Agitation Techniques Research Articles

Comparison of the Efficacy of K-File, Canal Brush Technique, and Sonic Irrigation Technique in the Retrievability of Calcium Hydroxide and Metapex Intracanal Medicaments from Root Canals: An In vitro Cone-Beam Computed Tomography Analysis

Background and Objectives:At present, none of the routinely used irrigating agents and activation techniques were able to completely remove the Ca(OH)2 intracanal medicament placed inside the root canal system during endodontic therapy. With this as the background, the aim of this study was to achieve complete removal of Ca(OH)2 when mixed with two different vehicles, using various irrigant activation techniques such as K-file, canal brush technique, and sonic irrigation technique, from the root canals of extracted human teeth.Materials and Methods:Seventy-two mandibular premolar teeth with straight single root canal were selected and filled either with oil-based Metapex or calcium hydroxide powder mixed with distilled water and were activated using different activation techniques such as K-file, canal brush, and sonic MM1500 and NaOCl alone. Volumetric analysis was performed utilizing cone-beam computed tomography.Results:None of the irrigants used were able to completely remove Ca(OH)2 from root canal. Sonic MM1500 showed significant removal efficacy than K-file, canal brush technique, and NaOCl for both aqueous-based and oil-based calcium hydroxide.Conclusion:Sonic MM1500 performed better than K-file, canal brush technique, and NaOCl in removing both Metapex and Ca(OH)2 powder. Regardless of the vehicles and agitation technique used, the remnants of Ca(OH)2 were present on all thirds of the canal walls.

Adjunctive procedure with solvent mixtures in non-surgical endodontic retreatment: does it affect root dentin hardness?

The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root's middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p < 0.05). Comparing to NaOCl + EDTA sequence, dentin hardness increased significantly with the additional exposure to MEK/TCE (3%NaOCl + 17%EDTA + MEK/TCE) or MEK/OOil (3%NaOCl + 17%EDTA + MEK/OOil) (p < 0.05). There were no significant differences regarding agitation effects on dentin hardness decrease. The irrigation protocols affected dentin hardness significantly. However, the additional solvent proposals do not seem to address further concerns on dentin's mechanical properties. Agitation did not show any influence on dentin's hardness reduction.

Ultrasonic-Assisted Technique as a Novel Method for Removal of Naphthenic Acid from Model Oil Using Piperidinium-Based Ionic Liquids.

In this study, piperidinium-based ionic liquids (IL) containing trifluoromethanesulfonate, phenolate, and dicyanamide anions were synthesized. Using the ILs, extraction of naphthenic acid from highly acidic oil with a total acid number (TAN) of 1.44 was studied. Two agitation techniques have been implemented for the extraction process, which were mechanical stirring and ultrasonic-assisted irradiation. 1-Butyl-1-methylpiperidinium phenolate [BMPi][Phe] showed the best potential in extracting naphthenic acid from oil, with complete removal of naphthenic acid with IL-to-oil ratios of 0.010 and 0.0025 for the mechanical stirring method and the ultrasonic-assisted method, respectively. Ultrasonic-assisted extraction process shows very good potential in enhancing the extraction efficiency of naphthenic acid. Optimization and study on the effects of ultrasonic parameters, namely, IL-to-oil ratio, ultrasonic amplitude, and time, were studied through response surface methodology (RSM). Using [BMPi][Phe], the optimum conditions obtained are IL-to-oil ratio of 0.03, 53.91% of amplitude, and 4.29 min of extraction time. Under these optimum conditions, 100% removal of naphthenic acid was achieved.

Irrigant Agitation Techniques versus Passive Ultrasonic Irrigation for Removing Debris from Curved Root Canals: An Environmental Scanning Electron Microscopic Study.

