CLEANING EFFICACY OF DIFFERENT FINAL IRRIGATION ACTIVATION TECHNIQUES
Keywords:
Debris, Diode laser, Irrigation activation ,Gentle file brush, Smear layer, Sodium hypochlorite, XP Endo Finisher
Abstract
Purpose: The cleaning effectiveness of ultrasonic, diode laser, XP endo finisher, and finsher gentlefile brush was assessed and compared.
Methods: 40 single-rooted mandibular premolars extracted and decoronated to a coronal length of 12 mm to the apex, biomechanically instrumented with protaper Next up to size X3. The roots were then randomly divided into four groups (n=10) and received a final irrigation and activation. GI: Ultrasonic system activated the final irrigant, GII: 980-nm diode laser, GIII: Xp-endo finisher, GIV: Finisher gentle file-brush. Under a scanning electron microscope, the teeth were longitudinally sectioned into two halves and scored. To compare groups, the Kruskal-Wallis Test was used, and P 0.05 was regarded as statistically significant.
Results: Finisher gentle file brush was most efficient in removing the smear layer, with a statistically significant difference with Diode laser (p<0.0037) and XP EndoFinisher (p<0.0198). There was no statistically significant difference in the Debris removal between all groups.
Conclusions: No irrigation activation technique was able to eliminate debris and smear layer completely from root canals. The Finisher gentle file brush was most efficient in removing smear layer. Diode laser showed the least smear layer removal
Downloads
Download data is not yet available.
References
Abraham, S., Vaswani, S. D., Najan, H. B., Mehta, D. L., Kamble, A. B., & Chaudhari, S. D. (2019). Scanning electron microscopic evaluation of smear layer removal at the apical third of root canals using diode laser, endoActivator, and ultrasonics with chitosan: An in vitro study. Journal of conservative dentistry: JCD, 22(2), 149.
Alakshar, A., Saleh, A. R. M., & Gorduysus, M. O. (2020). Debris and smear layer removal from oval root canals comparing XP-Endo Finisher, EndoActivator, and manual irrigation: A SEM evaluation. European Journal of Dentistry, 14(04), 626-633.
Al-baker, H. S., & Al-Huwaizi, H. F. (2021). Efficacy of Smear Layer Removal from Root Canal Surface Using: Sonic, Ultrasonic, Different Lasers as Activation Methods of Irrigant (SEM study). Journal of Research in Medical and Dental Science, 9(5), 65-72.
Ali, S. A., Hussain, M., Shah, H., & Khan, H. (2018). Smear layer removal efficacy of conventional endodontic irrigants v/s phytochemical extracts-an in vitro study. Pakistan Oral & Dental Journal, 38(2), 254-258.
Al-Karadaghi, T. S., Franzen, R., Jawad, H. A., & Gutknecht, N. (2015). Investigations of radicular dentin permeability and ultrastructural changes after irradiation with Er, Cr: YSGG laser and dual wavelength (2780 and 940 nm) laser. Lasers in medical science, 30(8), 2115-2121.
Al-Mafrachi, R. M., Awazli, L. G., & Al-Maliky, M. A. (2018). The Effect of using 940 nm Diode Laser in Comparison with Endoactivator on Radicular Dentin Permeability and Smear Layer Removal (An in Vitro Study). Iraqi Journal of Laser, 17(B), 9-15.
Andreani, Y., Gad, B. T., Cocks, T. C., Harrison, J., Keresztes, M. E., Pomfret, J. K., ... & Rahimi, M. (2021). Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals.(Smear layer removal from irrigant activation using SEM). Australian Endodontic Journal, 47(2), 143-149.
Arslan, H., Ayrancı, L. B., Karatas, E., Topcuoğlu, H. S., Yavuz, M. S. & Kesim, B. (2013). Effect of agitation of EDTA with 808-nanometer diode laser on removal of smear layer. Journal of endodontics, 39, 1589-1592.
