Efficacy of ultrasonic activation of NaOCl and orange oil in removing filling material from mesial canals of mandibular molars with and without isthmus (original) (raw)

Evaluation of Two Shaping Systems and Two Ultrasonic Irrigation Devices in Removing Root Canal Filling Material from Mesial Roots of Mandibular Molars: A Micro CT Study

Dentistry Journal, 2019

We assessed the efficiency of two shaping file systems and two passive ultrasonic irrigation (PUI) devices for removing filling material during retreatment. The mesial canals from 44 extracted mandibular molars were prepared and obturated. The teeth were randomly divided into two groups, and then one group was retreated with Reciproc R25 (VDW, Munich, Germany) (n = 44) and the other group was retreated with 2Shape (TS, Micro Mega, Besançon, France) (n = 44). A micro-computed tomography (CT) scan was taken before and after the retreatment to assess the volume of the filling material remnants. The teeth were then randomly divided into four groups to test two different PUI devices: Irrisafe (Satelec Acteon Group, Merignac, France) and Endo Ultra (Vista Dental Products, Racine, WI, USA). The teeth in Group A were retreated with 2Shape to test the Endo Ultra (n = 22) device, the teeth in Group B were retreated with 2Shape in order to test the Irrisafe (n = 22) device, the teeth in Group C were retreated with Reciproc to test the Endo Ultra (n = 22) device, and Group D was retreated with Reciproc to test the Irrisafe (n = 22) device. A third micro-CT scan was taken after the retreatment to test the PUIs. The percentage of Gutta-Percha (GP) and sealer removed was 94.75% for TS2 (p < 0.001) and 89.3% for R25 (p < 0.001). The PUI significantly enhanced the removal of the filling material by 0.76% for Group A (p < 0.001), 1.47% for Group B (p < 0.001), 2.61% for Group C (p < 0.001), and by 1.66% for Group D (p < 0.001). 2Shape was more effective at removing the GP and sealer during retreatment (p = 0.018). The supplementary approach with PUI significantly improved filling material removal, with no statistical difference between the four groups (p = 0.106).

Efficacy of Sonic and Ultrasonic Activation for Removal of Calcium Hydroxide from Mesial Canals of Mandibular Molars: A Microtomographic Study

Journal of Endodontics, 2011

Background: The purpose of this study was to use micro-computed tomography (micro-CT) scanning to evaluate the efficacy of sonic and passive ultrasonic irrigation (PUI) on calcium hydroxide (Ca[OH] 2 ) removal and to measure the volume and percentage of Ca (OH) 2 remaining in the root canal system. Methodology: The root canals of 46 extracted human mandibular molar teeth were prepared with rotary instruments and randomly assigned to two experimental groups (n = 40) as well as positive and negative controls (n = 6). In each experimental group, 20 teeth were assigned to each irrigation protocol, sonic or passive ultrasonic irrigation. All experimental teeth and the positive controls were filled with Ca(OH) 2 , whereas the negative control teeth did not receive Ca(OH) 2 . All teeth were scanned using micro-CT scanning to determine the dressing volume. After 7 days, the Ca(OH) 2 was removed in the experimental groups using rotary instrumentation only, and the teeth were again scanned using micro-CT scanning to calculate volume and percentage of Ca(OH) 2 removed. Positive control teeth were not subjected to rotary instrumentation. Experimental samples were then irrigated using either sonic or passive ultrasonic and the volume of remaining Ca(OH) 2 was calculated using micro-CT. Results: Remnants of Ca(OH) 2 were found in all experimental groups. No Ca(OH) 2 was found in the negative controls, whereas a mean of 8.7 mm 3 of Ca(OH) 2 was recorded in the positive controls. Rotary plus passive ultrasonic irrigation removed significantly more Ca(OH) 2 (85.7%) than rotary plus sonic irrigation (71.5%) (p < 0.001). Conclusions: The combination of rotary instrumentation and passive ultrasonic activation for 3 periods of 20 seconds results in significantly lower amounts of Ca(OH) 2 remnants in the canal compared with sonic irrigation. (J Endod 2011;37:235-238)

