ProTaper Universal Rotary System Research Articles

Impact of LASER activated irrigation on the retrievability of Guttaflow bioseal (in-vitro study)

BackgroundThis study aimed to evaluate the efficiency of diode LASER activated irrigation in the removal of GuttaFlow Bioseal root canal filling material during retreatment.Materials and subjectsRoot canals of forty-five single-rooted human mandibular premolar teeth were prepared with ProTaper Universal rotary system and obturated with lateral condensation obturation technique using Gutta Percha and Roeko GuttaFlow Bioseal root canal sealer. All specimens were retreated with ProTaper Universal Retreatment System files then divided to three different groups according to the technique of activation of irrigation. Samples were sectioned, and the residual filling remnants were captured using digital camera attached to microscope. Data was collected by three different interpreters, to eliminate the subjectivity of the process, using the ImageJ Software. The mean value of the data was obtained and evaluated statistically. The significance level was set at P ≤ 0.05.ResultsThe remaining filling materials in the canals irrigated with ultrasonic activation (6.17 ± 1.42 at coronal level, 10.93 ± 1.91at middle level, and 14.58 ± 2.23 at apical level) were less than these irrigated with LASER activation (15.87 ± 3.78 at coronal level, 21.28 ± 4.44 at middle level, and 27.06 ± 2.68 at apical level). Maximum amount of remaining filling materials was present in the canals irrigated with passive side-vented syringe (23.07 ± 3.22 at coronal level, 38.09 ± 7.27 at middle level, and 34.24 ± 9.77 at apical level).ConclusionThe activation of irrigation techniques used were incapable of complete removal of filling material at root canal walls.

Efficacy of different irrigation techniques in removal of N-acetyl cysteine as an intracanal medicament- An study

Intra canalmedicament must be completely removed from the pulp space for better penetration of sealers. Various methods of irrigant delivery are used for removal of medicament from root canals. Removal of N-acetyl cysteine when used as an intracanal medicament hasn't been studied yet.To compare efficacy of different irrigation techniques, ultrasonic, sonic, navi tips, side vented needles in removal of N-acetyl cysteine as an intracanal medicament- an study Fifty-two maxillary anterior teeth were decoronated and standardized to a root length of 13 mm. Root canals were prepared with Protaper Universal rotary system. N-acetyl cysteine paste was placed in root canals with lentulospiral and kept in an incubator for 7 days. Then four groups (n=13) were established according to the removal technique- Group 1- Passive ultrasonic irrigation, Group 2- Sonic irrigation, Group 3- Manual irrigation with NaviTip, Group 4- Manual irrigation with side vented needles. Each tip was placed 2 mm short of working length and irrigation was done using 5.25% sodium hypochlorite. Final irrigation was done, then roots were split buccolingually and evaluated for residual medicament under stereomicroscope at 24x magnification. Done using Kruskal-Wallis and Mann-Whitney tests (P ≤ 0.05). In coronal and middle third, there was significant difference in removal of medicament by Group 1- Passive ultrasonic irrigation compared to other techniques, whereas, in apical third Group 2- Sonic irrigation showed better result. Group 3-Manual irrigation with NaviTip and Group 4- Manual irrigation with side- vented needles was significantly less effective than other techniques.Use of irrigants with activation devices like ultrasonic and sonic revealed improved removal of N- acetyl cysteine intracanal medicament.

Effectiveness of H-files and Pro-Taper universal systems in removing Gutta-percha during endodontic retreatment: A comparative study

ObjectiveThis research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. MethodsThis ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. ResultsThe remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. ConclusionsPro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.

