Removal Of Triple Antibiotic Paste Research Articles

Micro-computed tomography assessment of triple antibiotic paste removal using different irrigation methods

Purpose: The study aimed to compare four irrigation methods for triple antibiotic paste (TAP) removal using micro-computed tomography (micro-CT) analysis. Materials and Methods: Forty bovine central incisor teeth were selected, and the root canals were prepared up to #6 Peeso reamer drills. Equal portions of metronidazole, ciprofloxacin, and minocycline were used for the TAP preparation. The TAP was prepared by mixing the powder with distilled water (with a powder to liquid ratio of 1 mg/1 mL). The TAP was introduced to the canals with a lentulo spiral; then, the access cavities were temporarily sealed. After 21 days of storage, the teeth were randomly divided into four equal groups according to irrigation techniques: open-ended, side-vented, double side-vented needle irrigations and EndoActivator irrigation device. The TAP was removed using 17% EDTA (20 mL) and distilled water (5 mL) for all of the groups. The volume of the intracanal medicament before and after the irrigationprocedure was recorded by scanning the samples with micro-CT, and the TAP percentage was calculated. Results: The results showed that there was no statistically significant difference among the TAP percentage volumes removed by the different irrigation techniques. Conclusion: The irrigation techniques used in this study showed similar TAP removal efficiency, however, they could not completely remove the TAP from the root canal systems.

Strategic Evaluation of Efficacy of Different Irrigants in Effective Removal of Triple Antibiotic Paste from the Canal Spaces: An Original Research Study

Strategic Evaluation of Efficacy of Different Irrigants in Effective Removal of Triple Antibiotic Paste from the Canal Spaces: An Original Research Study

Comparison of the efficacy of CanalBrush, EndoActivator, and Passive Ultrasonic Irrigation on the removal of triple antibiotic paste from root canal walls: An in vitro study

ABSTRACTAim:The aim of this study was to compare the efficacy of CanalBrush (CB), EndoActivator (EA), and Passive Ultrasonic Irrigation (PUI) on the removal of triple antibiotic paste (TAP) from root canal walls.Materials and Methods:Thirty-six extracted human single-rooted teeth were prepared using ProTaper Universal rotary files (DentsplyMaillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with TAP, and after 21 days, roots were randomly assigned to three groups (n = 10) according to irrigation regimens used: CB, EA, and PUI. In three teeth, TAP was not removed (positive controls), and the other three teeth were not filled with TAP (negative controls). The roots were sectioned, and the amount of TAP remaining was evaluated at the mesial halves of each tooth at ×30 magnification under a stereomicroscope using a 4-grade scoring system. Data were evaluated using the Kruskal–Wallis and Mann–Whitney U tests.Results:There were significant differences among the experimental groups according to the different parts of the root canals (P < 0.05). At the apical and middle third, EA and PUI groups removed more TAP than CB group; however, there was a statistically significant difference only between CB and PUI groups (<0.01 at apical third and <0.05 at middle third). At the coronal third, there was no statistically significant difference between all the three groups (P > 0.05).Conclusion:PUI led to superior results compared to CB in the middle and apical thirds. There was no significant difference between EA and PUI techniques.

XP endo® file: An update review

Clinical research has still focus on three-dimensional (3D) cleaning, shaping, and obturation of the oval root canal by improving irrigation, creating new alloys for instruments, and creating new sealers. This article only deals the MaxWire® technology instruments XP Endo® Shaper, Finisher, and XP Endo® Retreatment file and analyzes how they are effective in 3D cleaning and shaping, in biofilm removal, triple antibiotic paste removal, and also for debris and smear layer removal.

