Cleaning Of Root Canal Walls Research Articles

Comparative Evaluation Of Retrievability Of Calcium Hydroxide From Apical Third Of Root Canal With Commercially Available Root Canal Irrigants: An InVitro Study

Context: Calcium hydroxide is the most widely used intracanal medicament to aid chemomechanical preparation to thoroughly clean the root canal system. However, it is important to completely remove the medicament for predictable success of the root canal treatment. Aim: This study was aimed to compare the effectiveness of irriganting solutions and irrigation methods to remove calcium hydroxide from the root canal system. Material and Methodology: Eighty extracted single rooted teeth were selected and instrumented using ProTaper Gold rotary files, followed by application of calcium hydroxide. After incubating for a week, teeth were randomly allocated into 8 groups (n=10) based on irrigating solution (17% EDTA, 1% Phytic Acid, 3% NaOCl, 70% Ethanol) and method of irrigation used (PUI and NAI). The sample teeth were then sectioned horizontally to assess the residual calcium hydroxide on the canal walls under Confocal Laser Scanning Microscope. Statistical analysis: The difference in the mean value of the two parameters was assessed by using analysis of variance (ANOVA). Tukey’s test was used for post hoc multiple comparisons between different groups. The level of significance was fixed at p<0.05. Results: None of the irrigants were able to completely remove the calcium hydroxide from the root canal. However, irrigation with 70% Ethanol presented significantly cleaner root canal walls in NAI. Conclusion: 70% Ethanol presented with least amount of residual calcium hydroxide in comparison with phytic acid and commercially available irrigants i.e., EDTA and NaOCl in both NAI and PUI.

Effectiveness of a new endodontic irrigation system for removing smear layer and dissolving simulated organic matter.

The study aimed to evaluate the potential for the dissolution of organic tissue in areas of simulated complexity and cleaning of root canal walls of the new iVac® endodontic irrigation system. Thirty mandibular premolars were evaluated by scanning electron microscopy before and after biomechanical preparation. Then, they were distributed according to the final irrigation protocol into groups with conventional irrigation, ultrasonic agitation with metallic insert (UA), and iVac® system, and new photomicrographs were obtained. For tissue dissolution analysis, glass capillaries filled with catgut were attached to the cervical and apical thirds of twenty-one prototyped upper incisors. They were weighed before and after the previously mentioned irrigation protocols. The data were statistically compared with a significance level of 5%. The final irrigation provided greater cleaning of the root canal walls in the cervical, middle, and apical thirds of the root canals (P < 0.05), with no statistically significant difference between UA and iVac®, regardless of the analyzed thirds. Both ultrasonic irrigation protocols dissolved a significantly greater volume than the conventional irrigation protocol (P < 0.05), with no difference between the two protocols (P < 0.05). The iVac® system showed root canal wall cleaning and tissue dissolution similar to UA with a metallic insert, and both were superior to conventional irrigation. The new irrigation system iVac is more effective than conventional irrigation and has similar root canal wall cleaning and tissue dissolution to UA.

Root canal cleaning in roots with complex canals using agitated irrigation fluids.

The internal topography of the root canal is complex, especially for the mesial root of the permanent first molar. In response to such challenges, enhanced irrigation protocols have been developed, using laser pulses to agitate fluids and enhance the removal of microbial deposits. The aim of this laboratory study was to assess the effectiveness of laser agitation of sodium hypochlorite in removing multispecies biofilms grown in the mesial root of the permanent first molars. The five agitation groups (N=12 roots for each) were: 940 nm diode laser (superpulsed mode, 50 μs/pulses at 20 Hz using 20 mJ/pulse); 1064 nm Nd: YAG laser (200 μs/pulse at 20 Hz using 20 mJ/pulse); 2940 nm Er: YAG laser (50 μs/pulse at 15 Hz using a 400/14 conical tip in the SWEEPS protocol, with 20 mJ/pulse); passive ultrasonic agitation at 28 kHz (positive control); and irrigation with a 27-gauge side vented needle for 2 min per canal (negative control). Biofilm removal was assessed by confocal microscopic imaging of root slices at 1, 4 and 7 mm from the root apex. None of the tested methods were effective in completely eradicating biofilm from the most confined regions of the root canal system. The greatest challenge was cleaning the isthmus regions. There was a positive correlation between canal cleaning and isthmus cleaning, suggesting that increased effectiveness in cleaning root canal walls is associated with more effective isthmus cleaning. Wider and narrow isthmuses were cleaned better than long and narrow isthmuses.