Removal of Root Canal Fillings in Curved Canals Using Either Mani GPR or HyFlex NT Followed by Passive Ultrasonic Irrigation

This study compared the efficacy of HyFlex NT (HF; Coltene, New York, NY) and Mani GPR (MN; Mani Inc, Tokyo, Japan) systems followed by a supplementary approach with passive ultrasonic irrigation (PUI) in removing the filling material from curved root canals during retreatment. The mesial canals from 20 extracted mandibular molars with Vertucci type IV configuration were instrumented and obturated (N = 40). Each mesial canal was retreated using either HF or MN instruments, alternating the system used per canal from root to root. The final preparation size was 40/0.04 for both systems. The volume of canal filling material was assessed by means of micro–computed tomographic (micro-CT) imaging before and after retreatment, and the working time was recorded. Canals still showing remnants of filling material were subjected to a supplementary approach with PUI, and another micro-CT scan was taken. The percentage of filling material removed with MN instruments and HF was similar (95.5% and 92.7%, respectively) (P > .05). MN required significantly less time to remove the filling material (P < .05). The supplementary approach with PUI significantly enhanced the removal of filling material (P < .05). Both systems were equally effective in removing the root canal filling during retreatment. MN was faster than HF. The supplementary approach with PUI significantly improved filling material removal. (J Endod 2018;44:299–303)

Efficacy of 3 Supplementary Irrigation Protocols in the Removal of Hard Tissue Debris from the Mesial Root Canal System of Mandibular Molars

Journal of Endodontics, 2019

Removal of accumulated hard-tissue debris (AHTD) by two ultrasonically-assisted and one multisonic irrigation systems was assessed with micro-computed tomography (micro-CT). Twenty-four extracted mandibular molars having two mesial canals connected by an isthmus and converging to a single foramen were selected. After preparation of the mesial canals with WaveOne Gold instruments (Dentsply Sirona Maillefer, Ballaigues, Switzerland), anatomically matched specimens were assigned to three final irrigation protocols (n=8): intermittent-ultrasonic (IU), continuous-ultrasonic (CU) and GentleWave (GW) system (Sonendo Inc, Laguna Hills, CA). Datasets of the micro-CT scans were co-registered and the percentage reduction of AHTD was statistically compared using one-way ANOVA and post-hoc Tukey tests with 5% significance level. Mean percentage reduction of AHTD in canals and isthmuses was significantly higher for GW (96.4% and 97.9%, respectively) than for CU (80.0% and 88.9%, respectively) (P<0.05). AHTD reduction for IU (91.2% and 93.5%, respectively) did not differ significantly from GW and CU (P>0.05).

Distribution of sodium hypochlorite throughout the mesial root canal system of mandibular molars after adjunctive irrigant activation procedures: a micro-computed tomographic study

Clinical Oral Investigations, 2019

Objectives To evaluate and compare irrigant distribution throughout the root canal system of mesial roots of mandibular molars after application of distinct adjunctive irrigant activation procedures. Materials and methods Fifteen extracted mandibular molars presenting Fan's type II, III, or IV isthmus configurations were selected. The canals were initially enlarged and cleaned. The same specimens were subjected to conventional positive pressure irrigation (PPI) followed by adjunctive irrigation approaches: passive ultrasonic irrigation (PUI), mechanical activation with the XPendo Finisher instrument, and a control group in which the irrigant remained in the canal with no activation. Retention time for the irrigant was the same for all groups. Sodium hypochlorite mixed with a contrast medium (Omnipaque 300) was used as the irrigant. Before and immediately after the adjunctive irrigation, micro-computed tomographic (micro-CT) scans were taken to evaluate the volume of the entire root canal system that was filled by the irrigant. An exclusive analysis was also done for the isthmus area. Results Analysis of the entire root canal system showed that the XP-endo Finisher instrument promoted better distribution of the irrigant than PUI and the control group (p < 0.01). PUI was not significantly different from the control group (p > 0.05). A separate analysis of the isthmus area showed no significant difference between the adjunctive irrigation methods and the control (p > 0.05). Conclusions The XP-endo Finisher instrument promoted better distribution of irrigant throughout the root canal system, especially in the apical canal segment, when compared to PUI. However, the tested approaches did not differ as to the ability to drive irrigants into the isthmus area. Clinical relevance This study highlighted that the XP-endo Finisher instrument presented a better performance to distribute irrigant throughout the root canal system, especially in the apical canal segment compared to positive pressure irrigation and PUI.