Evaluation of Double and Triple Antibiotic Paste Removal Efficiency of Various Irrigation Protocols

Evaluation of Double and Triple Antibiotic Paste Removal Efficiency of Various Irrigation Protocols

Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal

Objectives: The aim of this study was to compare conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF) techniques in terms of modified triple antibiotic paste (mTAP) removal.Materials and Methods: A total of 30 mandibular premolars were instrumented to a size F3 file. A mixture of mTAP was prepared by mixing 3 antibiotics, including 250 mg ciprofloxacin, 250 mg metronidazole, and 150 mg clindamycin, with 1 ml distilled water and applied into the root canals. The teeth were allocated into 3 equal groups, irrigation/agitation was performed and teeth were divided into two halves. The removal of mTAP was evaluated with a scanning electron microscope by using the 4 grade scoring system.Results: In the apical thirds, significant difference was found between PUI and CNI groups (p&amp;lt;0.05), whilst no significant difference was found among the other irrigation activation regimens (p&amp;gt; 0.05). No statistically significant difference was found between all groups in the middle third. In the coronal thirds, XPF removed significantly more mTAP than the CNI group (p&amp;lt;0.05). However, no difference was recorded among other groups (p&amp;gt;0.05). Conclusions: Passive ultrasonic irrigation and XPF file agitation demonstrated superior efficacy in removing mTAP from root canals compared to CNI.

Effect of intracanal time of triple antibiotic paste on its removal from simulated immature roots using passive ultrasonic irrigation and XP-endo Finisher.

Background. The aim of this study was to evaluate the effectiveness of different irrigation techniques in the removal of triple antibiotic paste (TAP), which was applied for 7, 21 or 90 days, from simulated root canals of immature teeth. Methods. The root canal spaces of 190 maxillary canine teeth were filled with TAP and randomly divided into a control and 3 experimental groups according to the intracanal medicament period (7, 21 or 90 days). Syringe irrigation (SI), passive ultrasonic irrigation (PUI) and XP-endo Finisher (XP) were used for the removal of TAP (n=20). The amount of remaining medicament was calculated under a stereomicroscope using a 4-grade scoring system. Kruskal-Wallis H and Wilcoxon signedrank tests were used for statistical analyses (P<0.05). Results. The mean percentage of residual TAP was significantly greater in the SI group compared to PUI and XP at all the time intervals (P<0.05). Paste removal efficacy of PUI was not affected by the intracanal time of TAP (P>0.05), whereas the efficacy of SI and XP was significantly affected (P<0.05). No significant differences were detected between PUI and XP at 7- and 21-day intervals (P>0.05); however, at 90-day interval, PUI removed significantly greater amount of TAP than XP did (P<0.05). Conclusion. The time of the TAP in the root canal negatively affected the removal efficacy of the SI and XP-Endo Finisher; however, it did not affect the efficacy of the PUI.

Um novo instrumento para o tratamento do canal radicular após preparo quimiomecânico: XP-Endo Finisher

Objetivo: o objetivo deste trabalho é apresentar uma revisão da literatura sobre o XP-endo Finisher, abordando os resultados de estudos que avaliaram este novo instrumento endodôntico. Material e Métodos: foi realizada uma busca nas bases de dados PubMed e Bireme entre 2015 (quando o instrumento foi lançado ao mercado) e 2017, utilizando os seguintes descritores: XP-endo Finisher. Resultados: dezoito artigos foram recuperados e divididos em categorias de acordo com o tipo de avaliação: Remoção de pasta de hidróxido de cálcio; Remoção de pasta de antibiótico triplo; Remoção de material de enchimento; Extrusão de hipoclorito de sódio durante instrumentação; Extrusão de restos de dentina durante a instrumentação; Ação antimicrobiana e antibiofilme; e remoção de esfregaço e camada de detritos. Conclusão: de acordo com os artigos revisados ??neste estudo, pode-se concluir que XP-endo Finisher pode ter um impacto positivo no tratamento endodôntico. Este instrumento mostrou resultados promissores para remoção de medicação intracanal; remoção do material de enchimento durante o retratamento endodôntico; esfregaço e remoção de detritos; realce da ação antimicrobiana de irrigantes; e melhoria da remoção do biofilme.

