Top

Published in:

01-07-2019 | Original Article

Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals

Published in: Clinical Oral Investigations | Issue 7/2019

Abstract

Objective

To compare the effectiveness of the XP-endo Finisher instrument and passive ultrasonic irrigation (PUI) as final irrigation protocols on the removal of accumulated hard-tissue debris (AHTD) from oval-shaped canals using micro-computed tomographic (micro-CT) analysis.

Methods

Twenty mandibular incisors were anatomically pair-matched based on similar morphological dimensions (length, volume, aspect ratio, and configuration) through micro-CT analysis, prepared with Reciproc R25 instrument, scanned again, and assigned to one of the two experimental groups (n = 10), according to the final irrigation protocol: XP-endo Finisher and PUI. After the final irrigation protocols, the specimens were rescanned and the registered datasets were examined to quantify the amount of AHTD. Data were statistically analyzed using Student’s t test with a significance level of 5%.

Results

The final irrigation protocols were highly similar in terms of volumetric percentage reduction of AHTD (P = 1.000).

Conclusions

XP-endo Finisher and PUI showed the same effectiveness on the removal of AHTD. None of the tested final irrigation protocols completely removed the AHTD from oval-shaped root canals.

Clinical relevance

AHTD may be considered clinically relevant because it could harbor bacterial contents away from the disinfection procedures. Both final irrigation protocols were effective on the removal of AHTD.

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

Plotino G, Grande NM, Porciani PF (2015) Deformation and fracture incidence of Reciproc instruments: a clinical evaluation. Int Endod J 48:199–205. https://doi.org/10.1111/iej.12302 CrossRefPubMed

Siqueira JF Jr, Alves FR, Versiani MA et al (2013) Correlative bacteriologic and micro-computed tomographic analysis of mandibular molar mesial canals prepared by self-adjusting file, reciproc, and twisted file systems. J Endod 39:1044–1050. https://doi.org/10.1016/j.joen.2013.04.034 CrossRefPubMed

Alves FR, Andrade-Junior CV, Marceliano-Alves MF et al (2016) Adjunctive steps for disinfection of the mandibular molar root canal system: a correlative bacteriologic, micro-computed tomography, and cryopulverization approach. J Endod 42:1667–1672. https://doi.org/10.1016/j.joen.2016.08.003 CrossRefPubMed

Lopes RMV, Marins FC, Belladonna FG et al Untouched canal areas and debris accumulation after root canal preparation with rotary and adaptive systems. Aus Endod J

Siqueira JF Jr, Araújo MC, Garcia PF, Fraga RC, Dantas CJ (1997) Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod 23:499–502CrossRefPubMed

Siqueira JF Jr, Rôças IN (2008) Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 34:1291–1301. https://doi.org/10.1016/j.joen.2008.07.028 CrossRefPubMed

Paqué F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047. https://doi.org/10.1016/j.joen.2009.04.026 CrossRefPubMed

De-Deus G, Roter J, Reis C et al (2014) Assessing accumulated hard-tissue debris using micro-computed tomography and free software for image processing and analysis. J Endod 40:271–276. https://doi.org/10.1016/j.joen.2013.07.025 CrossRefPubMed

10.

Keleş A, Alçin H, Sousa-Neto MD, Versiani MA (2016) Supplementary steps for removing hard tissue debris from isthmus-containing canal systems. J Endod 42:1677–1682. https://doi.org/10.1016/j.joen.2016.07.025 CrossRefPubMed

11.

Siqueira JF Jr, Rôças IN (2011) Optimising single-visit disinfection with supplementary approaches: a quest for predictability. Aus Endod J 37:92–98. https://doi.org/10.1111/j.1747-4477.2011.00334.x CrossRef

12.

Ahmad M, Pitt Ford TR, Crum LA, Walton AJ (2009) Ultrasonic debridement of root canals: acoustic cavitation and its relevance. Int Endod J 42:391–398. https://doi.org/10.1111/j.1365-2591.2009.01560.x CrossRefPubMed

13.

Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A (2016) Antibacterial efficacy of a new sonic irrigation device for root canal disinfection. J Endod 42:1799–1803. https://doi.org/10.1016/j.joen.2016.08.024 CrossRefPubMed

14.

Versiani MA, Alves FR, Andrade-Junior CV 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 49:1079–1087. https://doi.org/10.1111/iej.12559 CrossRefPubMed

15.

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 50:398–406. https://doi.org/10.1111/iej.12630 CrossRefPubMed

16.

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 50:560–568. https://doi.org/10.1111/iej.12648 CrossRefPubMed

17.

Debelian G, Trope M (2015) Cleaning the third dimension. Endod Practice 8:22–24

18.

Azim AA, Aksel H, Zhuang T, Mashtare T, Babu JP, Huang GT (2016) Efficacy of 4 irrigation protocols in killing bacteria colonized in dentinal tubules examined by a novel confocal laser scanning microscope analysis. J Endod 42:928–934. https://doi.org/10.1016/j.joen.2016.03.009 CrossRefPubMedPubMedCentral

19.

