Passive Ultrasonic Irrigation Research Articles

The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris

ObjectiveThis study evaluated the effect of the XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation using side-vented needle (SVN) on the amount of apically extruded debris and canal cleanliness following the removal of double antibiotic paste (DAP) from immature root canal models.Material and methodsForty-eight extracted mandibular premolars were drilled using peeso drills to simulate immature apices. The canals were filled with DAP and were randomly assigned into 3 groups according to the DAP removal method: XPF, PUI, and SVN (n = 16). The amount of extruded debris was assessed with an analytical balance then roots were split longitudinally and imaged using stereomicroscope to evaluate the residual medicament. Data were statistically analyzed using Kruskal-Wallis and Dunn’s test. Spearman’s correlation coefficient was used to determine significant correlation between extruded debris and the residual DAP scores.ResultsThere was no significant difference between debris extrusion values for all groups (P value 0.237). For canal cleanliness, the amount of remaining DAP was significantly lower in the XPF and PUI compared to SVN (P value < 0.001). A non-significant positive (direct) correlation was found between the amounts of apically extruded debris and residual DAP scores (P value 0.087).ConclusionXPF and PUI were associated with better canal cleanliness during removal of DAP, no difference could be found between the three irrigation techniques regarding the debris extrusion.

Comparative Evaluation of Supplementary Cleaning Techniques for Removal of Bio-C Sealer and AH-Plus from Oval Root Canals: A Micro-CT Analysis.

This study aimed to compare the effectiveness of two endodontic cleaning techniques, passive ultrasonic irrigation (PUI) and the XP-endo Finisher R (XPR) system, in removing residual filling material during endodontic retreatment procedures. Forty mandibular premolars with oval canals were divided into four groups based on the sealer used (AH-Plus or Bio-C Sealer) and the cleaning technique employed (PUI or XPR). To ensure uniformity of canal volume among groups, initial micro-CT scans were conducted. The canals were instrumented, filled, and then re-instrumented before undergoing either PUI or XPR cleaning techniques. Residual filling material volumes were assessed through micro-CT scans, and statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests. Following instrumentation, there was no significant difference in residual filling material volumes between AH-Plus and Bio-C Sealer groups (1.35 mm3and 1.02 mm3, respectively; P>0.05). However, after supplementary cleaning techniques, XPR-cleaned specimens exhibited significantly less residual material compared to PUI-cleaned specimens (0.01 mm3 and 0.29 mm3 for Bio-C Sealer, and 0.07 mm3 and. 0.30 mm3for AH-Plus, P<0.05). The XPR system was found to be more effective than PUI in removing residual filling material from Bio-C Sealer-filled root canals. This highlights its potential as a useful supplementary cleaning technique in endodontic retreatment procedures.

Influence of Passive Ultrasonic Irrigation of the Photosensitizer Used in Photodynamic Therapy on Microbial Reduction in the Root Canal System: An in Vitro Study.

The success of endodontic treatment is based on microbial reduction promoted by the interaction of chemical and mechanical procedures. Photodynamic therapy (PDT) is used as an adjunct to conventional treatment, with significant microbial reduction. This study aimed to evaluate the influence of passive ultrasonic irrigation (PUI) of the photosensitizer (PS) used in PDT on microbial reduction in the root canal system. Forty-five mesiobuccal root canals from extracted human mandibular molars that were inoculated with standard strains of Enterococcus faecalis, Candida albicans, and Streptococcus mutans for 21 days were selected. The root canals were prepared using the ProTaper Next system and randomly divided into 3 groups (n=15): 1) PDT: PDT alone; 2) PUI+PDT: PUI followed by PDT; and 3) PUI/PS+PDT: PUI of the PS followed by PDT. Microbiological samples were collected from the canals before and after using the protocols described above. The data were analyzed by analysis of variance (Tukey's test) at a significance level of 5%. Microbial counts before PDT, PUI+PDT, and PUI/PS+PDT did not differ significantly (P>0.05), showing methodological standardization in the microbial contamination of the root canal system. There was a significant reduction in microbial counts after PDT (61.05%), PUI+PDT (65.04%), and PUI/PS+PDT (68.58%) (P<0.01), but with no statistically significant difference between the three groups (P>0.05). Based on the present findings, it was concluded that the combination of PUI with PDT or PS activation did not influence microbial reduction achieved by PDT alone.

