Radiographic evaluation of root canal cleaning, main and laterals, using different methods of final irrigation

Abstract

ResumoObjetivo: O objetivo deste estudo foi avaliar a eficácia da irrigação ultrassônica passiva (IUP), utilizando os fluxos intermitente ou contínuo, e da irrigação manual convencional (IMC) na limpeza de canais radiculares, principal e laterais simulados. Material e método: Os canais radiculares de 24 dentes artificiais foram preparados e os canais laterais foram confeccionados nos terços médio e apical. Os espécimes foram divididos em três grupos: G1-IMC, G2-IUP 1 (fluxo intermitente) e G3-IUP 2 (fluxo contínuo). Os canais radiculares foram preenchidos com uma solução de contraste e as raízes foram radiografadas antes e após a irrigação. As imagens digitais foram importadas para o programa Image Tool 3.0 e as áreas do canal totalmente preenchidas com o contraste, e após a irrigação, com remanescente do contraste, foram mensuradas para obtenção de dados percentuais. A análise estatística entre os grupos foi realizada por meio dos testes ANOVA e Tuckey. Resultado: No terço apical, os grupos G2 e G3 (IUP) mostraram melhor limpeza do que o grupo G1 (IMC) (p<0.05). Não houve diferenças estatisticamente significantes entre os grupos G2 e G3 (p>0.05). Conclusão: Irrigação ultrassônica passiva com fluxo intermitente promoveu melhor limpeza dos canais laterais simulados do que a irrigação manual convencional no terço apical do canal radicular. Não houve diferenças entre os grupos no canal principal e no terço médio. Descritores: Endodontia; irrigantes do canal radicular; ultrassom. AbstractObjective: To evaluate the efficacy of passive ultrasonic irrigation (PUI) using intermittent or continuous flushing and conventional manual irrigation (CMI) on the cleaning of main and simulated lateral root canals. Material and method: The root canals of 24 artificial teeth were prepared and simulated lateral canals were made in the medium and apical thirds of the root. The specimens were divided into three groups: G1-CMI, G2-PUI 1 (intermittent flushing) and G3-PUI 2 (continuous flushing). Root canals were filled with contrast solution and the roots were radiographed pre-and post-irrigation. The digital images were transferred to Image Tool 3.0 software and the areas of root canal completely filled with contrast, and after irrigation with contrast remnant, were measured to obtain percentage data. Statistical analysis between groups was performed by ANOVA and Tukey tests. Result: In the apical third, G2 and G3 (PUI) groups showed higher percentage of cleaning than G1 (CMI) (p<0.05). Conclusion: Passive ultrasonic irrigation using intermittent flushing promoted a higher cleaning of simulated lateral canals than conventional manual irrigation in the apical third. There were no differences between groups in the main root canal and the middle third.

Cleaning of Root Canal System by Different Irrigation Methods

“…The simulated lateral canals were made in resin teeth, as already described, [22][23][24] with 0.20 mm of diameter, according to other studies which used resin blocks artificial teeth and natural teeth. 5,22,25 The radiological contrast solution was thickened with propylene glycol and bismuth oxide to provide consistency and radiopacity, 22,26 allowing radiographic analysis.…”

“…The use of softwares and tools to evaluate different irrigation protocols have already been used in previous studies. 22,26,28,30,31 The root canal cleaning using various irrigation methods in comparison to manual irrigation has been studied. Howard et al 32 observed a similar cleaning capacity, at 2 and 4 mm from WL, for three irrigation techniques, such as EndoVac, PiezoFlow and irrigation with needle (Max-i-Probe).…”

“…There was no difference between EndoVac and PUI, but these techniques removed more Ca(OH) 2 than the CNI. Using similar methodology, Chávez-Andrade et al 22 evaluated the efficacy of IUP and manual irrigation (MI) in cleaning of simulated root canals and concluded that IUP with intermittent flow provided better cleaning of simulated lateral canals in the apical third, when compared to MI.…”

“…The methodology used in this study is in accordance with Chávez-Andrade et al 22 Forty-eight single-rooted resin teeth (Dental Rossetto Ltda., Arujá, SP, Brazil) were used. These teeth had crowns removed by using a cutting machine Isomet 1000 (Buelher Ltda., Lake Bluff, IL, USA) and their roots were standardized in 14 mm of length.…”

“…The irrigation period was divided as follows: 2 ml of solution in 30 seconds MI, 20 seconds PUI, 1 ml of the solution in 20 seconds MI, 20 seconds PUI and then 2 ml of the irrigant in 30 seconds MI, according with previous studies. 1,22 In EV1 and EV2 groups, the irrigation was performed with the EndoVac system, as follows (modified technique) 23 : two cycles of macroirrigation were executed with 3 ml of the solution using the macrocannula delivered at 4 mm short of WL in 30 seconds for each cycle (60 seconds in total), followed by 2 cycles of microirrigation during 60 seconds. Each cycle of microirrigation was performed with 3 ml of the solution, during 30 seconds of each cycle (final volume = 12 ml).…”