Modern nickel-titanium rotary systems in endodontic treatment

Background: One of the most important steps in endodontic treatment is the preparation of a uniform space, the use of endodontic irrigant and creating space for the endodontic filling. Therefore, improving endodontic treatment techniques is one of the most important tasks of modern dentistry. The success and effectiveness of endodontic treatment is largely determined by the quality of chemo-mechanical root canal treatment. In recent years there has been a major emphasis on the use of rotary mechanical instrumentation systems, namely the use of nickel-titanium (NiTi) alloys, which due to their properties represent a favorable flexibility in the instrumentation of difficult anatomies. Material and methods: 20 patients were examined and treated. They were divided into 2 groups: for the treatment of 6 patients was applied the Protaper Universal rotary system. In the second group of 14 patients to whom mechanical instrumentation was applied, were 7 patients following the Protaper Next and the other 7 Dc Taper with different pulpal and periodontal diseases. Results: Mechanical instrumentation was performed on different nosological entities, the prevalence being acute pulpitis. Among instrumented teeth, the prevalence was on the side of pluriradicular teeth. Conclusions: The practical application of different NiTi rotary systems has to be determined individually, as each clinical case has its own practical properties. But the success of an endodontic treatment depends not only on the rotary instruments used and, on the method, chosen, but also on the practitioner’s experience, detailed knowledge of the properties and step-by-step instrumentation protocols.

Pushout Bond Strength of Root Fillings after Irrigation of Root Canals Utilizing Sodium Hypochlorite, Chlorhexidine, and Homeopathic Mother Tincture (Arnica Montana)

The pushout bond strength of root fillings at radicular dentin was investigated employing NaOCl, CHX, and homoeopathic mother tincture (Arnica montana) as an irrigant. Sixty human permanent single-rooted extracted teeth were decoronated. The root canals were instrumented using Pro taper universal rotary system (Dentsply Tulsa Dental; Tulsa, Oklahoma) and were prepared up to F3 apical size. The roots were then randomly divided into three groups according to irrigation solution (n = 20) according to the final irrigation regimen: Group I: 3 mL 5.25% NaOCl followed by 3 mL Saline (control); Group II: 3 mL Arnica montana (10%, w/v) followed by 3 mL Saline; Group III: 3 mL CHX followed by 3 mL Saline. The canals were dried using paper points. The canals were coated with AH Plus sealer (Dentsply DeTey, Konstaz, Germany) with the aid of a Lentulo spiral (Dentsply DeTey, Konstaz, Germany) and obturated with #F3 gutta-percha. Each root was then horizontally sliced into three slices, labelled coronal, middle, and apical, each measuring 2 mm thick. Furthermore, at a crosshead speed of 2 mm/min, the test was carried out using the universal testing apparatus. The 5.25% NaOCl significantly decreased the bond strength of AH Plus to dentin. Both CHX and Arnica montana were capable of reversing the compromised pushout of AH Plus to NaOCl-treated dentin. After using NaOCl as an irrigant, the danger of diminished binding capacity of AH Plus to root canal walls arises. Final irrigation with Arnica montana and CHX reduces this risk.

The Effect of Smear Layer on the Push-out Bond Strength of Silicone-based Root Canal Sealers

Aims: The study aimed to evaluate the effect of smear layer on the push-out bond strength of silicone-based root canal sealers. Materials and methods: Sixty extracted, single-rooted, sound human mandibular first premolar teeth were selected for this study. The Crown portion of each tooth was decoronated to the level of cement-enamel junction to standardize the root length to 16 mm. The working length was measured by subtracting 1mm from the visually determined canal length and the canals were instrumented using ProTaper universal rotary system up to size F3. The canals were divided into two groups according to the irrigating solutions used. Group.1 was rinsed with 2.5% sodium hypochlorite followed by 17% EDTA to ensure complete smear layer removal. Group.2 was rinsed using 0.9% normal saline to keep the smear layer. Then the samples were subdivided into three subgroups according to the sealer used with gutta-percha. These include AH Plus, GuttaFlow 2, and GuttaFlow Bioseal groups. The push-out bond strength test was performed using the universal testing machine and the data were analyzed using independent sample T-test at (p ≤ 0.05) to compare the results of each sealer group in the presence and absence of the smear layer. Results: For all sealers’ groups the results has shown a statistically significant difference in the bond strength at (p ≤ 0.05) between group 1 (without smear layer) and group 2 (with smear layer). The smear layer removal produced higher bond strength in AH Plus sealer, whereas the bond strength of both GuttaFlow 2 and GuttaFlow Bioseal was decreased when the smear layer was removed. Conclusion:Smear layer removal has a positive effect on the bond strength value of AH Plus sealer. The bond strength of GuttaFlow 2 and GuttaFlow Bioseal was not improved following smear layer removal.

Push-out Bond Strength Evaluation for Different Endodontic Sealers (A Comparative Study).