The aim of this study was to compare the efficacy of passive ultrasonic irrigation (PUI) versus mechanical agitation of the irrigant promoted by the EasyClean (EC) and XP-Endo Finisher (XP-F) systems in removing debris from root canal walls, using environmental scanning electron microscopy (ESEM). Twelve curved mesiobuccal canals of mandibular molars were prepared with the ProTaper Next system up to file X2 (25/0.06). The specimens were embedded in flasks containing silicone putty, sectioned lengthwise, and a 4-mm long groove was made on the canal wall of the buccal half of the specimen, extending from 2 mm up to 6 mm short of the apex. Five cross-sectional markings were made along this groove to establish standardized locations for imaging. The same specimens were used to prepare a negative control group (without debris), a positive control group (completely covered by debris), and 3 experimental groups according to the final irrigation protocol employed: PUI, EC or XP-F. ESEM images were obtained and evaluated by 3 examiners. The amount of debris observed on the images was classified according to a 4-category scoring system. The kappa test was used to assess inter-examiner agreement, and the Kruskal-Wallis and Dunn tests were used to compare the scores (P<0.05). The scores attributed to the PUI, EC, and XP-F groups were statistically similar to those attributed to the negative control group (P>0.05). Based on this in-vitro study, the mechanical agitation of the irrigant promoted by EC and XP-F was as effective as using PUI to remove debris from the root canal walls.

Performance enhancement of a submerged vacuum membrane distillation (S-VMD) system using low-power ultrasound

Submerged vacuum membrane distillation (S-VMD) is a thermally driven separation process capable of desalinating water with high salt concentration. Agitation techniques such as aeration and circulation have been used to enhance the permeate flux and to mitigate the effect of temperature and concentration polarizations, a major drawback in S-VMD. In this study, an S-VMD system that uses ultrasonic energy as an agitation technique is proposed. The effects of ultrasonic power and frequency under different feed temperatures and concentrations were investigated experimentally. Results show that applying low-power ultrasound can improve the permeate flux up to 24% compared to the same process without ultrasonic energy under the same operating conditions. The ultrasound-assisted enhancement increases with higher ultrasonic power and lower frequency, as well as lower feed temperature and higher concentration. Possible heat and mass transfer enhancement mechanisms associated with integration of ultrasound were investigated and based on the variation of the permeate flux with frequency, the enhancement was mainly attributed to acoustic cavitation. The ultrasonic-assisted S-VMD system maintained a stable permeate flux and excellent water quality over a relatively long-term operation, indicating that ultrasonic energy is a promising and safe method to enhance the permeate flux in S-VMD systems.

Agitation Techniques to Enhance Drainage of Retained Hemothorax.

Background. Retained hemothorax (RH) is a common problem in cardiothoracic and trauma surgery. We aimed to determine the optimum agitation technique to enhance thrombus dissolution and drainage and to apply the technique to a porcine-retained hemothorax. Methods. Three agitation techniques were tested: flush irrigation, ultrasound, and vibration. We used the techniques in a benchtop model with tissue plasminogen activator (tPA) and pig hemothorax with tPA. We used the most promising technique vibration in a pig hemothorax without tPA. Statistics. We used 2-sample t tests for each comparison and Cohen d tests to calculate effect size (ES). Results. In the benchtop model, mean drainages in the agitation group and control group and the ES were flush irrigation, 42%, 28%, and 2.91 (P = .10); ultrasound, 35%, 27%, and .76 (P = .30); and vibration, 28%, 19%, and 1.14 (P = .04). In the pig hemothorax with tPA, mean drainages and the ES of each agitation technique compared with control (58%) were flush irrigation, 80% and 1.14 (P = .37); ultrasound, 80% and 2.11 (P = .17); and vibration, 95% and 3.98 (P = .06). In the pig hemothorax model without tPA, mean drainages of the vibration technique and control group were 50% and 43% (ES = .29; P = .65). Discussion. In vitro studies suggested flush irrigation had the greatest effect, whereas only vibration was significantly different vs the respective controls. In vivo with tPA, vibration showed promising but not statistically significant results. Results of in vivo experiments without tPA were negative. Conclusion. Agitation techniques, in combination with tPA, may enhance drainage of hemothorax.

