Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C-shaped canals.

Abstract

To evaluate the effect of instrumentation using Reciproc Blue (RB; VDW, Munich, Germany) and XP-endo Shaper (XP-S; FKG Dentaire, La Chaux-deFonds, Switzerland) systems on the area of untouched canal wall (AUCW), accumulated hard-tissue debris (AHTD) and the efficacy of three irrigation protocols on percentage reductions (red%) of AHTD within C-shaped canals of mandibular molars. Seventy mandibular molars with C-shaped canals were scanned, matched and assigned to two shaping groups (n=35): RB and XP-S. Following instrumentation, specimens were triple-matched with respect to the amount of remaining debris and assigned to three irrigation subgroups (n=10): syringe-and-needle irrigation (SNI), XP-endo Finisher (XP-F; FKG Dentaire) and passive ultrasonic irrigation (PUI). The AUCW% and AHTD% after instrumentation and the red% of AHTD after irrigation were calculated from micro-computed tomography. Data were analysed using comparisons for two groups (RB vs. XP-S) or multiple subgroups followed by pairwise comparison procedures (SNI vs. XP-F vs. PUI) at α=0.05. For RB and XP-S, 33.04% and 30.45%, respectively, of the canal wall remained untouched (P>0.05). For both groups, the apical third had larger AUCW% than the coronal third (P<0.05). Instrumentation with RB left more debris (2.8%) than XP-S (1.1%) (P<0.05). The PUI and XP-F subgroups had higher mean red% of AHTD than the SNI subgroup; the difference was significant for RB (P<0.05) but not for XP-S. Both RB and XP-S systems were associated with similar AUCW after instrumenting C-shaped canals. RB left significantly greater levels of AHTD compared with XP-S. PUI and XP-F irrigation removed more debris than SNI when using the RB system.