XP‐endo Finisher R instrument optimizes the removal of root filling remnants in oval‐shaped canals

Abstract

AimTo evaluate the performance of XP‐endo Finisher R instruments when removing root filling remnants from oval‐shaped canals using microcomputed tomographic (micro‐CT) imaging as the analytical tool. Passive ultrasonic irrigation (PUI) was used as a reference technique for comparison.MethodologyTwenty mandibular incisors with oval‐shaped canals were matched based on similar anatomic features of the canal (volume, aspect ratio and 3D configuration) after scanning procedures. The canals were prepared with Reciproc R25 instruments, filled with gutta‐percha and AH Plus sealer using the single‐cone technique and retreated up to a Reciproc R40 instrument. After retreatment procedures, the specimens were rescanned, and the homogeneity between the specimens, the oval‐shaped anatomy and the remaining filling material were confirmed. The pair‐matched samples were assigned to two experimental groups (n = 10), according to the supplementary approach used: XP‐endo Finisher R or PUI. Each sample was scanned after each endodontic procedure. The volume of remaining root filling material was quantified before and after the use of each supplementary approach. This analysis was performed considering the total canal (Student t‐test) and also by thirds (anova procedure followed by a Bonferroni correction). Data were analysed statistically with a significance level of 5%.ResultsThe volume of root filling material at baseline was similar between the groups (t‐test, P = 0.787). XP‐endo Finisher R removed significantly more root filling material compared to PUI (t‐test, P = 0.015), as it removed a mean of ≅32% material compared to 12% for the PUI. There was no difference in the amount of root filling material removed in the root canal thirds after using both supplementary approaches (one‐way anova, P = 0.07 for XP‐endo Finisher R and P = 0.886 for PUI).ConclusionsBoth supplementary approaches significantly reduced the volume of remaining root filling material from oval‐shaped canals. The XP‐endo Finisher R instrument removed significantly more root filling material than PUI. None of the supplementary approaches was able to render oval‐shaped canals completely free from remaining root filling material.

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

“…All of the included researches recorded a lower cleaning performance of the standard needle procedure than the other irrigation methods ( Table 3). The root filling material mean reduction (bacteria, AHTD, and organic tissues) obtained with XPF was equal to 63.84% [5,10,19,20,23,26]. Conventional needle irrigation and PUI guaranteed a mean reduction of 44.82% [10,19,23] and 64.12% [5,10,19,20,23], respectively.…”

“…The root filling material mean reduction (bacteria, AHTD, and organic tissues) obtained with XPF was equal to 63.84% [5,10,19,20,23,26]. Conventional needle irrigation and PUI guaranteed a mean reduction of 44.82% [10,19,23] and 64.12% [5,10,19,20,23], respectively. Azim et al [26] stated that the mean bacterial reduction in apical third (at 150 µm) was 70% using Er:YAG laser, 47% using EndoActivator, and 23% using XP-Endo Finisher, demonstrating that the irrigation protocol with the aid of erbium:yttrium-aluminium-garnet (Er:YAG) laser had the greatest disinfection efficacy at higher depths.…”

“…According to six of the included studies, the XP-Endo Finisher instrument (XPF) showed a greater root canal cleaning efficacy than the passive ultrasonic irrigation technique (PUI) [5,[15][16][17][18][19]. On the contrary, seven articles stated that the passive ultrasonic irrigation technique and XP-Endo Finisher showed no significant differences among them in removing root filling material from canal root, and that both protocols have a greater efficacy than conventional needle irrigation procedure (CNI) [10,12,[20][21][22][23][24].…”

“…Three studies used the BT-Race rotary system [15,17,29]. Reciproc rotary files were used by De-Deus et al [5,20], Gokturk et al [4,25], and by Zhao et al [23]. Turkaydin et al [18], Ulusoy et al [19], and Uygun et al [12] prepared the root canal system with the ProTaper Universal rotary system.…”

“…If residual intra-radicular infection occurs, a retreatment is required in order to eliminate the filling material and to reduce the presence of microorganisms. However, these goals are not always simple to achieve and may require adjunctive steps [5,6]. The only way to eliminate all of this type of debris is irrigation, a procedure that guarantees a positive impact on those areas of the canal system that cannot be reached by mechanical instruments [7].…”