Comparison of Needle, Ultrasonic, and Laser Irrigation for the Removal of Calcium Hydroxide from Mandibular Molar Root Canals

Objective: This study aimed to compare the efficacy of conventional needle irrigation (CI), ultrasonically activated irrigation (UAI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS) in removing calcium hydroxide [Ca(OH)2] from root canals of mandibular molars using microcomputed tomography. Background: Various adjunctive irrigation strategies have been recommended to improve the removal of Ca(OH)2. No reports have evaluated the SWEEPS laser-activated method for the removal of Ca(OH)2 from root canals of mandibular molars. Materials and methods: Forty mandibular molars were instrumented and filled with Ca(OH)2. Four irrigation groups (CI, UAI, PIPS, and SWEEPS) were established. The volume of root canals and Ca(OH)2 and the Ca(OH)2 volume reduction percentage (%Rd) were calculated. Data were analyzed by one-way analysis of variance and Kruskal-Wallis analysis of variance. Results: The residual Ca(OH)2 in the apical third was higher than that in the cervical and middle thirds in all groups (p < 0.05). Comparison of the %Rd of Ca(OH)2 in mesial canals revealed that PIPS and SWEEPS removed more Ca(OH)2 than CI and UAI in the cervical third (p < 0.05). The middle third of the mesial canals and the cervical and middle thirds of the distal canals did not show significant differences among groups (p > 0.05). Significant differences in the %Rd of Ca(OH)2 were noted between CI and other groups in the apical third of mesial and distal canals (p < 0.05). No group demonstrated complete removal of Ca(OH)2. Conclusions: UAI and laser-activated irrigation significantly improved Ca(OH)2 removal in the apical third of mesial and distal canals. No agitation technique could completely remove Ca(OH)2.

Microparticles and latexes prepared via suspension polymerization of a biobased vegetable oil and renewable carboxylic acid

AbstractNovel bio‐based microparticles and latexes are synthesized using green chemistry principles through the reaction of aconitic acid (a sugarcane byproduct) and epoxidized linseed oil (ELO). No volatile solvents have been used, and no initiators are present in this polymerization. Using different agitation techniques, we investigate the particles and latexes formed via suspension polymerization in contrast to bulk dispersion polymerization. With the addition of water and a small amount of surfactant to the ELO and aconitic system, a thermally stable material up to 250°C is created that exhibits adhesive and hydrophobic properties. These microparticle latexes are anticipated for applications in hydrophobic coating and personal care products.

Solar-heated submerged vacuum membrane distillation system with agitation techniques for desalination

Submerged membrane distillation (S-MD) has been proposed as an alternative to conventional cross-flow MD systems to desalinate hypersaline water. In conventional S-MD systems, the hydrophobic membrane is submerged in the feed water tank that is directly heated by an electric heating element, eliminating the need for feed pumping. In this study, a solar-heated submerged vacuum membrane distillation (S-VMD) system that uses an evacuated tube collector as the feed container is proposed. Indoor tests under steady-state operating conditions and daily outdoor tests under ambient weather conditions were conducted to investigate the system’s functionality. The effect of two agitation techniques (aeration and internal circulation) to reduce temperature and concentration polarizations were studied. The daily performance tests revealed that the solar-heated S-VMD system can achieve a permeate flux of 5.9–11.1 kg·m−2·h−1 depending on solar intensity. The permeate flux was enhanced by 9% under aeration and by 22% under circulation in the outdoor tests. The water production per solar absorbing area can be as high as 0.96 kg·m−2·h−1. The system maintained a stable permeate flux and excellent water quality over a long-term operation. The small-scale system can provide fresh water in remote areas with limited natural resources.

Current trends in endodontic irrigation amongst general dental practitioners and dental schools within the United Kingdom and Ireland: a cross-sectional survey.