Research of the major methods and clinical outcomes of irrigation in endodontics: a systematic review

Introduction: In the context of endodontic treatment, mainly endodontic irrigation, endodontic therapy promotes the removal of debris from the pulp tissue, seeking cleaning and asepsis against various microorganisms. Objective: Carried out a systematic review of the main methods and clinical outcomes of irrigation in endodontics, presenting information on the effectiveness and biocompatibility on the dentin surface. Methods: The present study followed by a systematic review (PRISMA). The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. Results and Conclusion: The success of endodontic treatment depends on eradicating microbes (if present) from the root canal system and preventing reinfection. In research comparing the effectiveness of EDTA 17% maleic acid to 7%, and observed a greater effectiveness of maleic acid in removing the smear layer from the apical third of single-adicular human teeth. When compared to maleic acid, 5% of 17% EDTA proved to be equally effective. Irrigation with 70% ethanol showed a significantly higher percentage of clean root canal walls and greater depth of clean dentinal tubules when compared to irrigation with 2.5% sodium hypochlorite and 17% EDTA-T. The volume of irrigants and agitation act to reduce the microhardness of dentin in the root canal. The smallest reduction in hardness was found in the EDTA + NaOCl association, which can be explained by the fact that one substance has the power to neutralize the other. An alternative EDTA (EDTA - T) to the conventional one was studied and showed good results to remove the smear layer and a good antimicrobial action, but showed a greater potential to generate inflammation than conventional 17% EDTA and 10% citric acid. Finally, one study showed that PUI with continuous irrigation and SAF were more effective than EndoVac and the conventional syringe in removing the drug Ca(OH)2 from a standardized artificial groove in the apical part of the root canal.

Evaluation of four final irrigation protocols for cleaning root canal walls

The aim of this study was to compare the efficiency of four final irrigation protocols in smear layer removal and bacterial inhibition in root canal systems. Thirty roots inoculated with Enterococcus faecalis were prepared with ProTaper Universal files. The teeth were disinfected by conventional needle irrigation, sonic agitation using the EndoActivator device, passive ultrasonic irrigation, or an M3 Max file. Teeth with no root canal preparation served as blank controls for the establishment of the infection baseline. Teeth with preparation but no final irrigation served as a post-instrumentation baseline. After the final irrigation, the teeth were sectioned in half. One half of each tooth was examined by scanning electron microscopy (SEM) to assess smear layer removal using a five-point scale. The other half was examined by confocal laser scanning microscopy (CLSM) using the LIVE/DEAD BackLight bacterial viability kit to evaluate the depth of bacterial survival in dentinal tubules. SEM analysis revealed no significant difference in smear layer removal throughout the whole canal among the EA, PUI, and M3 Max groups (P > 0.05). CLSM revealed that PUI achieved the greatest bacterial inhibition depth in the coronal ((174.27 ± 31.63) μm), middle ((160.94 ± 37.77) μm), and apical ((119.53 ± 28.49) μm) thirds of the canal (all P < 0.05 vs. other groups). According to this comprehensive SEM and CLSM evaluation, PUI appears to have the best infection control ability in root canal systems.

Final Endodontic Irrigation with 70% Ethanol Enhanced Calcium Hydroxide Removal from the Apical Third

