evaluation of the smear layer. Statistical analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Results: The EndoVac group showed significantly better smear layer removal compared with the Max-I probe at the apical 1 mm level. Conclusion: An apical negative pressure system (EndoVac) results in better debridement at apical 1 mm when compared with side-vented closed ended needle irrigation (Max-I probe).
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Affiliation(s)
- Deepti Dua
- Department of Conservative Dentistry and Endodontics, Private Practice, New Delhi, Maulana Azad Institute of Dental Sciences, India
| | - Ankur Dua
- Department of Conservative Dentistry and Endodontics, Private Practice, New Delhi, Maulana Azad Institute of Dental Sciences, India
| | - Veerendra M Uppin
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
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Holliday R, Alani A. Traditional and contemporary techniques for optimizing root canal irrigation. ACTA ACUST UNITED AC 2014; 41:51-2, 54, 56-8 passim. [PMID: 24640478 DOI: 10.12968/denu.2014.41.1.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Canal irrigation during root canal treatment is an important component of chemo-mechanical debridement of the root canal system. Traditional syringe irrigation can be enhanced by activating the irrigant to provide superior cleaning properties. This activation can be achieved by simple modifications in current technique or by contemporary automated devices. Novel techniques are also being developed, such as the Self-adjusting File (Re-Dent-Nova, Ra'anana, Israel), Ozone (Healozone, Dental Ozone, London, UK), Photoactivated Disinfection and Ultraviolet Light Disinfection. This paper reviews the techniques available to enhance traditional syringe irrigation, contemporary irrigation devices and novel techniques, citing their evidence base, advantages and disadvantages. CLINICAL RELEVANCE Recent advances in irrigation techniques and canal disinfection and debridement are relevant to practitioners carrying out root canal treatment.
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Zart PTM, Michelon C, Zanatta FB, Bier CAS, Manfio AP. Eficácia da irrigação ultrassônica passiva na remoção de hidróxido de cálcio. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/s1807-25772014000100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Remanescentes de Hidróxido de Cálcio [Ca(OH)2] podem interferir na qualidade da obturação endodôntica. OBJETIVO : Avaliar a eficácia da Irrigação Ultrassônica Passiva (IUP) associada à técnica convencional na remoção de medicação intracanal à base de Ca(OH)2. METODOLOGIA: Trinta dentes humanos anteriores monorradiculares foram usados. Os canais radiculares foram preparados com instrumentos manuais tipo K e preenchidos com medicação intracanal à base de Ca(OH)2, contendo PMCC e propilenoglicol. Após sete dias, a pasta de Ca(OH)2 foi removida de todos os canais radiculares com um instrumento manual e irrigação de NaOCl 1% com seringa. Os espécimes foram randomizados em dois grupos (n=12) de acordo com a irrigação final: Irrigação Manual - agitação manual de EDTA 17 % e irrigação de NaOCl 1%; IUP - agitação ultrassônica de NaOCl 1% (três ativações de 20s) seguida da ativação de EDTA 17% por 1 min. O Grupo Controle (n=6) não recebeu medicação intracanal. Todos os espécimes foram clivados e a quantidade de Ca(OH)2 remanescente foi calculada com o auxílio do estereomicroscrópio (20×). Os testes Kruskall-Wallis e Wilcoxon foram utilizados para avaliar a porcentagem de Ca(OH)2 remanescente. RESULTADO: O grupo da IUP apresentou, estatisticamente, as menores porcentagens de Ca(OH)2 remanescente, quando comparado ao grupo da Irrigação Manual, independentemente dos terços analisados (P < 0,05). O terço apical apresentou a maior quantidade de medicação residual, em ambos os grupos (P < 0,05). CONCLUSÃO : A associação da IUP com a técnica convencional demonstrou ser mais eficiente na remoção de medicação intracanal à base de Ca(OH)2 do que a combinação da Irrigação Manual com a técnica convencional.