Silva EJNL, Belladonna FG, Zuolo AS, Rodrigues E, Ehrhardt IC, Souza EM, de-Deus G (2018) Effectiveness of XP-Endo Finisher and XP-Endo Finisher R in removing root filling remnants: a micro-CT study. Int Endod J 51:86–91. https://doi.org/10.1111/iej.12788 CrossRefPubMed

20.

Wigler R, Dvir R, Weisman A, Matalon S, Kfir A (2017) Efficacy of XP-endo finisher files in the removal of calcium hydroxide paste from artificial standardized grooves in the apical third of oval root canals. Int Endod J 50:700–705. https://doi.org/10.1111/iej.12668 CrossRefPubMed

21.

Susin L, Liu Y, Yoon JC et al (2010) Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system. Int Endod J 4:1077–1090. https://doi.org/10.1111/j.1365-2591.2010.01778.x CrossRef

22.

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 30:1323–1341. https://doi.org/10.1016/j.mri.2012.05.001 CrossRefPubMedPubMedCentral

23.

Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9:671–675CrossRefPubMedPubMedCentral

24.

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 48:1033–1042. https://doi.org/10.1111/iej.12399 CrossRefPubMed

25.

Schmid B, Schindelin J, Cardona A, Longair M, Heisenberg M (2010) A high-level 3D visualization API for Java and ImageJ. BMC Bioinformatics 11:274. https://doi.org/10.1186/1471-2105-11-274 CrossRefPubMedPubMedCentral

26.

De-Deus G, Marins J, Silva EJ et al (2015) Accumulated hard-tissue debris produced during reciprocating and rotary nickel-titanium canal preparation. J Endod 41:676–681. https://doi.org/10.1016/j.joen.2014.11.028 CrossRefPubMed

27.

Rover G, Belladonna FG, Bortoluzzi EA, De-Deus G, Silva EJNL, Teixeira CS (2017) Influence of access cavity design on root canal detection, instrumentation efficacy, and fracture resistance assessed in maxillary molars. J Endod 43:1657–1662. https://doi.org/10.1016/j.joen.2017.05.006 CrossRefPubMed

28.

Versiani MA, Pécora JD, de Sousa-Neto MD (2011) Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod 37:1002–1007. https://doi.org/10.1016/j.joen.2011.03.017 CrossRefPubMed

29.

Elnaghy AM, Mandorah A, Elsaka SE (2017) Effectiveness of XP-endo Finisher, EndoActivator, and file agitation on debris and smear layer removal in curved root canals: a comparative study. Odontology 105:178–183. https://doi.org/10.1007/s10266-016-0251-8 CrossRefPubMed

30.

Trope M, Debelian G (2015) XP-3D FinisherTM file — the next step in restorative endodontics. Endod Practice US 8:22–24

31.

Keskin C, Sariyilmaz E, Sariyilmaz Ö (2017) Efficacy of XP-endo Finisher file in removing calcium hydroxide from simulated internal resorption cavity. J Endod 43:126–130. https://doi.org/10.1016/j.joen.2016.09.009 CrossRefPubMed

32.

Bao P, Shen Y, Lin J, Haapasalo M (2017) In vitro efficacy of XP-endo Finisher with 2 different protocols on biofilm removal from apical root canals. J Endod 43:321–325. https://doi.org/10.1016/j.joen.2016.09.021 CrossRefPubMed

33.

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

34.

Amato M, Vanoni-Heineken I, Hecker H, Weiger R (2011) Curved versus straight root canals: the benefit of activated irrigation techniques on dentin debris removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:529–534. https://doi.org/10.1016/j.tripleo.2010.11.002 CrossRefPubMed

35.

Boutsioukis C, Verhaagen B, Walmsley AD, Versluis M, van der Sluis LW (2013) Measurement and visualization of file-to-wall contact during ultrasonically activated irrigation in simulated canals. Int Endod J 46:1046–1055. https://doi.org/10.1111/iej.12097 CrossRefPubMed

36.

Lumley PJ, Walmsley AD, Laird WRE (1991) Streaming patterns produced around endosonic files. Int Endod J 24:290–297CrossRefPubMed

37.

Wu MK, van der Sluis LW, Wesselink PR (2003) The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals. Int Endod J 36:218–224CrossRefPubMed

38.

Silva EJNL, Carvalho CR, Belladonna FG, Prado MC, Lopes RT, de-Deus G, Moreira EJL (2018) Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars. Clin Oral Invest

Title: Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals
Publication date: 01-07-2019
Published in: Clinical Oral Investigations / Issue 7/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2729-y

At a glance: The STEP trials

Springer Medicine

Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 7/2019

In vivo evaluation of the genotoxicity and oxidative damage in individuals exposed to 10% hydrogen peroxide whitening strips

Perceived helpfulness of treatments for myofascial TMD as a function of comorbid widespread pain

Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study

Administration of systemic antibiotics during non-surgical periodontal therapy—a consensus report

Microstructural volumetric analysis of lateral ridge augmentation using differently conditioned tooth roots

Comparison of the hospitalization period after microvascular reconstruction flap in trismus patients: free anterolateral thigh flap versus free forearm flap