IntroductionThe purpose of this study was to evaluate the cleanliness of root canal walls and dentinal tubules after attempting to remove the calcium hydroxide dressing with different irrigant solutions and the use of nonactivated irrigation or passive ultrasonic irrigation (PUI). MethodsAfter root canal instrumentation, 80 single-rooted teeth were filled with calcium hydroxide mixed with propylene glycol and 0.1% rhodamine B dye and inserted into canals with a Lentulo spiral. The calcium hydroxide dressing was initially removed with 10 mL saline solution and reinstrumentation with the master apical file. Then, the samples were randomly assigned into 8 experimental groups (n = 10) according to the irrigant solution with or without PUI: 2.5% sodium hypochlorite, 17% ethylenediaminetetraacetic acid + 1.25% sodium lauryl ether sulfate (EDTA-T), 37% phosphoric acid, or 70% ethanol. A final flush with 5 mL saline solution was performed. The percentage of clean root canal walls and the depth of clean dentinal tubules were measured with images of confocal laser scanning microscopy. The groups were compared using the 2-way analysis of variance test with the Bonferroni post hoc test for depth analysis and the Kruskal-Wallis with Dunn post hoc test for the perimeter analysis. ResultsIrrigation with 70% ethanol presented a significantly higher percentage of clean root canal walls and a higher depth of clean dentinal tubules when compared with irrigation with 2.5% sodium hypochlorite and 17% EDTA-T for both irrigation methods (P < .05). No differences were observed between nonactivated irrigation or PUI protocols (P > .05). ConclusionsSeventy percent ethanol enhanced calcium hydroxide removal from the apical root third compared with 2.5% sodium hypochlorite or 17% EDTA-T.

The effect of 17% EDTA and QMiX ultrasonic activation on smear layer removal and sealer penetration: ex vivo study

This study aimed to compare the effect of conventional irrigation (CI) and passive ultrasonic irrigation (PUI) with 17% EDTA and QMiX on the maximum depth and percentage of sealer penetration into the dentinal tubules by confocal laser scanning microscopy (CLSM) and to describe the cleaning of root canal walls by scanning electron microscopy (SEM). Eighty single-rooted human mandibular premolars were instrumented and randomly assigned to four groups (n = 20): EDTA + CI, QMiX + CI, EDTA + PUI, and QMiX + PUI. Ten samples from each group were examined by SEM (2,000×) and the remaining 40 roots were filled with a single gutta-percha cone and AH Plus sealer mixed with 0.1% rhodamine B for analysis by CLSM (10×). Images were assessed at distances of 2 mm (apical), 5 mm (middle), and 8 mm (coronal) from the apex with the Leica Application Suite V4.10 software. The EDTA + PUI and QMiX + PUI protocols presented higher rates of debris/smear layer removal in the apical and middle thirds. The PUI was superior to CI in the maximum depth of sealer penetration at the middle third. The QMiX + PUI group had a higher percentage of sealer penetration at the apical third. The PUI and QMiX protocol improved debris/smear layer removal and tubular dentin sealer penetration.

Contrasting efficacy of cocoa POD HUSK extract and 8% propolis extract in maintaining of root canal wall cleanliness

Background: The existence of the smear layer, which can be produced during root canal instrumentation, may compromise the bond between filling material and the root canal walls. Therefore, the use of an effective root canal irrigation solution, a commonly employed form of which is sodium hypochloride (NaOCl), is important. Sodium hypochloride has several positive properties including effectiveness as a disinfectant agent and its ability to promote tissue-dissolution, although it is ineffective at cleaning the smear layer. There have been numerous recent studies of the application of phytomedicines in endodontics due to their advantages such as minimum toxicity and cost effectiveness. The saponin contained in both the propolis and cocoa pod husk acts as a surfactant that may lower surface tension and dissolve debris containing organic and anorganic materials. Purpose: The study aimed to provide evidence of the differences between root canal wall cleanliness when treated with 8% propolis extract and different concentrations of cocoa pod husk extract. Methods: 25 extracted teeth with single straight root canals were randomly divided into five categories (n=5). Sample preparation was performed using a rotary file and irrigated with different solutions. The first group was administered 2.5% NaOCl, the second group 8% propolis, the third group 3.12% cocoa pod husk extract, the fourth group 6.25% cocoa pod husk extract, and the fifth group 12.50% cocoa pod husk extract. The samples were then dissected into two sections at the apical third and their cleanliness scores subjected to a Mann-Whitney test with a significance level of p=0.05. Results: A significant difference was identified between all groups (p&lt;0.05) and on the median control test, the highest value of 1.6 was recorded by the 6.25% cocoa pod husk extract, compared to the other four groups Conclusion: Cocoa pod husk extract demonstrates greater efficacy at cleaning root canal walls compared to 8% propolis extract.