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Türker SA, Koçak MM, Koçak S, Sağlam BC. Comparison of calcium hydroxide removal by self-adjusting file, EndoVac, and CanalBrush agitation techniques: An in vitro study. J Conserv Dent 2013; 16:439-43. [PMID: 24082574 PMCID: PMC3778627 DOI: 10.4103/0972-0707.117523] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 07/04/2013] [Accepted: 07/11/2013] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study comparatively evaluated the efficacy of self-adjusting file (SAF), Endovac, and CanalBrush irrigant agitation protocols in removing calcium hydroxide (Ca(OH)2) from the root canals. Materials and Methods: Sixty extracted human mandibular canine teeth were instrumented with ProTaper rotary instruments to size #40 and dressed with Ca(OH)2. The roots were randomly assigned to four groups according to irrigant agitation protocol used (n = 15). In Group 1: Conventional syringe irrigation (no activation, control); Group 2: Rotary brush agitation (CanalBrush); Group 3: Apical negative pressure irrigation (EndoVac system); and Group 4: Sonic agitation (SAF) were used. Scanning electron microscopic (SEM) evaluation was done for assessment of Ca(OH)2 removal in the coronal and apical thirds. Statistical analysis was performed by Wilcoxon and Kruskal-Wallis tests. Results: There were statistically significant differences among the groups (P = 0.218). A statistically significant difference was seen between the test groups in Ca(OH)2 removal from the apical third of the canal (P < 0.05). In the coronal third, there was no difference between the groups (P > 0.05). The most efficient Ca(OH)2 removal in apical third was recorded in Group 3 (EndoVac) and Group 4 (SAF) (P < 0.05). In Group 4 (sonic agitation), there was no significantly difference between Ca(OH)2 removal in coronal and apical thirds. Conclusions: SAF and EndoVac showed significantly better performance than CanalBrush and conventional syringe irrigation in removing Ca(OH)2 from apical third of the root canals.
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Affiliation(s)
- Sevinç Aktemur Türker
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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Snjaric D, Carija Z, Braut A, Halaji A, Kovacevic M, Kuis D. Irrigation of human prepared root canal--ex vivo based computational fluid dynamics analysis. Croat Med J 2013; 53:470-9. [PMID: 23100209 PMCID: PMC3494157 DOI: 10.3325/cmj.2012.53.470] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To analyze the influence of the needle type, insertion depth, and irrigant flow rate on irrigant flow pattern, flow velocity, and apical pressure by ex-vivo based endodontic irrigation computational fluid dynamics (CFD) analysis. METHODS Human upper canine root canal was prepared using rotary files. Contrast fluid was introduced in the root canal and scanned by computed tomography (CT) providing a three-dimensional object that was exported to the computer-assisted design (CAD) software. Two probe points were established in the apical portion of the root canal model for flow velocity and pressure measurement. Three different CAD models of 27G irrigation needles (closed-end side-vented, notched open-end, and bevel open-end) were created and placed at 25, 50, 75, and 95% of the working length (WL). Flow rates of 0.05, 0.1, 0.2, 0.3, and 0.4 mL/s were simulated. A total of 60 irrigation simulations were performed by CFD fluid flow solver. RESULTS Closed-end side-vented needle required insertion depth closer to WL, regarding efficient irrigant replacement, compared to open-end irrigation needle types, which besides increased velocity produced increased irrigant apical pressure. For all irrigation needle types and needle insertion depths, the increase of flow rate was followed by an increased irrigant apical pressure. CONCLUSIONS The human root canal shape obtained by CT is applicable in the CFD analysis of endodontic irrigation. All the analyzed values -irrigant flow pattern, velocity, and pressure - were influenced by irrigation needle type, as well as needle insertion depth and irrigant flow rate.
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Affiliation(s)
- Damir Snjaric
- Department of Restorative Dentistry and Endodontics, Medical Faculty, School of Dentistry, Kresimirova 40, Rijeka, Croatia
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Andrabi SMUN, Kumar A, Zia A, Iftekhar H, Alam S, Siddiqui S. Effect of passive ultrasonic irrigation and manual dynamic irrigation on smear layer removal from root canals in a closed apex in vitro model. ACTA ACUST UNITED AC 2013; 5:188-93. [PMID: 23595996 DOI: 10.1111/jicd.12033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 12/26/2012] [Indexed: 11/27/2022]
Abstract
AIM To compare the effect of passive ultrasonic irrigation with manual dynamic irrigation on smear layer removal from root canals using a closed apex in vitro model. METHODS The root canals of 45 freshly-extracted human single-rooted mandibular premolar teeth were prepared by the Pro-Taper rotary system to an apical preparation of F4 size. Prepared teeth were randomly divided into three groups; two experimental groups and one control group (n = 15) on the basis of the type of activation of final irrigation as follows: (a) Group A, 3% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), no activation received; (b) Group B, 3% NaOCl and 17% EDTA, ultrasonic activation with a small file; and (c) Group C, 3% NaOCl and 17% EDTA, manual activation with a master gutta-percha point. The prepared teeth were decoronated and split into two halves longitudinally, and observed under a scanning electron microscope to assess the removal of the smear layer. RESULTS In the apical-third region, the mean smear scores for groups B and C were significantly less than those of Group A (control group) (P < 0.05). CONCLUSION Both activation techniques are important adjuncts in removing the smear layer, with manual dynamic activation being a simpler, safer, and more cost-effective technique.
