Effect of different obturation techniques on sealer penetration into dentinal tubules after final irrigation with XP-Endo finisher file

The first objective of this research was to evaluate the effectiveness of XP-Endo Finisher on dentinal tubule penetration of irrigation solution using confocal laser scanning microscopy. The main purpose of this research was to compare the effect of cold lateral condensation, continuous wave obturation and core-carrier based techniques on sealer penetration. Sixty mandibular premolars were prepared and allocated into two experimental groups (n=30) as the final irrigation technique and obturation technique experiment. In the final irrigation technique experiment, final irrigation was performed with XP-Endo Finisher, passive ultrasonic irrigation (PUI) and conventional needle irrigation (CNI) (n=10). The roots in the obturation technique experiment were also assigned into 3 groups and obturated with cold lateral condensation, continuous-wave obturation and core-carrier techniques (n=10). The most effective activation method, which emerged as a result of the first part of this study, was used as the final irrigation method in the obturation technique experiment. Then, all roots were sectioned in 1-mm-thick slices at 3mm from the apex for scanning. In terms of depth and percentage of material penetration, CNI exhibited significantly the lowest values and no significant difference was found between others. Also, there was no significant difference among obturation methods. In conclusion, XP-Endo Finisher and PUI are more effective than CNI on irrigant penetration. Sealer penetration into dentinal tubules is independent of obturation techniques.

El objetivo principal de esta investigación fue evaluar la eficacia de XP- Endo Finisher en la penetración de la solución de irrigación en los túbulos dentinarios mediante microscopía de láser confocal. Se prepararon sesenta premolares mandibulares y se distribuyeron en dos grupos experimentales (n=30) según el tipo de método de evaluación utilizado. En el experimento de la técnica de irrigación final, la irrigación final se realizó con XP-Endo Finisher, irrigación ultrasónica pasiva (PUI) e irrigación con aguja convencional (CNI) (n=10). Las raíces en el experimento de la técnica de obturación también se asignaron en 3 grupos y se obturaron con técnicas de condensación lateral fría, obturación de onda continua y portador de núcleo (n=10). El método de activación más eficaz, que surgió como resultado de la primera parte de este estudio, se utilizó como método de irrigación final en el experimento de la técnica de obturación. Luego, todas las raíces se seccionaron en muestras de 1mm de espesor. En términos de profundidad y porcentaje de penetración del material, CNI exhibió significativamente los valores más bajos y no se encontraron diferencias significativas entre los demás. Además, no hubo diferencias significativas entre los métodos de obturación. En conclusión, XP-Endo Finisher y PUI son más efectivos que CNI en la penetración del irrigante. La penetración del sellador en los túbulos dentinarios es independiente de las técnicas de obturación.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) - Bio-C Temp and Ultracal - after different activation protocols in teeth with simulated internal root resorption. Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05). There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05). Due to this, it can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption

In vitro study of different methods in the removal of calcium hydroxide from root canals / 口腔疾病防治

Objective@#To compare the efficacy of different methods in the removal of calcium hydroxide from root canals and to provide a reference for clinical treatment. @*Methods@# A total of 160 extracted single-rooted mandibular premolars were instrumented up to ProTaper Universal F4. The roots were split longitudinally, and standardized groove and depression models were prepared and filled with calcium hydroxide. The samples were randomly divided into 4 groups (n=40) according to different irrigation methods: syringe needle irrigation, passive ultrasonic irrigation, XP-endo finisher (XPF) irrigation, and M3-Max irrigation. Each group was then divided into 2 subgroups (n=20) according to the irrigation protocol: NaOCl and NaOCl+EDTA. Photos of grooves and depressions were taken under a microscope after irrigation, and the residual calcium hydroxide was scored to compare the removal effects of different irritation methods and solutions.@*Results@#In the groove and depression model, when sodium hypochlorite is used as the irrigation fluid, ultrasound irrigation, XPF and M3-Max are better than syringe needle irrigation in removing calcium hydroxide (P < 0.05); when sodium hypochlorite combined with EDTA flushing, the effect of removing calcium hydroxide with ultrasound irrigation, XPF and M3-Max is better than that of syringe needle irrigation (P < 0.05); but there is no statistically significant difference between ultrasound, XPF and M3-Max (P > 0.05); when compared with the use of sodium hypochlorite, the combined use of EDTA irrigation could enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide (P < 0.05), but there was no significant improvement in the syringe needle irrigation group (P > 0.05). @*Conclusion @#Sodium hypochlorite combined with EDTA can enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide, and there is no significant difference among these approaches, which are more effective than syringe needle irrigation.