Evaluation of debris and smear layer removal with XP-endo finisher: A scanning electron microscopic study.

The presence of smear layer and debris can prevent the irrigant and sealer from penetrating the dentinal tubules thereby compromising the seal of the root canal filling. This study aims to evaluate the efficacy of XP-endo Finisher with ProTaper Next and HyFlex in smear layer and debris removal. : Thirty-two extracted mandibular premolar teeth were selected and sectioned at the cementoenamel junction. The roots were then randomly divided into 4 groups. In group 1 and 2, canals were instrumented with X2 ProTaper Next (25 0.06 taper). In group 3 and 4, canals were instrumented with HyFlex system (25 0.06 taper). The canals in group 2 and 4 were further finished with XP-endo Finisher. Irrigation was carried out using 3% sodium hypochlorite during instrumentation, and 17% ethylenediaminetetraacetic acid was used as the final rinse. The roots were then split longitudinally. The canal wall was observed under the scanning electron microscope in coronal, middle, and apical thirds at a magnification of ×400 and ×1000 for evaluation of debris and smear layer, respectively. Photomicrographs were taken, and qualitative assessment for debris and smear layer removal was done. The results were analyzed using Kruskal-Wallis test and Mann-Whitney U-test. Lower debris and smear layer scores were seen in canal thirds instrumented with ProTaper Next and XP-endo Finisher (P < 0.01). The use of XP-endo Finisher as an adjuvant during shaping and cleaning produced cleaner root canal walls.

Smear layer removal efficiency of Er,Cr;YSGG and Er:YAG lasers in root canals prepared with different NiTi File systems

Aim: Evaluation of the root canal dentinal wall by scanning electron microscopy (SEM) in order to verify the presence/absence of smear layer after applying different NiTi file systems and Er:YAG and Er,Cr:YSGG lasers. Material and Methods: Hundred ninety-two mandibular incisors randomly divided into four groups (n=48). Each group was prepared with one of NiTi files: ProTaper Next, One Shape, Reciproc and Twisted file Adaptive using 5.25% NaOCl irrigation. Each group was then subdivided into four groups (n=12). Er,Cr:YSGG laser, Er:YAG laser and EDTA were separately applied to the first three subgroups. In the control group, no further disinfection protocol was performed. Then the roots were sectioned longitudinally and halves were examined under SEM. Results: Erbium laser systems removed the smear layer better than NaOCl irrigation, but not as much as EDTA/NaOCl. The greatest reduction in smear was obtained with Reciproc/EDTA and Reciproc/Er,Cr:YSGG groups. The success of irrigation protocols from highest to lowest was EDTA, ErCr: YSGG laser and Er:YAG laser.Conclusions: Single file NiTi instruments appeared to be more effective than multiple-file systems in leaving clean root canal walls. The reciprocating systems produced less smear layer than rotating instruments. Er:YAG and Er,Cr:YSGG laser activations appeared to be more efficient than syringe irrigation to remove the smear layer.Keywords: Er,Cr:YSGG laser; Er:YAG laser; NiTi file; SEM; smear layer.

Removal of calcium hydroxide medicament from root canal walls - a review of the different techniques

Introduction: Calcium hydroxide is used widely as an intracanal medication dressing due to its antibacterial activity. It is left into the root canal for a different period of time. Intracanal calcium hydroxide is usually removed by the use of instrumentation and irrigation. The residual material may interact with the root canal sealer and interfere with its sealing ability. Aim : The aim of this article is to review the literature in order to compare the main techniques that can be used to remove calcium hydroxide from the root canal system. Results: Intracanal calcium hydroxide is usually removed by the use of continuous irrigation, in conjunction with rotary or hand instruments, sonic or ultrasonic activation of the irrigants. Conclusion: None of the described techniques is able to provide a complete removal of the intracanal calcium hydroxide from the root canal walls in all clinical cases, because of the complexity of the root canal system of every tooth. There is no standard protocol and different techniques should be applied and combined in order to achieve clean root canal walls before the definitive obturation of the root canal system.