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Affiliation(s)
- Syed Mukhtar-Un-Nisar Andrabi
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Castagna F, Rizzon P, da Rosa RA, Santini MF, Barreto MS, Húngaro Duarte MA, Reis Só MV. Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal-a sem analysis. Microsc Res Tech 2013; 76:496-502. [DOI: 10.1002/jemt.22192] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/30/2013] [Accepted: 01/31/2013] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Ricardo Abreu da Rosa
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
| | | | - Mirela Sangoi Barreto
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
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The effect of the NRT files instrumentation on the quality of the surface of the root canal wall. J Appl Biomater Funct Mater 2012; 10:136-40. [PMID: 22798244 DOI: 10.5301/jabfm.2012.9268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To analyze in vitro, trough scanning electron microscope (SEM), the shaping ability of NRT NiTi rotary system (Mani, Inc, Toshigi-Ken, Japan). METHODS Ten extracted human teeth were cut at the level of the CEJ and prepared with Gates-Glidden burs 4-3-2 and NRT rotary files up to size #35. Irrigation was performed with 7.5 mL of 5% NaOCl and 7.5 mL of 10% EDTA during each canal instrumentation. Following the shaping sequence, a final irrigation was performed with EDTA followed by NaOCl, each left in situ for three minutes. Teeth were then fractured longitudinally, and the coronal, middle, and apical thirds of the canals were inspected with SEM. Three parameters, divided into four different levels (Alfa and Bravo, considered clinically acceptable; Charlie and Delta, considered clinically unacceptable), were used to score the canal morphology: presence and amount of smear layer; presence of organic and inorganic debris; surface profile. RESULTS SEM assessment revealed that in the coronal and middle third the majority of canals shaped with NRT rotary system presented a clinically acceptable surface. The apical third presented a higher amount of smear layer and dentinal debris instead, compared to the coronal and middle third. CONCLUSIONS NRT files demonstrated that they provided good instrumentation of the coronal and middle third, while being unable to obtain a defects-free surface in the apical third.
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Al-Ali M, Sathorn C, Parashos P. Root canal debridement efficacy of different final irrigation protocols. Int Endod J 2012; 45:898-906. [PMID: 22486845 DOI: 10.1111/j.1365-2591.2012.02046.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To compare the smear layer and debris removal effectiveness of four root canal irrigation protocols as well as their effectiveness in removing remaining soft tissues in curved root canals. METHODOLOGY The mesiobuccal and mesial root canals of 107 extracted human maxillary and mandibular molars were instrumented using Mtwo rotary NiTi instruments then randomly divided into four groups according to a final rinse protocol: Group 1 (n = 28) - manual agitation of 1% NaOCl and 15% EDTA; Group 2 (n = 26) - CanalBrush agitation of 1% NaOCl and 15% EDTA; Group 3 (n = 26) - 3% H(2) O(2) alternated with 1% NaOCl; Group 4 (n = 27) - passive ultrasonic agitation of 1% NaOCl and 15% EDTA. All irrigation protocols were performed in a closed system. Eleven roots per group were prepared and histologically stained (H&E) to assess percentage of remaining pulpal tissues in the apical thirds. The remaining specimens were split longitudinally and examined under scanning electron microscope at ×2000 magnification to assess smear layer and debris removal. Image Pro Plus 6.0 software was used to analyse smear layer and remaining pulp tissue. Debris presence was scored by two blinded investigators using a five-point scale. Data were analysed using Univariate analysis of variance (GenStat 13, α = 0.05). RESULTS CanalBrush and passive ultrasonic irrigation were equally effective with significantly less smear layer and debris than manual agitation and H(2) O(2) alternated with NaOCl (P < 0.05). The H(2) O(2) alternated with NaOCl protocol was significantly more effective in removing pulp tissue remnants in the apical level than manual agitation (P = 0.009) and passive ultrasonic irrigation (P = 0.01). CONCLUSIONS CanalBrush was as effective as passive ultrasonic irrigation in smear layer and debris removal. Alternating H(2) O(2) with NaOCl was effective in removing soft tissues from root canal complexities. Further studies are required to evaluate effectiveness of this regimen taking into account irrigant volume differences and effect of root canal system configuration.
