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Furuncuoğlu F, Uğur Aydın Z, Doğan Çankaya T, Ocak MG. Evaluation of the efficacy of different irrigation activation techniques in removing of calcium hydroxide on teeth with the simulated internal root resorption cavity: a confocal laser scanning microscope analysis. Lasers Med Sci 2024; 39:213. [PMID: 39129047 DOI: 10.1007/s10103-024-04167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 07/31/2024] [Indexed: 08/13/2024]
Abstract
The aim of this study is to evaluate the effect of different irrigation activation methods on root canal sealer penetration in teeth with simulated internal root resorption (IRR) and calcium hydroxide (CH) applied using a confocal laser scanning microscope (CLSM). 60 incisors with a single root and a single canal were included in the study. IRR cavities were created in the middle third of the root canal, and CH was placed. The samples were randomly divided into 4 groups (n = 15) according to the irrigation activation method to be tested: standard needle irrigation (SNI), sonic activation (EDDY), photon-induced photoacoustic flow (PIPS), and shock wave enhanced emission photoacoustic flow (SWEEPS). After irrigation activation applications, the root canals were obturated. Sections of 1.0 ± 0.1 mm were taken from the apical, middle, and coronal regions of each sample. The penetration area (µm2) and maximum penetration depth (µm) of the root canal sealer were examined by CLSM and analyzed using ImageJ software. Statistical analysis was performed with a one-way ANOVA and post-hoc Tukey test at the P < 0.05 significance level. Among all irrigation activation methods tested, both the penetration area and maximum penetration depth of the root canal sealer were greater in the coronal region than in the apical region (p < 0.05). In the IRR region, there was no difference in terms of maximum penetration depth between PIPS and SWEEPS (p > 0.05), it was highest in SWEEPS (p < 0.05). PIPS and SWEEPS were better than other irrigation activation methods in the penetration of root canal sealer in the resorption areas of teeth with IRR.
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Affiliation(s)
- Fatma Furuncuoğlu
- Faculty of Dentistry, Department of Endodontics, Sakarya University, Sakarya, Turkey
| | - Zeliha Uğur Aydın
- Gülhane Faculty of Dentistry, Department of Endodontics, Health Sciences University, Ankara, Turkey
| | - Tülin Doğan Çankaya
- Faculty of Dentistry, Department of Endodontics, Alanya Alaaddin Keykubat University, Antalya, Turkey.
| | - Mehmet Görkem Ocak
- Faculty of Dentistry, Department of Endodontics, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Pauletto G, Padoin Y, de Pellegrin SF, Bier CAS. The use of sonic and ultrasonic activation of endodontic sealer to improve sealer filling quality in the root canal: a scoping review. Odontology 2024; 112:657-671. [PMID: 38381264 DOI: 10.1007/s10266-024-00901-9] [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: 07/14/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
This scoping review aimed to map whether the use of sonic and ultrasonic methods to activate the endodontic sealer improves the sealer filling quality in the root canal, considering the bond strength and intratubular penetration to the root dentin as evaluation criteria. The study protocol was prospectively registered and is available online ( https://osf.io/x5fma/ ). Reporting was based on PRISMA Extension for Scoping Reviews. The search was performed in Embase, PubMed, Scopus, and Web of Science. We selected studies without time and language restrictions that used sonic or ultrasonic methods to activate endodontic sealer, whose outcomes were bond strength and intratubular penetration. Three researchers independently selected the articles and collected data. Of 1422 articles, 19 were read in full and 13 studies were included. The vast majority of studies opted for direct activation of the endodontic sealer. The most investigated sealers were the epoxy resin-based sealers, and the ultrasonic activation method was the most explored. For the bond strength outcome, there was a trend toward higher values when the sealer was activated ultrasonically, but the findings seem to be divergent. The sonic activation was not effective for its intended purpose. For the outcome of intratubular penetration, the vast majority of studies indicate that the use of sonic and ultrasonic methods to activate the endodontic sealer is capable of increasing intratubular penetration. The use of sonic and ultrasonic methods to directly activate the endodontic sealer can increase the intratubular penetration of the sealer, but their benefits on the bond strength are uncertain.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil.
| | - Yasmin Padoin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Sidnei Flores de Pellegrin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil
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Cordova AT, Alcalde MP, Klymus ME, Bonjardim LR, Vivan RR, Duarte MAH. Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature. Restor Dent Endod 2024; 49:e12. [PMID: 38841384 PMCID: PMC11148408 DOI: 10.5395/rde.2024.49.e12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Materials and Methods Sixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic- PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Results All dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. Conclusions Ultramint X resulted in the most significant number of completely clean specimens.
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Affiliation(s)
- Abel Teves Cordova
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Michel Espinosa Klymus
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Leonardo Rigoldi Bonjardim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
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Keles A, Askerbeyli Ors S, Purali N, Kucukkaya Eren S. Effect of different sealer activation techniques on dentinal tubule penetration. AUST ENDOD J 2023; 49:470-475. [PMID: 36723389 DOI: 10.1111/aej.12738] [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: 09/26/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 02/02/2023]
Abstract
The aim of this study was to evaluate the influence of different activation techniques on dentin tubule penetration of root canal sealer. Seventy-five teeth with single canals were chemomechanically prepared. A calcium silicate-based sealer was stained with a fluorescent dye (rhodamine B), placed into the canals and activated according to the following groups: control (no activation), EDDY, EndoActivator, ultrasonic and XP-Endo Finisher. Then, the samples were obturated. The percentages of sealer penetration at various depth levels of root sections were measured with confocal laser scanning microscopy. XP-Endo Finisher presented the highest penetration at 50 μm (p < 0.05). XP-Endo Finisher showed similar penetration with EDDY at 100 and 200 μm (p > 0.05) while presented higher penetration than the other groups (p < 0.05). At 500 μm, XP-Endo Finisher presented higher penetration than EndoActivator (p < 0.05) while similar penetration with the other groups (p > 0.05). XP-Endo Finisher can be recommended for activation during sealer placement for better penetration into dentin tubules.
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Affiliation(s)
- Ahmet Keles
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli Ors
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Nuhan Purali
- Departmant of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Selen Kucukkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Falakaloğlu S, Yeniçeri Özata M, Güneş B, Silva EJNL, Gündoğar M, Güçyetmez Topal B. Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study. Restor Dent Endod 2023; 48:e25. [PMID: 37675447 PMCID: PMC10477421 DOI: 10.5395/rde.2023.48.e25] [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: 11/26/2022] [Revised: 03/05/2023] [Accepted: 04/18/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.
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Affiliation(s)
- Seda Falakaloğlu
- Department of Endodontics, School of Dentistry, İstanbul Health and Technology University, İstanbul, Turkey
| | - Merve Yeniçeri Özata
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Betül Güneş
- Department of Endodontics, School of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | | | - Mustafa Gündoğar
- Department of Endodontics, School of Dentistry, İstanbul Medipol University, İstanbul, Turkey
| | - Burcu Güçyetmez Topal
- Department of Pedodontics, School of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Adl A, Razavian A, Eskandari F. The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study. BMC Oral Health 2022; 22:564. [PMID: 36463133 PMCID: PMC9719616 DOI: 10.1186/s12903-022-02626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls. METHODS The root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal-Wallis, Dunn's post hoc, and Friedman tests. P < 0.05 was considered to be statistically significant. RESULTS No statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023). CONCLUSION Within the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.
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Affiliation(s)
- Alireza Adl
- Department of Endodontics, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Razavian
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Eskandari
- School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, Shiraz, 71956-15878, Iran.
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