Impact of needle insertion depth on the removal of hard‐tissue debris

Pérez, Renata; Neves, Aline de Almeida; Belladonna, Felipe Gonçalves; Silva, Emmanuel João Nogueira Leal; Souza, Erick Miranda; Fidel, Sandra Rivera; Versiani, Marco Aurélio; Lima, I.; Carvalho, Carla Rodrigues; De‐Deus, Gustavo

doi:10.1111/iej.12648

Cited by 46 publications

(37 citation statements)

References 39 publications

(106 reference statements)

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“…A recent micro‐CT study also demonstrated a significant influence of the needle insertion depth on the removal of AHTD from isthmus‐containing mesial root of mandibular molars (Perez et al . ). Positioning of the irrigation needle at 1 mm short of WL resulted in percentage levels of AHTD removal almost three times higher than an insertion depth of 5 mm from the WL (Perez et al .…”

Section: Discussionmentioning

confidence: 97%

“…Positioning of the irrigation needle at 1 mm short of WL resulted in percentage levels of AHTD removal almost three times higher than an insertion depth of 5 mm from the WL (Perez et al . ). However, no other studies are available comparing manual irrigation and different activation techniques for the removal of AHTD.…”

Section: Discussionmentioning

confidence: 97%

“…, Perez et al . ) to produce comparable amounts of debris before final irrigation. Thus, an average volume of ADHT after preparation of 7.9% was achieved which is within the range (3.4–10.1%) reported by previous studies (Paqué et al .…”

Section: Discussionmentioning

confidence: 99%

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Micro‐CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard‐tissue debris from isthmus‐containing mesial root canal systems of mandibular molars

et al. 2019

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Aim To evaluate the efficacy of sonically and ultrasonically activated irrigation on removal of accumulated hard‐tissue debris (AHTD) in mesial root canal systems of mandibular molars using micro‐computed tomographic (micro‐CT) analysis. Methodology Forty mesial roots of mandibular molars with two independent canals joined apically by an isthmus (Vertucci type II) were selected. The root canals were instrumented using Reciproc R25 instruments, and specimens were scanned at a resolution of 10.5 μm. Subsequently, n = 10 roots were assigned to each of the four final irrigation groups such that the group means and variances were almost identical: sonically activated irrigation with EndoActivator (EA) or EDDY (ED), ultrasonically activated irrigation (UAI) and manual irrigation without activation (MI). The final irrigation procedures were performed using a total of 5 mL 1% NaOCl and 5 mL 15% EDTA per canal over 5 min with activation time of 4 × 20 s. Reconstructed data sets were coregistered, and the mean percentage reduction of AHTD after final irrigation was compared statistically between groups using analysis of variance at a significance level set at 5%. Results A significant reduction of AHTD was achieved after final irrigation in all groups (P < 0.05), ranging from 44.1% to 66.8%. The vol% of debris after irrigation was 3.7 ± 1.9% for EA, 3.3 ± 2.3% for ED, 2.1 ± 1.6% for UAI and 4.4 ± 2.3% for MI, with no significant difference between groups (P > 0.05). Conclusions None of the final irrigation protocols completely removed AHTD from mesial root canal systems in extracted human mandibular molars. Sonically and ultrasonically activated irrigation performed no better compared to manual irrigation.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

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Micro‐CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard‐tissue debris from isthmus‐containing mesial root canal systems of mandibular molars

et al. 2019

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“…The lack of standardization in how the individual IATs were used does not allow for comparisons to be made between techniques. Factors such as insertion depths (Sedgley et al 2005, Boutsioukis et al 2010, Perez et al 2017, power intensities (Jiang et al 2011) andcanal taper (de Gregorio et al 2013) all impact the degree of smear layer and debris removal. Significant variations in these features as well as activation time and file type were found to be present in the studies included in this review (Table 5).…”

Section: Efficacy Of Individual Iatsmentioning

confidence: 99%

Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta‐analysis

et al. 2017

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Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. International Endodontic Journal.Aims To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). Methodology Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1 mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis.Results From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57 / SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53 / SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62 / SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1 mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. Conclusions IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.

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“…Although both techniques have very low spatial resolution (ranging from 100 to 1000 μm), radiographs have also de limitation of being a bidimensional evaluation. Moreover, major differences in the root canal anatomy among the used specimens (lack of paired specimens) may be a source of bias in evaluating the effectiveness of a certain technique in endodontic studies and for this reason, the use of prototypes, with individualized root canal anatomy may bring advantages in this regard. Finally, a detailed quantitative tridimensional analysis of voids and effectiveness of root canal obturation in primary teeth have not yet been performed.…”

Section: Introductionmentioning

confidence: 99%

Root canal obturation materials and filling techniques for primary teeth: In vitro evaluation in polymer‐based prototyped incisors

Aragão

Pintor

Marceliano-Alves

et al. 2019

Int J Paed Dentistry

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Background Achieving a void‐free root canal filling is a challenge in current clinical pulpectomy practice. Aim To compare filling effectiveness and internal voids of root filling materials and obturation techniques in resin‐prototyped primary incisors by micro‐CT. Design Fifty prototypes were instrumented and randomly divided (n = 10) according to the filling materials (Vitapex®, ZOE, Calcicur®, Feapex, and Calen®‐ZO) and obturation technique: lentulo or pressure syringe (n = 5). The specimens were micro‐CT scanned (pixel size = 7.83 μm) and reconstructed, and the total volume of filled canal (%FC) and internal voids (%IV) of the bulk filling material was calculated. Kruskal‐Wallis and Mann‐Whitney tests were used to detect differences and interactions among groups. Results Calen®‐ZO, Vitapex®, and ZOE showed similar %FC. Calcicur® showed lower %FC compared with Calen®‐ZO, Vitapex®, and ZOE (P < .05) but similar to Feapex. No statistically significant differences in %FC between lentulo or pressure syringe were disclosed. Regarding %IV, Vitapex®, and Calen®‐ZO performed better with syringe, although Calcicur® was better with lentulo. The number of voids in the obturation bulk was similar among materials, but always lower (P < .05) in syringe filled specimens. Conclusion Vitapex®, Calen®‐ZO, and ZOE outperformed Calcicur® and Feapex in %FC and if the syringe technique is used, %IV of the obturation bulk and presence of defects was lower.

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Impact of needle insertion depth on the removal of hard‐tissue debris

Abstract: The insertion depth of irrigation needles significantly influenced the removal of hard-tissue debris. A needle tip positioned 1 mm short of the WL resulted in percentage levels of hard-tissue debris removal almost three times higher than when positioned 5 mm from the WL.

Cited by 46 publications

References 39 publications

Micro‐CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard‐tissue debris from isthmus‐containing mesial root canal systems of mandibular molars

Micro‐CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard‐tissue debris from isthmus‐containing mesial root canal systems of mandibular molars

Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta‐analysis

Root canal obturation materials and filling techniques for primary teeth: In vitro evaluation in polymer‐based prototyped incisors

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