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VOLUME 19 , ISSUE 9 ( 2018 ) > List of Articles

ORIGINAL RESEARCH

Evaluation of Influence of Widening Apical Preparation of Root Canals on Efficiency of Ethylenediaminetetraacetic Acid Agitation Protocols: Study by Scanning Electron Microscopy

Ana CL Marques, Bernardo A Aguiar, Luciana MA Frota, Bruno M Guimarães, Nilton Vivacqua-Gomes, Rodrigo R Vivan, Marco AH Duarte, Bruno C de Vasconcelos

Keywords : Easy clean, Endodontics, Ethylenediaminetetraacetic acid, Laboratory research, Passive ultrasonic irrigation, Scanning electron microscopy evaluation

Citation Information : Marques AC, Aguiar BA, Frota LM, Guimarães BM, Vivacqua-Gomes N, Vivan RR, Duarte MA, Vasconcelos BC. Evaluation of Influence of Widening Apical Preparation of Root Canals on Efficiency of Ethylenediaminetetraacetic Acid Agitation Protocols: Study by Scanning Electron Microscopy. J Contemp Dent Pract 2018; 19 (9):1087-1094.

DOI: 10.5005/jp-journals-10024-2386

License: CC BY-NC 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI). Materials and methods: A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750×). Scores were attributed to the images, and data were analyzed by the Kruskal–Wallis, Student–Newman–Keuls and Friedman tests. Results: A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed. Conclusion: A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third. Clinical significance: The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.


