Abstract
This study compares conventional endodontic needle irrigation, passive ultrasonic irrigation, apical negative pressure irrigation, and mechanical activation to remove calcium hydroxide from single straight root canals. Eighty-four mandibular premolars were prepared in a crown-down manner up to size #40. Two teeth represented a negative control, and another two served as a positive control. Calcium hydroxide paste was placed inside root canals. The remaining eighty samples were analyzed based on the activation techniques, and the cleanliness of the canals was quantified using Fiji’s software on 500× magnified SEM backscattered electron micrographs. Considering the whole canal, all instruments showed better performance than conventional endodontic needle irrigation in removing calcium hydroxide (p < 0.05). Irrisafe and XP-endo Finisher could remove a significantly higher amount of calcium hydroxide than Endovac (p < 0.05). Irrisafe and XP-endo Finisher have been able to remove more calcium hydroxide than EndoVac.
Highlights
The prevention and eradication of bacteria from tooth cavities still represents one of the major concerns of root canal treatment
Kourti and Pantelidou [20] demonstrated that the use of the EndoVac (Kerr Endo, Orange County, CA, USA), an irrigation system using apical negative pressure that sucks the irrigants employing a microcannula placed at the working length (WL), improved CH removal with respect to ultrasonic activation and conventional endodontic needle irrigation
0.05was was Figure 3 shows a backscattered electron micrograph acquired into a CH-treated tooth canal at 15,000× magnification (Figure 3A) and the relative spot EDX spectra (Figure 3B)
Summary
The prevention and eradication of bacteria from tooth cavities still represents one of the major concerns of root canal treatment. Despite the various protocols and techniques that have been proposed [13–16], studies have shown that instrumentation and irrigation are unable to clean completely the whole root canal system from CH [17,18]. A recent review reported that the ultrasonic activation of irrigants seems more effective for removing CH than other techniques [9]. Kourti and Pantelidou [20] demonstrated that the use of the EndoVac (Kerr Endo, Orange County, CA, USA), an irrigation system using apical negative pressure that sucks the irrigants employing a microcannula placed at the WL, improved CH removal with respect to ultrasonic activation and conventional endodontic needle irrigation. XP-endo Finisher (FKG Dentaire SA, La Chaux de Fonds, Switzerland) has been developed to improve the efficacy of the final irrigation procedure. The first published articles [22–24] confirmed the XP-endo Finisher’s superior effectiveness in cleaning the dentin walls compared to the conventional technique
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