The efficacy of XP-endo SHAPER (XPS) in cleaning the apical third of the root canal

Abstract

Introduction The aim of this study was to evaluate the efficacy of new rotary NiTi instrument XP endo SHAPER (XPS) used with conventional irrigation protocol on the root canal cleaning in the apical area. Material and methods The research was conducted in vitro on 40 extracted single-rooted teeth divided into the four groups. Instrumentation in the first group was performed using iRa Ce NiTi rotary instruments, in the second group the same instruments were used plus XP endo FINISHER (XPF) for smear layer removal. In the third group, canal instrumentation was done using new instrument XPS, and in the fourth XPS instruments plus XPF was used. During the instrumentation 2% NaOCl solution was used for rinsing canals. The SEM analysis of the cleaning quality in the apical third of the canal was performed on longitudinal root cross-sections and standardized microphotography with a 2000x magnification. Results The thickest smear layer in the apical third was recorded in the first group (iRa Ce) NiTi instruments (2.12), and somewhat less in the group with the new XPS instrument (1.95). An identical and somewhat smaller amount of smear layer was registered in the second and fourth groups where XPF was used with the final irrigant (1.64) (p<0.001). Conclusion The application of only one instrument (XPS) in the canal enabled efficient cleaning of a very complex apical third. Cleaning was more efficient when XPF was used with final irrigant after the canal instrumentation.

The influence of the final irrigation protocol on the efficiency of root canal cleaning

“…This is in accordance with the findings of other authors who have showed that increasing the number of irrigation cycles increases the cleaning capacity as the amount of fresh solution is restored, while in the case of continuous irrigation, the saturation of the solution occurs faster [7, 11, 25, 26,]. Živković et al [25] have determined that the protocol of the final irrigation in three cycles improves the efficacy of removing the smear layer in the apex segment of the root canal, and Macedo et al [26] showed that the irrigation protocol in three cycles of fresh NaOCl solution increases its cumulative effect and thus the efficacy of cleaning root canal walls.…”

“…The worst cleaning of dentinal walls in both groups is observed in the apical third of the root canal, then in the middle, while the smallest amount of the smear layer is noticed in the coronal third of both groups, which is in compliance with the results of other studies confirming that the smear layer from the canal walls is more easily removed from the coronal and middle third [9,10,21,26]. The cleansing problem is particularly emphasized in the region of the apical third due to anatomical specificity (isthmuses, ramification, additional canals), and due to the small diameter of the apical preparation, which makes the debridement of the canal more difficult [3,5,7,25].…”

“…Earlier investigations used light microscopy to identify the smear layer on the canal walls, but today SEM analysis is the standard in the field of quantitative and qualitative estimation of the presence of the smear layer due to high resolution and high magnification [22][23][24][25].…”

Efficiency of XP endo Shaper (XPS) and irrigation protocol on the quality of cleaning the apical third of root canal: SEM study

“…Diameter of the apical preparation formed in this way allows the tip of the needle to easily reach the apical terminus, which also improves the efficiency of the irrigant in the removal of the smear layer 2,9 . One of the problems of such deep application of irrigation needles in clinical conditions can be the conveyance of irrigant (NaOCl) into periapex, which can cause adverse effects on periapical structures 26 .…”

Evaluation of centering ability of XP endo shaper, Edge Evolve and Hyflex CM in simulated curved canals (A comparative study)

“…12 This finding of XP endo shaper disagrees with other studies such as Živković S. et al, in 2017 and Al-khazali and Salim in 2018 that showed in their results best-centering ability of this file when compared with other instruments. 27,28 In this study the centering ability of XP endo shaper is less than Edge Evolve may be because the file has "snake" shaper, superelasticity and extreme flexibility these properties when combined with continuous rotation at very high speed "800-1000 rpm" and minimal torque may cause the file not to remain in the center of the canal during instrumentation, and finally, the deviation from the center of the canal instrumented by XP endo shaper may be related to six cutting edges at the tip called (booster tips) which enable it to start shaping after a glide path of at least ISO 15, and to gradually increase its working field to achieve an ISO 30. 11 In this study the result of Hyflex CM disagrees with study done by Burklein et al, 2014 and Perez, 2015 which showed better centering ability of Hyflex CM compared with other files, this disagreement may be because the canals instrumented in these studies were "S" shaped and the taperness of other files was larger than Hyflex CM.…”