Filling Material Bond Strength to Dentin Is Positively Influenced by the Agitation of Endodontic Final Irrigating Solutions.

The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third.

Effect of different irrigation activation systems using continuous chelating irrigation protocol on the removal of smear layer in the apical third of root canals: An in vitro scanning electron microscope study

Aim: Continuous chelation is a novel irrigation regimen popular as a single solution for irrigation of the root canal system during root canal therapy, especially for the removal of the smear layer. This study aimed to compare the effectiveness of three different irrigation activation systems in removing the smear layer from the apical third in single-rooted mandibular premolars using a scanning electron microscope (SEM). Methods: Fifty-six extracted single-rooted mandibular premolars were decoronated, and canals prepared till #30/0.09, with Chloroquick (3% NaOCl + 9% HEBP) as the working solution. Teeth were randomly divided into four groups based on the final irrigant activation protocol; Group A - (control group) conventional syringe irrigation with a 30-gauge single-side vented needle. Group B - (passive ultrasonic irrigation method) passive ultrasonic irrigation (PUI) with #20-Irrisafe ultrasonic files activated for 1 min. Group C - (sonic activation) EndoActivator system using the yellow tip (#20/0.04) activated for 1 min. Group D - Tornado Disinfection Kit using GF-brush for 20–30 s as per manufacturer’s instructions. The canals were dried, samples were hemi-sectioned, and the amount of remaining smear layer was scored according to the Tabrizizadeh criteria (2015) with SEM images at ×2500 by two blinded operators. The collected data were analyzed statistically using the Chi-square test (P &lt; 0.05). Results: The results showed statistically significant differences in terms of smear removal among the groups (P &lt; 0.05) with the Gentlefile group performing better, followed by PUI, EndoActivator, and the conventional group. Conclusion: Within the limitations of the study, continuous chelation with Gentlefile activation could be a viable and efficient protocol for the removal of the smear layer from the apical third of root canals.

Calcium silicate-based intracanal medication: Physicochemical properties and effectiveness of techniques for removing medication from the human root canal.

Our purpose was to investigate the physicochemical properties of Bio-C Temp, a bioceramic intracanal medication, and whether its residues remain adhered to the dentine walls after conventional manual irrigation (CMI) or passive ultrasonic irrigation (PUI) in comparison to Calen. The pH after 12 hours, 1 day, 3 days, 7 days, 14 days, 21 days and 28 days, and the flow, radiopacity, and the solubility of the medications after immersion for 7 and 30 days in distilled water (dH2O) or phosphate-buffered saline (PBS) solution were evaluated. Filling capacity, and volumetric changes after 14 days were assessed by micro-computed tomography (micro-CT). The residues of medications after CMI or PUI were analysed with scanning electron microscopy. Statistical analysis was performed using ANOVA and Tukey's post-hoc test, Student's t test or the Kruskal-Wallis and Dunn post-hoc test (α = 0.05). Bio-C Temp presented a lower pH, flow, volumetric change, and weight loss after immersion in PBS on the 7th and 14th days (p < 0.05) and greater radiopacity and filling capacity (p < 0.05) than Calen. Both medications showed lower solubility in PBS than in dH2O (p < 0.05). There was no difference in the residue content of the two medications between two irrigation methods in three-thirds of the roots (p > 0.05). Although Bio-C Temp had less volumetric loss and satisfactory filling capacity, this medication provided lower alkalinity than did Calen. Furthermore, neither CMI nor PUI completely removed the medicament residues within the human root canal.

Push-Out Bond Strength of Fiber-Reinforced Post Using Various Post Space Irrigation Treatments.