Azimian, S., Bakhtiar ,H., Azimi ,S., Esnaashari, E.(2019). In vitro effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls. Dental research journal,16(3),179
Bao, P., Shen, Y., Lin, J. & Haapasalo, M. (2017). In vitro efficacy of XPendo Finisher with 2 different protocols on biofilm removal from apical root canals. Journal of endodontics, 43, 321-325.
Bitter, K., Vlassakidis, A., Niepel, M., Hoedke, D., Schulze, J., Neumann, K., ... & Noetzel, J. (2017). Effects of diode laser, gaseous ozone, and medical dressings on Enterococcus faecalis biofilms in the root canal ex vivo. BioMed research international, 2017.
Castagna, F., Rizzon, P., Da rosa, R. A., Santini, M. F., Barreto, M. S., Hungaro duarte, M. A. & Reis so, M. V. (2013.) Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal—a SEM analysis. Microscopy research and technique, 76, 496-502
De-Deus, G., Belladonna, F. G., de Siqueira Zuolo, A., Perez, R., Carvalho, M. S., Souza, E. M., ... & Silva, E. J. N. L. (2019). Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals. Clinical oral investigations, 23(7), 3087-3093.
Elsawaf GH, Dwedar RA, Emara RS. Antibacterial efficacy of sodium hypochlorite at different temperatures against E. faecalis in Single Rooted Teeth.
Grinkevičiūtė, P., Povilaitytė, G. & Siudikienė, J. (2019). The Effect Of Laser Irradiation In Smear Layer Removal –A Review Of The Literature. European International Journal of Science and Technology, 8(3), 72-84.72
Gutmann, J.L., Saunders, W.P., Nguyen, L., Guo, I.Y., Saunders, E.M., (1994). Ultrasonic root‐end preparation Part 1. SEM analysis. Int. Endod. J.; 27: 318–324.
Hülsmann M., Peters O.A., Dummer P.M.H (2005). Mechanical preparation of root canals: shaping goals, techniques and means. Endodontic Topics, 10, 30- 76. J, 210(5),242.
Jayakumaar A, Ganesh A, Kalaiselvam R, Rajan M, Deivanayagam K.(2019). Evaluation of debris and smear layer removal with XP-Endo finisher: A scanning electron microscopic study. Indian Journal of Dental Research,30(3),420.
Jiang, L.-M., Verhaagen, B., Versluis, M., Langedijk, J., Wesselink, P. & Van der sluis, L. W. (2011). The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. Journal of endodontics, 37, 688-69.
Kamaci, A., Aydin, B., & Erdilek, N. (2018). The effect of ultrasonically activated irrigation and laser based root canal irrigation methods on debris removal. The International Journal of Artificial Organs, 41(2), 71-75.
Khaleefah, F. J., & Abdul-Ameer, Z. M. (2020). The Effect of Different Endodontics Irrigant Activators on Removal of Debris and Smear Layer from Root Canal Dentin (An In Vitro Study). International Medical Journal; 25( 04).
Leoni GB, Versiani MA, Silva‐Sousa YT, Bruniera JF, Pécora JD, Sousa‐Neto MD (2017.) Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root cana Malki, M., Verhaagen, B., Jiang, L.-M., Nehme, W., Naaman, A., Versluis, M., Wesselink, P. & Van der sluis, L. (2012). Irrigant flow beyond the insertion depth of an ultrasonically oscillating file in straight and curved root canals: visualization and cleaning efficacy. Journal of endodontics, 38, 657-661.l system of mandibular first molars. International endodontic journal, 50, 398-406
Mancini, M., Cerroni, L., Iorio, L., Armellin, E., Conte, G. & CianconI, L.( 2013). Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. Journal of endodontics, 39, 1456-1460.
Manjunath P, Sujatha I, Jayalakshmi KB, Nadig P, Shetty S, Joseph MA. (2021).Efficacy of Different Irrigating Systems on Debris and Smear Layer Removal: A Scanning Electron Microscopic Study. RGUHS Journal of Dental Sciences, 13(4).