Effectiveness of the REvision System and Sonic Irrigation in the Removal of Root Canal Filling Material from Oval Canals: An In Vitro Study

Bioengineering

This study aimed to evaluate the effectiveness of the Endostar REvision system (Poldent, Warsaw, Poland) in the removal of filling materials from oval root canals using sonic irrigation as an additional cleaning method. Thirty human-extracted mandibular premolars with oval canals were prepared using the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland) up to instrument F1 (20/.07), and then filled by the continuous wave vertical compaction technique using pulp canal sealer EWT (Sybron Dental Specialties, Orange, CA, USA). The teeth were randomly divided into two groups (n = 15) according to the instrumentation system and the additional cleaning method, as follows: REvision (30/.08, 25/.06) with EQ-S sonic activation (Meta Biomed, Chungcheongbuk-do, Korea), REvision (30/.08, 25/.06) without additional activation. All specimens were sectioned longitudinally at 3 and 7 mm from the apex, and analyzed using digital microscopy (KEYENCE, Osaka, Japan) to measure the t...

The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from human root canals prepared using instruments of varying taper

International Endodontic Journal, 2005

van der Sluis LWM, Wu M-K, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from human root canals prepared using instruments of varying taper. International Endodontic Journal, 38, 764-768, 2005. Aim To investigate the influence of the taper of root canals on the effectiveness of ultrasonic irrigation to remove artificially placed dentine debris. Method Forty-four maxillary and mandibular canines were selected after bucco-lingual and mesiodistal radiographs indicated that their internal diameters were smaller than the diameters of a size 20, .06 taper System GT instrument (Dentsply Maillefer, Ballaigues, Switzerland). These canines were divided into three groups and prepared using either size 20, .06 taper System GT instruments, size 20, .08 taper or size 20, .10 taper System GT instruments. Each root was then split longitudinally through the canal, forming two halves. In one canal wall, a standard groove was cut 2-6 mm from the apex, to simulate uninstrumented canal extensions. Each groove was filled with dentine debris mixed with 2% NaOCl to simulate a situation when dentine debris accumulates in the uninstrumented canal extensions. Each canal was reassembled by joining the two halves of the teeth by means of wires and sticky wax. In each canal ultrasonic irrigation was performed with a size 15 K file using 2% NaOCl as an irrigant. Before and after irrigation, images of each half of the canal with a groove were taken using a microscope and a digital camera, after which they were scanned into a PC as TIFF images. The quantity of dentine debris in the groove was evaluated using a scoring system: the higher the score, the larger the amount of debris. The scores before and after irrigation were compared. The differences in percentage of score reduction between the three groups were analysed by means of one-way anova. Results After ultrasonic irrigation, the debris score reduced by 74, 81 and 93%, respectively, in the size 20, .06, 20, .08 and 20, .10 taper groups. However, the difference amongst groups was not statistically significant (P ¼ 0.078). Conclusion There was a tendency that ultrasonic irrigation was more effective in removing artificially placed dentine debris from simulated canal extensions from canals with greater tapers.

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

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 man-dibular 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.

Efficacy of passive ultrasonic irrigation in removing root filling material during endodontic retreatment

Revista de Odontologia da UNESP, 2016

Introduction The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. Objective To evaluate the efficacy of passive ultrasonic irrigation (PUI) in the removal of residual root filling material after removing the bulk of the root filling with nickel-titanium rotary instruments. Material and method Eighteen mesial isthmus-containing roots of human mandibular molars were prepared and filled. The root canal filling was removed with the ProTaper Retreatment system and K-files. The specimens were randomized into 2 groups (n = 9), both irrigated with 2.5% NaOCl and 17% EDTA. In the conventional group, an irrigation syringe was used. In the PUI group, the PUI technique was used. The roots were sectioned longitudinally and evaluated under stereomicroscopy. Student’s t test was used to compare groups and the general linear model was used to compare the apical, cervical, a...