Abstract
Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction.
Highlights
A successful endodontic procedure requires a proper shaping and irrigation
Finisher that met the following criteria were included in our systematic review: Comparison between the efficacy of XP-Endo® Finisher in removing root canal debris and those of other irrigation agitation protocols; Irrigation solution composed by NaOCl or ethylenediaminetetraacetic acid (EDTA), or both; Quantitative data about the effectiveness of XP-Endo® Finisher; and Randomized controlled trial
Seven articles stated that the passive ultrasonic irrigation technique and XP-Endo Finisher showed no significant differences among them in removing root filling material from canal root, and that both protocols have a greater efficacy than conventional needle irrigation procedure (CNI) [10,12,20,21,22,23,24]
Summary
A successful endodontic procedure requires a proper shaping and irrigation. The linear movement and rotation of mechanical instruments in the root system produce the smear layer, a crystalline structure with 1–2 μ thickness, whose components (pulp residues, dentinal debris, bacteria, and their products [1])can be found on the canal walls, root canal branches, and pressed into the dentinal tubules [2,3].during a canal retreatment, calcium hydroxide is used as intra-canal medicaments, in order to achieve the decrease of the bacterial amount. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction
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