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01-02-2019 | Original Article

Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars

Authors: Emmanuel João Nogueira Leal Silva, Carla Rodrigues Carvalho, Felipe Gonçalves Belladonna, Marina Carvalho Prado, Ricardo Tadeu Lopes, Gustavo De-Deus, Edson Jorge Lima Moreira

Published in: Clinical Oral Investigations | Issue 2/2019

Abstract

Objectives

This study aimed to compare four final irrigation protocols (passive ultrasonic irrigation [PUI], EndoVac, Self-Adjusting File [SAF] and EasyClean) on the removal of accumulated hard-tissue debris (AHTD) from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis.

Materials and methods

Forty mesial roots of mandibular molars presenting isthmuses type I or III were scanned in a micro-CT device and instrumented up to Reciproc R40 instrument. After the completion of canal preparations, root canals of each group were submitted to a final rinse using 20 mL of solution (16 mL of 5.25% NaOCl and 4 mL of 17% EDTA) in a total time of 5 min according to one of the four final irrigation protocols (n = 10): PUI, EndoVac, SAF and EasyClean operated at reciprocating motion. The sample was scanned again after canal preparation and after the use of the final irrigation protocols, and the registered data sets were examined to evaluate the percentage of AHTD. Data were statistically compared using the Tukey test with a significance level set at 5%.

Results

All groups presented a decrease on the accumulation of hard-tissue debris after the use of the final irrigation protocols (P < 0.05). No significant differences in the removal of AHTD were observed among the final irrigation protocols (P > 0.05).

Conclusions

All final irrigation protocols showed the same effectiveness in the removal of AHTD. None of them was able to render mesial canals of mandibular molars completely free from packed debris.

Clinical relevance

This study highlighted that all final irrigation protocols (PUI, EndoVac, SAF, and EasyClean) promoted a similar removal of AHTD. However, none of the final irrigation protocols was able to render mesial canals of mandibular molars completely free from packed debris.

Metzger Z, Solomonov M, Kfir A (2013) The role of mechanical instrumentation in the cleaning of root canals. Endod Top 29:87–109CrossRef

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

De-Deus G, Marins J, Silva EJ, Souza E, Belladonna FG, Reis C et al (2015) Accumulated hard tissue debris produced during reciprocating and rotary nickel-titanium canal preparation. J Endod 41:676–681CrossRef

Lopes RMV, Marins FC, Belladonna FG, Souza EM, De-Deus G, Lopes RT et al. (2017) Untouched canal areas and debris accumulation after root canal preparation with rotary and adaptive systems. Aust Endod J. https://doi.org/10.1111/aej.12237CrossRefPubMed

Zuolo ML, Zaia AA, Belladonna FG, Silva EJNL, Souza EM, Versiani MA et al. (2017) Micro-CT assessment of the shaping ability of four root canal instrumentation systems in oval-shaped canals. Int Endod J 51:564–71CrossRef

Siqueira JF Jr (2003) Microbial causes of endodontic flare-ups. Int Endod J 36:453–463CrossRef

De-Deus G, Reis C, Beznos D, de Abranches AM, Coutinho-Filho T, Paciornik S (2008) Limited ability of three commonly used thermoplasticized gutta-percha techniques in filling oval-shaped canals. J Endod 34:1401–1405CrossRef

Nusstein JM (2015) Sonic and ultrasonic irrigation. In: Bettina B (ed) Endodontic irrigation: chemical disinfection of the root canal system. Springer, Cham, pp 173–198CrossRef

Nielsen BA, Baumgartner JC (2007) Comparison of the EndoVac system to needle irrigation of root canals. J Endod 33:611–615CrossRef

10.

Metzger Z, Teperovich E, Zary R, Cohen R, Hof R (2010) The self-adjusting file (SAF). Part 1: respecting the root canal anatomy—a new concept of endodontic files and its implementation. J Endod 36:679–690CrossRef

11.

Andrade-Junior CV, Batista RM, Marceliano-Alves M, Alves F, Silva EJNL (2016) Efficacy of a new activation device in irrigant penetration into simulated lateral canals. Eur Endod J 1:2–5

12.

Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS (2016) Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod 42:659–663CrossRef

13.

Schneider SW (1971) A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 32:271–275CrossRef

14.

Fan B, Pan Y, Gao Y, Fang F, Wu Q, Gutmann JL (2010) Three-dimensional morphologic analysis of isthmuses in the mesial roots of mandibular molars. J Endod 36:1866–1869CrossRef

15.

Susin L, Liu Y, Yoon JC, Parente JM, Loushine RJ, Ricucci D, Bryan T, Weller RN, Pashley DH, Tay FR (2010) Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system. Int Endod J 43:1077–1090CrossRef

16.

Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M, Buatti J, Aylward S, Miller JV, Pieper S, Kikinis R (2012) 3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging 30:1323–1324CrossRef

17.