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  1. Versiani MA, Pecora JD, de Sousa-Neto MD. Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod 2011 Jul;37(7): 1002-1007.
  2. Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlrorite: effect of concentration, temperature, agitation and surfactant. J Endod 2010 Sep;36(9):1558-1562.
  3. Ozdemir HO, Buzoglu HD, Calt S, Cehreli ZC, Varol E, Temel A. Chemical and ultramorphologic effects of ethylenediaminetetraacetic acid and sodium hypochlorite in young and old root canal dentin. J Endod 2012 Feb;38(2):204-208.
  4. Machado R, Garcia LD, da Silva Neto UX, Cruz Filho AM, Silva RG, Vansan LP. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech 2018 Mar;81(3):275-282.
  5. Arslan H, Ayrancý LB, Karatas E, Topçuoðlu HS, Yavuz MS, Kesim B. Effect of agitation of EDTA with 808-nanometer diode laser on removal of smear layer. J Endod 2013 Dec;39(12): 1589-1592.
  6. Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern endodontic principles part 4: irrigation. Dent Update 2016 Jan-Feb;43(1):20-22, 25-26, 28-30 passim.
  7. Versiani MA, Leoni GB, Steier L, De-Deus G, Tassani S, Pécora JD, de Sousa-Neto MD. Micro-computed tomography study of oval-shaped canals prepared with the self-adjusting file, Reciproc, WaveOne, and ProTaper universal systems. J Endod 2013 Aug;39(8):1060-1066.
  8. Bürklein S, Benten S, Schäfer E. Quantitative evaluation of apically extruded debris with different single-file systems: Reciproc, F360 and OneShape versus Mtwo. Int Endod J 2014 May;47(5):405-409.
  9. Arnold M, Ricucci D, Siqueira JF Jr. Infection in a complex network of apical ramifications as the cause of persistent apical periodontitis: a case report. J Endod 2013 Sep;39(9): 1179-1184.
  10. Agarwal A, Deore RB, Rudagi K, Nanda Z, Baig MO, Fareez MA. Evaluation of apical vapor lock formation and comparative evaluation of its elimination using three different techniques: an in vitro study. J Contemp Dent Pract 2017 Sep;18(9):790-794.
  11. Rodrigues RC, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Orstavik D, Siqueira JF Jr. Influence of the apical preparation size and the irrigant type on bacterial reduction in root canal-treated teeth with apical periodontitis. J Endod 2017 Jul;43(7):1058-1063.
  12. Kuah HG, Lui JN, Tseng PS, Chen NN. The effect of EDTA with and without ultrasonics on removal of the smear layer. J Endod 2009 Mar;35(3):393-396.
  13. da Costa Lima GA, Aguiar CM, Câmara AC, Alves LC, Dos Santos FA, do Nascimento AE. Comparison of smear layer removal using the Nd:YAG laser, ultrasound, ProTaper universal system and canal brush methods: an in vitro study. J Endod 2015 Mar;41(3):400-404.
  14. Kato AS, Cunha RS, da Silva Bueno CE, Pelegrine RA, Fontana CE, de Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning microscopic study. J Endod 2016 Apr;42(4):659-663.
  15. Duque JA, Duarte MA, Canali LC, Zacan RF, Vivan RR, Bernardes RA, Bramante CM. Comparative effectiveness of new mechanical irrigant agitating devices for debris removal from the canal and isthmus of mesial roots of mandibular molars. J Endod 2017 Feb;43(2):326-331.
  16. Ahmed HM, Versiani MA, De-Deus G, Dummer PM. A new system for classifying root and root canal morphology. Int Endod J 2017 Aug;50(8):761-770.
  17. Arslan D, Guneser MB, Dincer AN, Kustarci A, Er K, Siso SH. Comparison of smear layer removal ability of Qmix with different activation techniques. J Endod 2016 Aug;42(8):1279-1285.
  18. Herrera DR, Martinho FC, de-Jesus-Soares A, Zaia AA, Ferraz CC, Almeida JF, Gomes BP. Clinical efficacy of EDTA ultrasonic activation in the reduction of endotoxins and cultivable bacteria. Int Endod J 2017 Oct;50(10):933-940.
  19. Thomas AR, Velmurugan N, Smita S, Jothilatha S. Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems. J Endod 2014 Oct;40(10):1676-1680.
  20. Freire LG, Iglecias EF, Cunha RS, Dos Santos M, Gavini G. Micro-computed tomographic evaluation of hard tissue debris removal after different irrigation methods and its influence on the filling of curved canals. J Endod 2015 Oct;41(10): 1660-1666.
  21. Dietrich MA, Kirkpatrick TC, Yaccino JM. In vitro canal and isthmus debris removal of the self-adjusting file, K3, and WaveOne files in the mesial root of human mandibular molars. J Endod 2012 Aug;38(8):1140-1144.
  22. Koçak S, Baðcý N, Çiçek E, Türker SA, Can Saðlam B, Koçak MM. Influence of passive ultrasonic irrigation on the efficiency of various irrigation solutions in removing smear layer: a scanning electron microscope study. Microsc Res Tech 2017 May;80(5):537-542.
  23. Tanomaru-Filho M, Miano LM, Chávez-Andrade GM, Torres FF, Leonardo Rde T, Guerreiro-Tanomaru JM. Cleaning of root canal system by different irrigation methods. J Contemp Dent Pract 2015 Nov;16(11):859-863.
  24. Usman N, Baumgartner JC, Marshall JG. Influence of instrument size on root canal debridement. J Endod 2004 Feb;30(2):110-112.
  25. De-Deus G, Belladonna FG, Silva EJ, Marins JR, Souza EM, Perez R, Lopes RT, Versiani MA, Paciornik S, Neves Ade A. Micro-CT evaluation of non-instrumented canal areas with different enlargements performed by NiTi systems. Braz Dent J 2015 Nov-Dec;26(6):624-629.
  26. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 2007 Jun;40(6):415-426.
  27. Cavenago BC, Ordinola-Zapata R, Duarte MA, del Carpio- Perochena AE, Villas-Bôas MH, Marciano MA, Bramante CM, Moraes IG. Efficacy of xylene and passive ultrasonic irrigation on remaining root filling material during retreatment of anatomically complex teeth. Int Endod J 2014 Nov;47(11):1078-1083.
  28. Plotino G, Pameijer CH, Grande NM, Somma F. Ultrasonics in endodontics: a review of the literature. J Endod 2007 Feb;33(2): 81-95.
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