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

Abstract

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.

Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery

“…The quantity of tissue debris present in each section was graded by two independent, blinded, calibrated operators (D.A, R.F) established on the following criteria: grade 1: the existence of debris all over the area, grade 2: the presence of debris more increased than 50% of the entire area, grade 3: the existence of debris higher than 25% of the complete area, and grade 4: absence of debris or less than 25% throughout the area ( Table 1 ) [ 14 ].…”

Smear Layer and Debris Removal from Root Canals Comparing Traditional Syringe Irrigation and 3D Cleaning: An Ex Vivo Study

“…As specified by the input gained from a systematic review, endodontic treatment outcomes are enhanced if the smear layer is eliminated [ 3 ]. Furthermore, prior studies have investigated the implication of chemo-mechanical debridement strategies in clearing the smear layer’s attached inorganic and organic contents [ 11 , 12 ]. With this in mind, a standard smear layer removal protocol was proposed by applying sodium hypochlorite (NaOCl) pursued by ethylenediaminetetraacetic acid (EDTA) for 1 min [ 13 ].…”

Two-Year Healing Success Rates after Endodontic Treatment Using 3D Cleaning Technique: A Prospective Multicenter Clinical Study

“…Regardless, the rapid buffering of the heat under in vivo conditions may render this technique rather ineffective compared to the results of in vitro studies. An alternative approach is intracanal or internal heating, wherein sodium hypochlorite within root canals is heated using heat carrier tips [ 9 ].…”

“…Furthermore, an interesting recent study showed an interesting finding that intracanal heating of NaOCl resulted in significantly less debris on the root canal walls compared to irrigation with pre-heated NaOCl [ 4 ]. Other studies showed how internal heating combined with ultrasonic activation is considered an effective technique [ 4 , 9 ]. Specifically, this approach (internal heating + ultrasonic activation) is named 3D cleaning.…”