Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review

Lauritano, D; Moreo, Giulia; Vella, Fedora Della; Spirito, Federica Di; Sbordone, Ludovico; Petruzzi, Massimo

doi:10.3390/app9235001

Cited by 12 publications

(8 citation statements)

References 28 publications

(87 reference statements)

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“…It is well established that contemporary mechanical preparation strategies are not able to adequately reach root canal walls, thus leaving residual tissue and microbial residues inside the root canal system [19][20][21][22][23][24], and, consequently, negatively affect endodontic treatment outcomes, secondary to potential persistent infection and re-infection [17]. Therefore, it appears essential to improve irrigation procedure to subdue the inadequacy of current instrumentation techniques.…”

Section: Discussionmentioning

confidence: 99%

Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis

et al. 2022

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Background and Objectives: The endodontic space is a complex area on both micro and macro levels; therefore, traditional irrigation techniques may not guarantee a complete cleaning of such a complicated tridimensional system. The presented ex vivo study aimed to evaluate root canal cleanliness, obtained through an equal volume of traditionally applied sodium hypochlorite (NaOCl), compared to ultrasonically activated NaOCl and ultrasonically activated NaOCl that had undergone intracanal heating NaOCl. Materials and Methods: A total of 60 freshly extracted human mandibular premolars underwent root sample length standardization (18 mm), root canal preparation and, based on the irrigation method employed, were randomly and equally assigned to three study groups, composed of root samples treated with ultrasonically activated NaOCl, ultrasonically activated NaOCl that had undergone intracanal heating and traditionally applied NaOCl. The root specimens were subsequently fixated with 4% buffered formalin solution and decalcified in Morse liquid. A total often 6-micron-thick serial cross-sections were obtained, dyed using hematoxylin and eosin and examined through an optical microscope at 40×, 100×, and 200×. Results: Ultrasonically activated NaOCl that had undergone intracanal heating showed a significantly smaller amount of debris compared to ultrasonically activated and traditionally applied NaOCl groups (p value < 0.05). Conclusions: Root canal cleanliness saw significant enhancements by ultrasonically activated NaOCl that had undergone intracanal heating.

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Section: Discussionmentioning

confidence: 99%

Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis

et al. 2022

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“…After de-duplication, we browsed titles and abstracts of the remaining 770 studies, and we excluded 752 articles. Among the excluded studies, nine were reviews or meta-analysis [42][43][44][45][46][47][48][49][50], four compared the effectiveness of PUI with XPF on removing hardtissue debris or smear layer [51][52][53][54], three evaluated the efficacy on biofilm or bacteria removal when using the two techniques [55][56][57], one focused on post-operative pain of root canal treatment using the PUI versus XPF [58]. Moreover, 13 studies did not investigate the effectiveness of XPF on intracanal medicaments removal, 45 articles examined the efficacy of PUI on hard-tissue debris, smear layer, root filling remnants, bacteria, or biofilm removal.…”

Section: Literature Selectionmentioning

confidence: 99%

“…A wide array of studies compared the efficacy of PUI with that of XPF, and their results showed clear controversy [ 26 , 30 , 33 ]. A systematic review by Lauritano et al revealed that it was still unclear whether XPF could outperform PUI in terms of intracanal medicaments removal [ 34 ]. To sum up, most researchers regarded the PUI as the gold standard for irrigation in the past.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis

2021

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Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

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“…After de-duplication, we browsed titles and abstracts of the remaining 770 studies, and we excluded 752 articles. Among the excluded studies, nine were reviews or meta-analysis [43][44][45][46][47][48][49][50][51], four compared the effectiveness of PUI with XPF on removing hard-tissue debris or smear layer [52][53][54][55], three evaluated the e cacy on bio lm or bacteria removal when using the two techniques [56][57][58], one focused on post-operative pain of root canal treatment using the PUI versus XPF [59]. Moreover, 13 studies did not investigate the effectiveness of XPF on intracanal medicaments removal, 45 articles examined the e cacy of PUI on hard-tissue debris, smear layer, root lling remnants, bacteria, or bio lm removal.…”

Section: Literature Selectionmentioning

confidence: 99%

“…A wide array of studies compared the e cacy of PUI with that of XPF, and their results showed clear controversy [27,31,34]. A systematic review by Lauritano et al revealed that it was still unclear whether XPF could outperform PUI in terms of intracanal medicaments removal [35]. Therefore, our purpose is to quantitatively compare the e cacy of XPF with that of PUI in removing intracanal medicaments.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of XP-Endo Finisher and Passive Ultrasonic Irrigation on Intracanal Medicament Removal From Root Canals: a Systematic Review and Meta-analysis

Zhou¹,

Liu²,

Guo³

2021

Preprint

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Background: XP-Endo finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias.Results: Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96-4.86; P < 0.001). In subgroup analysis, when anatomical areas were focused on the apical third region of the canal, PUI was also significantly more effective than XPF (OR: 3.42; 95% CI, 1.32-8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79-9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74-3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71-16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74-3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44-4.61; P = 0.56). Conclusions: PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. More large-scale and high-quality trials are warranted to validate the conclusions.

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Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review

Cited by 12 publications

References 28 publications

Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis

Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis

Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis

Effectiveness of XP-Endo Finisher and Passive Ultrasonic Irrigation on Intracanal Medicament Removal From Root Canals: a Systematic Review and Meta-analysis

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