Estudio comparativo de la remoción de Hidróxido de Calcio entre irrigación sónica y limas XP-ENDO Finisher, en canales radiculares curvos, Santiago de Chile, Abril 2017

Tesis (Cirujano Dentista)Objetivos: Determinar el protocolo de remoción de Ca (OH)2 más eficiente entre irrigación sónica e instrumentación mecanizada, en canales radiculares curvos de sección transversal circular. Métodos: De un total de 120 molares mandibulares, se seleccionaron 92 muestras los cuáles presentaban canales con curvatura moderada. Estos canales fueron instrumentados con limas Protaper Universal® a -2 milimetros de LT, alternando irrigación con 3 ml de hipoclorito de sodio al 5,25%. Se irrigó con EDTA por 1 minuto, para ser finalmente enjuagados con hipoclorito de sodio. Luego de instrumentadas las muestras fueron medicadas con mezcla estandarizada de Ultracal XS® y tinta china negra. Posterior a la medicación las muestras fueron separadas en 3 grupos aleatoriamente según el sistema de remoción utilizado (XP ENDO Finisher®, Endoactivator ® y Técnica Convencional manual). El área cubierta por Ca (OH)2 fue observada y delimitada a través de un microscopio óptico asociado a un software computarizado (Micrometrics). Resultados: El área de Ca (OH)2 residual obtenida por cada grupo tuvo un nivel significancia de P > 0.05, por lo que no existen diferencias estadísticamente significativas entre ellos. Limas XP ENDO Finisher® mostraron leve tendencia a la remoción total de Ca (OH)2 por sobre los otros grupos, pero al ser un N pequeño no alcanza a ser representativo para generar una diferencia significativa. Conclusiones: Sí bien no existe ningún sistema que remueva la totalidad del Ca (OH)2 en canales radiculares con curvatura moderada, estos sistemas logran removerlo parcialmente sin generar diferencias estadísticamente significativas entre ellos

A comparative evaluation of smear layer removal using apical negative pressure (EndoVac), sonic irrigation (EndoActivator) and Er:YAG laser - an in vitro SEM study

This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy. 40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test. The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups. None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal

COMPARATIVE STUDY OF THE EFFECT OF THREE DIFFERENT IRRIGATING TECHNIQUES ON DEBRIS AND SMEAR LAYER DISTRIBUTION IN ROOT CANALS (AN IN VITRO STUDY)

The aim of this study was to compare, in vitro, the cleaning efficacy of three different irrigation techniques: syringe irrigation (Navitip) using NaOCl, sonic irrigation system (EndoActivator), and passive ultrasonic irrigation system (PUI) on debris and smear layer distribution in the root canal at three different levels. Materials and Methods: Sixty freshly extracted single-rooted human mandibular premolars were decoronated to a standardized length of twenty millimeters. Specimens were shaped to IRace 25 size and irrigated with 3 mL 2.5% NaOCl between instrumentation. Teeth were divided randomly into three equal groups: Group I (n=20): Irrigation manually with a syringe (Navitip) (n=20), irrigation was done with 3 mL 2.5% NaOCl for one minute using 30 gauge needle. Group II (n=20): Final rinse with 3 ml 2.5% NaOCl activated for one minute with passive sonic irrigation system (endoactivator). Group III (n=20): Final rinse with 3 ml 2.5% NaOCl activated for one minute with PUI system. Root canals were then split longitudinally and field emission scanning electron microscopy was used to eval¬uate endodontic smear layer and debris removal from the instrumented root canals. This was done using a scale from 0-5 as described by Hulsmann et al. Results of this study showed that Both (PUI) and (EndoActivator®; Dentsply) have resulted in superior removal of smear layer and debris when compared to needle-and-syringe irrigation. Conclusion: None of the techniques completely removed all the smear layer and debris from root canal walls at the apical part of the canal. However, PUI system showed significantly better cleaning than needle and sonic systems in the entire length of the root canal

Cleaning Efficiency of Root Canal after Irrigation with New Irrigation Technique: A Scanning Electron Microscopic Study

Introduction: The aim of this study was to evaluate the ability of pressurized water irrigation technique (AquaPick Device) as an intra-canal irrigation technique and compare it with sonic irrigation device (Endoactivator) for their ability to remove smear layer from canals. Methods and Materials: Total number of 80 single rooted teeth (premolars) were prepared, divided into eight main groups, Group 1: Aquapick with apically vented needle/18 mm depth, Group 2: Aquapick with apically vented needle/15 mm depth, Group 3: Endoactivator device/18 mm depth, Group 4: Endoactivator device/15 mm depth, Group5: Aquapick with 2 side vented needle/18 mm depth, Group 6: Aquapick with 2 side vented needle/15 mm depth and two control groups. Then all samples were tested by SEM in 3, 6 and 9-mm distances from the apical foramen. The data were statistically analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: There was a high significant difference among the tested groups with the best removal of smear layer by the use of pressurized water irrigation device with apical vented needle especially at the 3 mm area. Conclusion: Pressurized water irrigation technique could be used as intra-canal irrigation technique with good results.Keywords: AquaPick Device; Endoactivator; Smear Layer Removal; Pressurized Wate