Aims: The aim of this study was to compare the push-out bond strength values between four different types of sealers. Materials and method: Forty extracted straight, single-rooted, sound human mandibular first premolar teeth were selected for this study. The crown portion of each tooth was decoronated to the level of the cement-enamel junction (CEJ) to standardize the root length to 16 mm. The working length was measured and the canals were instrumented using Nickel-Titanium ProTaper Universal Rotary System up to size F3. The canals were rinsed with 2.5% sodium hypochlorite followed by 17% EDTA, then the samples were divided into four groups (n=10) according to the sealer to be used with F3 gutta-percha. These are (AH Plus, GuttaFlow 2, GuttaFlow Bioseal and MTA Fillapex) sealers. The push-out bond strength test was performed and the data were analyzed using one way ANOVA, and post hoc Duncan’s multiple range tests at (p ≤ 0.05). Results: There was a statistically significant difference in the push-out bond strength among the four sealers’ groups at (p ≤ 0.05). The highest mean value of bond strength (3.605) MPa was shown in the AH Plus group. Bioseal group produced (1.833) MPa followed by (0.822) MPa for GuttaFlow2 group. The lowest value (0.645) MPa was shown in MTA Fillapex group. Conclusion: Based on the findings of this study, AH Plus sealer revealed the highest bond-strength value followed by GuttaFlow Bioseal and GuttaFlow 2, whereas MTA Fillapex showed the least bond value.

Comparative evaluation of efficacy of different endodontic file systems for removal of gutta percha from root canals using CBCT

Aim- To evaluate the removal of gutta percha by hand file system, rotary file system and reciprocating file system from root canals by using CBCT. Materials and Method: Root canals of 42 extracted human mandibular premolars were prepared using the ProTaper Universal rotary system and then obturated. Root filling quality was confirmed on CBCT images. Specimens were divided into 3 groups (n = 14) according to the system used for filling removal, group 1: H File, group 2: MTwo rotary retreatment file, and group 3:WaveOne file. Each specimen was sent for CBCT Analysis. Statistical Analysis Used: Evaluation of data was done statistically using One-way Analysis of Variance and Tukey’s post hoc test. Results: There was statistical difference in all the groups (P>0.05). All systems demonstrated presence of remnants of filling material. Mean reduction in the volume of GP after retreatment of Group I was 0.006mm3, Group II was 0.002mm3 Group III was 0.003mm3. Conclusion: The system responsible for a better removal of root canal filling material was the MTwo Retreatment file system, followed by the WaveOne system and H File.

Comparative evaluation of efficacy of different endodontic file systems for removal of gutta percha from root canals using CBCT

Aim- To evaluate the removal of gutta percha by hand file system, rotary file system and reciprocating file system from root canals by using CBCT. Materials and Method: Root canals of 42 extracted human mandibular premolars were prepared using the ProTaper Universal rotary system and then obturated. Root filling quality was confirmed on CBCT images. Specimens were divided into 3 groups (n = 14) according to the system used for filling removal, group 1: H File, group 2: MTwo rotary retreatment file, and group 3: WaveOne file. Each specimen was sent for CBCT Analysis. Statistical Analysis Used: Evaluation of data was done statistically using One-way Analysis of Variance and Tukey’s post hoc test. Results: There was statistical difference in all the groups (P>0.05). All systems demonstrated presence of remnants of filling material. Mean reduction in the volume of GP after retreatment of Group I was 0.006mm3, Group II was 0.002mm3 Group III was 0.003mm3. Conclusion: The system responsible for a better removal of root canal filling material was the MTwo Retreatment file system, followed by the WaveOne system and H File.