The cleanliness differences of root canal walls after irrigated with East Java propolis extract and sodium hypoclorite solutions

Background: Root canal instrumentation produces smear layer that covers dentine tubules of the root canal surface. Smear layer is organic and inorganic particles that have to be removed. East Java propolis extracts contais of saponin components used as a natural surfactant. 2.5% NaOCl and 5% NaOCl solutions have been widely used for irrigation in root canal treatment. Purpose: The purpose of this study was to analyze the cleanliness of the root canal walls, irrigated with aquadest, 8% East Java propolis extract, 2.5% NaOCl and 5% NaOCl. Method: Forty extracted teeth with straight single root canals were randomly divided into four groups(n=10). The specimens were prepared with ProTaper. During instrumentation, the root canals were irrigated with different solutions: Control Group irrigated with aquadest; Group 1 irrigated with 8% East Java propolis extract; Group 2 irrigated with 2.5% NaOCl and Group 3 irrigated with 5% NaOCl. The root canals were cut at apical third and SEM scores were tested by using Mann-Whitney test at the significance level of p=0.05 and Median Control test. Result: The results of Mann-Whitney Test, there were significant differences between control group with Group 1, 2 and 3 (p&lt;0.05). Based on the Median Control test, the value of 8% East Java propolis extracts was 1,000, which was the best value compared to 2.5% NaOCl, 5% NaOCl and aquadest. Conclusion: It can be concluded that 8% East Java propolis extract is the most effective solution for cleaning root canal walls compared with 2.5% NaOCl and 5% NaOCl.

Influence of ultrasonic activation over final irrigants in the removal of photosensitizer from root canal walls after photodynamic therapy

IntroductionThe aim of the present study was to evaluate the influence of ultrasonic activation (US) of the final irrigant in the removal of the photosensitizer from root canal walls after photodynamic therapy. MethodsThe root canals of 60 single-rooted bovine extracted teeth were filled with 0.01% methylene blue and submitted to photodynamic therapy for 90s. After that, the roots were divided into six groups (n=10) according to the final irrigation protocol: distilled water (DW), DW+US, 17% EDTA, QMix, EDTA+US, and QMix+US. Then, the samples were submitted to scanning electron microscopy where a scoring system was used to evaluate the images and effectiveness of proposed treatments in the cervical, middle and apical regions of the root canals. The data were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests for intergroup comparisons as well as the Wilcoxon and Friedman tests for intragroup comparisons at 5% of significance. ResultsThe 17% EDTA+US and QMix+US treatments were most effective in the removal of the photosensitizer in all regions of the root canal; the difference was statistically significant when compared to all other groups (p<0.05). There were no significant differences in the intragroup analysis comparing the effectiveness in the different regions of the same group (p<0.05). ConclusionsUS can aid 17% EDTA and QMix in removing the photosensitizer after photodynamic therapy and contributes to cleaning root canal walls.

Efektivitas Ekstrak Daun Belimbing Wuluh (Averrhoa bilimbi Linn) sebagai Bahan Pembersih Saluran Akar Gigi (The Effectiveness of Wuluh Starfruit (Averrhoa bilimbi Linn) Leaf Extract as Root Canal Cleaner)

Background: Preparation is one of the stages in endodontic treatment that always produce debris as a result of intrumentation on root canal walls. Debris consist of organic and inorganic materials. Debris will impede the penetration of disinfection materials and reduce attachment of the root canal filling material, therefore needed root canal irrigant which can remove the debris. Wuluh starfruit leaf extract (Averrhoa bilimbi Linn) contain various active compound, such as saponin. Saponin act as “surfactants” which can remove the debris. Purpose: This study was to determine the cleaning effectiveness concentration of wuluh starfruit leaf extract which can clean the root canal walls from debris. Method: Twenty five first premolar human teeth with straight single roots were randomized into five groups in which each group consist of five teeth. Those teeth instrumented with K-file and irrigated as follows: Group 1 (control) used aquadest as irrigant, group 2 used extract 5%, group 3 used extract 10%, group 4 used extract 15%, and group 5 used extract 20%. Then, those teeth were split horizontally and longitudinally in 1/3 apex. After that, the apical third of root canal walls were observed by using scanning electron microscope (SEM). Result: There were significant differences between each group (p&lt;0,05). Group 4 and 5 had smallest median score that was 1. Saponin in wuluh star fruit leaf extract 15% has been reach critical micelle concentration (CMC). Conclusion: Wuluh starfruit leaf extract 15% effective for cleaning root canal walls from debris.

