Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment

Abstract

The aim of this study was to compare the efficacy of passive ultrasonic irrigation and EasyClean for removing residual filling material in retreatment. Twenty-two maxillary lateral incisors with apical curvature were instrumented with ProTaper files and filled with Endofill using the lateral compactation technique. Removal of filling material was performed with Reciproc, Mtwo and ProDesign Logic 50/.01 files. The teeth were inserted in a silicone mould, which was placed in a metal muffle, and split to visualize the residual filling material. The samples were divided into two groups (n = 11) according to the irrigation protocol: Passive ultrasonic irrigation (PUI group) with 3 activations of 20 seconds and EasyClean (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) (EC group) used in continuous rotation with 3 activations of 20 seconds, both using NaOCl and EDTA. Environmental scanning electron microscopic images of the apical, middle, and cervical thirds were taken before and after the irrigant activation. The Kappa test was used to determine interexaminer agreement. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests (p < 0.05). PUI and EC improved the removal of remnant filling material in all root canal thirds (p < 0.05). PUI and EC presented similar performance in the final step of retreatment (p > 0.05). No significant difference was observed in the removal of filling material in the apical, middle, and cervical thirds in both groups (p > 0.05). EasyClean in continuous rotary motion is useful in retreatment and was shown to be as effective as ultrasonic activation in the removal of remnant filling material.

Efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite in the reduction of microbial content and virulence factors in teeth with primary endodontic infection

“…Therefore, irrigating solutions need to be in direct contact with the entire root canal wall and have good penetration capacity (Plotino et al , de Gregorio et al , Duque et al , Urban et al ). The most commonly used irrigation method is the use of conventional syringes and needles; however, they have limitations regarding removal of dentinal debris, access to the apical portion of the root canal and areas of anatomical complexity (Tay et al , Duque et al , Generali et al , Rodrigues et al ).…”

“…These protocols include several techniques such as manual dynamic activation (Virdee et al ), passive ultrasonic irrigation (Plotino et al , van der Sluis et al ), sonic irrigation (Karade et al , Zeng et al ), apical negative pressure irrigation (Gu et al , Tomson & Simon ), reciprocating activation (Kato et al ), laser activation with photon‐induced photo‐acoustic streaming (PIPS) (Arslan et al ), and irrigant activation using either XP‐endo finisher (FKG Dentaire, La Chaux de Fonds, Switzerland), self‐adjusting file system (SAF; ReDent Nova, Ra'anana, Israel), TRUShape (Dentsply Sirona, Ballaigues, Switzerland) or XP‐endo shaper (FKG Dentaire) (Siqueira et al ). In the literature, there is no consensus on the best irrigation protocol necessary for effective activation of the irrigant and the removal of smear layer and debris from the root canal (Rodrigues et al , Nakamura et al ).…”

“…Passive ultrasonic irrigation (PUI) is the activation of an irrigant using an oscillating instrument placed in the centre of the root canal to induce acoustic transmission and/or cavitation of the irrigant solution (Rodrigues et al ). It was designed to improve the cleaning of the root canal space by releasing microorganisms, dentinal debris and organic tissue, which enhances disinfection even in difficult‐to‐access areas (Weller et al , Rodrigues et al ). Several studies have demonstrated that PUI is associated with better cleansing of the root canal (van der Sluis et al , Plotino et al ), but there are no data on the concomitant reduction in the levels of LPS and LTA.…”

Estratégias para otimizar a remoção da camada de smear do sistema de canais radiculares

“…In addition, since the instrument is made of plastic (ABS) and has a cross-section in the shape of an "airplane wing" with lower cutting power, there is less wear on the dentin wall. 24,25 However, according to the authors Kato et al 25 and Rodrigues et al, 24 PUI promotes a more efficient cleaning of intermediate portions of straight and conical canals, since in these regions the diameter of the conduit is greater than in the apical millimetres, allowing the ultrasonic insert to work freely without contact with the dentin walls. However, due to the large anatomical variations of the roots, such as in curved and atresic canals, the ultrasonic tip can touch the walls of the canal, limiting its movement and generating a negative result in the conduction of the ultrasonic energy, besides being able to cause accidents, as uncontrolled removal of dentin, deviation of the original canal pathway, apical obstruction and even root perforation.…”

“…The Easy Clean (Dental Equipment, Belo Horizonte, MG, Brazil) is a system that aims to clean the root canals through the mechanical agitation of irrigation solutions throughout its length, with no risk of deforming the canal structure because, unlike the ultrasonic tips, this instrument is made of a plastic material called acrylonitrile butadiene styrene (ABS), with tip # 25/04 and cross section in the form of "wing of airplane", which can be inserted until the apical region. 24 It can act in reciprocating motion, that is, a turn of 180° clockwise followed by a turn of 90° counterclockwise, 24,25 or in a rotational movement, where it presents more satisfactory results in cleaning the conduit and the areas of isthmus. 26…”