Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis

Liang, Ailin; Hy, Luo; Li, Baoyu; Huang, Yihua; Zhou, Xiaoyan; Zhang, Xufang; Gong, Qimei

doi:10.3390/jcm11206053

Cited by 10 publications

(5 citation statements)

References 93 publications

(149 reference statements)

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“…Various methods, such as the canal staining and clearing technique, spiral computed tomography (CT) thin-layer scanning, micro-CT, radiographic examination, cone-beam CT (CBCT), and dental operating microscope, have been employed for evaluating the root canal morphology [ 3 , 7 – 11 ]. CBCT has been used to assess the root canal morphology owing to its short exposure time, low cost compared to that of conventional CT, high resolution and accuracy, minimal distortion, three-dimensional visualization, and noninvasiveness [ 1 , 5 , 6 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Morphology and classification of the second mesiobuccal canal in maxillary first molars: a cone-beam computed tomography analysis in a Chinese population

Xiang,

Wu,

Yang

et al. 2024

BMC Oral Health

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Background Understanding the tooth anatomy is crucial for ensuring effective endodontic treatment. This study investigated the root canal morphology of the second mesiobuccal (MB2) canal in maxillary first molars (MFMs) in a Chinese population using cone-beam computed tomography (CBCT). Methods This study evaluated 486 MFMs with MB2 canals from 285 participants undergoing CBCT examination and determined the Vertucci’s classification and position of the MB2 canal orifice. The prevalence of the MB2 canal was correlated with the sex, age, and tooth side. The correlations between the prevalence of the MB2 canal and sex and tooth side were assessed using the Fisher's exact test. The chi-square test was used for evaluating the correlation between the prevalence of the MB2 canal and age. Results The number of type II, III, IV, V, VI, VII, and other root canals in the MFMs was 30.9%, 0.6%, 65.0%, 1.2%, 1.2%, 0.4%, and 0.6%, respectively. Among the 201 cases with bilateral inclusion, 87.6% showed consistent canal configuration. Results of the first clear apparent position (FCAP) of the MB2 canals showed that 434, 44, and 3 teeth had FCAP at the upper, middle, and bottom one-third of the root, respectively. The FCAPs of the MB2 canal in the MFMs with types II, IV, and VI, as well as types III and V canals showed significant differences (p<0.05). The horizontal distance between the MB1 and MB2 canal orifices in the type II canals of MFMs was significantly lesser than those in the type IV canals of MFMs (p < 0.01). The longitudinal distance between the pulp chamber floor plane and MB2 canal orifice significantly correlated with age (p < 0.05). Conclusions The morphology of the mesiobuccal root canal in the MFMs is complex. Complete understanding of the anatomical morphology of the root canal combined with the CBCT and dental operating microscope is necessary for the accurate detection of the MB2 canal and consequently improved success rate of root canal treatment. Our study findings can help endodontists improve endodontic treatment outcomes.

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Section: Introductionmentioning

confidence: 99%

Morphology and classification of the second mesiobuccal canal in maxillary first molars: a cone-beam computed tomography analysis in a Chinese population

Xiang,

Wu,

Yang

et al. 2024

BMC Oral Health

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“…Previous studies have shown that conventional irrigation, without using agitation methods, has low diffusion potential through the root canal system [13,14], leading to endodontic therapy failure.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a new endodontic irrigation system for removing smear layer and dissolving simulated organic matter

de Oliveira Neto,

de Souza Lima,

Titato

et al. 2023

Clin Oral Invest

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OBJECTIVES:The study aimed to evaluate the potential for dissolution of organic tissue in areas of simulated complexity and cleaning of root walls of the new iVac® endodontic irrigation system. MATERIAL AND METHODS: Thirty mandibular premolars were evaluated by scanning electron microscopy before and after biomechanical preparation. Then, they were distributed according to the nal irrigation protocol into groups with conventional irrigation, passive ultrasonic irrigation with metallic insert (PUI), and iVac® system, and new photomicrographs were obtained. For tissue dissolution analysis, glass capillaries lled with catgut were attached to the cervical and apical thirds of twenty prototyped upper incisors. They were weighed before and after the previously mentioned irrigation protocols. The data were statistically compared with a signi cance level of 5%. RESULTS:The nal irrigation provided greater cleaning of the walls in the cervical, middle, and apical thirds of the root canals (P<0.05), with no statistically signi cant difference between PUI and iVac®, regardless of the analyzed thirds. Both ultrasonic irrigation protocols dissolved a signi cantly greater volume than the conventional irrigation protocol (P<0.05), with no difference between the two protocols (P<0.05).CONCLUSIONS:The iVac® system showed wall cleaning and tissue dissolution similar to PUI with a metallic insert, and both were superior to conventional irrigation.CLINICAL RELEVANCE: The new irrigation system iVac is more effective than conventional irrigation and has similar wall cleaning and tissue dissolution to PUI.