XP-endo Finisher: A New Solution for Smear Layer Removal

Abstract Introduction The aim of this study was to evaluate using SEM analysis the effectiveness of a new instrument XP-endo Finisher in cleaning root canal walls after instrumentation with BioRaCe NiTi rotary instruments. Material and Methods This in vitro study was conducted on 30 extracted single rooted teeth divided in two groups. Instrumentation of all canals was done using basic BioRaCe NiTi rotary instruments with copious irrigation of 2% NaOCl. In the first group, after complete instrumentation smear layer was removed using XP-endo Finisher, while the other group served as negative control. The roots were then after longitudinally cut and SEM analysis was performed. The presence of smear layer in the coronal, middle and apical third was assessed. The data were statistically analyzed using Mann-Whitney U-test (p&lt;0.05). Results The results showed that average value of smear layer on the canal walls in the XP-endo Finisher group was significantly lower than in the control group (p&lt;0.05). Conclusion XP-endo Finisher after canal instrumentation with NiTi rotary instruments effectively cleaned canal walls and removed smear layer.

The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study

The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n = 20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. QG and EG presented similar amounts of sealer penetration (P > .05). MG and CG presented the lowest penetrability values (P < .05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P < .05). Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike gutta-percha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

In vitro evaluation of root canal preparation with two rotary instrument systems - Pro Taper and Hero Shaper.

Background and aimsThe purpose of this study was to compare several parameters of root canal preparation using two different rotary Nickel-Titanium instruments: Pro-Taper (Dentsply Maillefer, Ballagigues, Switzerland) and Hero-Shaper (Micro Mega, Besancon, France).MethodsTwelve extracted maxillary premolars were randomly divided into two groups and embedded into a muffle system. All root canals were prepared to size 25 using Pro-Taper or Hero-Shaper rotary instruments. The following parameters were evaluated: root canal form, centering capacity of the instrument, the presence of residual dentinal debris and smear layer on the root canal walls, working time and the occurrence of intraoperative accidents. Statistical analysis was performed using the chi2 test (p=0.05).ResultsThe majority of the root canals prepared with Hero Shaper (88.89%) and ProTaper (77.78%) showed a round or oval cross-section postoperatively. Superposition of pre- and postoperative photographs of the cross-sections showed that for the coronal third of the root canals the Hero Shaper performed in a superior manner, while for the apical third better results were obtained with the Pro Taper system. Cleanliness of the root canal walls was investigated under the SEM, in the middle third of the canal, using a five-score system for debris and smear layer. For debris Hero Shaper and Pro Taper rotary systems achieved 66.67% and 50% scores of 1 or 2, respectively. The results for the smear layer were similar: cleaner root canal walls were found after preparation with Hero Shaper (66.67% scores 1, 2), followed by Pro Taper (50%). Mean working time was shorter for Hero Shaper (124s) than for Pro Taper (184s); the difference was not significant.ConclusionsWithin the limits of this study, both systems had almost the same cleaning ability and excellent centering capacity.

The Effectiveness of Three Different Plant Extracts Used as Irrigant in Removal of Smear Layer: A Scanning Electron Microscope Study

ABSTRACT Aim In the present study, the role of three plant extracts as irrigant in root canal cleaning after instrumentation was evaluated. The effect of Syzygium aromaticum (S. Aromaticum), Ocimum sanctum (O. Sanctum) and Cinnamomum zeylanicum (C. zeylanicum) plant extracts was evaluated in smear layer removal. Methods The study was divided into different groups having 5 teeth each using various irrigating agents to evaluate smear layer removal. Group A: O. Sanctum extract; group A1: O. Sanctum extract with EDTA, group B: S. Aromaticum extract; group B1 S. Aromaticum extract with EDTA, group C: C. zeylanicum extract; group C1 C. zeylanicum extract with EDTA and two control group of 5 teeth each in group D: 3% NaOCl; group D1 3% NaOCl with EDTA (as positive control) and group E: Distilled water (as negative control); group E1 3% Distilled water with EDTA. Each tooth was split longitudinally and prepared for examination by scanning electron microscopy. Results The herbal extracts were effective in cleaning root canal walls when combine with EDTA with maximum activity of S. Aromaticum extract with EDTA group. Conclusion Under the condition of present study the three herbal plant extracts were ineffective in removal of smear layer when used alone.

