Influence of size and taper of basic root canal preparation on root canal cleanliness: a scanning electron microscopy study

Plotino, Gianluca; Özyürek, Taha; Grande, Nicola M.; Gündoğar, Mustafa

doi:10.1111/iej.13002

Cited by 72 publications

(80 citation statements)

References 37 publications

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“…Recent histological studies report significant amounts of pulp tissue remnants and bacteria in the apical area after single‐file reciprocating instrumentation and conventional sodium hypochlorite irrigation (Siqueira et al 2018, Varela et al 2019). According to some authors, preparation of root canals to larger sizes allows better removal of infected dentine (Card et al 2002), enhances deeper penetration of irrigants (Boutsioukis et al 2010), significantly reduces the amount of bacteria in the canal system (McGurkin‐Smith et al 2005) and cleans more debris from the canal (Plotino et al 2019). There have been numerous published studies that investigated the influence of the root canal preparation size on different outcomes: intracanal debridement (Boutsioukis et al 2010), microbial reduction (Aminoshariae & Kulild 2015), smear layer removal (Plotino et al 2019) and healing of periapical periodontitis (Saini et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth

Bago

Plotino²,

Katić

et al. 2020

Int Endodontic J

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Aim To compare the retreatment ability of several rotary and reciprocating file systems in curved root canals of extracted teeth and to evaluate the influence of additional apical enlargement performed after a basic retreatment on the amount of remaining filling material. Methodology A total of 65 round curved root canals were used. The root canals were prepared with the ProTaper Next rotary system to size 25, .06 taper and filled with an epoxy resin‐based sealer and gutta‐percha using continuous wave vertical compaction and warm injection back‐filling. The canals were randomly divided into four groups according to the retreatment system used: Group I. ProTaper Universal Retreatment system + ProTaper Gold (PTG) instrumentation system up to PTG F2; Group II. Reciproc Blue system up to the instrument RB25; Group III. Reciproc system up to the instrument R25; Group IV. Wave One Gold (WOG) system up to the instrument WOG25. After the basic retreatment, additional apical enlargement was performed in each group with an instrument that was one size larger: in Group I, II and III up to apical size 40, and in Group IV up to 35. The final irrigation protocol included the following: 15% ethylenediaminotetraacetic acid followed by NaOCl irrigation. The volume of filling material was measured using an industrial micro‐CT four times: after root canal filling (Volume I), after basic retreatment with size 25 files (Volume II), after additional root canal enlargement with larger instruments (Volume III), and after the final irrigation protocol (Volume IV). The decrease in the amount of filling material after each retreatment protocol was analysed using a Kruskal–Wallis test. Intergroup analyses were performed with a Kruskal–Wallis test and between‐group differences were further analysed with Mann–Whitney U test. Results There were no significant differences amongst the systems tested in the amount of remaining filling material, or the reduction rates after each phase of the retreatment procedures (P > 0.05). Intragroup analysis indicated that the use of a larger final instrument removed significantly more filling material in all groups (P < 0.001). Conclusion The four tested instrumentation systems were equally effective in removing filling materials from curved root canals in extracted teeth. Additional apical enlargement with larger files improved the removal of filling remnants after basic retreatment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth

Bago

Plotino²,

Katić

et al. 2020

Int Endodontic J

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“…Only one study compared a size 20, .04 preparation with a size 25, .04 preparation in conjunction with sonic activation (Plotino et al . ), concluding that the size 25 resulted in cleaner canals, despite the presence of debris.…”

Section: Introductionmentioning

confidence: 90%

“…Studies on this topic have investigated the influence of apical preparation size on root canal cleanliness (Benatti et al 1985, Usman et al 2004, Khademi et al 2006, Fornari et al 2010, Borges et al 2011, microbial reduction (Ørstavik et al 1991, Yared & Dagher 1994, Card et al 2002, Coldero et al 2002, Rollison et al 2002, Mickel et al 2007, Rodrigues et al 2017 or healing outcome (de Souza Filho et al 1987, Saini et al 2012, Souza et al 2012, after preparation with instruments and irrigation using a syringe and a needle. Only one study compared a size 20, .04 preparation with a size 25, .04 preparation in conjunction with sonic activation (Plotino et al 2018), concluding that the size 25 resulted in cleaner canals, despite the presence of debris.…”