Efficacy of XP-Endo Finisher in the Removal of Triple Antibiotic Paste from Immature Root Canals

IntroductionThe aim of this study was to evaluate and compare the effectiveness of the XP-Endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland) with passive ultrasonic irrigation (PUI) and needle irrigation in the removal of triple antibiotic paste (TAP) from the straight immature root canals of extracted teeth. MethodsThirty-four freshly extracted single-rooted teeth were used. All canals were prepared up to the ProTaper F5 file (Dentsply Maillefer, Ballaigues, Switzerland). Apices were drilled to simulate teeth with immature apices. The canals were filled with TAP, sealed, and incubated at 37°C and 100% humidity for 1 month. Samples were randomly assigned to 3 experimental groups according to the method used for TAP removal: XP-Endo Finisher, PUI, and needle irrigation (n = 10). Then, the roots were split into 2 halves. The amount of TAP residue in the apical portion of each segment was evaluated using a scanning electron microscopy and scored. ResultsThe amount of remaining TAP was significantly lower in the XP-Endo Finisher group compared with the needle irrigation and PUI groups (P < .05). Between the needle irrigation and PUI groups, there were no statistically significant differences (P > .05). ConclusionsWithin the limitations of this study, the XP-Endo Finisher removed significantly more TAP than needle irrigation and PUI.

Comparison of triple antibiotic paste removal by different irrigation techniques.

This study compared different irrigation techniques in triple antibiotic paste (TAP) removal from root canals. Fifty-six maxillaryanterior-teeth were filled with TAP for 28 days, and assigned into 5 experimental groups (n=10): Syringe irrigation (SI), NaviTip FX (NFX), Vibringe-Syringe irrigation (V-SI), NaviTip FX-Vibringe (V-NFX), passive ultrasonic irrigation (PUI) and positive and negative control groups (n=3 for each). Following the removal of the medicament, the remaining medicament was evaluated using 4-grade scoring-system. V-NFX and NFX showed similar performances (p>0.05) while V-NFX was significantly more efficient than SI and PUI (p<0.05) at all parts of root canals. VSI was less efficient at apical part when compared to NFX and V-NFX (p<0.05) while not significantly different from PUI and SI at all parts of the root canals (p>0.05). Regarding different parts of the root canals, V-SI and PUI were significantly less efficient at the apical part (p<0.05). In conclusion, the brush form of irrigation delivery with and without sonic activation improved the removal of TAP from the root canals when compared to ultrasonic activation, syringe irrigation or sonic activation alone.

Effectiveness of conventional syringe irrigation, vibringe, and passive ultrasonic irrigation performed with different irrigation regimes in removing triple antibiotic paste from simulated root canal irregularities.

Background:This study evaluated the efficacy of a sonic device (Vibringe), passive ultrasonic irrigation (PUI), and conventional syringe irrigation (CSI) in the removal of triple antibiotic paste (TAP) from artificial standardized grooves in the apical and coronal thirds of a root canal.Materials and Methods:One-hundred eighteen root canals were prepared using the ProTaper system. The roots were split longitudinally, and a standardized groove was prepared in the apical and coronal parts of one segment. The grooves were filled with TAP, and the roots were reassembled. The roots were randomly divided into nine experimental groups and two control groups, according to the following irrigation methods: (1) CSI with sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA), (2) CSI/EDTA, (3) CSI/NaOCl, (4) PUI/NaOCl + EDTA, (5) PUI/EDTA, (6) PUI/NaOCl, (7) Vibringe/NaOCl + EDTA, (8) Vibringe/EDTA, and (9) Vibringe/NaOCl. The amount of remaining medicament was evaluated under a stereomicroscope.Results:In the apical third, Vibringe/NaOCl + EDTA and PUI/NaOCl + EDTA were superior to the other groups (P < 0.05); there was no significant difference between the other experimental groups (P > 0.05). In the coronal third, there was no significant difference between the experimental groups (P > 0.05).Conclusions:The use of the NaOCl/EDTA combination together with sonic or ultrasonic agitation improved the removal of TAP from the apical third.

Effectiveness of different irrigation solutions on triple antibiotic paste removal from simulated immature root canal.

