Efficacy of finisher files in the removal of calcium hydroxide paste from the root canal system – preliminary results
Keywords:Brush-Finisher, calcium hydroxide, radiovisiography, rinsing activation, XP-endo Finisher
Introduction. Successful endodontic treatment is affected by a number of factors associated with the disinfection and filling of the root canal. The chemical-mechanical root canal preparation consists in a thorough removal of any content from the pulp space, including inflamed pulp, bacteria, as well as canal filling materials.
Aim. The aim of the study was to analyse the efficacy of the XP-endo Finisher and the Brush-Finisher on the removal of a calcium hydroxide dressing.
Material and Methods. The study was conducted using extracted single-rooted human teeth prepared according to sample standardization. Calcium hydroxide with iodoform was inserted into the canals. After two weeks, canal cleaning was performed with the use of 2% sodium hypochlorite solution and both finisher files. A conventional endodontic needle and syringe (SNI) were used in the control group. Following rinsing activation, two projection radiographs were performed and uploaded to software developed specifically for the study. The graphic files were evaluated in terms of the remaining amount of dressing. In order to analyse whether the percentage of the canal area that remained untreated was statistically significant, the Kruskal-Wallis ANOVA test with Dunn’s post-hoc test were employed.
Results. The intracanal dressing was most effectively removed in the XP-endo Finisher group (in both projections 96.32% and 91.35%), and its removal was considerably better than that in the control group (p<0.0001), although not significantly different from the Brush-Finisher group (89.68% and 81.85%).
Conclusions. Supplementary irrigant activation with either the XP-endo Finisher or the Brush-Finisher improved the removal of calcium hydroxide from the root canal walls.
Kim S, Kim Y. Influence of calcium hydroxide intracanal medication on apical seal. Int Endod J 2002;35:623-80.
Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009;35:791‑804.
Chala S, Abouqal R, Rida S. Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endodod 2011;112:36-42.
Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011;44:697–730.
Böttcher DE, Hirai VHG, Neto UXDS, Grecca FS. Effect of calcium hydroxide dressing on the long-term sealing ability of two different endodontic sealers: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:386-9.
Uygun AD, Gündoğdu EC, Arslan H, Ersoy I. Efficacy of XP-endo finisher and TRUS hape 3D conforming file compared to conventional and ultrasonic irrigation in removing calcium hydroxide. Aust Endod J 2017;43.2:89-93.
Neelakantan P, Khan K, Li KY, Shetty H, Xi W. 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. Int Endod J 2018;51:800-7.
De-Deus G, Belladonna FG, Zuolo AS, Cavalcante DM, Carvalhal JCA, Simões-Carvalho M et al. XP-endo Finisher R instrument optimizes the removal of root filling remnants in oval-shaped canals. Int Endod J 2019;52.6:899-907.
Capar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA. Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod 2014;40:451–54.
Lee SJ, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different-sized simulated plastic root canals. Int Endod J 2004;37:607–12.
Rödig T, Hirschleb M, Zapf A, Hülsmann M. Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals. Int Endod J 2011;44:1155-61.
Nandini S, Velmurugan V, Kandaswamy D. Removal efficiency of calcium hydroxide intracanal medicament with two calcium chelators: Volumetric analysis using spiral CT, an in vitro study. J Endod 2006;32:1097–101.
Zhao Y, Fan W, Xu T, Tay FR, Gutmann JL, Fan B. Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C-shaped canals. Int Endod J 2019;52:1354-65.
Swimberghe RCD, De Clercq A, De Moor RJG, Meire MA. Efficacy of sonically, ultrasonically and laser-activated irrigation in removing a biofilm-mimicking hydrogel from an isthmus model. Int Endod J 2019;52.4:515-23.
Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Endod J 2007;52:64-82.
Al-Ali M, Sathorn C, Parashos P. Root canal debridement efficacy of different final irrigation protocols. Int Endod J 2012;45:898-906.
Harlamb SC. Management of incompletely developed teeth requiring root canal treatment. Aust Endod J 2016;61:95-106.
de Carvalho Maciel AC, Zaccaro Scelza MF. Efficacy of automated versus hand instrumentation during root canal retreatment: an ex vivo study. Int Endod J 2006;39:779–84.
Kfir A, Tsesis I, Yakirevich E, Matalon S, Abramovitz I. The efficacy of five techniques for removing root filling material: microscopic versus radiographic evaluation. Int Endod J 2012;45.1:35-41.
Phillips M, McClanahan S, Bowles W. A titration model for evaluating calcium hydroxide removal techniques. J Appl Oral Sci 2015;23:94-100.
Ethem Yaylali I, Kececi A, Ureyen Kaya B. Ultrasonically Activated Irrigation to Remove Calcium Hydroxide from Apical Third of Human Root Canal System: A Systematic Review of In Vitro Studies. J Endod 2015;41:1589-99.
Wigler R, Dvir R, Weisman A, Matalon S, Kfir A. Efficacy of XP-endo finisher file in the removal of calcium hydroxide paste from artificial artificialized groove in the apical third of oval root canals. Int Endod J 2017;50:700-5.
Leoni GB, Versiani MA, Silva-Sousa YT, Brunier JF, Pécora JD, Sousa-Neto MD. Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root canal system of mandibular first molars. Int Endod J 2017;50:398-406.
Krasimir H, Gateva N. Effectiveness of different root canal irrigation protocols in treatment of immature permanent teeth. MedInform 2019;2:1043-52. DOI: 10.18044/Medinform.201962.1043
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