Effect of Laser Irradiation on the Apical Root Canal Sealing

Cleaning and shaping of the root canal system are essential for the successful outcome of endodontic treatment. In addition to the routinely used irrigating solutions, other technologies have been investigated for the treatment of root canal dentine, such as different types of laser systems. Purpose: The aim of our in vitro study was to evaluate the effect of different types of laser irradiation (Er:YAG , Nd:YAG, diode laser and photodynamic therapy) on the intracanal dentin and their interference in the apical seal of filled root canals. Methodology: 72 human single rooted teeth were randomly assigned into 6 groups. Root canal preparation was done using ProTaper Universal rotary system up to F3. The laser irradiation was performed at the end of the traditional endodontic preparation as a final means of decontaminating the endodontic system. Teeth were filled with a core-carrier system Guttacore (Dentsply, Sirona) and sealer AH- plus. Results: Statistical analysis showed that all groups had significantly less leakage in apical third than the control group. The laser-treated groups presented better results than Group II (Classical disinfection protocol), without statistically significant difference. The morphological changes on the apical intraradicular dentin surface caused by Nd:YAG and Er:YAG laser irradiation resulted at least linear dye apical leakage. Conclusions: Laser irradiation may improve the apical seal of the root canal. Different type of laser systems with appropriate parameters are recommended to be used as an adjunct to the current chemical root canal disinfection protocols.

Influence of the Remnants of Silicone Oil on Penetration of Three Different Sealers into the Dentinal Tubules: A Confocal Laser Scanning Microscopy Study.

The aim of this study was to assess penetration of AH Plus, MTA Fillapex and GuttaFlow Bioseal sealers into dentinal tubules after placement and removal of silicone oil using Confocal Laser Scanning Microscopy. Sixty single-canaled premolars were instrumented using ProTaper Universal rotary system. Roots were divided into two main groups (n=30) where either Silicone oil was used or not. Subsequently, each main group was subdivided into 3 subgroups according to the investigated sealers. In subgroups where Silicone oil was used, it was placed in canals and then cleared. Obturation was completed utilizing lateral compaction technique using Rhodamine B labeled sealers. Penetration depth of sealer was evaluated by image J software. One way ANOVA, Duncan's test as posthoc test was performed for evaluation of statistical significances among the groups. In each sealer group, Independent -t-test was used to compare between with and without oil. P value was set at <0.05. Using silicone oil resulted in less dentinal tubule penetration depth with all sealers. Mean dentinal tubule penetration depth was the lowest in apical thirds. AH Plus showed higher penetrability in all thirds compared to MTA Fillapex and GuttaFlow Bioseal despite oil placement and removal. MTA Fillapex displayed higher penetrability in all thirds than GuttaFlow Bioseal. Remnants of silicone oil has a negative impact on the penetration depth of the tested sealers.

Does the vehicle type affect the persistence of calcium hydroxide on the root canal walls when removing with sonic activation?

Background This in vitro study aimed to evaluate the persistence of calcium hydroxide (CH) associated with different vehicles on the artificial cavities after removing with sonic activation or conventional needle irrigation (CNI). Methods Seventy-two extracted single-rooted teeth were instrumented with ProTaper Universal rotary system up to F4. The roots were split longitudinally, and standardized cavities were prepared. The roots were assigned into 3 groups (n=24), according to vehicles used; distilled water, glycerin, and propylene glycol. In each group, cavities were filled with CH mixed with the respective vehicle. After reassembly, the removal of CH dressing was performed with either sonic activation (with EDDY) or CNI (n=12).The remnants of CH was assessed under a microscope with x40 magnification. A four-grade scoring system was used to evaluate. Kruskal-Wallis and Mann-Whitney U-tests were used to compare the data. (p &amp;lt;0.05). ResultsThere was a significant difference among groups (p&amp;lt;0.05). Complete removal of CH was found in the distilled water and propylene glycol groups when EDDY was used (p&amp;lt;0.05).EDDY was significantly more effective than CNI in the removal of CH mixed with distilled water and propylene glycol (p&amp;lt;.05).Whereas no significant difference was found between EDDY and CNI in the glycerin group (p&amp;gt;0.05).The lowest CH remnants were found in the distilled water group when CNI was used (p&amp;lt;0.05).Conclusion The vehicle associated with CH and irrigation activation is important for its retrieval. EDDY provided the complete removal of CH when mixed with distilled water or propylene glycol.

Effectiveness of different rotary file systems in removing the root canal filling material: A micro-computed tomography study.