Objective: This study aims to provide the impact of different endodontic irrigation treatments after post space preparation on the push-out bond strength of fiber posts to dentin using self-adhesive cements. Methods and Materials: A total of 180 extracted premolar teeth were selected. The canals were instrumented by and then were filled. After preparing the post space, teeth were divided into 12 groups according to irrigants (normal saline solution; 17% EDTA [ethylenediaminetetraacetic acid] + 5.25% NaOCl [sodium hypochlorite]; 17% EDTA; 5.25% NaOCl; and 1.2% chlorhexidine [CHX]) and irrigation technique (conventional syringe irrigation [CSI] and passive ultrasonic irrigation [PUI]). After cementation, the samples were sectioned to obtain 1-mm disks from coronal and apical parts, a push-out test was performed using a universal testing machine (Z050, Zwick/Roell, Ulm, Germany) at a speed of 1 mm/min. The data were analyzed using one-way analysis of variance (ANOVA) and Mann-Whitney U tests. Results: The push-out bond strength was higher in coronal segment in comparison to apical segment. The highest push-out bond strength value was related to NaOCl + EDTA using PUI (12.39 ± 1.08). There are significant differences when comparing NaOCl + EDTA group with EDTA group using CSI or PUI technique (p < 0.05) except in coronal region with CSI technique. In both apical and coronal regions, phosphoric acid irrigation was found to be similar to normal saline solution and CHX groups regardless of activation technique. Conclusion: The push-out bond strength values were significantly affected by the irrigation protocol. Using PUI and 17% EDTA + 5.25% NaOCl in apical region could be an effective irrigant for smear layer removal after post space preparation.

Is SWEEPS (Laser assisted irrigation) better than Passive Ultrasonic Irrigation and XP-Endo Finisher?-An in vitro study

Is SWEEPS (Laser assisted irrigation) better than Passive Ultrasonic Irrigation and XP-Endo Finisher?-An in vitro study

Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study.

The objective of the study was to compare and evaluate the depth of penetration of an epoxy resin-based sealer following a final rinse of 17% ethylenediaminetetraacetic acid (EDTA) and 18% 1-hydroxyethylidene 1, 1-diphosphonate (HEDP), with diode laser and passive ultrasonic activation (PUI): an in vitro confocal laser scanning microscopy study. Fifty-two extracted human mandibular premolar teeth with single root and single canal were selected. They were disinfected in 0.1% thymol solution, cleaned of calculus and soft tissues, and stored in 0.1% thymol solution till use. All teeth were radiographed and selected as per the inclusion and exclusion criteria. The teeth were decoronated using a diamond disk under copious water spray to acquire a standardized root length of 14 mm. Working length was established by inserting a size 10-K file into each root canal until it is visible at the apical foramen and by subtracting 1 mm from the recorded length. Instrumentation of the root canal was done till master apical file size of F3 using ProTaper universal, rotary instruments. The canals were irrigated with 2 mL of 3% sodium hypochlorite between successive files. Teeth were randomly divided into four subgroups n = 12 according to the intervention. Passive ultrasonic irrigation and diode laser were used to activate the irrigants. Final irrigation was performed with distilled water. These specimens were examined using confocal laser scanning microscope (OLYMPUS FLUOVIEW FV 3000) for dentinal tubule penetration of the sealer. Two-way ANOVA test and Tukey's multiple post hoc test were used for statistical analysis. Highly significant difference was seen between the groups with EDTA and HEDP, with HEDP demonstrating the highest penetration. Among the activation techniques used in this study, PUI showed the highest penetration of the sealer. The least penetration was seen with diode laser activation and EDTA. The irrigation activation techniques significantly influence the penetration of sealer into root dentinal tubules. When penetration of sealer with different irrigation techniques and irrigants was evaluated, significant greater level of sealer penetration was attained with PUI activation of HEDP.

Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature.

This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Sixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic- PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. All dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. Ultramint X resulted in the most significant number of completely clean specimens.

Passive ultrasonic irrigation on postoperative pain after endodontic treatment: a randomized clinical trial

