FESEM evaluation of smear layer removal using different irrigant activation methods (EndoActivator, EndoVac, PUI and LAI). An in vitro study

Mancini, Manuele; Cerroni, Loredana; Iorio, Lorenzo; Dall'Asta, Lorenzo; Cianconi, L

doi:10.1007/s00784-017-2179-y

Cited by 46 publications

(62 citation statements)

References 42 publications

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“…All the roots were prepared by using the ProTaper Universal System (Dentsply‐Maillefer), according to the manufacturer's protocol, up to F4 file (Mancini, Cerroni, Iorio, Dall'Asta & Cianconi, ; Saber Sel & Hashem, ). Irrigation was performed at each change of file with 2.5mL of 5% NaOCl (Fórmula & Ação, São Paulo, SP, Brasil) and NaviTip 29 gauge needles 25 mm in length (Ultradent Prod Inc, South Jordan, UT), calibrated to 1 mm short of the working length (Kuah, Lui, Tseng & Chen, ).…”

Section: Methodsmentioning

confidence: 99%

“…Several methods and devices have been used for irrigation, such as conventional needles, EndoActivator, EndoVac, and ultrasound. They have also been used to carry out different final irrigation protocols, aiming to potentiate the removal of the smear layer and to obtain greater tubular dentin sealer penetration (Bolles, He, Svoboda, Schneiderman & Glickman, ; Chaudhry, Yadav, Talwar & Verma, ; Elnaghy, Mandorah & Elsaka, ; Kara Tuncer & Unal, ; Mancini et al, ; Mancini, Cerroni, Iorio, Dall'Asta & Cianconi, ; Suman, Verma, Prakash‐Tikku, Bains & Kumar‐Shakya, ; Uroz‐Torres, Gonzalez‐Rodriguez & Ferrer‐Luque, ).…”

Section: Introductionmentioning

confidence: 99%

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Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study

Machado¹,

Cruz

Araujo

et al. 2018

Microscopy Res & Technique

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The aim of this study was to evaluate tubular dentin sealer penetration, comparing different final irrigation protocols using a conventional needle (CONV), EndoActivator system (EAS), EndoVac system (EVS), and ultrasound (PUI). Initially, fifty-two first maxillary molars with a single canal in the palatal root, without abrupt curvatures, resorptive processes, or previous endodontic treatment were selected for this study. Then, the crowns were sectioned to obtain palatal roots 15 mm in length. The root canals were prepared with the ProTaper Universal System and irrigated with 5% NaOCl. Afterwards, the specimens were divided into four groups (n. 13), according to the final irrigation protocol: CONV, EAS, EVS, and PUI. After filling, slices at 3 mm and 5 mm from the apex were obtained for analysis by confocal laser scanning microscopy. Two-way comparisons between the groups and the levels were performed with Games Howell's test (p < .05). Tubular dentin sealer penetration was higher at 5 mm compared with 3 mm from the apex (p < .05). The EAS group showed a higher percentage of tubular dentin sealer penetration, compared with the CONV group, at both levels. At 3 mm, there was no statistically significant difference among EAS, EVS, and PUI; however, these groups showed better performance, compared with the CONV group. At 5 mm, there was no statistically significant difference between the EAS and EVS groups, but both showed higher sealer penetration than the PUI group (p < .05). The EAS and EVS groups achieved better degrees of tubular dentin sealer penetration, compared with the other groups.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study

Machado¹,

Cruz

Araujo

et al. 2018

Microscopy Res & Technique

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“…Traditional treatment involves the sequential use of root canal irrigants with different modes of action against the organic and inorganic matter. Although there is no clear consensus on the sequence of irrigation, the most common protocol is to use sodium hypochlorite (NaOCl) during mechanical preparation to dissolve the organic matter and kill microorganisms, then a strong chelating agent like ethylenediaminetetraacetic acid (EDTA) to remove the smear layer inorganic components and to promote sealer penetration into dentinal tubules (Baca, Junco, Arias-Moliz, González-Rodríguez, & Ferrer-Luque, 2011;Jardine et al, 2016;Mancini, Cerroni, Iorio, Dall'Asta, & Cianconi, 2017;Zehnder, 2006). Alternatively, the use of a weak chelating agent such as etidronic acid (HEBP) (Tartari et al, 2017;Ulusoy, Zeyrek, & Çelik, 2017;Zehnder, Schmidlin, Sener, & Waltimo, 2005) in combination with NaOCl has been proposed as a single irrigating solution to be used during root canal preparation and as the final solution.…”

Section: Introductionmentioning

confidence: 99%

Dentine tubule disinfection by different irrigation protocols

Morago

Ruiz-Linares

Ferrer-Luque

et al. 2019

Microscopy Res & Technique

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The purpose of this study was to test the antimicrobial activity and the smear layer removal of different irrigation protocols—sodium hypochlorite (NaOCl), NaOCl followed by ethylenediaminetetraacetic acid (EDTA), and NaOCl combined with etidronic acid (HEBP)—against infected dentine tubules during root canal preparation. Single rooted premolars contaminated with Enterococcus faecalis were chemomechanically prepared. Depending on the irrigation protocols, the roots were divided into the following groups: (1) distilled water during and after instrumentation; (2) 2.5% NaOCl during and after instrumentation; (3) 2.5% NaOCl/9% HEBP during and after instrumentation; and (4) 2.5% NaOCl during instrumentation followed by 17% EDTA after instrumentation. The percentage of dead cells and the biovolume in infected dentine tubules were measured using confocal laser scanning microscopy and the live/dead technique. Smear layer removal on root canal wall surfaces was observed by means of scanning electron microscopy. Results were compared through parametric tests (p < .05). The groups NaOCl, NaOCl/HEBP, and NaOCl+EDTA exerted the highest antimicrobial activity (p > .05), followed by the group irrigated with water. All the irrigation protocols—including water—significantly reduced the bacteria biovolume. No dentine tubules free of smear layer were found in the positive control or the 2.5% NaOCl group. With NaOCl/HEBP and NaOCl+EDTA, respectively, 90.41% ± 7.33 and 76.54% ± 15.30 of dentine tubules were free of smear layer (p = .01). NaOCl/HEBP and NaOCl+EDTA exerted an important antimicrobial activity against bacteria inside dentine tubules, lowering the bacteria biovolume and eliminating a high amount of the smear layer, particularly in the NaOCl/HEBP group.

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“…25 Recently, the use of irrigation activated by ultrasonic, lasers, and negative apical pressure (Endovac) has been discussed. 52 However, the activation does not necessary imply a better bond strength. 23,24 In addition, the association of NaOCl/EDTA with ultrasonic agitation had a better performance when compared with non-activated NaOCl/EDTA on the removal of debris capacity.…”

Section: Discussionmentioning

confidence: 99%

Can intra-radicular cleaning protocols increase the retention of fiberglass posts? A systematic review

et al. 2018

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The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved "in vitro" studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photoninduced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.

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FESEM evaluation of smear layer removal using different irrigant activation methods (EndoActivator, EndoVac, PUI and LAI). An in vitro study

Abstract: In our study, none of the activation/delivery systems completely removed the smear layer from the root canal walls; nevertheless, EV and EA showed, respectively, statistically significant better results at 1, 3, 5, and 8 mm and 3, 5, and 8 mm from the apex.

Cited by 46 publications

References 42 publications

Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study

Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study

Dentine tubule disinfection by different irrigation protocols

Can intra-radicular cleaning protocols increase the retention of fiberglass posts? A systematic review

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