To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of irrigation solutions on removal of triple antibiotic paste (TAP) from root canals of the simulated immature teeth. Fifty single-rooted teeth were used. TAP was placed into each root canal, and specimens were stored in distilled water for 4 weeks at 37°C. After 4 weeks, the temporary coronal seal was removed and the samples were randomly divided into five groups as follows: (i) saline; (ii) ultrasonic activation of saline; (iii) NaOCl; (iv) ultrasonic activation of NaOCl; (v) chlorhexidine digluconate (CHX). The amount of remaining TAP on the canal walls was measured under stereomicroscope with 30× magnification. The data were analyzed using a one-way ANOVA and post-hoc Tukey test at a significance level of 0.05. There were statistically differences among CHX and ultrasonic activation of NaOCl and other groups (p < 0.05). There were no significant differences among the ultrasonic activation of saline, NaOCl, and saline groups (p > 0.05). Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove the triple antibiotic paste from simulated immature root canals. Ultrasonic activation of the NaOCl gave the best and CHX was the worst results.

Comparative scanning electron microscopy evaluation of Canal Brushing technique, sonic activation, and master apical file for the removal of triple antibiotic paste from root canal (in vitro study).

Aims:To compare and evaluate the effectiveness of Canal Brushing technique, sonic activation, and master apical file (MAF) for the removal of triple antibiotic paste (TAP) from root canal using scanning electron microscopy (SEM).Materials and Methods:Twenty-two single rooted teeth were instrumented with ProTaper up to the size number F2 and dressed with TAP. TAP was removed with Canal Brush technique (Group I, n: 6), sonic (EndoActivator) (Group II, n: 6), and MAF (Group III, n: 6). Four teeth served as positive (n: 2) and negative (n: 2) controls. The roots were split in the buccolingual direction and prepared for SEM examination (×1000) at coronal, middle, and apical third. Three examiners evaluated the wall cleanliness.Statistical Analysis:Statistical analysis was performed by Kruskal–Wallis test and Wilcoxon rank sum test.Results:Difference in cleanliness between three groups is statistically significant in cervical region only. Pairwise comparison in cervical region Canal Brush and sonic activation showed more removal of TAP than MAF.Conclusions:Canal Brush and sonic activation system showed better result than MAF in the cervical and middle third of canal. In the apical third, none of the techniques showed a better result. None of the techniques showed complete removal of TAP from the canal.

Farklı Kök Kanal Şekillendirme Tekniklerinin Simüle Açık Apeksli Dişlerden Üçlü Antibiyotik Patını Kaldırmadaki Etkinliklerinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı, farklı kök kanal şekillendirme tekniklerinin simüle açık apeksli dişlerden üçlü antibiyotik patını (metronidazol, siprofloksasin ve minosiklin) (ÜAP) uzaklaştırmadaki etkinliklerinin değerlendirilmesidir. Gereç ve Yöntemler: Çalışmada 60 adet tek köklü insan dişi kullanıldı. Dişlerin kök kanalları 50 no'lu Reciproc eğesiyle şekillendirildi. Açık apeksli kök simülasyonu 4 no'lu yeşil renkli 1,5 mm çaplı post frezi kullanılarak gerçekleştirildi. Daha sonra kök kanalları ÜAP ile dolduruldu ve köklerin apikal ve koronal kısımları rezin modifiye cam iyonomer siman ile kapatılarak polimerize edildi. Örnekler, distile su içerisinde dört hafta 37oC'de bekletildikten sonra kökün koronalindeki geçici dolgu maddesi uzaklaştırıldı. Örnekler, kök kanallarındaki ÜAP'nin uzaklaştırılmasında kullanılan kanal şekillendirme türüne göre beş çalışma grubu (her grup için n=10) (ProTaper, Reciproc, One Shape, Wave One ve el eğesi ile birlikte NaOCI kullanıldı) ve kontrol grubu (sadece NaOCI ile irrigasyon yapıldı) olmak üzere toplam altı gruba ayrıldı (n=10). Kanal içerisinde kalan artık ÜAP miktarı stereomikroskop ile x30 büyütme ile değerlendirildi. İstatistiksel analizde Kruskal-Wallis, Tamhane ve Kappa testleri kullanıldı. Bulgular: Reciproc, One Shape, Wave One ve el aletinin kontrol grubuna oranla istatistiksel olarak daha fazla miktarda ÜAP uzaklaştırdıkları görüldü (p<0,05). ProTaper grubunda kontrol grubundan daha fazla miktarda ÜAP uzaklaştırıldığı, ancak her iki grup arasında istatistiksel farklılık olmadığı gözlendi (p>0,05). Reciproc, One Shape, Wave One, ProTaper ve el eğesinin ÜAP'yi kaldırma etkinlikleri açısından aralarında istatistiksel fark olmadığı gözlendi (p>0,05). Sonuç: Simüle açık apeksli dişlerden ÜAP'nin uzaklaştırılmasında Reciproc, One Shape, Wave One ve el aletinin NaOCI irrigasyonu ile birlikte kullanımının yalnızca NaOCI irrigasyonu kullanımından daha etkili olduğu görülmüştür. Ancak kullanılan tekniklerin hiçbiri ÜAP' yi tamamen kök kanalından uzaklaştıramamıştır.