Eficacia del instrumento XP-endo Finisher y del sistema EndoActivator en la reducción/eliminación del biofilm bacteriano: un ensayo ex vivo / Ability of the XP-endo Finisher instrument and the EndoActivator system to reduce/eliminate of the bacterial biofilm: an ex vivo assay

Objetivos: Comparar ex vivo la eficacia del instrumento XP-endo Finisher y del sistema EndoActivator en la reducción/eliminación del biofilm microbiano en conductos radiculares infectados. Materiales y métodos: Se utilizaron 23 premolares inferiores humanos extraídos cuya longitud fue estandarizada en 17 mm. Todos los conductos se prepararon con el sistema WaveOne Gold Medium (#35.06). Los dientes se esterilizaron, se inocularon con Enterococcus faecalis y se separaron en dos grupos experimentales de 10 piezas cada uno. De los 3 dientes remanentes, 1 fue utilizado como control positivo y 2, como controles negativos. En el grupo 1, las soluciones irrigantes se agitaron con XP-endo Finisher. En el grupo 2, se utilizó EndoActivator. Se tomaron muestras antes de la contaminación, luego de esta y después de la agitación de los irrigantes mediante conos de papel estériles. La carga microbiana fue sembrada en agar sangre y los conos se cultivaron en caldo tripteína de soja. La remoción de la carga microbiana se determinó por la presencia o ausencia de turbiedad del medio. Las unidades formadoras de colonias (UFC) remanentes se cuantificaron y los resultados se categorizaron como R1 (≤10 UFC) o R2 (>10 UFC). Los datos fueron analizados mediante la prueba de Fisher. Resultados: No hubo diferencias significativas entre XP-endo Finisher y EndoActivator (P>0,05). El número de usos no influyó sobre la capacidad operativa de ambos instrumentos (AU)

Aim: To compare ex vivo the effectiveness of the XP-endo Finisher and the EndoActivator in biofilm reduction/ removal from infected root canals. Materials and methods: Twenty three extracted human single-rooted lower premolars were selected and standardised to 17 mm in length. All the canals were prepared with WaveOne Gold Medium reciprocating files (#35.06). The teeth were autoclaved and inoculated with Enterococcus faecalis. The infected teeth were then assigned to 2 experimental groups of 10 teeth each according to the final irrigation/agitation protocol. Of the three remaining teeth, one was used as a positive control, and the other two were used as negative controls. In Group 1 the irrigating solutions were agitated with XP-endo Finisher while in Group 2 the EndoActivator was used. All root canals were sampled before and after contamination, and again after irrigant agitation with sterile paper points. The microbial load was spread on blood agar plates and the paper points were cultured in sterile trypticase soy broth. The removal of the microbial load was determined by visual observation of the turbidity of the media and by quantification of the number of colony-forming units (UFC). The results were categorized as R1 (≤10 UFC) or R2 (>10 UFC). Data were analysed by the Fisher's exact test at P<0.05. Results: No significant differences was found between XP-endo Finisher and EndoActivator (P>0.05) regarding their effectiveness in the reduction/removal of the microbial biofilm. The number of uses of both instruments did not affect their operative performance (AU) Conclusion: XPF and EA were both equally effective for microbial biofilm reduction/removal from ex vivo infected root canals (AU)

Evaluation of debris and smear layer removal with XP-endo finisher: A scanning electron microscopic study

Context: The presence of smear layer and debris can prevent the irrigant and sealer from penetrating the dentinal tubules thereby compromising the seal of the root canal filling. Aim: This study aims to evaluate the efficacy of XP-endo Finisher with ProTaper Next and HyFlex in smear layer and debris removal. Materials and Methods: Thirty-two extracted mandibular premolar teeth were selected and sectioned at the cementoenamel junction. The roots were then randomly divided into 4 groups. In group 1 and 2, canals were instrumented with X2 ProTaper Next (25 0.06 taper). In group 3 and 4, canals were instrumented with HyFlex system (25 0.06 taper). The canals in group 2 and 4 were further finished with XP-endo Finisher. Irrigation was carried out using 3% sodium hypochlorite during instrumentation, and 17% ethylenediaminetetraacetic acid was used as the final rinse. The roots were then split longitudinally. The canal wall was observed under the scanning electron microscope in coronal, middle, and apical thirds at a magnification of ×400 and ×1000 for evaluation of debris and smear layer, respectively. Photomicrographs were taken, and qualitative assessment for debris and smear layer removal was done. Statistical Analysis Used: The results were analyzed using Kruskal–Wallis test and Mann–Whitney U-test. Results: Lower debris and smear layer scores were seen in canal thirds instrumented with ProTaper Next and XP-endo Finisher (P < 0.01). Conclusion: The use of XP-endo Finisher as an adjuvant during shaping and cleaning produced cleaner root canal walls.

