Apical root canal cleaning after preparation with endodontic instruments: a randomized trialin vivoanalysis

Abstract

Objectives: This study aimed to evaluate vital pulp tissue removal from different endodontic instrumentation systems from root canal apical third in vivo. Materials and Methods: Thirty mandibular molars were selected and randomly divided into 2 test groups and one control group. Inclusion criteria were a positive response to cold sensibility test, curvature angle between 10 and 20 degrees, and curvature radius lower than 10 mm. Root canals prepared with Hero 642 system (size 45/0.02) (n = 10) and Reciproc R40 (size 40/0.06) (n = 10) and control (n = 10) without instrumentation. Canals were irrigated only with saline solution during root canal preparation. The apical third was evaluated considering the touched/untouched perimeter and area to evaluate the efficacy of root canal wall debridement. Statistical analysis used t-test for comparisons. Results: Untouched root canal at cross-section perimeter, the Hero 642 system showed 41.44% ± 5.62% and Reciproc R40 58.67% ± 12.39% without contact with instruments. Regarding the untouched area, Hero 642 system showed 22.78% ± 6.42% and Reciproc R40 34.35% ± 8.52%. Neither instrument achieved complete cross-sectional root canal debridement. Hero 642 system rotary taper 0.02 instruments achieved significant greater wall contact perimeter and area compared to reciprocate the Reciproc R40 taper 0.06 instrument. Conclusions: Hero 642 achieved higher wall contact perimeter and area but, regardless of instrument size and taper, vital pulp during in vivo instrumentation is not entirely removed.

Periradicular repair after single- and two-visit root canal treatments using ultrasonic irrigant activation and calcium hydroxide dressing of teeth with apical periodontitis: study protocol for randomized controlled trials

“…Systematic reviews criticize the volume and time that the irrigating solution remains inside the root canal system [16,17]. Furthermore, some studies do not use ultrasound as an irrigation intensifying agent [7,13] and still do not specify the volume of the chemical substance used during treatment [4]. This variety of protocols promotes different results in the studies and, consequently, divergences of opinions and clinical approaches.…”

“…In cases of apical periodontitis, it is recommended that the efficient chemomechanical preparation should be able to promote cleaning, decontamination, and shaping, being aided by the use of intracanal dressing [2,3]. Mechanical instrumentation plays a fundamental role in reducing the intracanal microbial load; however, around 30 to 40% of the walls of the main canal are not touched by the instruments [4], thus requiring the irrigating substance to perform an auxiliary chemical action during the instrumentation step [5]. 5.25% sodium hypochlorite (NaOCl) solution has shown satisfactory results due to its excellent properties, such as antimicrobial action, tissue dissolution, bleaching action, and debris removal [6].…”

In Vitro Evaluation of the Antibacterial Activity of EndoSeal MTA, iRoot SP, and AH Plus against Planktonic Bacteria

“…Dental practitioners may consider the application of EndoSeal MTA for patients with recurrent and/or persistent endodontic infection, especially those with a past medical history of antibiotic resistance. Mechanical cleaning of the canal system remains important for the elimination of intracanal bacteria loads [ 2 , 3 , 4 ]. Although all three investigated endodontic sealers exhibited a certain degree of antibacterial activity, none of them were able to demonstrate a strong and long-lasting antibacterial effect against all four planktonic bacteria.…”

“…Complete elimination of microorganisms residing within the infected root canal system has always been the ultimate goal of endodontic treatment [ 1 ]. The successful rate of endodontic treatment is mainly composed of three main stages, including the removal of infected pulp tissues within the tooth [ 2 , 3 , 4 ], disinfection and shaping of the root canals, and lastly, the filling of the root canal chamber with inert materials [ 5 , 6 , 7 , 8 ]. Although each stage is equally important, the success rate of endodontic treatment is heavily dependent on the final stage [ 9 ].…”

Evaluation of Canal Transportation and Centering Ability of Curved Canal Prepared by Two Rotary Systems

“…Over the years, a diverse variety of Ni-Ti instruments for RC shaping has been introduced. Ni-Ti instruments have provided for safer, faster canal preparation and improved preservation of the original canal since their introduction into endodontics (13) . Instead of continuous rotation motion, a modern instrumentation technique was used, which used a single file in reciprocation motion (14) .…”