Objective:This randomized clinical trial evaluated the effect of passive ultrasonic irrigation (PUI) protocol employed during endodontic treatment on the incidence of postoperative pain. Methods: Sixty adult patients with non-vital asymptomatic premolar and molars were included. The treatments were performed using ProTaper Universal instruments with working length set 1.0 mm short of the apical foramen. The patients were randomly divided to receive one of the following two final cleansing protocols (n = 30): PUI - the canals were rinsed with 2.5% NaOCl, 17% EDTA, and 1.0% NaOCl sequentially, with 3 cycles of 20 seconds in each irrigation solution, under ultrasonic agitation; Control (CON) - similar final irrigation protocol was employed without any agitation. To evaluate postoperative pain, a numerical rating scale was applied every 24 hours until the fifth day. Data were statically analyzed with Pearson's Chi-square, Friedman's and ANOVA tests with 5% of significance. Results: There were no significant differences in any of the periods (P=0.46). The great majority of patients in both groups showed no pain symptoms. No patient reported severe pain (≥ 7), with moderate pain occurring in only 2 patients in the CON group (7.4%) and 4 patients in the PUI group (16.7%), exclusively in the first 24 hours. Conclusions: The use of passive ultrasonic irrigation protocol did not influence the occurrence of postoperative pain in patients submitted to endodontic treatment.

Removal of Calcium Hydroxide Medicament from the Apical Root Canal using Different Irrigation Methodologies: A Scanning Electron Microscopy Study

Introduction: To evaluate the efficiency of different irrigants and agitation techniques in the removal of calcium hydroxide Ca(OH)2 medicament from the root canal walls. Material and Methods: N=84 mandibular premolars were selected for this study. The root canal of these 84 premolars was cleaned up using the ProTaper rotary system up to the file size F3 and then filled with Ca(OH)2 medicament. For seven days, the root samples were maintained at 37o C and 100% relative humidity. The sample was divided into four groups (n=20 each) using random allocation employing different agitation methods: Group 1- MAF - Master Apical File, Group 2 - PUI - Passive Ultrasonic Irrigation, Group 3 - CB - Canal Brush, and Group 4 - FF - F File. Each group was further subdivided into two subgroups based on the specific chelating agent employed: (a) 10% Citric Acid and (b) 17% EDTA. Longitudinal bisection was performed in the apical (lower) third of the root structure. Further, an assessment was done using SEM (scanning electron microscopy) to study the elimination of Ca(OH)2. Kruskal- Wallis and Mann-Whitney tests were used for statistical analysis. Results: Groups 1 (MAF) and Group 3 (CB) showed a significant statistical difference (p&lt;0.05) when compared to Group 2 (PUI) and Group 4 (FF). An insignificant difference (p&gt;0.05) was seen between the performance of chelating agents (10% Citric Acid and 17% EDTA). Conclusion: Irrespective of the specific chelating agents employed, both the PUI (Passive Ultrasonic Irrigation) and FF (F File) agitation techniques exhibited superior efficacy in the removal of Ca(OH)2 medicament from the apical (lower) third when compared to the CB (Canal Brush) and MAF (Master Apical File) methods.

A Comparative Evaluation of the Cleaning Efficacy of Five Different Root Canal Irrigation Devices: A Histological Study.

This study is aimed to evaluate the cleaning efficacy of five different irrigation systems as SonicMax, RinsEndo, EndoVac, passive ultrasonic irrigation (PUI), and manual needle irrigation (MNI) to histologically evaluate the presence of organic structures and the penetration of irrigation solution. Forty-two single-rooted, extracted human mandibular premolars were used in the study. Each tooth was decoronated at the cementoenamel junction and the root canals were instrumented using ProTaper rotary instruments in a crown-down manner. The specimens were randomly divided into five experimental groups (n = 7) Group (1) SonicMax, group (2) RinsEndo,group (3) EndoVac, group (4) PUI, group (5) MNI, and the control groups (n = 7). Each system used 2.5% sodium hypochlorite (NaOCl), 17% ethylenediamine tetraacetic acid (EDTA), and 2.5% NaOCl, respectively, in the experimental groups. The control group did not receive any final irrigation.The measurements were analyzed by employing two-way analysis of variance multivariate results to show significant differences between the length of the dentin tubules in the apical, middle, and coronal of the six groups. The post-hoc test was used when groups were compared by pairs. The results of this study indicate that among the five groups, the RinsEndo and EndoVac were found to be most effective in the cleaning of root canals. The RinsEndo shows highly significant results in the cleaning efficiency of the coronal and middle parts compared with the other groups. The cleaning efficiency in the apical area was the same for RinsEndo and EndoVac. The result of our study indicates that RinsEndo and EndoVac may be more effective in clinical practice.