Aims To investigate current trends in endodontic irrigation amongst general dental practitioners (GDPs) and dental schools within UK and Ireland. Secondly, to evaluate if significant differences exist between the irrigant practices of National Health Service (NHS) and private GDPs.Methodology In 2019, an online questionnaire was distributed to the 18 dental schools within the UK and Ireland and 8,568 GDPs. These surveys explored current trends in teaching and usage of endodontic irrigants. Chi-squared tests were performed to make comparisons between NHS and private GDPs (α <0.01).Results All 18 dental schools (100%) and 495 GDPs (6%) returned valid questionnaires. Three hundred and thirty (66.7%) practitioners were NHS and 165 (33.3%) were private. There was strong consensus on irrigation teaching amongst dental schools. These results aligned with GDP responses in terms of irrigant selection (sodium hypochlorite [NaOCl]); NaOCl concentration (≤3%); ethylenediaminetetraacetic acid (EDTA) contact time (>0-5 minutes); final rinse protocols (penultimate EDTA rinse); irrigant temperature (room); and agitation techniques (manual dynamic activation; >0-60 seconds). There was, however, considerable variation in NaOCl contact time and GDPs infrequently used chelating agents or agitation techniques. Compared with private practitioners, NHS GDPs used significantly lower NaOCl contact times and concentrations, less EDTA and activation techniques, and more chlorhexidine (P <0.01).Conclusions Overall, irrigation teaching within the UK and Ireland is consistent and evidence-based. Furthermore, trends in irrigant usage amongst UK GDPs are now more aligned with these teaching practices. Significant differences were, however, observed between NHS and private practitioners.

Efficacy of diode laser and sonic agitation of Chlorhexidine and Silver-nanoparticles in infected root canals

Objective: To assess the efficacy of agitation of chlorohexidine (CHX) and Silver nanoparticles “AgNps” with 810nm diode laser or sonic endoactivator compared to side –vented needle on infected root canals with Enterococcus “E” Faecalis biofilms. Material and Methods: Sixty-five extracted human premolars with single oval canals were instrumented by protaper system up to F3. Biofilms of E. faecalis were generated based on a previously established protocol. Two teeth were used to check the biofilm formation, then the remaining Teeth were randomly divided into three equal experimental groups according to agitation techniques used: group 1 (810 nm diode laser with 1 watt), group 2 (sonic endoactivator) and group 3 (Side vented needle). Each group was further divided into three equal subgroups according to the irrigant solution into; subgroup A: chlorohexidine, subgroup B: silver nanoparticles and subgroup C: distilled water: Confocal laser scanning microscopy “CLSM” was used to assess bacterial viability. Data were analyzed by appropriate statistical analyses with P = 0.05. Results: Regarding the activation method, all groups had a significantly high percentage of dead bacteria (P &lt; 0.05). However, Laser was significantly the highest and Endoactivator the least (P &lt; = 0.001). Diode laser agitation of AgNps irrigant showed the highest reduction percentage of bacteria (78.1%) with a significant difference with both CHX and water irrigation, Conclusion: Under the condition of the present study; results reinforced that laser activation is a useful adjunct, 810 nm diode laser agitation of AgNps or chlorhexidine was more effective in disinfection of oval root canals than endoactivator and side vented needle techniques.KeywordsDentinal infection; Silver-nanoparticles; chlorohexidine; agitation; Diode Laser; Sonic endoactivator.

Correction to: Photomed Laser Surg 2017;35:71-77 DOI: 10.1089/pho.2016.4125.