Nair, S. G., Saraf, P. A., Metri, M. S., & Kar, P. P.(2019). Comparative Evaluation of Smear Layer Removal Using Gutta Percha, Ultrasonic, Sonic, Plastic Finishing File and Canal Brush Methods: A Scanning Electron Microscope Study, 8 ( 12) .
Neelakantan, P., Khan, K., Li, K. Y., Shetty, H., & Xi, W. (2018). Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments. International endodontic journal, 51(7), 800-807.
Ruddle, C. J., Machtou, P., & West, J. D. (2013). The shaping movement 5th generation technology. Dent Today, 32(4), 94.
Ruddle, C. J. (2002). Cleaning and shaping the root canal system. Pathways of the Pulp; 231-91.
SA, F. D. 2016. The XP Endo Finisher File Brochure.
Sanabria-Liviac D, Moldauer BI, Garcia-Godoy F, Antonio-Campos A, Casaretto M, Torres-Navarro J, Scalercio JM .(2017). Comparison of the XP-Endo Finisher file system and passive ultrasonic irrigation (PUI) on smear layer removal after root canal instrumentation. Journal of DentaL Oral Health,4,1-7
Saraswathi MV, Ballal NV, Padinjaral I, Bhat S.(2012). Ultra morphological changes of root canal dentin induced by 940 nm diode laser: An in-vitro study. Saudi Endodontic Journal ,2(3),131.
Tay, F. R., Gu, L. S., Schoeffel, G. J., Wimmer, C., Susin, L., Zhang, K., ... & Pashley, D. H. (2010). Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. Journal of endodontics, 36(4), 745-750
Violich D.R., Chandler ,N.P. (2010) .The smear layer in endodontics – a review. International Endodontic Journal . 43(1),2-15. [DOI: 10.1111/j.1365-2591.2009.01627.x] [PMID: 20002799]
Wagner MH, Da Rosa RA, de Figueiredo JA, Duarte MA, Pereira JR, Só MV. (2017).Final irrigation protocols may affect intraradicular dentin ultrastructure. Clinical oral investigations,21(7),2173-82
Zhang, R., Chen, M., Lu, Y., Guo, X., Qiao, F., & Wu, L. (2015). Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix. Scientific reports, 5(1), 1-5.
Živković, S., Nešković, J., Jovanović-Medojević, M., Popović-Bajić, M., & Živković-Sandić, M. (2015). XP-endo Finisher: a new solution for smear layer removal. Stomatološki glasnik Srbije, 62(3), 122-129.
Alakshar, A., Saleh, A. R. M., & Gorduysus, M. O. (2020). Debris and smear layer removal from oval root canals comparing XP-Endo Finisher, EndoActivator, and manual irrigation: A SEM evaluation. European Journal of Dentistry, 14(04), 626-633.
Al-baker, H. S., & Al-Huwaizi, H. F. (2021). Efficacy of Smear Layer Removal from Root Canal Surface Using: Sonic, Ultrasonic, Different Lasers as Activation Methods of Irrigant (SEM study). Journal of Research in Medical and Dental Science, 9(5), 65-72.
Ali, S. A., Hussain, M., Shah, H., & Khan, H. (2018). Smear layer removal efficacy of conventional endodontic irrigants v/s phytochemical extracts-an in vitro study. Pakistan Oral & Dental Journal, 38(2), 254-258.
Al-Karadaghi, T. S., Franzen, R., Jawad, H. A., & Gutknecht, N. (2015). Investigations of radicular dentin permeability and ultrastructural changes after irradiation with Er, Cr: YSGG laser and dual wavelength (2780 and 940 nm) laser. Lasers in medical science, 30(8), 2115-2121.
Al-Mafrachi, R. M., Awazli, L. G., & Al-Maliky, M. A. (2018). The Effect of using 940 nm Diode Laser in Comparison with Endoactivator on Radicular Dentin Permeability and Smear Layer Removal (An in Vitro Study). Iraqi Journal of Laser, 17(B), 9-15.
