Evaluation of Apically Extruded Debris Using Positive and Negative Pressure Irrigation Systems in Association with Different Irrigants

Abstract

This study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) using positive and negative pressure irrigation systems [Conventional irrigation (CI) and EndoVac (EV)] in association with different irrigants [6% Sodium Hypochlorite (NaOCl), 2% Chlorhexidine gel + saline solution (CHXg + SS), 2% Chlorhexidine solution (CHXs) or Saline solution (SS)]. Eighty mandibular premolars with single root canals were selected and randomly assigned into 8 groups (n = 10) according to the irrigation system and the irrigant used during CMP: G1 (EV + NaOCl), G2 (EV + CHXg + SS), G3 (EV + CHXs), G4 (EV + SS), G5 (CI + NaOCl), G6 (CI + CHXg + SS), G7 (CI + CHXs) and G8 (CI + SS). Reciproc® R25 files (25/.08) were used during the CMP and the extruded debris from each tooth was collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed using a microbalance, and the data were statistically analyzed using ANOVA and the post hoc Tukey's test (a = 0.05). All groups were associated with debris extrusion. EV was the irrigation system with less extruded debris (p < 0.05). No differences were observed regarding the irrigant when EV was used. When CI was used, CHXg + SS were associated with lower debris extrusion (p < 0.05). It was concluded that no irrigation protocol succeeded in preventing debris extrusion. EV resulted in lower levels of debris extrusion than CI. The use of CHXg + SS resulted in lower debris extrusion.

Negative Pressure Irrigation Presents Mineralizing Potential in Dogs’ Immature Teeth with Periapical Lesion

“…The chemicalmechanical preparation has as primary objective to eliminate the infection of the root canals system, being a fundamental step of the endodontic treatment (21). However, during the use of endodontic instruments and irrigation solution, organic and inorganic debris, bacteria and irrigating solution can be extruded, exacerbating the periapical pathological condition (22). It is known that the larger the apical diameter of the teeth, the higher the risk of damage to the periapical tissues (23).…”

Apically Extruded Debris Using Passive Ultrasonic Irrigation Associated with Different Root Canal Irrigants

“…Reciproc® R25 files (25/0.08, VDW, Munich, Germany) were used with the RECIPROC ALL program (VDW) in a slow in-and-out pecking motion and 3-mm amplitude limit combined with brushing motion. After 3 pecking motions, the endodontic file was withdrawn from the root canal, cleaned and inspected before being reused (6).…”

“…The method used for the collection of apically extruded debris was adapted from previous studies (6,9,13,14).…”

“…Sodium hypochlorite (NaOCl) is the most used chemical substance during the root canal treatment (4). Chlorhexidine (CHX) has been recently proposed as an alternative to NaOCl due to its properties, such as lubricating action, broad spectrum, substantivity and lower toxicity compared to NaOCl (5,6). In addition, the rheological action of CHXbased gel maintains the debris in suspension (5), and as a result it prevents apical extrusion of debris (6).…”

Avaliação da mineralização apical em dentes de cães com rizogênese incompleta e lesão periapical submetidos à irrigação dos canais radiculares por pressão apical negativa

“…Os resultados da terapia endodôntica regenerativa (RET) para o tratamento de dentes permanentes jovens, com ápice aberto, e presença de necrose pulpar e lesão periapical foram avaliados por Lin et al (2017), em comparação à apicificação. (Bürklein et al, 2013;Jamleh et al, 2016;Barbosa-Ribeiro et al,2018). Sabe-se que quanto maior o diâmetro apical dos dentes, maior o risco de ocorrência de danos aos tecidos periapicais (Mehara et al, 2000;Gernhardt et al, 2004;Aksel et al, 2014).…”