Investigating the effect of Er,Cr:YSGG laser agitation of sodium hypochlorite on the removal of mature biofilm in the complex root canal systems using atomic force microscopy.

Endodontic infections caused by remaining biofilm following disinfection with chemical fluids encourage secondary bacterial infection; hence, employing laser pulses to activate the fluids is advised to improve microbial biofilm clearance. This study investigated the performance of Er,Cr:YSGG laser in photon-induced photoacoustic streaming (PIPS) agitation of 5.25% sodium hypochlorite (NaOCl) to enhance the removal of mature Enterococcus faecalis (E. faecalis) biofilms in complex root canal systems. The mesial roots of the lower first and second molars were separated and inoculated with E. faecalis bacteria for 30 days. The roots were irrigated with 5.25% NaOCl, some of them were agitated with passive ultrasonic irrigation (PUI), and the other roots were agitated by Er,Cr:YSGG laser using PIPS at 60 µs/pulse, 5 Hz, and 0.25, 0.5, 0.75, 1, and 1.25 W. An atomic force microscope (AFM) was used as a new method to obtain the results in the isthmus area; the results that have been obtained from each group were compared with each other. ANOVA was utilized to compare the means of the test groups. Based on the AFM and SEM analyses, laser agitation and passive ultrasonic activation groups have shown higher antimicrobial efficacy than the conventional syringe irrigation group (P<0.05). Based on the findings of this investigation, the agitation of 5.25% NaOCl solution by Er,Cr:YSGG laser in PIPS at (60 µs/pulse, 5 Hz, 1.25 W) offers better mature bacterial biofilm removal in the mesial root of lower human molars than the same irrigant with syringe irrigation and passive ultrasonic activation technique.

Pulp tissue dissolution capacities of different irrigation agitation techniques in artificial internal resorption cavities.

The aim of this in vitro study was to compare the organic tissue dissolution capacities of 3 different irrigation agitation techniques (IATs) in artificial internal root resorption cavities (IRCs). Ninety freshly extracted maxillary human incisors were selected. After decoronation procedure, the roots were split longitudinally, and a standard IRC were prepared in the canals on each half of the roots. Then, the bovine pulp samples (~2,3 mg) were previously weighed and placed into the cavities. The root fragments were reassembled and cemented to create a circular IRC within the canal. Teeth samples were randomly divided into 6 groups (n=15); sodium chlorur (NaCl) and sonic irrigation (SI), sodium hypochlorite (NaOCl) and SI, NaCl and passive ultrasonic irrigation (PUI), NaOCl and PUI, NaCl and laser activated irrigation (LAI), NaOCl and LAI. After that, the teeth were decemented and the tissue samples inside the cavities were weighed again. The percentage of weight loss was calculated and statistically analyzed. SI has significantly more successful results than PUI and LAI in groups which the irrigant was NaCl. There was also a significant difference between LAI and PUI in groups which the irrigant was NaOCl (Group 6 ˃ Group 4, p=0.003). There was no significant difference between LAI and SI with NaOCl. Complete dissolution of bovine pulp tissue from IRCs was not achieved by any tested techniques. However, the LAI with NaOCl was more effective than other IATs. In addition, there is no significant difference between the LAI and SI with NaOCl.

Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation.

The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.

Comparative evaluation of penetration of sealers in dentinal tubules using passive ultrasonic irrigation and Erbium: yttrium-aluminum-garnet laser - A confocal laser scanning microscope study.

Smear layer clearance and sealer penetration into dentinal tubules play a crucial role in root canal treatment. Hence, efficient irrigation is a crucial component of the root canal debridement. This in vitro study's objective was to assess the effectiveness of passive ultrasonic activation and Erbium: yttrium-aluminum-garnet (Er: YAG) laser-activated irrigation on irrigation solution penetration and sealer penetration into dentinal tubules. The aim of this study was to evaluate and compare the dentinal tubule penetration of epoxy resin-based sealer and bioceramic sealer after ultrasonic agitation and Er: YAG laser activation of the irrigant. This was an in vitro study. Extracted tooth samples (n = 42) into 06 groups (Group A-F) with 7 samples in each group. Postobturation transverse section was made and assessed under a confocal laser scanning microscope for the total dentinal tubule penetration area and recorded as the mean apical, middle, and coronal penetration. One-way analysis of variance test, followed by post hoc was used. The intergroup comparison showed that Group E and Group F have significantly more penetration as compared to the controls and ultrasonic irrigation, P < 0.001 and P < 0.01, respectively. Er: YAG laser with AH plus sealer has the highest penetration in all the sections of tooth, followed by CeraSeal sealer.