Andreani, Y., Gad, B. T., Cocks, T. C., Harrison, J., Keresztes, M. E., Pomfret, J. K., ... & Rahimi, M. (2021). Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals.(Smear layer removal from irrigant activation using SEM). Australian Endodontic Journal, 47(2), 143-149.
Arslan, H., Ayrancı, L. B., Karatas, E., Topcuoğlu, H. S., Yavuz, M. S. & Kesim, B. (2013). Effect of agitation of EDTA with 808-nanometer diode laser on removal of smear layer. Journal of endodontics, 39, 1589-1592.
Azimian, S., Bakhtiar ,H., Azimi ,S., Esnaashari, E.(2019). In vitro effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls. Dental research journal,16(3),179
Bao, P., Shen, Y., Lin, J. & Haapasalo, M. (2017). In vitro efficacy of XPendo Finisher with 2 different protocols on biofilm removal from apical root canals. Journal of endodontics, 43, 321-325.
Bitter, K., Vlassakidis, A., Niepel, M., Hoedke, D., Schulze, J., Neumann, K., ... & Noetzel, J. (2017). Effects of diode laser, gaseous ozone, and medical dressings on Enterococcus faecalis biofilms in the root canal ex vivo. BioMed research international, 2017.
Castagna, F., Rizzon, P., Da rosa, R. A., Santini, M. F., Barreto, M. S., Hungaro duarte, M. A. & Reis so, M. V. (2013.) Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal—a SEM analysis. Microscopy research and technique, 76, 496-502
De-Deus, G., Belladonna, F. G., de Siqueira Zuolo, A., Perez, R., Carvalho, M. S., Souza, E. M., ... & Silva, E. J. N. L. (2019). Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals. Clinical oral investigations, 23(7), 3087-3093.
Elsawaf GH, Dwedar RA, Emara RS. Antibacterial efficacy of sodium hypochlorite at different temperatures against E. faecalis in Single Rooted Teeth.
Grinkevičiūtė, P., Povilaitytė, G. & Siudikienė, J. (2019). The Effect Of Laser Irradiation In Smear Layer Removal –A Review Of The Literature. European International Journal of Science and Technology, 8(3), 72-84.72
Gutmann, J.L., Saunders, W.P., Nguyen, L., Guo, I.Y., Saunders, E.M., (1994). Ultrasonic root‐end preparation Part 1. SEM analysis. Int. Endod. J.; 27: 318–324.
Hülsmann M., Peters O.A., Dummer P.M.H (2005). Mechanical preparation of root canals: shaping goals, techniques and means. Endodontic Topics, 10, 30- 76. J, 210(5),242.
Jayakumaar A, Ganesh A, Kalaiselvam R, Rajan M, Deivanayagam K.(2019). Evaluation of debris and smear layer removal with XP-Endo finisher: A scanning electron microscopic study. Indian Journal of Dental Research,30(3),420.
Jiang, L.-M., Verhaagen, B., Versluis, M., Langedijk, J., Wesselink, P. & Van der sluis, L. W. (2011). The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. Journal of endodontics, 37, 688-69.
Kamaci, A., Aydin, B., & Erdilek, N. (2018). The effect of ultrasonically activated irrigation and laser based root canal irrigation methods on debris removal. The International Journal of Artificial Organs, 41(2), 71-75.
Khaleefah, F. J., & Abdul-Ameer, Z. M. (2020). The Effect of Different Endodontics Irrigant Activators on Removal of Debris and Smear Layer from Root Canal Dentin (An In Vitro Study). International Medical Journal; 25( 04).