Evaluation of Triple Antibiotic Paste Removal by Different Irrigation Procedures

IntroductionRegenerative endodontics aims to re-establish a functional pulp-dentin complex. First, the root canal system is disinfected primarily by irrigants and medicaments. Triple antibiotic paste (TAP), a commonly used intracanal medicament, has been shown to be directly toxic to stem cells at concentrations greater than 0.1 g/mL. Thus, its complete removal is a crucial step in regenerative endodontic procedures. We hypothesized that currently used irrigation techniques do not completely remove TAP from root canal system. MethodsTAP was radiolabeled by the incorporation of I125, and calcium hydroxide (Ultracal; Ultradent, South Jordan, UT) was radiolabeled with Ca45. The intracanal medicaments were placed into standardized human root segments and incubated for 28 days at 37°C. Then, canals were irrigated with EndoActivator (Dentsply, Tulsa, OK), passive ultrasonic irrigation, EndoVac (SybronEndo, Coppell, TX), or a syringe/Max-i-Probe needle (Dentsply Rinn, Elgin, IL) using a standardized irrigation protocol in a closed system. Radioactivity levels (counts per minute values) were measured for each tooth before and after the irrigation protocols. Furthermore, the canals were sequentially enlarged and dentin samples collected and evaluated for radioactivity. Data were analyzed with analysis of variance and Bonferroni post hoc testing (P < .05). ResultsApproximately 88% of the TAP was retained in the root canal system regardless of the irrigation technique used (no difference among groups). Furthermore, approximately 50% of the radiolabeled TAP was present circumferentially up to 350 μm within the dentin. Conversely, up to 98% of the radiolabeled intracanal calcium hydroxide was removed, and most residual medicament was found present in the initial 50 μm of dentin. ConclusionsCurrent irrigation techniques do not effectively remove TAP from root canal systems, possibly because of its penetration and binding into dentin. However, calcium hydroxide is effectively removed with significant less residual presence.

Efficacy of various irrigation protocols on the removal of triple antibiotic paste

To compare the efficacy of irrigation protocols on the removal of triple antibiotic paste (metronidazole, ciprofloxacin and minocycline) (TAP) from artificial grooves in root canals. Root canals in 72 extracted single-rooted teeth were prepared using ProTaper rotary instruments up to size F5. The roots were split longitudinally and a standardized groove was prepared in the apical part of one segment. TAP was placed in the grooves, and the root halves were reassembled. The roots were randomly divided into six experimental groups according to the irrigation protocol used: distilled water, 1% NaOCl, 2.5% NaOCl, 100% ethanol, 17% EDTA and passive ultrasonic irrigation (PUI) with 1% NaOCl. The root segments were disassembled, and the amount of TAP remaining was evaluated under a stereomicroscope at 20× magnification using a four-grade scoring system. The data were evaluated statistically using Kruskal-Wallis and Mann-Whitney U-tests with a 95% confidence level (P=0.05). There were significant differences amongst the groups (P<0.001). Passive ultrasonic irrigation (PUI) with 1% NaOCl removed significantly more TAP than the other irrigating solutions (P<0.05). Distilled water, 1% NaOCl, ethanol and EDTA were associated with significantly more remaining TAP. PUI with 1% NaOCl was more effective in removing TAP from artificial grooves in root canals than other irrigating solutions without ultrasonic agitation. It was not possible completely to remove TAP from root canals.