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

Abstract

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.

Effectiveness of Various Final Irrigation Techniques on Sealer Penetration in Curved Roots: A Confocal Laser Scanning Microscopy Study

“…In this study, among the four different irrigation techniques, no significant differences were observed in the investigated parameters in relation to sealer penetration. While these findings align well with some of the earlier studies [7,9], the results of other studies in a review of the literature were found to be contrasting [10,11,13,[33][34][35]. Galler et al [34] found greater penetration depths in the apical thirds for ultrasonic and sonic activation groups compared to MDA.…”

“…Several techniques have been used for root canal irrigation, such as conventional needle irrigation (CI), manual dynamic activation (MDA), sonic irrigation (SI), and passive ultrasonic irrigation (PUI). There are numerous studies which investigate the effect of different agitation techniques on the removal of the smear layer and the sealer penetration into dentinal tubules [7][8][9][10][11][12][13]. The mechanical flushing action created by CI is relatively weak [1].…”

“…Barbosa et al [35] reported that the ultrasonic activation provides better penetration of the sealer than MDA did. Machado et al [13] also concluded that SI achieved better degrees of tubular dentin sealer penetration, compared with the CI. The main factor affecting these contrasting findings could be the sample selection.…”

Avaliação da mineralização apical em dentes de cães com rizogênese incompleta e lesão periapical submetidos à irrigação dos canais radiculares por pressão apical negativa

“…Dentes com rizogênese incompleta são aqueles que ainda não atingiram o estágio 10 de Nolla e, portanto, não apresentam toda a camada de dentina radicular revestida por cemento. As raízes desses dentes apresentam paredes finas e frágeis e abertura apical acentuadamente ampla (Lin et al,2017;da Silva, 2018).…”

“…Paralelamente, o Endovac promove melhor distribuição da solução irrigadora por todo o comprimento de trabalho (Adorno et al, 2015) e o seu emprego permite uma maior penetrabilidade do material obturador na dentina tubular, principalmente no terço apical do canal (Kara Tuncer e Unal, 2014; Machado et al, 2018). Assim, o preparo biomecânico associado ao sistema de irrigação por pressão negativa pode ser considerado um protocolo terapêutico promissor para o combate à infecção do sistema de canais radiculares de dentes com lesão periapical (Hockett et al, 2008; da Cohenca et al, 2013), inclusive nos casos de rizogênese incompleta (Cohenca et al, 2010;Rodríguez-Benítez et al, 2014).…”