Background. This study aimed to examine the retreatment efficiency of four NiTi rotary file systems with micro-computed tomography (micro-CT). Methods. Forty premolar teeth were shaped up to F2 using the ProTaper Universal rotary file system and obturated with MTA Fillapex. The root canals were scanned with micro-CT to evaluate the volume of root canal filling before retreatment. The samples were randomly divided into four groups according to the file system used to remove root canal filling material (n=10): ProTaper Universal Retreatment, ProTaper NEXT, EdgeFile XR, and EdgeFile® X3 NiTi system. All the samples were scanned with a micro-CT device for the second time to evaluate the amount of residual filling material in the root canals. The percentages of filling material removed from root canals were calculated. Additionally, the time spent on the removal of the root canal filling material was recorded. The data were analyzed using the Shapiro-Wilk and Kruskal-Wallis tests. Results. There were no significant differences between the groups in the percentage of root canal filling material removal. However, a statistically significant difference was found between the groups in the time required to reach the apex and remove the entire filling material. The time required to remove the root canal filling material was higher in the EdgeFile® X3 group. Conclusion. NiTi files manufactured for root canal preparation can be used effectively and safely to remove root canal filling materials. EdgeFile XR produced for retreatment can be used as an alternative to ProTaper Universal Retreatment files.

Post-Operative Pain after Single-Visit Endodontic Treatment Using Different Root Canal Irrigation Activating Techniques

Aim: To clinically evaluate the effect of different irrigation activation techniques (needle irrigation, passive ultrasonic irrigation (PUI) and EndoVac) on post-operative pain after single-visit endodontic treatment. Materials and methods: Thirty patients aged between 16 and 40 years requiring endodontic therapy of asymptomatic vital/non vital maxillary central or canine teeth were selected for this study. In all cases, root canal treatment was done is single-visit in which root canals were prepared using nickel-titanium ProTaper Universal rotary system in crown down manner up to master apical file size F4 or F5 according to the initial apical canal size. Irrigation was done using 2.5% NaOCl. Patients were randomly assigned into three groups according to the final irrigation activation method, group 1 (control group) needle irrigation, group 2 PUI and group 3 EndoVac system. Obturation was done using cold lateral compaction technique. Post-operative pain was assessed after 6, 12, 24, 48 hours, one week and two weeks respectively. Post-operative pain evaluation was done using Visual Analogue Scale (VAS). Results: EndoVac group showed the least post-operative pain values while needle irrigation group showed the highest values. This was statistically significant at 6 and 48 hours time intervals. PUI group showed lower pain values than needle group and this was significant at 48 hours time interval. In all groups the intensity of post-operative pain decreased over time. Conclusion: EndoVac system and PUI reduce post-operative pain after single-visit endodontic treatment than needle irrigation in the first 48 hours.

Microscopic Assessment of Dentinal Defects Induced by ProTaper Universal, ProTaper Gold, and Hyflex Electric Discharge Machining Rotary File Systems - An in vitro Study.

Background:Biomechanical preparation of root canal can damage root dentin leading to the formation of dentinal cracks which can eventually lead to fracture and failure of the treatment.Aim:The aim was to investigate the incidence of dentinal defects in root canals prepared with ProTaper Universal, ProTaper Gold, and Hyflex electric discharge machining (EDM) rotary file systems using handheld USB digital microscope.Materials and Methods:One hundred and fifty extracted mandibular premolar teeth with single canal were randomly divided into five groups (n = 30). Group 1: unprepared (negative control). Group 2: canal preparation done with nickel–titanium hand files (positive control), Group 3: canals prepared with ProTaper Universal rotary system, Group 4: canal preparation done with ProTaper Gold rotary system, and Group 5: canals prepared with Hyflex EDM rotary system. The specimens were sliced at 3 mm, 6 mm, and 9 mm from the apex with a slow-speed saw under water cooling. Digital images of each section were captured at ×40 magnification with the aid of a microscope. Two independent evaluators assessed the images for the presence of dentinal defects. The number of dentinal defects was recorded and Chi-square test was used for statistical analysis (P < 0.05).Results:The number of specimens presenting dentinal defects was as follows: Group 3; ProTaper Universal – 9/30 (30.0%), Group 4; ProTaper Gold – 2/30 (6.7%), and Group 5; Hyflex EDM – 1/30 (3.3%). No defects were detected in the negative and positive control groups (Group 1 and Group 2).Conclusion:ProTaper Universal showed the highest percentage of defects in comparison to ProTaper Gold and Hyflex EDM.

