Improved dentin disinfection by combining different-geometry rotary nickel-titanium files in preparing root canals

Abstract

ObjectivesThis study was to evaluate the antibacterial effect of different instrumentation and irrigation techniques using confocal laser scanning microscopy (CLSM) after root canal inoculation with Enterococcus faecalis (E. faecalis).Materials and MethodsMesiobuccal and mesiolingual canals of extracted mandibular molars were apically enlarged up to a size 25 hand K-file, then autoclaved and inoculated with E. faecalis. The samples were randomly divided into 4 main groups according to the system of instrumentation and irrigation: an XP-endo Shaper (XPS) combined with conventional irrigation (XPS/C) or an XP-endo Finisher (XPF) (XPS/XPF), and iRaCe combined with conventional irrigation (iRaCe/C) or combined with an XPF (iRaCe/XPF). A middle-third sample as taken from each group, and then the bacterial reduction was evaluated using CLSM at a depth of 50 µm inside the dentinal tubules. The ratio of red fluorescence (dead cells) to green-and-red fluorescence (live and dead cells) represented the percentage of bacterial reduction. The data were then statistically analyzed using the Kruskal-Wallis test for comparisons across the groups and the Dunn test was used for pairwise comparisons.ResultsThe instrumentation and irrigation techniques had a significant effect on bacterial reduction (p < 0.05). The iRaCe/XPF group showed the strongest effect, followed by the XPS/XPF and XPS/C group, while the iRaCe/C group had the weakest effect.ConclusionsCombining iRaCe with XPF improved its bacterial reduction effect, while combining XPS with XPF did not yield a significant improvement in its ability to reduce bacteria at a depth of 50 µm in the dentinal tubules.

Efficacy of Combined Use of XP-endo shaper and XP-endo Finisher in Cleaning Simulated Internal Root Resorption Defects: An In-Vitro Comparative Study

“…In the present study regarding the control groups 5 specimens did not receive CGM to ensure that the analysis of cleaned canal did not yield false positive of residual CGM, likewise, 5 specimens received CGM without subsequent removal to assure that CGM was uniformly present in the simulated IRR cavities and that amount initially applied was significantly different from any amounts remaining after cleaning procedure in tested groups (25) In the present study , the complete removal of the colored gelatin material off the walls of the simulated IRR cavities was not obtained in any of the test groups (A,B) this was in accordance with previous studies (10,11,12,15,17 ) Regarding the results of the present study group A (cleaned using PUI) recorded a low Mean percentage of residual CGM at 16. 88% which comes in agreement with previous studies (4,5,6) Whom also found PUI to be an effective method of removing debris and smear layer , bacterial biofilm, intracanal medicaments in either normal canal configuration or simulated IRR cavities This may be due to the irrigation agitation which creates more intense shear forces with in the fluids in root canal which increases the irrigant penetration into the tissues and through the root canal and may explain the efficacy in flushing out CGM from IRR cavities as previously described by Jiang et al (26) .…”

“…In addition to the agitation and activation of the irrigation in group B which leads to turbulence in the irrigation and amplifies its action with in the root canal as previously reported by Alves etal (35) who observed a drop in bacterial count in infected root canals after application of XP-endo finisher Likewise XP-endo finisher was shown to be superior in removing smear layer and hard tissue debris from root canal walls in studies by Leoni etal (32) and Elnaghy etal (16) furthermore this may be attributed to the use of combination of instruments ( XP-shaper and Finisher) compared to a single instrument PUI which comes in accordance with similar findings by Abdelhady etal 2018 (36) who showed that the combined use of XP and PUI together was more efficient in removing smear layer than each instrument used separately and which is consistent with results of Bedier etal (11) whom found the combination of XP shaper and finisher was significantly more efficient in removing E Faecalis from root canals than when used alone. however, results from the present study disagrees with those shown by Keskin etal (15) who found no significant difference between XP and PUI in removing intracanal medicaments from resorpative defects And Wigler et al (37) who also showed no significant difference between XP-finisher and PUI in removing calcium hydroxide from artificial grooves in the apical third of root canal Which was also confirmed by Uygun et al (38) .…”

“…The novel instrument has also proven to be very efficient in chemo mechanical preparation of root canal , moreover removal of bacterial biofilms as shown in a study by Bedier etal 2018 (11) where they compared the efficacy of combination of several instruments in the removal of bacterial biofilm from root canals using confocal laser scanning electron microscopy. The authors concluded that the highest bacterial removal was recorded when i-Race and XP-finisher were used together followed by XPshaper and XP-finisher while all the other groups recorded significantly lower values.…”

Effect of Adaptive, Rotary, and Manual Root Canal Instrumentation in Primary Molars: A Triple-Armed, Randomized Controlled Clinical Trial

“…The present finding that root canals instrumented with the XP-endo Shaper allowed a more frequent (76%) optimal obturation result, according to the above criteria, may be explained by previous ex vivo studies of this adaptive file. The ability of this file to adequately instrument and clean the canals of permanent teeth with an oval cross-section has been studied using microCT [ 20 , 27 , 31 , 32 ]. It has been demonstrated that the XP-endo Shaper resulted in better 3D instrumentation than rotary files, affecting a higher percentage of the root canal walls [ 20 , 27 , 31 , 32 ].…”

Avaliação da permeabilidade dentinária após o emprego de diferentes protocolos de irrigação e técnicas de instrumentação mediante análise histoquímica por microscopia digital e microscopia confocal a laser

“…Embora o preparo biomecânico reduza o contingente bacteriano, a desinfecção completa do SCR é dificultada devido à sua complexidade anatômica (MACHTOU, 1980;HAAPSALO et al, 2014;GRAYSON, 2016;SILVA et al, 2017;BEDIER;HASSAN, 2018). Portanto, o uso das soluções irrigadoras é indispensável, visto que conseguem atingir áreas de difícil acesso, onde os instrumentos não conseguem tocar (ALKAHTANI; AL-KHUDHAIRI; ANIL, 2014;KONSTANTINIDI et al, 2017) como canais laterais, istmos e ramificações apicais WESSELINK, 2001;BERGENHOLTZ, 2003, NAIR et al, 2005GANAHL;PETERS, 2009;METZGER et al, 2010;ALVES et al, 2011;ZANDI et al, 2016;DUQUE et al, 2017).…”