Abstract
This study investigated the effectiveness of XP-Endo Finisher (XPF) associated with XP-Endo Shaper (XPS) or Reciproc Blue (RB) files in reducing bacterial load in oval-shaped root canals (RC) during chemomechanical preparation (CMP) using 0.9% saline solution (NaCl) or 2.5% sodium hypochlorite (NaOCl). Eighty mandibular incisors with single oval-shaped RC were contaminated with Enterococcus faecalis. The teeth were randomly assigned to eight experimental groups (n = 10) according to the CMP, as follows: G1: XPS, G2: XPS + XPF, G3: RB, and G4: RB + XPF. CMP was performed with NaCl or NaOCl. The reduction of bacterial load was assessed by colony-forming unit count before (S1) and after (S2) CMP. Data normality was verified by using Shapiro-Wilk test. ANOVA, Tukey's test, and Bonferroni post-hoc test were used at a 5% significance level. Culturable bacteria were present in all S1 samples (p>0.05). All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution (p < 0.05). With the use of NaCl, RB was more effective than XPS (p = 0.035). With the use of NaOCl, XPS and RB presented similar effectiveness (p = 0.779). XPF enhanced the bacterial reduction of both systems tested (p < 0.05). The use of NaOCl improved the CMP, irrespective of the instrumentation technique used (p < 0.05). In conclusion, XPS and RB files are effective in reducing bacterial levels in oval-shaped RC. The use of XPF as a method of agitation of the irrigating solution improved the cleaning efficiency of both file systems tested. Mechanical preparation performed with saline solution decreased culturable bacteria from the root canal, but antimicrobial substances such as NaOCl should be used to achieve a significantly better disinfection.
Highlights
The main goal of endodontic therapy is to prevent or eliminate apical periodontitis by means of cleaning, shaping, disinfecting, and filling the root canal system
Table provides an overview of the amount of culturable bacteria (CFU/mL) between the groups before (S1) and after (S2) chemomechanical preparation (CMP)
All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution used (p < 0.05)
Summary
The main goal of endodontic therapy is to prevent or eliminate apical periodontitis by means of cleaning, shaping, disinfecting, and filling the root canal system. The removal of microorganisms is considered the most important step in root canal therapy.[1,2,3] Anaerobic bacteria, gram-negative species, have been linked to the signs and symptoms of periapical disease. Faecalis, have been detected in infected root canals and may be related to failure of root canal treatment, showing capacity to survive intracanal procedures.[1,4,5]. Mechanical preparation of the root canals is recognized as one of the most important stages in root canal treatment. Many advances in file designs have been made in the last decades, irrespective of the technique used, several studies have shown that complete removal of organic tissues/debris[6,7,8] and bacteria[9,10] is not commonly attained
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