Leoni GB, Versiani MA, Silva‐Sousa YT, Bruniera JF, Pécora JD, Sousa‐Neto MD (2017.) Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root cana Malki, M., Verhaagen, B., Jiang, L.-M., Nehme, W., Naaman, A., Versluis, M., Wesselink, P. & Van der sluis, L. (2012). Irrigant flow beyond the insertion depth of an ultrasonically oscillating file in straight and curved root canals: visualization and cleaning efficacy. Journal of endodontics, 38, 657-661.l system of mandibular first molars. International endodontic journal, 50, 398-406
Mancini, M., Cerroni, L., Iorio, L., Armellin, E., Conte, G. & CianconI, L.( 2013). Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. Journal of endodontics, 39, 1456-1460.
Manjunath P, Sujatha I, Jayalakshmi KB, Nadig P, Shetty S, Joseph MA. (2021).Efficacy of Different Irrigating Systems on Debris and Smear Layer Removal: A Scanning Electron Microscopic Study. RGUHS Journal of Dental Sciences, 13(4).
Nair, S. G., Saraf, P. A., Metri, M. S., & Kar, P. P.(2019). Comparative Evaluation of Smear Layer Removal Using Gutta Percha, Ultrasonic, Sonic, Plastic Finishing File and Canal Brush Methods: A Scanning Electron Microscope Study, 8 ( 12) .
Neelakantan, P., Khan, K., Li, K. Y., Shetty, H., & Xi, W. (2018). Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments. International endodontic journal, 51(7), 800-807.
Ruddle, C. J., Machtou, P., & West, J. D. (2013). The shaping movement 5th generation technology. Dent Today, 32(4), 94.
Ruddle, C. J. (2002). Cleaning and shaping the root canal system. Pathways of the Pulp; 231-91.
SA, F. D. 2016. The XP Endo Finisher File Brochure.
Sanabria-Liviac D, Moldauer BI, Garcia-Godoy F, Antonio-Campos A, Casaretto M, Torres-Navarro J, Scalercio JM .(2017). Comparison of the XP-Endo Finisher file system and passive ultrasonic irrigation (PUI) on smear layer removal after root canal instrumentation. Journal of DentaL Oral Health,4,1-7
Saraswathi MV, Ballal NV, Padinjaral I, Bhat S.(2012). Ultra morphological changes of root canal dentin induced by 940 nm diode laser: An in-vitro study. Saudi Endodontic Journal ,2(3),131.
Tay, F. R., Gu, L. S., Schoeffel, G. J., Wimmer, C., Susin, L., Zhang, K., ... & Pashley, D. H. (2010). Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. Journal of endodontics, 36(4), 745-750
Violich D.R., Chandler ,N.P. (2010) .The smear layer in endodontics – a review. International Endodontic Journal . 43(1),2-15. [DOI: 10.1111/j.1365-2591.2009.01627.x] [PMID: 20002799]
Wagner MH, Da Rosa RA, de Figueiredo JA, Duarte MA, Pereira JR, Só MV. (2017).Final irrigation protocols may affect intraradicular dentin ultrastructure. Clinical oral investigations,21(7),2173-82
Zhang, R., Chen, M., Lu, Y., Guo, X., Qiao, F., & Wu, L. (2015). Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix. Scientific reports, 5(1), 1-5.
Živković, S., Nešković, J., Jovanović-Medojević, M., Popović-Bajić, M., & Živković-Sandić, M. (2015). XP-endo Finisher: a new solution for smear layer removal. Stomatološki glasnik Srbije, 62(3), 122-129.
Published
2023-05-04
How to Cite
MUSTAFA, B. M., & SELIVANY, B. J. (2023). CLEANING EFFICACY OF DIFFERENT FINAL IRRIGATION ACTIVATION TECHNIQUES. Journal of Duhok University, 26(1), 109-117. https://doi.org/10.26682/sjuod.2023.26.1.11
Section
Pure and Engineering Sciences
It is the policy of the Journal of Duhok University to own the copyright of the technical contributions. It publishes and facilitates the appropriate re-utilize of the published materials by others. Photocopying is permitted with credit and referring to the source for individuals use.
Copyright © 2017. All Rights Reserved.