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“…Recently, laser activated irrigation (LAI) became more popular in endodontic irrigation protocols and the benefits in terms of hard tissue and smear layer removal is evident (Liang et al., 2022). According to current systematic review, LAI is claimed to perform superior compared to ultrasonic activated irrigation in terms of removing microorganisms, dentine debris and smear layer from the root canal system (Badami et al., 2023).…”

Section: Introductionmentioning

confidence: 99%

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

Bürklein,

Abdi,

Schäfer

et al. 2023

Int Endodontic J

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AimTo investigate the influence of pulse energy, tip geometry and tip position in simulated 3D‐printed root canals with multiple side canals at different levels in all directions on the cleaning performance of laser‐activated irrigation (LAI) compared to sonic activation (EDDY) and conventional needle irrigation (NI).Methodology3D‐printed root canal models (25/.06, length 20 mm, curvature 60°, radius 5 mm) with side canals (diameter 0.2 mm) at 2, 5 and 8 mm from the apex were filled with coloured biofilm‐mimicking hydrogel. LAI (Morita AdvErL Evo, Kyoto, Japan) was performed with six settings (n = 20; pulse‐energy, pulses per second [PPS], tip position): LAI1 (50 mJ, 25 PPS, P400FL, canal entrance [CE]), LAI2 (same as LAI1, but insertion depth 9 mm before the apical endpoint [AE] [corresponding to 1 mm above the first lateral canals]), LAI3 (80 mJ, 25 PPS, P400FL, 9 mm before AE), LAI4 (same as LAI 3, but at CE) for 3 × 20 s each, LAI5 (50 mJ, 25 PPS, P400FL 2 × 20 s, CE & R200T (30 mJ, 25 PPS, 1 × 20 s, 9 mm before AE), LAI6 (30 mJ, 25 PPS, R200T, 9 mm before AE, 3 × 20 s). A continuous irrigation (3 mL/20 s) using distilled water accompanied the irrigation cycles. NI and EDDY (3 × 20 s each; 3 mL/20 s irrigation, insertion AE minus 1 mm, amplitude 4 mm) served as control groups. Biofilm‐mimicking hydrogel removal (ImageJ, NIH) was assessed for the entire system, the central canal and the lateral canals using standardized photographs with a microscope (Expert DN, Müller‐Optronic) and statistically analysed was performed using Kruskal–Wallis and Dunn tests (p = .05). Irrigant extrusion beyond the foramina was also recorded.ResultsLAI2 (99.08%; interquartile range [IQR]: 96.85–100.00) and LAI3 (97.50%; 96.24–100.00) achieved the significantly best and LAI6 (80.08%; 73.41–84.69) the significantly worst removal of hydrogel from the entire root canal system amongst all LAI configurations (p < .05). There were no significant differences between LAI6, EDDY (72.89%; 67.49–76.22) and manual irrigation (54.39%; 51.01–56.94) (p > .05). R200T laser tip caused significantly more often irrigant extrusion than all other techniques (p < .05).ConclusionTip design, energy settings, and the positioning of the laser tip below the canal entrance caused an improvement in cleaning performance of the LAI. However, the small R200T tip created significantly more procedural errors (irrigant extrusion) due to higher concentrated energy.

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Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 93 publications

Morphology and classification of the second mesiobuccal canal in maxillary first molars: a cone-beam computed tomography analysis in a Chinese population

Morphology and classification of the second mesiobuccal canal in maxillary first molars: a cone-beam computed tomography analysis in a Chinese population

Effectiveness of a new endodontic irrigation system for removing smear layer and dissolving simulated organic matter

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

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