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Affiliation(s)
- M Al-Ali
- Melbourne Dental School, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Blank-Gonçalves LM, Nabeshima CK, Martins GHR, Machado MEDL. Qualitative Analysis of the Removal of the Smear Layer in the Apical Third of Curved Roots: Conventional Irrigation versus Activation Systems. J Endod 2011; 37:1268-71. [DOI: 10.1016/j.joen.2011.06.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/05/2011] [Accepted: 06/06/2011] [Indexed: 10/18/2022]
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Saber SED, Hashem AAR. Efficacy of Different Final Irrigation Activation Techniques on Smear Layer Removal. J Endod 2011; 37:1272-5. [DOI: 10.1016/j.joen.2011.06.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 06/04/2011] [Accepted: 06/06/2011] [Indexed: 10/18/2022]
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Iandolo A, Ametrano G, Amato M, Rengo S, Simeone M. IG-File: un nuovo strumento per l’ottimizzazione della detersione canalare e per la misurazione del diametro apicale. GIORNALE ITALIANO DI ENDODONZIA 2011. [DOI: 10.1016/j.gien.2011.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Cleaning Efficacy Using Two Engine-driven Systems versus Manual Instrumentation in Curved Root Canals: A Scanning Electron Microscopic Study. J Endod 2011; 37:1279-82. [DOI: 10.1016/j.joen.2011.05.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 05/28/2011] [Accepted: 05/31/2011] [Indexed: 11/22/2022]
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Dadresanfar B, Khalilak Z, Delvarani A, Mehrvarzfar P, Vatanpour M, Pourassadollah M. Effect of ultrasonication with EDTA or MTAD on smear layer, debris and erosion scores. J Oral Sci 2011; 53:31-6. [PMID: 21467812 DOI: 10.2334/josnusd.53.31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The purpose of this study was to compare the effects of ultrasonication with ethylenediaminetetraacetic acid (EDTA) and a mixture of tetracycline isomer, an acid, and a detergent (MTAD) as final canal irrigants on the smear layer, debris and erosion scores. Fifty-eight extracted single-rooted human teeth were instrumented with ProTaper rotary files up to size F3. According to the final irrigation regimen, the samples were distributed into the following groups: EDTA, MTAD, EDTA ultrasonicated for 1 min, and MTAD ultrasonicated for 1 min. The smear layer, debris and erosion scores were recorded at the apical, middle, and coronal third of each canal using a scanning electron microscope. Data were subjected to statistical evaluation using the Kruskal-Wallis and Mann-Whitney tests (P < 0.05). There were no significant differences in smear layer or debris removal between the experimental groups. EDTA caused significantly more erosion at the middle level than MTAD. Also EDTA resulted in more erosion at the coronal level than MTAD when subjected to ultrasonication. Ultrasonic activation of EDTA significantly increased its erosive effects at the middle and coronal levels. Based on the present findings, MTAD appears to cause less dentinal erosion while allowing proper removal of the smear layer and debris.
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Affiliation(s)
- Bahareh Dadresanfar
- Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran
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Abarajithan M, Dham S, Velmurugan N, Valerian-Albuquerque D, Ballal S, Senthilkumar H. Comparison of Endovac irrigation system with conventional irrigation for removal of intracanal smear layer: an in vitro study. ACTA ACUST UNITED AC 2011; 112:407-11. [PMID: 21664151 DOI: 10.1016/j.tripleo.2011.02.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 02/10/2011] [Accepted: 02/12/2011] [Indexed: 11/29/2022]
Abstract
AIM This study comparatively evaluated the efficacy of Endovac irrigation system with conventional needle irrigation in removing smear layer from the root canal. STUDY DESIGN Thirty permanent maxillary central incisors were divided into 3 groups of 10 teeth each. In group I, the teeth were instrumented and irrigated by conventional irrigation using 27-gauge irrigation needle. In group II, irrigation was done using Endovac irrigation system. In group III (negative control) chemomechanical preparation was performed using saline solution. Scanning electron microscope evaluation was done for assessment of smear layer removal in the coronal, middle, and apical thirds. RESULTS Data were analyzed using post hoc test and Kruskal-Wallis test for significance at P < .05. Statistically significant difference was seen between the 2 test groups in smear layer removal from the apical third (3 mm) of the root canal, although no significant difference was seen in the coronal and middle thirds. The most efficient smear layer removal was seen in group II (Endovac) compared with other groups (P < .05). CONCLUSIONS The study showed significantly better removal of smear layer from the apical third of root canal using Endovac compared with conventional needle irrigation.
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Affiliation(s)
- Mohan Abarajithan
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Chennai, India.
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[Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files]. SRP ARK CELOK LEK 2010; 138:551-6. [PMID: 21180083 DOI: 10.2298/sarh1010551b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. OBJECTIVE The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. METHODS The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. RESULTS The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GTand ProTaperfiles has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups. shaped with different instruments. CONCLUSION Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.