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confidence: 99%

Influence of apical preparation size and irrigation technique on root canal debridement: a histological analysis of round and oval root canals

Lee

Khan

et al. 2019

Int Endodontic J

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Aim To examine the debridement of round and oval root canals prepared to two apical sizes with and without ultrasonically activated irrigation. Methodology Mandibular premolars with round (n = 48) and oval (n = 48) root canals were pair‐matched after microCT scanning and randomly divided into two experimental groups (n = 20): group 1, rotary NiTi to size 20, .04 taper; group 2, rotary NiTi to size 40, .04 taper. Specimens were subdivided into two subgroups (n = 10): subgroup A, syringe and needle (SNI); subgroup B, ultrasonically activated irrigation (UAI). Untreated canals (eight oval and eight round) served as controls. Specimens were processed for histological evaluation for measurement of the remaining pulp tissue and debris (RPT), and the perimeter percentage of root canal area untouched by the instruments (PRAU). Following assessment of normality, multiple‐way anova models were used to study the effects of preparation size, irrigation technique and canal cross‐sectional shape, and their interactions on the RPT and PRAU (α = 0.05). Results All experimental groups had significantly less RPT than the control (P < 0.05). Both the preparation size (20 vs. 40) and the irrigation technique (SNI vs. UAI) had a significant effect on RPT (P = 0.006 and P < 0.001, respectively). Groups irrigated with SNI always had significantly greater RPT than those irrigated with UAI, irrespective of the preparation size (P < 0.001). Canals prepared to size 20 had significantly greater RPT than those with size 40 in the SNI subgroup (P < 0.001), but there was no significant difference in the UAI subgroup (P = 0.481). Conclusions Root canals prepared to a larger size (40) were cleaner than those prepared to a smaller size (20), when irrigation was performed with a syringe and needle. When the irrigant was ultrasonically activated, smaller preparations resulted in canals that were as clean as larger preparations. This finding was common to both round and oval canals of freshly extracted premolars with vital pulp tissue.

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“…Além do mais, a alta complexidade morfológica do sistema de canais radiculares, principalmente no terço apical, dificulta a atuação dos instrumentos endodônticos, por considerar áreas não tocadas por esses instrumentos (GUALABIVALA et al, 2005;KONSTANTINIDI et al, 2017). Essa é a razão pela qual se justifica a busca incessante por novos protocolos de irrigação, para que venham potencializar a ação das soluções irrigadoras, que é considerada parte essencial do tratamento endodôntico, pois permite melhor limpeza e desinfecção quando considerado apenas a ação mecânica dos instrumentos (KAMEL & KATAIA, 2014;PLOTINO et al, 2018).…”

Section: Discussão Discussão Discussão Discussãounclassified

“…As análises histoquímicas por meio de microscopia digital e microscopia confocal a laser se limitaram a verificar a permeabilidade dentinária dos terços médio e apical do grupo de dentes selecionado, pois a literatura demonstra que a dentina do terço cervical é mais permeável que a dos terços médio e apical (MARSHALL;MASSLER;DUTE, 1960;FRÓIS et al, 1981;ZUOLO et al, 1987;PÉCORA et al, 1987;LOVE, 1996;BRUGNERA JÚNIOR et al, 2003;PLOTINO et al, 2018).…”

Section: Discussão Discussão Discussão Discussãounclassified

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

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Influence of size and taper of basic root canal preparation on root canal cleanliness: a scanning electron microscopy study

Cited by 72 publications

References 37 publications

Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth

Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth

Influence of apical preparation size and irrigation technique on root canal debridement: a histological analysis of round and oval root canals

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

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