Efficacy of 3 Supplementary Irrigation Protocols in the Removal of Hard Tissue Debris from the Mesial Root Canal System of Mandibular Molars

Chan, Rebecca Wing-Yan; Versiani, Marco Aurélio; Friedman, Shimon; Malkhassian, Gevik; Sousa‐Neto, Manoel Damião; Leoni, Graziela Bianchi; Silva‐Sousa, Yara Teresinha Corrêa; Basrani, Bettina

doi:10.1016/j.joen.2019.03.013

Cited by 40 publications

(43 citation statements)

References 34 publications

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“…7 Despite the limitations of this study, it is acceptable to recommend the use of magnification for better visualization of the isthmus in both dental groups, as well as additional cleaning methods and irrigation solution activation, as previously described, improving disinfection in untouched areas in the RCS. 9,27,33,34 Some studies have evaluated the best cleaning protocols for mandibular molars 19,34 and premolars. 33 However, the present study points to the need to investigate the maxillary first molars, due to their complex internal anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…7 Isthmus may occur in the MB root because of the relationship between MB1 and MB2 canals. 8,9 These critical zones retain microorganisms in the root canal system (RCS) and are frequently associated with apical periodontitis due to the difficulty in accessing them during cleaning, shaping, and filling procedures. 7,10,11,12 Furthermore, the position of the major apical foramen in relation to the anatomic apex is highly variable in the MB2 canal.…”

Section: Introductionmentioning

confidence: 99%

“…2,5,13,14 Most recently, several micro-CT studies on the anatomical complexity of the RCS have been used as the basis for the development of more efficient methods and protocols for irrigating solutions applied in mandibular molars. 7,9,17,18,19 However, there is a gap in the literature about the investigation into the isthmus and apical anatomy of maxillary molars using micro-CT. 12,20,21 This micro-CT study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of MB2 and some aspects of the internal anatomy of the MB root, including isthmus and the apical canal system anatomy.…”

Section: Introductionmentioning

confidence: 99%

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Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

et al. 2021

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“…It also has substantial organic dissolving capacity (Tartari et al 2015, Tejada et al 2019 and antimicrobial activity against dentine surface biofilms and inside dentinal tubules (Arias-Moliz et al 2014, Morago et al 2019, this activity being enhanced when activated by various methods that include ultrasonic activation (Neelakantan et al 2015). The protocol of three irrigating solution activations for 20 s was performed instead of continuous irrigation and agitation, as it facilitates the renewal of the solution and provides for better cleaning of the canal apical third and isthmus , Duque et al 2017, Chan et al 2019.…”

Section: Discussionmentioning

confidence: 99%

A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid

et al. 2020

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AimTo evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP‐endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth.MethodologyFifty‐six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP‐endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P‐value calculations).ResultsRoot canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP‐endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP‐endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses.ConclusionsIn this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP‐endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.

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“…Several other studies using the same irrigating solutions, usually sodium hypochlorite associated with EDTA, but with different activating protocols also demonstrated the influence of the activation protocol in the removal of accumulated hard tissue debris from root canals (Chan et al . 2019, De‐Deus et al . 2019, Silva et al .…”

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confidence: 99%

Response to the letter to the editor‐ Is EDTA the protagonist for the enhancement of accumulated hard tissue debris removal from root canals?

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et al. 2020

Int Endodontic J

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Efficacy of 3 Supplementary Irrigation Protocols in the Removal of Hard Tissue Debris from the Mesial Root Canal System of Mandibular Molars

Cited by 40 publications

References 34 publications

Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid

Response to the letter to the editor‐ Is EDTA the protagonist for the enhancement of accumulated hard tissue debris removal from root canals?

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