In vitro evaluation of the effectiveness of XP-endo Finisher file on smear layer removal after root canal instrumentation / 华西口腔医学杂志

OBJECTIVE@#This study aimed to evaluate the effectiveness of XP-endo Finisher (XPF) file and passive ultrasonic irrigation (PUI) in the smear layer removal of the root canal.@*METHODS@#A total of 60 human single-rooted premolars were selected and decoronated to standardize their canal length to 16 mm. Tooth samples were prepared using a S3 rotary system to prepare root canal with the file size of 3S and then randomly divided into 6 groups according to the final irrigation protocol, as follows: XPF 3 mL of 3% NaOCl for 1 min (group A); XPF 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% ethylene diamine tetraacetic acid (EDTA) for 1 min (group B); PUI of 3 mL of 3% NaOCl for 1 min (group C); PUI of 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% EDTA for 1 min (group D); 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle (group E); and 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle, followed by 4 mL of 17% EDTA for 1 min (group F). After the completion of the root canal preparation, the teeth were split into two longitudinally. The mean numbers of the visible open dentinal tubules in the apical and middle thirds of the root canals were evaluated via scanning electron microscope.@*RESULTS@#The whole surfaces of the root canals in groups A, C, and E were covered by a smear layer. Groups A and C possessed significantly higher number of visible open dentinal tubules than in group E (P0.05). The apical third of the samples in groups B and D and in the middle thirds of canals in group F exhibited a small amount of smear layer, and the dentinal tubules were open or semi-open. The root canal surfaces in the apical third of the samples in group F were covered by a smear layer, and the dentinal tubules were sealed or semisealed. The smear layers in the middle third of the samples in groups B and D were removed, and the dentinal tubules were more visibly open than those of the four other groups (P0.05).@*CONCLUSIONS@#The difference between XPF and PUI in terms of the smear layer removal of the root canals was insignificant. Hence, XPF, as a new irrigation agitation technique, can aid in improving smear layer removal.

Mechanical properties of anatomic finishing files: xp-endo finisher and xp-clean

Abstract The aim of the present study was to evaluate the cyclic fatigue of two anatomic finishing files: XP-Endo Finisher and XP-Clean. Roughness pattern and the micro-hardness of the files were also assessed. Instruments were subjected to cyclic fatigue resistance measuring the time to fracture in an artificial stainless-steel canal with a 60° angle and a 5-mm radius of curvature. The fracture surface of all fragments was examined with a scanning electron microscope. The roughness of the working parts was quantified by using a profilometer and the micro-hardness test was carried out using a Vickers hardness tester. Results were statistically analyzed using a student´s t-test at a significance level of P < 0.05. Weibull analysis was also performed. XP-Endo Finisher presented significantly longer cyclic fatigue life than XP-Clean instruments (P<0.05). XP-Endo Finisher was able to withstand 1000% more cycles to fracture when compared to XP-Clean instruments. SEM visual inspection of the fracture surfaces revealed fractographic characteristics of ductile fracture in all tested instruments; wide-ranging forms of dimples were identified and no plastic deformation in the helical shaft of the fractured instruments was observed. When mean life was compared XP-Endo Finisher lasted longer than XP-Clean with a probability of 99.9%. XP-Endo Finisher instruments also exhibited significantly lower roughness than XP-Clean instruments (P<0.05). No differences in the micro-hardness was observed between the files (P>0.05). It can be concluded that XP-Endo Finisher instruments showed improved performance when compared with XP-Clean instruments, demonstrating higher cyclic fatigue resistance and lower roughness.

Resumo O objetivo do presente estudo foi avaliar a fadiga cíclica de dois instrumentos finalizadores anatômicos: XP-Endo Finisher e XP-Clean. O padrão de rugosidade e a micro dureza dos instrumentos também foram avaliados. Os instrumentos foram submetidos à resistência à fadiga cíclica, medindo o tempo de fratura em um canal artificial de aço inoxidável com um ângulo de 60 ° e um raio de curvatura de 5 mm. A superfície de fratura de todos os fragmentos foi examinada com um microscópio eletrônico de varredura. A rugosidade dos instrumentos foi quantificada usando um perfilômetro e o teste de micro dureza foi realizado usando um testador de dureza Vickers. Os resultados foram analisados ​​estatisticamente usando o teste t de student em um nível de significância de p<0,05. A análise Weibull também foi realizada. XP-Endo Finisher apresentou vida de fadiga cíclica significativamente mais longa do que os instrumentos XP-Clean (p<0,05). XP-Endo Finisher foi capaz de suportar 1000% mais ciclos para fratura quando comparado aos instrumentos XP-Clean. A inspeção visual em microscópio eletrônico de varredura das superfícies de fratura revelou características fractográficas da fratura dúctil em todos os instrumentos testados. Não foi observada deformação plástica no eixo helicoidal dos instrumentos fraturados. Quando o tempo para a fratura foi comparado entre os instrumentos, o XP-Endo Finisher durou mais do que o XP-Clean com uma probabilidade de 99,9%. Os instrumentos XP-Endo Finisher também exibiram uma rugosidade significativamente menor do que os instrumentos XP-Clean (p<0,05). Não foram observadas diferenças na micro dureza entre os arquivos (p>0,05). Pode-se concluir que os instrumentos XP-Endo Finisher apresentaram desempenho melhorado em comparação com os instrumentos XP-Clean, demonstrando maior resistência à fadiga cíclica e menor rugosidade.