Efficacy of an Organic Solvent and Ultrasound for Filling Material Removal

The aim of this study was to investigate whether a final rinse with Endosolv R® solvent and ultrasound resulted in cleaner root canal walls during endodontic retreatment. A total of 56 extracted premolar teeth were manually instrumented using a step-back flare technique and filled with gutta-percha and AH Plus sealer. After 9 months, the canals were retreated by removing the gutta-percha and sealer with ProTaper Universal Retreatment and rotary preparation with ProTaper Universal System up to an F5 file. As a final step, the teeth were randomly divided in 4 groups (n=14) and were subjected to passive ultrasonic irrigation (PUI) with either Endosolv R or distilled water. In the control groups, the irrigants were left undisturbed. Roots were cleaved and examined under scanning electron microscopy (SEM), and the amount of filling remnants on the canal walls was assessed by two calibrated examiners in a blinded fashion. Data were analyzed by the Kruskal-Wallis test and the Student-Newman-Keuls post hoc test (α=0.05). All groups presented filling debris in the three root canal thirds after retreatment. There were no significant differences between the groups or among the root canal thirds within each group (p>0.05). PUI with Endosolv R was not effective in the removal of filling debris from root canal walls.

A comparison of four nickel titanium rotary systems, quantec series, k3 endo, race and hero 642 for canal cleaning ability - An in vitro study

Background And Objectives : To compare in-vitro, the cleaning effectiveness of pulp space preparation under Scanning electron microscope (SEM) using four different NiTi rotary instrumentation systems – Quantec SC, K3 Endo, RaCe and HERO 642. Materials and Method : Forty-eight freshly extracted palatal roots of human maxillary first molar teeth were procured, stored and surfaced adhering to infection control protocols in the laboratory as prescribed by Centre for Disease Control Global. Random sampling of specimens into four groups of ten teeth each and one group of eight teeth was done. Groups I, II, III & IV served as experimental with Group V as control. Access cavities were prepared in all groups and working length was determined only in experimental groups. Control group remained non-instrumented. Cleaning and shaping was done for experimental groups only. Teeth were prepared to # 40 master apical file using crown down technique. The experimental groups: I. Teeth with Pulp space instrumented with Quantec SC. II. Teeth with Pulp space instrumented with K3 Endo. III. Teeth with Pulp space instrumented with RaCe. IV. Teeth with Pulp space instrumented with HERO 642. V. Control group: Teeth with pulp space not instrumented. Thereafter all teeth were longitudinally sectioned buccolingually and examined under SEM at 20.0 kV and 500 X magnifications in the middle third of the canal. Debris was defined as dentin chips, pulp remnants, and particles loosely attached to the root canal wall. Analysis of SEM images was performed using following five score index:-Numerical Evaluation (Scoring System): Score 1 – Clean root canal walls, only few small debris particles. Score 2 - Few small agglomeration of debris. Score 3- Many agglomerations of debris covering less than 50% of the root canal wall. Score 4- More than 50% of the root canal wall covered with debris. Score 5- Complete or nearly complete root canal walls covered with debris. Statistical Analysis : Kruskal Wallis test was used to determine whether a statistical difference existed amongst the four group of instruments, with P < 0.001, considered to be statistically very highly significant. Whitney Mann -U test for individual intergroup comparison and “CHI-square” test was used to detect frequency of individual debris score in each tested groups followed by Kendell’s tau-b test to measure observer agreement. Results : Teeth with pulp space instrumented with RaCe system exhibited maximum canal cleanliness compared to the other experimental groups. The differences observed within the groups were statistically very highly significant (p<0.001). Conclusion : Post pulp space preparation with four different NiTi rotary systems, statistically very highly significant differences in canal wall cleanliness at the midroot level was achieved. Under the conditions of this study, best canal cleaning efficacy was achieved by RaCe, followed by HERO 642, K3 Endo and Quantec SC.