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01-09-2016 | Original Article

Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning

Authors: Mário Tanomaru-FIlho, Fernanda Ferrari Esteves Torres, Gisselle Moraima Chávez-Andrade, Lucas Martinati Miano, Juliane Maria Guerreiro-Tanomaru

Published in: Clinical Oral Investigations | Issue 7/2016

Abstract

Objectives

The aim of this study was to evaluate the efficacy of two passive ultrasonic irrigation (PUI) methods and conventional manual irrigation (CMI) in root canal system (RCS) cleaning.

Materials and methods

Artificial single-rooted teeth were used. Four lateral canals were made 2 and 7 mm short from the apex. Root canals were filled with a contrast solution. The specimens were divided into four groups (n = 8): PUI1—intermittent flushing; PUI2—continuous flushing; CMI1—at 1 mm; and CMI2—at 3 mm. Micro-computed tomographic images were obtained. New images were taken after the irrigation protocols enabling the evaluation of the contrast solution volume (in mm³) within RCS (main and lateral root canals) in comparison to the initial analysis. The comparison among groups was performed using ANOVA and Tukey’s tests with 5 % significance level.

Results

There was no difference among PUI1, PUI2, and CMI1 regarding the contrast solution removal from RCS (p > 0.05). These methods demonstrated greater cleaning than CMI2. At the apical third, CMI2 showed lower cleaning capacity when compared to the other methods (p < 0.05).

Conclusions

PUI with intermittent or continuous flushing and CMI with the needle placed 1 mm from the working length were efficient in cleaning the main and lateral root canals.

Clinical relevance

Root canal irrigation plays an important role in cleaning and disinfection of the RCS. Effective apical irrigation is an important procedure during root canal treatment. PUI and CMI (at 1 mm short) were effective in cleaning of the main and simulated lateral root canals.

Beus C, Safavi K, Stratton J, Kaufman B (2012) Comparison of the effect of two endodontic irrigation protocols on the elimination of bacteria from root canal system: a prospective, randomized clinical trial. J Endod 38:1479–1483CrossRefPubMed

Castelo-Baz P, Martin-Biedma B, Cantatore G, Ruiz-Pinon M, Bahillo J, Rivas-Mundina B, Varela-Patino P (2012) In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod 38:688–691CrossRefPubMed

Guerreiro-Tanomaru JM, Loiola LE, Morgental RD, Leonardo Rde T, Tanomaru-Filho M (2013) Efficacy of four irrigation needles in cleaning the apical third of root canals. Braz Dent J 24:21–24CrossRefPubMed

Peeters HH, Mooduto L (2013) Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er,Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig 17:2105–2112CrossRefPubMed

de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36:1216–1221CrossRefPubMed

Helvacioglu Kivanc B, Deniz Arisu H, Yanar NO, Silah HM, Inam R, Gorgul G (2015) Apical extrusion of sodium hypochlorite activated with two laser systems and ultrasonics: a spectrophotometric analysis. BMC Oral Health 15:71CrossRefPubMedPubMedCentral

Sedgley CM, Nagel AC, Hall D, Applegate B (2005) Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 38:97–104CrossRefPubMed

Uzunoglu E, Gorduysus M, Gorduysus O (2015) A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 7:e218–e223CrossRefPubMedPubMedCentral

Grischke J, Muller-Heine A, Hulsmann M (2014) The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig 18:1845–1851CrossRefPubMed

10.

Weller RN, Brady JM, Bernier WE (1980) Efficacy of ultrasonic cleaning. J Endod 6:740–743CrossRefPubMed

11.

van der Sluis LW, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40:415–426CrossRefPubMed

12.

van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR (2010) Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 36:737–740CrossRefPubMed

13.

Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR (2009) Review of contemporary irrigant agitation techniques and devices. J Endod 35:791–804CrossRefPubMed

14.

van der Sluis L, Wu MK, Wesselink P (2009) Comparison of 2 flushing methods used during passive ultrasonic irrigation of the root canal. Quintessence Int 40:875–879PubMed

15.

Macedo RG, Verhaagen B, Wesselink PR, Versluis M, van der Sluis LW (2014) Influence of refreshment/activation cycles and temperature rise on the reaction rate of sodium hypochlorite with bovine dentine during ultrasonic activated irrigation. Int Endod J 47:147–154CrossRefPubMed

16.

Park E, Shen Y, Haapasalo M (2013) Irrigation of the apical root canal. Endod Top 27:54–73CrossRef

17.

Chávez-Andrade GM, Guerreiro-Tanomaru JM, Miano LM, Toledo RL, Tanomaru-Filho M (2014) Radiographic evaluation of root canal cleaning, main and laterals, using different methods of fi nal irrigation. Rev Odontol UNESP 43:333–337CrossRef

18.

Tanomaru-Filho M, Sant’anna-Junior A, Bosso R, Guerreiro-Tanomaru JM (2011) Effectiveness of gutta-percha and Resilon in filling lateral root canals using the Obtura II system. Braz Oral Res 25:205–209CrossRefPubMed

19.

