Irrigant Agitation Techniques versus Passive Ultrasonic Irrigation for Removing Debris from Curved Root Canals: An Environmental Scanning Electron Microscopic Study
Iranian Endodontic Journal,
Vol. 16 No. 1 (2021),
1 January 2021
,
Page 26-32
https://doi.org/10.22037/iej.v16i1.26741
Abstract
Introduction: The aim of this study was to compare the efficacy of passive ultrasonic irrigation (PUI) versus mechanical agitation of the irrigant promoted by the EasyClean (EC) and XP-Endo Finisher (XP-F) systems in removing debris from root canal walls, using environmental scanning electron microscopy (ESEM). Methods and Materials: Twelve curved mesiobuccal canals of mandibular molars were prepared with the ProTaper Next system up to file X2 (25/0.06). The specimens were embedded in flasks containing silicone putty, sectioned lengthwise, and a 4-mm long groove was made on the canal wall of the buccal half of the specimen, extending from 2 mm up to 6 mm short of the apex. Five cross-sectional markings were made along this groove to establish standardized locations for imaging. The same specimens were used to prepare a negative control group (without debris), a positive control group (completely covered by debris), and 3 experimental groups according to the final irrigation protocol employed: PUI, EC or XP-F. ESEM images were obtained and evaluated by 3 examiners. The amount of debris observed on the images was classified according to a 4-category scoring system. The kappa test was used to assess inter-examiner agreement, and the Kruskal-Wallis and Dunn tests were used to compare the scores (P<0.05). Results: The scores attributed to the PUI, EC, and XP-F groups were statistically similar to those attributed to the negative control group (P>0.05). Conclusion: Based on this in-vitro study, the mechanical agitation of the irrigant promoted by EC and XP-F was as effective as using PUI to remove debris from the root canal walls.
- Debridement; Dental Instruments; Root Canal Irrigants; Scanning Electron Microscopy; Ultrasonic Surgical Procedures
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References
- Guimaraes LS, Gomes CC, Marceliano-Alves MF, Cunha RS, Provenzano JC, Siqueira JF Jr. Preparation of oval-shaped canals with TRUShape and Reciproc systems: a micro-computed tomography study using contralateral premolars. J Endod. 2017; 43(6): 1018-22.
- Castagna F, Rizzon P, da Rosa RA, Santini MF, Barreto MS, Duarte MA, Só MV. Effect of passive ultrasonic instrumentation as a final irrigation protocol on debris and smear layer removal--SEM analysis. Microsc Res Tech. 2013; May;76(5):496-502
- Thomas AR, Velmurugan N, Smita S, Jothilatha S. Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems. J Endod. 2014; 40(10): 1676-80.
- Haapasalo M, Shen Y, Qian W, Gao Y (2010) Irrigation in Endodontics. Dent Clin North Am. 2010; 54(2): 291-312.
- Schmidt TF, Teixeira CS, Felippe MC, Felippe WT, Pashley DH, Bortoluzzi EA. Effect of ultrasonic activation of irrigants on smear layer removal. J Endod. 2015; 41(8): 1359-63.
- Bao P, Shen Y, Lin J, Haapasalo M. In vitro efficacy of XP-endo Finisher with 2 different protocols on biofilm removal from apical root canals. J Endod. 2017; 43(2): 321-5.
- Walters MJ, Baumgarther JC, Marshall JG. Efficacy of irrigation with rotary instrumentation. J Endod. 2002; 28(12): 837-9.
- Rödig T, Döllmann S, Konistschke 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(12): 1983-7.
- Castelo-Baz P, Martín-Biedma B, Cantatore G, Ruíz-Piñón M, Bahillo J, Rivas-Mundiña B, Varela-Patiño P. In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod. 2012; 38(5): 688-91.
- Munoz HR, Camacho-Cuandra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod. 2012; 38(4): 445-8.
- 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(12): 2009-14.
- van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR. Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod. 2010; 36(4): 737-40.