Photobiomodulation, Photomedicine, and Laser SurgeryVol. 38, No. 6 CorrectionOpen AccessCorrection to: Photomed Laser Surg 2017;35:71–77 DOI: 10.1089/pho.2016.4125is erratum ofEffect of Different Agitation Techniques on the Penetration of Irrigant and Sealer into Dentinal TubulesPublished Online:22 Jun 2020https://doi.org/10.1089/photob.2020.29016.cxnAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail The article “Effect of Different Agitation Techniques on the Penetration of Irrigant and Sealer into Dentinal Tubules,” by Gu et al., published in Photomed Laser Surg 2017;35:71–77, requires a correction. The author, David J.W. Kum, was erroneously listed and should have been listed as David J.W. Jin.The online version of the article has been corrected to reflect this change. The author regrets this error.FiguresReferencesRelatedDetailsRelated articlesEffect of Different Agitation Techniques on the Penetration of Irrigant and Sealer into Dentinal Tubules01 Feb 2017Photomedicine and Laser Surgery Volume 38Issue 6Jun 2020 InformationCopyright 2020, Mary Ann Liebert, Inc., publishersTo cite this article:Photobiomodulation, Photomedicine, and Laser Surgery.Jun 2020.392-392.http://doi.org/10.1089/photob.2020.29016.cxnPublished in Volume: 38 Issue 6: June 22, 2020PDF download

Volumetric Analysis of Irrigant Extrusion in Immature Teeth after Different Final Agitation Techniques

IntroductionThe aim of this study was to evaluate the volume of irrigant extrusion by different final agitation techniques in experimental models of immature teeth. MethodsFifteen single roots of mandibular premolars with a length of 14 mm and an open apex were used to form 6 groups according to the final agitation technique: group 1, positive pressure and no agitation; group 2, ultrasonic agitation with Irrisonic (Helse Dental Technology, Santa Rosa de Viterbo, Brazil); group 3, ultrasonic agitation with Irrisonic Power (Helse Dental Technology); group 4, mechanical agitation with Easy Clean (Easy Dental Equipment, Belo Horizonte, Brazil); group 5, mechanical agitation with XP-endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland); and group 6, sonic agitation with Eddy (VDW, Munich, Germany). A prototype was made from an Eppendorf plastic tube filled with agar to fix the tooth and to collect the extruded irrigant. Ioditrast 76 (Justesa Imagen Mexicana, Tlalpan, Mexico) contrast solution was used to simulate the irrigant. The volume of irrigant extruded in cubic millimeters was calculated by micro–computed tomographic imaging. Data were analyzed using Kruskal-Wallis and Dunn tests with a significance level of 5%. ResultsThe values for the volume of irrigant extruded were as follows: 0.67 (group 5), 0.76 (group 1), 2.28 (group 2), 3.14 (group 3), 3.15 (group 4), and 17.19 (group 6). There was a statistically significant difference (P < .05) when the values of group 6 were compared with those of the other groups. ConclusionsAll techniques caused irrigant extrusion. The higher extrusion values occurred when sonic agitation was performed with the Eddy instrument.

Analysis of throwing power for megasonic assisted electrodeposition of copper inside THVs

The deposition of increased volumes of Cu down an interconnect through-hole via (THV) of a Printed Circuit Board (PCB) is highly desirable for the fabrication of increasing component density and PCB stacks. A quality metric, called micro-throwing power, characterises the volume of Cu that can be deposited within a THV. In this paper, we analyse the influence of 1 ± 0.05 MHz megasonic (MS) assisted agitation applied to copper (Cu) electroplating baths on the micro-throwing ability of a standard, non-filling Cu electroplating solution. Our results indicate that megasonic agitation is shown to increase the Cu deposition volume within a THV by 45% for an increase of MS pressure from 225 W to 450 W, highlighting the significance of acoustic pressure as a key parameter to control MS THV plating volume. Bulk fluid flow rate within a 500 L plating tank is shown to increase by 150% due to Eckhart acoustic streaming mechanisms, compared to existing bath agitation techniques and panel movement. From MS plating experiments and COMSOLTM finite element acoustic scattering simulations, transducer orientation is shown to influence plating performance, with higher-order acoustic resonant modes forming within THVs identified as the cause. Simulations indicate that higher potential acoustic energy was coupled into a 0.200 mm diameter THV cavity, width-to-length aspect ratio (ar): 8:1, than a larger cavity of diameter 0.475 mm, ar 3.4:1. The maximum acoustic energy coupled into THV cavity is observed for a wavefront propagating along the axis of the cavity entrance, indicating an ideal alignment for the MS plating setup.