Efficacy of different methods of calcium hydroxide removal on bond strength of calcium silicate-based sealer

AimTo evaluate the efficacy of different methods of calcium hydroxide removal [XP-endo finisher (XP-F) file, passive ultrasonic irrigation (PUI) and NaviTip FX (NTFX) irrigating needle] on push-out bond strength of Endoseal MTA calcium silicate-based sealer.Materials and methodsForty extracted human premolars with nearly straight mature roots were used in this study. Teeth were decoronated to obtain a standardized root length of nearly 15 ± 1 mm. Root canals were prepared using ProTaper Universal rotary system up to F4 (40/0.06). Thirty samples were filled with calcium hydroxide paste then after 7 days, it was removed using different methods: G1: XP-F, G2: PUI, G3: NTFX. The remaining ten teeth with no prior medication were used as a control group (G4). All samples were obturated using gutta-percha/Endoseal MTA then transversally sectioned into coronal, middle, apical sections. The obtained sections were subjected to push-out bond strength test using a universal testing machine.ResultsThe highest mean push-out bond strength values were recorded for the control group followed by XP-F file and PUI while the lowest value for NTFX groups. The coronal section recorded the highest mean push-out bond strength value while the lowest value for the apical section with a significant difference in all groups.ConclusionPush-out bond strength values for XP-F and PUI groups were higher than NTFX group.

Impact of Irrigation Solutions on the Apical Sealing Potential of Different Endodontic Sealers Used with the Continuous-wave Obturation Technique: An In vitro Study

Abstract Aim: This study is aimed to evaluate the impact of three irrigating solutions on the apical sealing ability of three endodontic sealers. Materials and Methods: One hundred maxillary central incisors were decoronated, and their roots were assigned into three experimental groups (n = 30 each) according to the nature of the irrigating solution and two control groups (n = 5 each). Each experimental group was divided equally into three subgroups (n = 10 each) according to the type of root canal sealer. All root canals were instrumented using ProTaper Universal rotary system and irrigated with 3% sodium hypochlorite (NaOCl/Group 1), 3% hydrogen peroxide (H2O2/Group 2), and 2% chlorhexidine gluconate (CHX/Group 3). The final irrigating solutions for all groups were 17% ethylenediaminetetraacetic acid (EDTA) and distilled water. The continuous-wave technique was used to fill the prepared canals with the following materials: MTA-Fillapex/Gutta-percha (Subgroup A), AH Plus/Gutta-percha (Subgroup B), and Realseal SE/Realseal (Subgroup C). The microleakage was assessed after 72 hours using the linear dye penetration method. The results were statistically analyzed with one-way analysis of variance. Results: Significant differences were found only between the experimental groups (P &lt; 0.05). All root canal sealers after irrigation with 3% H2O2 showed the lowest amount of leakage. The highest apical leakage was observed when 3% NaOCl and 2% CHX were used. Conclusions: The type of irrigating solution could affect the apical sealing ability of experimental sealers used with the continuous-wave obturation technique. Root canal irrigation with 3% H2O2 +17% EDTA increased the apical sealing ability of all root canal sealers. Root canal irrigation with 3% NaOCl or 2% CHX +17% EDTA decreased the apical sealing ability of all root canal sealers.

Evaluation of Post-operative Pain after Irrigation Using End-vented NaviTip Tips versus Vibringe Sonic Irrigating System in Teeth with Acute Pulpitis with Apical Periodontitis: A Randomized Clinical Trial

AIM: This clinical study was conducted to evaluate and compare the post-operative pain after the using of two different irrigating techniques: Vibringe sonic irrigating system with end-vented NaviTip and conventional needle with end-vented NaviTip immediate postoperatively and 4, 12, 24, 48, and 72 h and 7 days utilizing a numerical rating scale (NRS).&#x0D; METHODS: Thirty-eight patients with acute pulpitis with apical periodontitis were involved in this study. Root canals were prepared using NiTi ProTaper Universal rotary system then randomized into two equal groups according to the technique used for irrigation Group A, Vibringe sonic irrigating system with end-vented NaviTip and Group B, conventional syringe with end-vented NaviTip® irrigating tip. The needles of irrigation were penetrated 2 mm shorter than the working length. The trial design of this study is a parallel randomized controlled trial.&#x0D; RESULTS: All demographic data, clinical and radiographic findings, and modified NRS scores obtained from patients were statistically analyzed. Results showed that there was no statistically difference between the two groups regarding the demographic data, prevalence of pre-operative pain, after 4 h, 12 h, 24 h, and 48 h and 7 days, while in both groups, there was a statistically significant decrease in pain intensity preoperatively compared with all other time periods.&#x0D; CONCLUSION: There is no statistical significance difference between Vibringe sonic irrigating syringe with endvented needle and conventional syringe with end-vented NaviTip, while in both groups, there was a statistically significant decrease in pain intensity preoperatively compared with all other time periods.