- Macedo R, Verhaagen B, Rivas DF, Versluis M, Wesselink P, van der Sluis L. Cavitation measurement during sonic and ultrasonic activated irrigation. J Endod. 2014; 40(4): 580-3.
- Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod. 2016; 42(4): 659-63.
- Andrade-Junior CV, Batista RM, Marceliano-Alves M, Alves LRF, Silva EJNL. Efficacy of a new activation device in irrigant penetration into simulated lateral canals. Eur Endod J (2016); 1(2): 1-4.
- Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera JF, Pécora JD, Sousa-Neto MD. Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root canal system of mandibular first molars. Int Endod J. 2017; 50(4): 398-406.
- Wigler R, Dvir R, Weisman A, Kfir A. Efficacy of XP-endo Finisher files in the removal of calcium hydroxide paste from artificial standardized groove in the apical third of oval root canals. Int Endod J. 2017; 50(7), 700–5.
- Schneider SW (1971) A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971; 32(2): 271-5.
- Gambarini G, Laszkiewicz J. A scanning electron microscopic study of debris and smear layer remaining following use of GT rotary instruments. Int Endod J. 2002; 35(5): 422–7.
- Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, Arun SN, Kim J, Looney SW, Pashley DH. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010; 36(4): 745-50.
- Yeung W, Raldi DP, Cunha RS, Mello I. Assessment of smear layer removal protocols in curved root canals. Aust Endod J. 40(2): 66-71.
- Neelakantan P, Devaraj S, Jagannathan N. Histologic assessment of debridement of the root canal isthmus of mandibular molars by irrigant activation techniques ex vivo. J Endod. 2016; 42(8): 1268-72.
- Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Top. 2005; 10: 77-102.
- Mancini M, Armellin E, Casaglia A, Cerroni L, Cianconi L. A comparative study of smear layer removal and erosion in apical intraradicular dentine with three irrigating solutions: a scanning electron microscopy evaluation. J Endod. 2009; 35(6): 900-3.
- Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod. 2011; 37(10): 1437-41.
- De Deus G, Reis C, Paciornik S. Critical appraisal of published smear layer-removal studies: methodological issues. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112(4): 531-43.
- Simezo AP, da Silveira Bueno CE, Cunha RS, Pelegrine RA, Rocha DG, de Martin AS, Kato AS. Comparative analysis of dentinal erosion after passive ultrasonic irrigation versus irrigation with reciprocating activation: an Environmental Scanning Electron study. J Endod. 2017; 43(1):141-6.
- Duque JA, Duarte MA, Canali LC, Zancan RF, Vivan RR, Bernardes RA, Bramante CM. Comparative effectiveness of new mechanical irrigant agitating devices for debris removal from the canal and isthmus of mesial roots of mandibular molars. J Endod. 2017; 43(2): 326-31.
- van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007; 40(6): 415-26.
- 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(10): 1545-9.
- Silva EJNL, Belladonna FG, Zuolo AS, Rodrigues E, Ehrhardt IC, Souza EM, De-Deus G. Effectiveness of XP-endo Finisher and XP-endo Finisher R in removing root filling remnants: a micro-CT study. Int Endod J. 2018; 51(1): 86-91.
- Keskin C, Sariyilmaz E, Sariyilmaz Ö. Efficacy of XP-endo Finisher file in removing calcium hydroxide from simulated internal resorption cavity. J Endod. 2017; 43(1): 126-30.
- Mai S, Kim YK, Arola DD, Gu LS, Kim JR, Pashley DH, Tay FR. Differential aggressiveness of ethylenediamine tetracetic acid in causing canal wall erosion in the presence of sodium hypochlorite. J Dent. 38(3): 201-6.
- Zargar N, Dianat O, Asnaashari M, Ganjali M, Zadsirjan S. The Effect of Smear Layer on Antimicrobial Efficacy of Three Root Canal Irrigants. Iran Endod J. 2015;10(3): 179-83.
- Mohammadi Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Impact of Ultrasonic Activation on the Effectiveness of Sodium Hypochlorite: A Review. Iran Endod J. 2015;10 (4):216-20.
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