Michelotto AL, Moura-Netto C, Araki AT, Akisue E, Moura AA, Sydney GB (2010) In vitro analysis of thermocompaction time and gutta-percha type on quality of main canal and lateral canals filling. Braz Oral Res 24:290–295CrossRefPubMed

20.

Almeida JF, Gomes BP, Ferraz CC, Souza-Filho FJ, Zaia AA (2007) Filling of artificial lateral canals and microleakage and flow of five endodontic sealers. Int Endod J 40:692–699CrossRefPubMed

21.

Carvalho-Sousa B, Almeida-Gomes F, Carvalho PR, Maniglia-Ferreira C, Gurgel-Filho ED, Albuquerque DS (2010) Filling lateral canals: evaluation of different filling techniques. Eur J Dent 4:251–256PubMedPubMedCentral

22.

Swain MV, Xue J (2009) State of the art of Micro-CT applications in dental research. Int J Oral Sci 1:177–188CrossRefPubMedPubMedCentral

23.

Nielsen RB, Alyassin AM, Peters DD, Carnes DL, Lancaster J (1995) Microcomputed tomography: an advanced system for detailed endodontic research. J Endod 21:561–568CrossRefPubMed

24.

Rhodes JS, Ford TR, Lynch JA, Liepins PJ, Curtis RV (1999) Micro-computed tomography: a new tool for experimental endodontology. Int Endod J 32:165–170CrossRefPubMed

25.

Endal U, Shen Y, Knut A, Gao Y, Haapasalo M (2011) A high-resolution computed tomographic study of changes in root canal isthmus area by instrumentation and root filling. J Endod 37:223–227CrossRef

26.

Mirfendereski M, Roth K, Fan B, Dubrowski A, Carnahan H, Azarpazhooh A, Basrani B, Torneck CD, Friedman S (2009) Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: a microcomputed tomography analysis. J Endod 35:1512–1517CrossRefPubMed

27.

Paque F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047CrossRefPubMed

28.

Zogheib C, Naaman A, Sigurdsson A, Medioni E, Bourbouze G, Arbab-Chirani R (2013) Comparative micro-computed tomographic evaluation of two carrier-based obturation systems. Clin Oral Investig 17:1879–1883CrossRefPubMed

29.

Metzger Z, Zary R, Cohen R, Teperovich E, Paque F (2010) The quality of root canal preparation and root canal obturation in canals treated with rotary versus self-adjusting files: a three-dimensional micro-computed tomographic study. J Endod 36:1569–1573CrossRefPubMed

30.

Somma F, Cretella G, Carotenuto M, Pecci R, Bedini R, De Biasi M, Angerame D (2011) Quality of thermoplasticized and single point root fillings assessed by micro-computed tomography. Int Endod J 44:362–369CrossRefPubMed

31.

Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD (2011) Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod 37:235–238CrossRefPubMed

32.

Bronnec F, Bouillaguet S, Machtou P (2010) Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 43:663–672CrossRefPubMed

33.

Bhuva B, Patel S, Wilson R, Niazi S, Beighton D, Mannocci F (2010) The effectiveness of passive ultrasonic irrigation on intraradicular Enterococcus faecalis biofilms in extracted single-rooted human teeth. Int Endod J 43:241–250CrossRefPubMed

34.

Spoorthy E, Velmurugan N, Ballal S, Nandini S (2013) Comparison of irrigant penetration up to working length and into simulated lateral canals using various irrigating techniques. Int Endod J 46:815–822CrossRefPubMed

35.

Cavenago BC, Pereira TC, Duarte MA, Ordinola-Zapata R, Marciano MA, Bramante CM, Bernardineli N (2013) Influence of powder-to-water ratio on radiopacity, setting time, pH, calcium ion release and a micro-CT volumetric solubility of white mineral trioxide aggregate. Int Endod J 47:120–126CrossRefPubMed

36.

Pereira ES, Peixoto IF, Nakagawa RK, Buono VT, Bahia MG (2012) Cleaning the apical third of curved canals after different irrigation protocols. Braz Dent J 23:351–356CrossRefPubMed

37.

Bertacci A, Baroni C, Breschi L, Venturi M, Prati C (2007) The influence of smear layer in lateral channels filling. Clin Oral Investig 11:353–359CrossRefPubMed

38.

Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW (2010) The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 36:1664–1668CrossRefPubMed

39.

Jiang LM, Lak B, Eijsvogels LM, Wesselink P, van der Sluis LW (2012) Comparison of the cleaning efficacy of different final irrigation techniques. J Endod 38:838–841CrossRefPubMed

40.

Park E, Shen Y, Khakpour M, Haapasalo M (2013) Apical pressure and extent of irrigant flow beyond the needle tip during positive-pressure irrigation in an in vitro root canal model. J Endod 39:511–515CrossRefPubMed

Title: Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning
Authors: Mário Tanomaru-FIlho
Fernanda Ferrari Esteves Torres
Gisselle Moraima Chávez-Andrade
Lucas Martinati Miano
Juliane Maria Guerreiro-Tanomaru
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 7/2016
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-015-1645-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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