Effect of XP-endo Finisher on Post-Instrumentation Pain after Using Different NiTi Rotary Systems

Purpose: This study was conducted to assess and compare the effect of XP-endo Finisher on post-instrumentation pain after using either One Shape single-file rotary system or ProTaper Universal multi-file rotary system in root canal preparation. Materials and Methods: Forty-eight consented patients, with 52 single-rooted teeth requiring endodontic treatment were selected for this study based on inclusion/exclusion criteria. Teeth were randomly assigned into two equal groups according to the NiTi rotary system used for root canal preparation, Group (I), One Shape rotary system was used and Group (II), ProTaper Universal rotary system was used. Each group was further subdivided into two equal subgroups (A and B) according to whether XPendo Finisher was used in finishing the root canal preparation or not. Pain Intensity was measured using modified visual analogue scale at 6, 12, 24 and 72 hours after root canal instrumentation. Results: The patients’ highest mean pain scores occurred in the first 24 hours and significantly declined at the subsequent observation time of 72 hours. ProTaper Universal groups showed the highest mean pain scores, while the lowest mean pain scores were found in One Shape groups with no significant difference. The highest mean pain scores were found in XP-endo Finisher subgroups, while the lowest were found in No XP-endo Finisher subgroups with no significant difference. Conclusion: One Shape system produced less postoperative pain when used in conjunction with XP-endo Finisher.

Comparative Evaluation of Modified Endodontic Sealers’ Penetration Following Sonic Activation of Irrigants: A Scanning Electron Microscope Study

Introduction: When sealer is adapted well to the root canal wall, there is less tendency for microleakage and strength of root canal is enhanced. Therefore, it is important for the sealer to possess good tubular penetration depth and adaptation to dentinal walls. Aim: To compare the effects of sonic activation of 5.25% Sodium Hypochlorite (NaOCl) and incorporation of Zinc Oxide (ZnO) nanoparticles in AH Plus sealer on tubular sealer penetration. Materials and Methods: Forty extracted human mandibular premolars with a single root canal were used for this invitro study from October 2019 to January 2020. All teeth were prepared upto F3 with Pro Taper Universal rotary system. Teeth were randomly divided into four groups of 10 teeth each. Group I (control) included teeth obturated using AH plus sealer, Group II: teeth obturated using AH plus sealer incorporated with ZnO nanoparticles, Group III: teeth prepared along with sonic activation of the irrigant followed by obturation using AH plus sealer and Group IV: teeth prepared along with sonic activation of the irrigants followed by obturation with AH plus sealer incorporated with ZnO nanoparticles. Irrigation was achieved with 5.25% sodium hypochlorite. The canals were dried and obturated using respective sealers and single gutta percha cones. After storage at 37°C and 100% humidity, the roots were split into two halves and sealer penetration in the dentinal tubules was examined by using scanning electron microscope. The values obtained were statistically analysed using One-way Analysis of Variance (ANOVA) with significant p-value less than 0.05. Results: In all the groups, sealer penetrated into the dentinal tubules. There was enhanced tubular sealer penetration (289.57±59.43 μm) after sonic activation of the irrigant (group 3) followed by that on addition of ZnO nanoparticles to the sealers (group 2) (278.21±71.24 μm) and the least was seen in the control group (group 1) (211.5±66.33 μm). The combined effect of both i.e., use of sonic activation of irrigant followed by obturation using modified sealer with gutta percha (group 4) (318.64±88.27 μm) showed greatest tubular sealer penetration depth. Conclusion: Incorporation of nanoparticles aids in improving sealer penetration which is further enhanced in case of sonic activation during irrigation.