A IMPORTÂNCIA DA IRRIGAÇÃO ULTRASSÔNICA PASSIVA PARA O SUCESSO DO TRATAMENTO ENDODÔNTICO: revisão narrativa de literatura

The objective of this study was to highlight the advantages of Passive Ultrasonic Irrigation (PUI) in endodontic treatments, describing its techniques, execution, and effective outcomes. The research was based on a narrative literature review, with a search in national and international databases, using specific keywords. The results demonstrate that the selection of an appropriate irrigating solution is fundamental since the failure of endodontic treatment is often related to the survival of microorganisms in the root canals. The ideal irrigation should be chosen based on the specific needs of each case, considering the chemical properties of the irrigating solutions. PUI is an effective technique for activating irrigating solutions in root canals and may be more efficient in cleaning the canals than simultaneous ultrasonic instrumentation. PUI is particularly useful in curved canals, and a smooth wire can be as effective as a cutting K-file. The study also highlights the continuous evolution of dentistry and the need to invest in advanced technologies to enhance clinical outcomes. It is concluded that PUI is a promising technique that offers significant benefits for the success of endodontic treatments. Its ability to reach challenging areas and its effectiveness in disinfecting root canals emphasize the relevance of the technique in dental practice. It is expected that this knowledge will contribute to improving irrigation protocols and, consequently, the effectiveness of endodontic treatments.

Did in-between rinsing and agitating with distilled water prevents precipitate formation by the interaction between sodium hypochlorite and chlorhexidine canal irrigants?

The interaction of sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) produces an orange-brown precipitate. The present study evaluated the influence of distilled water (H2 O) in different irrigation protocols designed to prevent the formation of precipitate with NaOCl and CHX. Fifty canine teeth were instrumented and split longitudinally. The canal was examined with a stereomicroscope and photographed by canal-thirds. The tooth halves were repositioned and distributed randomly into five groups, according to the final irrigation protocol (n = 10): G1 (control)-Ethylenediaminetetraacetic acid (EDTA) + NaOCl + CHX, conventional irrigation (CI); G2-EDTA + NaOCl + CHX, activated with passive ultrasonic irrigation (PUI); G3-EDTA (PUI) + NaOCl (PUI) + H2 O (CI) + CHX (PUI); G4-EDTA + NaOCl + H2 O + CHX (PUI); G5-EDTA (PUI) + NaOCl (PUI) + H2 O (continuous ultrasonic irrigation [CUI]) + CHX (PUI). The specimens were evaluated with a stereomicroscope and scanning electron microscope (SEM). Energy dispersive x-ray spectroscopy analysis was performed to identify the elemental profile of the irrigated canal walls. The images were scored according to the extensiveness of precipitate. Data were analyzed (Kruskal-Wallis test, α = 5%). Under the stereomicroscope, G1 had significantly higher scores than all the other groups in all canal-thirds (p < .05). All four experimental groups showed similar scores (p > .05). There were no significant differences in precipitate formation among root-thirds in intragroup analysis (p > .05). Upon SEM examination, overall, only G5 had lower scores than G1 (p < .05). Analysis by canal-thirds showed no significant difference among groups and among canal-thirds in the intragroup analysis (p > .05). G1 showed high Cl peaks. In-between irrigation with H2 O activated by CUI is effective in preventing precipitate formation during canal debridement with NaOCl and CHX. RESEARCH HIGHLIGHTS: Continuous ultrasonic irrigation with distilled water was capable to prevent the precipitate formation. The precipitate can be classified as a chemical smear layer.

Effect of Xp endo Finisher and Passive Ultrasonic irrigation on bacterial reduction: in vitro study

Effect of Xp endo Finisher and Passive Ultrasonic irrigation on bacterial reduction: in vitro study