Neves AA, Silva EJ, Roter JM, Belladona FG, Alves HD, Lopes RT, Paciornik S, de-Deus GA (2015) Exploiting the potential of free software to evaluate root canal biomechanical preparation outcomes through micro-CT images. Int Endod J 48:1033–1042CrossRef

18.

Perez R, Neves AA, Belladonna FG, Silva EJNL, Souza EM, Fidel S, Versiani MA, Lima I, Carvalho C, de-Deus G (2017) Impact of needle insertion depth on the removal of hard-tissue debris. Int Endod J 50:560–568CrossRef

19.

de Pablo OV, Estevez R, Peix Sanchez M, Heilborn C, Cohenca N (2010) Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 36:1919–1931CrossRef

20.

Paragliola R, Franco V, Fabiani C, Mazzoni A, Nato F, Tay FR, Breschi L, Grandini S (2010) Final rinse optimization: influence of different agitation protocols. J Endod 36:282–285CrossRef

21.

Siqueira JF Jr, Alves FRF, Versiani MA, Rôças IN, Almeida BM, Neves MA et al (2010) Correlative bacteriologic and micro-computed tomographic analysis of mandibular molar mesial canals prepared by Self-Adjusting File, Reciproc, and Twisted File systems. J Endod 39:1044–1050CrossRef

22.

Ordinola-Zapata R, Bramante CM, Aprecio RM, Handysides R, Jaramillo DE (2014) Biofilm removal by 6% sodium hypochlorite activated by different irrigation techniques. Int Endod J 47:659–666CrossRef

23.

Peters OA (2004) Current challenges and concepts in the preparation of root canal systems: a review. J Endod 30:559–567CrossRef

24.

Versiani MA, Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Provenzano JC, Rôças IN et al (2016) Micro-CT evaluation of the efficacy of hard-tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J 49:1079–1087CrossRef

25.

van der Sluis LW, Shemesh H, Wu MK, Wesselink PR (2007) An evaluation of the influence of passive ultrasonic irrigation on the seal of root canal fillings. Int Endod J 40:356–361CrossRef

26.

ElAyouti A, Kiefner P, Hecker H, Chu A, L€ost C, Weiger R (2009) Homogeneity and adaptation of endodontic fillings in root canals with enlarged apical preparation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e141–e146CrossRef

27.

Brunson M, Heilborn C, Johnson DJ, Cohenca N (2010) Effect of apical preparation size and preparation taper on irrigant volume delivered by using negative pressure irrigation system. J Endod 36:721–724CrossRef

28.

Thomas AR, Velmurugan N, Smita S, Jothilatha S (2014) Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems. J Endod 40:1676–1680CrossRef

29.

Freire LG, Iglecias EF, Cunha RS, Dos Santos M, Gavini G (2015) Micro-computed tomographic evaluation of hard tissue debris removal after different irrigation methods and its influence on the filling of curved canals. J Endod 41:1660–1666CrossRef

30.

Keleş A, Alçin H, Sousa-Neto MD, Versiani MA (2016) Supplementary steps for removing hard tissue debris from isthmus-containing canal systems. J Endod 42:1677–1682CrossRef

31.

Topçuoglu HS, Akti A, Düzgün S, Ceyhanli KT, Topçuoglu G (2015) Effectiveness of different irrigation procedures for removal of dentin debris from a simulated internal resorption cavity. Int J Artif Organs 38:165–169CrossRef

32.

Yamada RS, Armas A, Goldman M, Lin PS (1983) A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: part 3. J Endod 9:137–142CrossRef

33.

Baker NA, Eleazer PD, Averbach RE, Seltzer S (1975) Scanning electron microscopic study of the efficacy of various irrigating solutions. J Endod 1:127–135CrossRef

34.

Fornari VJ, Silva-Sousa YT, Vanni JR, Pécora JD, Versiani MA, Sousa-Neto MD (2010) Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals. Int Endod J 43:988–994CrossRef

35.

Prado MC, Leal F, Simão RA, Gusman H, do Prado M (2017) The use of auxiliary devices during irrigation to increase the cleaning ability of a chelating agent. Restor Dent Endod 42:105–110CrossRef

36.

De-Deus G, Marins J, Neves Ade A, Reis C, Fidel S, Versiani MA et al (2014) Assessing accumulated hard-tissue debris using micro-computed tomography and free software for image processing and analysis. J Endod 40:271–276CrossRef

37.

Paqué F, Boessler C, Zehnder M (2011) Accumulated hard tissue debris levels in mesial roots of mandibular molars after sequential irrigation steps. Int Endod J 44:148–153CrossRef

38.

Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera JF, Pécora JD, Sousa-Neto MD (2017) 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 50:398–406CrossRef

Title: Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars
Authors: Emmanuel João Nogueira Leal Silva
Carla Rodrigues Carvalho
Felipe Gonçalves Belladonna
Marina Carvalho Prado
Ricardo Tadeu Lopes
Gustavo De-Deus
Edson Jorge Lima Moreira
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 2/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2483-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars

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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