Effect of sonic agitation of a binary mixture of solvents on filling remnants removal as an alternative to apical enlargement — a micro-CT study

Background: This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. Methods: Twenty-four mandibular incisors were prepared with ProTaper Next (X1, X2) and obturated with the single-cone technique and AH Plus sealer. The teeth were retreated with ProTaper Universal Retreatment and ProTaper Next and divided into two groups (n = 12) according to the final instrument (X3 or X4). All canals were submitted to a supplementary procedure consisting of a mixture of solvents―methyl ethyl ketone/tetrachloroethylene, agitated with EndoActivator. The volume of filling remnants was assessed through micro-computed tomography in the apical 5 mm. Statistical analysis was performed with a significance level of 5%. Results: The supplementary procedure of agitation of the solvent mixture was beneficial in both groups (p p > 0.05). Conclusions: An additional step with a two-solvent solution potentiated by EndoActivator showed to be very effective for the removal of gutta-percha and resinous sealer remnants from apical root canals of mandibular incisors, avoiding further enlargement.This article was supported by National Funds through FCT-Fundacao para a Ciencia e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020)

A Comparative Evaluation of Endodontic Irrigation Methods for Removal of the Smear Layer

The purpose of this in vitro study is to compare the effect of various irrigation systems on smear layer removal in curved root canals. Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. It has been well documented that the flushing component of the irrigants is as important as the tissue dissolving capability. Therefore, the efficacy of the irrigant might also be influenced by the method by which it is introduced. Fifty-one recently extracted molar teeth with root curvatures of more than 30° were selected according to Schneider\u27s method. The teeth were decoronated to obtain a standardized root length of 12 mm. The root tips were sealed with hot glue and embedded into a silicone mold. The canal preparations were performed by using ProTaper™ and ProFile™ systems up to #35,04. Sodium hypochlorite (NaOCl 6%) and ethylenediaminetetraacetic acid (EDTA 17%) were used as root canal irrigants according to Yamada protocol. To maintain irrigation consistency, a programmable syringe pump was connected to each system. After finishing the cleaning and shaping of the curved canals, the final cleansing of the root canal space, with proper irrigation solutions, were accompanied by activation systems. Five different treatment modalities were tested; Group 1: Traditional irrigation, Group 2: EndoActivator™, Group 3: Passive ultrasonic irrigation (PUI), Group 4: EndoVac™, Group 5: Saline. The root halves (n=102) were imaged with the FEI Quanta 200 scanning electron microscope™ (SEM). Over 7000 magnified images were reviewed and scored by three board certified Endodontists in a double-blind manner. The data was analyzed by using the Cochran-Mantel-Haenszel method, Pairwise Comparisons and Intra-class correlation coefficients. The EndoVac™ system (an apical negative pressure irrigation system) was found to be significantly more effective (p\u3c0.05) than the other groups in all sections observed, this would include the apical, middle and coronal sections for the elimination of the smear layer as well as the debris removal and improved tubule visibility. The negative pressure delivery systems may provide cleaner surfaces in the canals of curved roots of at least 30 degree or more

Effect of EndoActivator and Er,Cr:YSGG laser activation of Qmix, as final endodontic irrigant, on sealer penetration: a confocal microscopic study

Through chemomechanical debridement of the root canal is a primary requisite for successful endodontic therapy. Thus the aim of this study was to evaluate the effects of using QmiX alone, QmiX with EndoActivator and QmiX with Er,Cr:YSGG laser for final irrigation on sealer penetration into the dentinal tubules. 75 extracted human mandibular premolar teeth were treated with sodium hypochlorite (NaOCl) irrigation. The samples were divided into 5 groups according to the final irrigation solution used: (1) 17% EDTA and 2.5% NaOCl, (2) QmiX (3) QmiX with Er,Cr:YSGG laser and (4) QmiX with EndoActivator (5) 2.5%NaOCl. All teeth were obturated using cold lateral condensation technique with gutta percha and AH 26 sealer (Dentsply; DeTrey,Konstanz, Germany) labeled with Rhodamine B dye. The teeth were sectioned at distances of 2 and 5 from root apex. Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy. Results of one way Anova analysis showed that there was a significant difference in the percentage and depth of sealer penetration among all groups at 3 and 5 mm level sections (P < .05). Within the groups maximum sealer penetration was recorded for Er,Cr:YSGG laser activated group. Greater depth of sealer penetration was recorded at 5mm as compared to 3mm in all the groups. Activation of QMix using EndoActivator and Er,Cr:YSGG laser enhanced the sealer penetration at apical and middle third. Thus Er,Cr:YSGG laser and EndoActivator may act as an appropriate adjunct during chemomechanical preparation of the root canal

Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: A scanning electron microscope study

Abstract Aim Aim of this study was to compare the removal of smear layer and organic debris within the tooth canal among conventional needle irrigation, EndoVac and Endoactivator. Methodology Eighty single-rooted extracted human teeth were prepared with rotary NiTi instrumentation and randomly separated into 4 groups. Twenty teeth were used as positive control (Group 1), irrigated with only saline. Teeth assigned to Group 2 ( n = 20) received irrigation with a conventional syringe and a 30-gauge needle (NaviTip, Ultradent, South Jordan, UT); samples in Group 3 ( n = 20) were rinsed with an irrigation device based on apical negative pressure (EndoVac, Discus Dental, Culver City, CA) and teeth in Group 4 ( n = 20) were treated with a sonic irrigation system (EndoActivator, Dentsply Tulsa Dental, Tulsa, OK, USA). The amount of residual smear layer and debris was evaluated under a scanning electron microscope, and a semi-quantitative score was assigned to each root at the coronal, middle and apical thirds; the chi-square test was used to compare the results of the S.E.M. analysis. Results EndoActivator performed the best cleansing for both smear layer and organic debris in all root canal thirds, followed by EndoVac and conventional irrigation ( p > 0.001). EndoVac and conventional irrigation showed better cleaning in the coronal area, whereas EndoActivator performed an homogeneous cleansing at all levels. Conclusions The EndoVac system and the EndoActivator system demonstrated significantly more efficacy in cleansing root canal walls than conventional needle irrigation

Comparative Evaluation of Smear Layer Removal Using Four Different Irrigation Techniques: An in-vitro Study

INTRODUCTION: Irrigation is the vital part of root canal debridement. Usually post biomechanical preparation, the canal walls are covered by smear layer. It is important to remove this layer before obturation for better bond between the filling and walls. Conventional needle irrigation doesn’t give us adequate cleaning, therefore, new irrigation techniques are being tried to facilitate better smear layer removal. AIM: The aim was to evaluate and compare the smear layer removal by PATS,&nbsp; EndoActivator device, Passive ultrasonic irrigation and side vent needle irrigation from canal walls. MATERIALS AND METHODS: &nbsp;60 extracted mandibular premolars were instrumented up to 35/.04 with Heroshaper files. Samples were divided into 4 groups randomly before final irrigation as follows: Group I (n=15): Irrigation with side vent needles (Nexus ltd.,India), Group II (n=15): Irrigation with EndoActivator (Advanced Endodontics, Santa Barbara, CA ) Group III (n=15): Irrigation with PATS ( InnovationsEndo,India), Group IV (n=15): Irrigation with ultrasonic tips (Mani inc.). Teeth were split and one-half of each tooth was chosen for SEM examination. &nbsp;The images were taken at apical third and scoring was done according to criteria by Torabinejad et al in 2003. Data obtained were analyzed using Kruskal-Wallis analysis of variance followed by Mann–Whitney U-test for individual comparison. RESULTS: All irrigating systems remove smear layer but PUI has better cleaning ability as compared to other groups. CONCLUSION: Passive ultrasonic irrigation shows better smear layer removal as compared to other technique

Efficacy of three methods for inserting calcium hydroxide-based paste in root canals

To compare the quality of calcium hydroxide paste fillings performed by three different techniques. Sixty extracted maxillary central incisors, with previous root canal treatment, were decoronated and the gutta-percha was completely removed from the root canals. Subsequently, the canals were filled with a calcium hydroxide-based paste composed of calcium hydroxide, bismuth carbonate, and glycerin. The study samples were divided into the following three groups on the basis of three insertion techniques (n = 20, each): conventional technique using a hand instrument (MAN), rotary Lentulo spiral (LEN) technique, and a combined technique combining conventional hand files with sonic activation through the EndoActivator device (EA). The quality of fillings was evaluated radiographically by two examiners on the basis of the amount of voids and the apical limit. The canals filled with LEN or MAN had less void volume compared to the EA technique (P >0.01), with no significant differences between them. Considering the apical limits, the three tested techniques showed comparable results (P >0.05). A combined approach utilizing hand files with sonic activation showed no enhancements over the LEN or MAN techniques on the quality of intracanal placement of calcium hydroxide paste