Physico-chemical remediation of polycyclic aromatic hydrocarbons contaminated soil

This study exploited the solvent extraction and mechanical agitation techniques for the remediation of soils contaminated with polycyclic aromatic hydrocarbons (PAHs). The removal of pollutants from diesel contaminated site through ethanol, hexane, and ethanol-hexane mixtures was evaluated. 50 g dried contaminated soil was placed in a Soxhlet extractor and 250 ml solvent (ethanol, or hexane, or ethanol-hexane mixture) was added with extraction occurring at different temperatures of 30, 35, 45, 50, and 60 °C for 16 h. Mechanically agitated method was carried out by weighing out an equal amount of 50 g of the contaminated soil, thoroughly washing with 250 ml of ethanol, hexane, and equal ratio of ethanol to hexane. Qualitative analysis recovered PAHs was done by Agilent series gas chromatography equipped with flame ionization detector. The chromatographic evaluations of the solvent extraction of the contaminated soil showed that more of the polluted compounds were removed when hexane was the solvent. The maximum yield of extracted diesel by the solvent hexane was 11.84% at 60 °C. Extracted diesel removal was also directly proportional to periods of extraction.

Retreatability of two hydraulic calcium silicate-based root canal sealers using rotary instrumentation with supplementary irrigant agitation protocols: a laboratory-based micro-computed tomographic analysis.

To investigate the retreatability of two calcium silicate-based materials (BioRoot RCS, Septodont, Saint-Maur-des-Fossés, France and GuttaFlow Bioseal, Colténe/Whaledent AG, Langenau, Germany) using rotary instrumentation combined with supplementary irrigant agitation techniques using extracted teeth in a laboratory setting. The root canals of extracted single-rooted mandibular premolars were prepared to size 40, .04 taper and randomly divided into two experimental groups (n=36) depending on the root filling material. Root canals were filled with gutta-percha and GuttaFlow Bioseal (GB, group 1) or BioRoot RCS (BR, group 2), scanned using a micro-CT scanner and stored in phosphate-buffered saline for 4months. Removal of root filling was performed with rotary instruments, and specimens were randomly allocated to one of the subgroups for supplementary irrigant agitation (n=12): subgroup A, syringe irrigation (control); subgroup B, Tornado Brush (M.I.B, Suresnes, France) and subgroup C, ultrasonically activated irrigation. Specimens were re-scanned with micro-CT to calculate the volume of remnant root filling material. Data were analysed statistically by two-way ANOVA and post hoc Tukey's tests (P=0.05). Specimens filled with GuttaFlow Bioseal were associated with a significantly smaller volume of root filling remnants compared with BioRoot RCS (P<0.05). There was no significant difference between the supplementary irrigant agitation subgroups in the removal of GB (P>0.05). In group 2 (BioRoot RCS), subgroups B (Tornado Brush) and C (ultrasonically activated irrigation) were associated with a significantly smaller volume of root filling remnants compared with subgroup A (syringe irrigation) (P<0.05). There was no significant difference between subgroups B and C (P>0.05). Significantly smaller volumes of root filling remnants of GuttaFlow Bioseal, than BioRoot RCS, were present after their removal with rotary instruments and irrigation. Supplementary irrigant agitation techniques were associated with smaller volumes of remnants during the removal of BioRoot RCS but not that of GuttaFlow Bioseal.