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Rödig T, Döllmann S, Konietschke F, Drebenstedt S, Hülsmann M. Effectiveness of Different Irrigant Agitation Techniques on Debris and Smear Layer Removal in Curved Root Canals: A Scanning Electron Microscopy Study. J Endod 2010; 36:1983-7. [DOI: 10.1016/j.joen.2010.08.056] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 08/27/2010] [Accepted: 08/28/2010] [Indexed: 11/29/2022]
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Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue Dissolution by Sodium Hypochlorite: Effect of Concentration, Temperature, Agitation, and Surfactant. J Endod 2010; 36:1558-62. [PMID: 20728727 DOI: 10.1016/j.joen.2010.06.021] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 06/04/2010] [Accepted: 06/20/2010] [Indexed: 11/26/2022]
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Tunga U, Parlak E, Bodrumlu E, Aydemir H, Yeşilsoy C. Effect of F-File on removal of the smear layer: A scanning electron microscope study. AUST ENDOD J 2010; 37:65-9. [DOI: 10.1111/j.1747-4477.2010.00251.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee LW, Hsiao SH, Chang CC, Chen LK. Duration for Apical Barrier Formation in Necrotic Immature Permanent Incisors Treated With Calcium Hydroxide Apexification Using Ultrasonic or Hand Filing. J Formos Med Assoc 2010; 109:596-602. [DOI: 10.1016/s0929-6646(10)60097-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 08/19/2009] [Accepted: 08/24/2009] [Indexed: 10/19/2022] Open
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Caron G, Nham K, Bronnec F, Machtou P. Effectiveness of Different Final Irrigant Activation Protocols on Smear Layer Removal in Curved Canals. J Endod 2010; 36:1361-6. [DOI: 10.1016/j.joen.2010.03.037] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 03/23/2010] [Accepted: 03/25/2010] [Indexed: 11/26/2022]
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Influence of a Passive Sonic Irrigation System on the Elimination of Bacteria from Root Canal Systems: A Clinical Study. J Endod 2010; 36:1315-8. [DOI: 10.1016/j.joen.2010.04.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 04/29/2010] [Accepted: 04/29/2010] [Indexed: 11/18/2022]
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Salman MI, Baumann MA, Hellmich M, Roggendorf MJ, Termaat S. SEM evaluation of root canal debridement with Sonicare CanalBrush irrigation. Int Endod J 2010; 43:363-9. [DOI: 10.1111/j.1365-2591.2009.01675.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Self-adjusting File (SAF). Part 3: Removal of Debris and Smear Layer—A Scanning Electron Microscope Study. J Endod 2010; 36:697-702. [DOI: 10.1016/j.joen.2009.12.037] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 12/03/2009] [Accepted: 12/29/2009] [Indexed: 11/20/2022]
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Efficacy of the NaviTip FX Irrigation Needle in Removing Post Instrumentation Canal Smear Layer and Debris in Curved Root Canals. J Endod 2009; 35:1270-3. [DOI: 10.1016/j.joen.2009.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2009] [Revised: 04/29/2009] [Accepted: 05/03/2009] [Indexed: 11/18/2022]
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Goel S, Tewari S. Smear layer removal with passive ultrasonic irrigation and the NaviTip FX: a scanning electron microscopic study. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2009; 108:465-70. [PMID: 19576804 DOI: 10.1016/j.tripleo.2009.04.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 04/02/2009] [Accepted: 04/17/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effect of continuous, intermittent passive ultrasonic irrigation (PUI) and active scrubbing of irrigants with NaviTip FX (Ultradent, South Jordan, UT) in removing smear layer. STUDY DESIGN Forty single-rooted teeth were randomly divided into 5 test groups and subjected to final irrigation with 17% EDTA followed by 2.5% NaOCl for 1 minute each using different activation methods: no activation (control), brushing with NaviTip FX, continuous PUI with irrigant delivered at pulp chamber, continuous PUI with irrigant delivered through the ultrasonic unit, and intermittent PUI. Specimens were examined under scanning electron microscope, and the data were analyzed using Friedman 2-way analysis of variance, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS NaviTip FX and intermittent PUI showed significantly lower smear score than other groups at the 3 mm level (P < .05). CONCLUSIONS Both brush and intermittent ultrasonic activation were effective in the removal of smear layer from the apical third.
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Affiliation(s)
- Shweta Goel
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
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Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of Contemporary Irrigant Agitation Techniques and Devices. J Endod 2009; 35:791-804. [DOI: 10.1016/j.joen.2009.03.010] [Citation(s) in RCA: 400] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 03/03/2009] [Accepted: 03/05/2009] [Indexed: 11/26/2022]
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