Comparison of bacterial removal from dentinal tubules with different irrigant agitation techniques: An in vitro study

AimThis investigation was conducted to assess the ability of various irrigant agitation devices to eradicate Enterococcus faecalis from the dentinal tubules of extracted teeth. MethodologyFifty roots of extracted human teeth were instrumented to size 30 k with a 0.04 taper. The roots were autoclaved and then injected with E. faecalis. The canals were assigned to one of four intervention groups and disinfected using (A) standard needle irrigation, (B) EndoUltra® Ultrasonic Activator, (C) the EndoActivator system, or (D) EDDY sonic activation and to two control groups that were (E) treated with saline and (F) not inoculated with any bacteria. The roots were split in half, dyed with a LIVE/DEAD Back Light Bacterial Viability Kit, and then scanned with a confocal laser scanning microscope (CLSM) to identify live/dead bacteria in the dentinal tubules. ResultsCLSM images revealed differences among the groups. Both the EndoUltra® Ultrasonic Activator group and the EDDY group had a combination of dead and live bacteria, while the EndoActivator group had mostly dead bacteria, in contrast to single needle irrigation which had mostly live bacteria. Activation of the irrigating solution resulted in more dead bacteria than standard needle irrigation at the coronal, middle, and apical parts of the roots. Overall, the EndoActivator system was superior to all other techniques in reducing live bacteria within the root canal. ConclusionActivation of sodium hypochlorite with sonic and ultrasonic systems dramatically reduced live bacteria contamination in the dentinal tubules of infected root canals.

In vitro evaluation of the effectiveness of XP-endo Finisher file on smear layer removal after root canal instrumentation

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. 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. 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 (P<0.05), with statistically insignificant difference between groups A and C (P>0.05). 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 (P<0.05). The difference between groups B and D were statistically insignificant (P>0.05). 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.

Assessment of the Effect of Three Agitation Techniques on the Removal Efficacy of Sodium Hypochlorite for the Organic Films

Assessment of the Effect of Three Agitation Techniques on the Removal Efficacy of Sodium Hypochlorite for the Organic Films

The Effects of Different Agitation Techniques of Canal Irrigant on Tubular Penetration of a Bioceramic Sealer.

This study aimed to compare the effects of different agitation techniques of sodium hypochlorite (NaOCL) as the final irrigation with XP-Finisher file, passive ultrasonic irrigation (PUI), Er:YAG laser and irrigation with conventional syringes, on penetration of Sure Seal Root bioceramic sealer into dentinal tubules. Forty freshly extracted single-rooted human teeth were included in the present in vitro study. All the teeth were prepared up to #40 (4%) with Bio Race rotary file system, using crown-down technique. After chemomechanical preparation, the teeth were randomly assigned to 4 groups based on the agitation protocol: conventional needle irrigation (CNI) with a 30-G needle in a syringe, PUI, Er:YAG laser and XP-Finisher file, Subsequent to the agitation procedure, the root canals were obturated with tapered bioceramic-covered gutta-percha point and, bioceramic sealer, using the single-cone technique. The maximum penetration of the sealer into the dentinal tubules was determined in the coronal, middle and apical thirds using the scanning electron microscope (SEM) technique. After confirmation of the normal distribution of data with Shapiro-Wilk test, Data were analyzed using the one-way ANOVA and Tukey tests. The mean penetration depth of the bioceramic sealer into the dentinal tubules in the PUI group was greater than that of other groups; however, the difference between the two PUI and Er:YAG laser groups in the apical third was not significant (P=0.078). Er:YAG laser, PUI and XP-Finisher file agitation techniques resulted in significantly greater penetration of the bioceramic sealer into the dentinal tubules compared to the CNI (P<0.001). The XP-Finisher file technique in the apical (P=0.752) and middle thirds (P=0.339) and the Er:YAG laser technique in the apical thirds (P=0.086) were not significantly different from the conventional irrigation technique. The PUI technique resulted in significantly deeper penetration of the Bioceramic sealer into the dentinal tubules compared to the three other techniques.