Filling Material Bond Strength to Dentin Is Positively Influenced by the Agitation of Endodontic Final Irrigating Solutions.

Introduction: The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Materials and Methods: Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. Results: There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Conclusion: Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third.

Comparative evaluation of the effect of ultrasonic and rotary agitation of herbal irrigating solutions on smear layer: A SEM study.

Context: Instrumentation and irrigation balance helps in effective removal of endodontic microbes housing inside the smear layer. Aim: This study aimed to (1) evaluate whether activation of the irrigating solutions with two different systems during the final irrigation step can lead to smear layer formation in the middle and apical third of the root canal and (2) evaluate and compare the smear layer removal ability of the aqueous extracts of Emblica officinalis and Morinda citrifolia. Materials and Methods: A total of 72 single-rooted teeth were prepared up to F4 ProTaper. The specimens were assigned into eight groups of nine teeth each, according to the final irrigant and activation techniques. Further, the teeth were evaluated under SEM for endodontic smear layer at the middle and apical third. Statistical Analysis: Inferential statistics included Pearson's Chi-square. Level of significance was set at 0.05 at 95% confidence level. Results: Ultrasonic activation system showed significant (P = 0.000) amount of smear layer compared to XP-Endo Finisher file. A significant difference (P = 0.00) in the smear layer removal was observed when 6% M. citrifolia was activated with XP-Endo Finisher file both in the middle and apical third. Conclusion: Within the limitations of this in vitro study, it can be concluded that smear layer formation was noted with ultrasonic and XP-Endo Finisher file when saline was used as an irrigant. 6% M. citrifolia when activated with XP-Endo Finisher file showed best results among all other experimental groups.

Analysis of the penetration of NaOCl 5.25% into dentinal tubules using different irrigation protocols: An ex vivo study.

The objective of the study was to investigate the 5.25% sodium hypochlorite (NaOCl) penetration into the dentinal tubules after different irrigation methods. Seventy canines were stained with 1% crystal violet and divided into groups (n = 20): GEC-EasyClean; GPUI-E1 Irrisonic ultrasonic insert; GXP-XP-Endo finisher; GPC-conventional irrigation and GNC-stained tooth without irrigation. Axial sections (16×) were assessed and irrigant penetration was quantified as a bleaching halo on the surface of the apical, middle and coronal third. In the apical third, GPUI promoted greater NaOCl penetration (p < 0.05). GXP was better than GEC (p < 0.05), as was GPC (p > 0.05). The GPUI and GXP groups were similar in the middle and coronal third (p > 0.05). GPUI and GXP showed better results than GEC (p < 0.05). GPUI was more effective in the apical third and like GXP in the cervical and middle third.

Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation.

OBJECTIVES: The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. MATERIALS AND METHODS: Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. RESULTS: Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). CONCLUSIONS: Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). CLINICAL RELEVANCE: None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.

The effect of the irrigant activation protocol on postoperative pain in maxillary incisors with asymptomatic apical periodontitis: A three-arm randomized clinical trial.

OBJECTIVES: This study aimed to compare the effects of three irrigation activation systems (IAS) on postoperative pain (PP) in activating three final irrigants: sodium hypochlorite 5.25%, ethylenediaminetetraacetic acid 17%, and chlorhexidine 2%. MATERIALS AND METHODS: This parallel randomized clinical trial included referred patients with asymptomatic large-sized apical lesion incisors. A standard method was followed in the canal cleaning and shaping for all included patients in the study. Then, the patients were randomly assigned (1:1 allocation) into three groups: G1 (n = 20) with passive ultrasonic irrigation activation; G2 (n = 20) with XP-Endo Finisher file activation; and G3 (n = 20) with diode laser (810 nm) activation. PP was estimated in all groups using a visual analog scale after 1, 3, 7, and 14 days of treatment. Comparisons between the groups were made using the Kruskal-Wallis test, whereas the Mann-Whitney U test was used in the pairwise comparisons. RESULTS: Sixty patients were followed-up in this trial. There were significant differences between the groups in terms of PP After 1, 3, and 7 days of treatment (p = 0.002, p = 0.017, and p = 0.006, respectively). On the first day of treatment, G3 showed the lowest PP compared with G1 and G2 (p = 0.007 and p = 0.001, respectively). On the third day of treatment, G3 showed less PP compared with G2 (p = 0.005). On the seventh day of treatment, G2 showed the highest PP compared with G1 and G3 (p = 0.012 and p = 0.003, respectively). CONCLUSIONS: The XP-Endo Finisher file caused the highest PP level especially in the next day and 3 days of the treatment, whereas the diode laser had the lowest PP level during the first week of treatment. It is noteworthy that PP disappeared completely after 2 weeks of treatment with all three IASs. TRIAL REGISTRATION: The trial was registered in the ISRCTN registry (Trial ID: SRCTN99457940).

Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study.

AIM: To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. METHODS AND MATERIALS: Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I-XP-endo Finisher; group II-EndoVac; group III-plastic finishing file; and group IV-standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. RESULTS: Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). CONCLUSION: The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. CLINICAL SIGNIFICANCE: The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.

Effect of different obturation techniques on sealer penetration into dentinal tubules after final irrigation with XP-Endo finisher file

The first objective of this research was to evaluate the effectiveness of XP-Endo Finisher on dentinal tubule penetration of irrigation solution using confocal laser scanning microscopy. The main purpose of this research was to compare the effect of cold lateral condensation, continuous wave obturation and core-carrier based techniques on sealer penetration. Sixty mandibular premolars were prepared and allocated into two experimental groups (n=30) as the final irrigation technique and obturation technique experiment. In the final irrigation technique experiment, final irrigation was performed with XP-Endo Finisher, passive ultrasonic irrigation (PUI) and conventional needle irrigation (CNI) (n=10). The roots in the obturation technique experiment were also assigned into 3 groups and obturated with cold lateral condensation, continuous-wave obturation and core-carrier techniques (n=10). The most effective activation method, which emerged as a result of the first part of this study, was used as the final irrigation method in the obturation technique experiment. Then, all roots were sectioned in 1-mm-thick slices at 3mm from the apex for scanning. In terms of depth and percentage of material penetration, CNI exhibited significantly the lowest values and no significant difference was found between others. Also, there was no significant difference among obturation methods. In conclusion, XP-Endo Finisher and PUI are more effective than CNI on irrigant penetration. Sealer penetration into dentinal tubules is independent of obturation techniques.

El objetivo principal de esta investigación fue evaluar la eficacia de XP- Endo Finisher en la penetración de la solución de irrigación en los túbulos dentinarios mediante microscopía de láser confocal. Se prepararon sesenta premolares mandibulares y se distribuyeron en dos grupos experimentales (n=30) según el tipo de método de evaluación utilizado. En el experimento de la técnica de irrigación final, la irrigación final se realizó con XP-Endo Finisher, irrigación ultrasónica pasiva (PUI) e irrigación con aguja convencional (CNI) (n=10). Las raíces en el experimento de la técnica de obturación también se asignaron en 3 grupos y se obturaron con técnicas de condensación lateral fría, obturación de onda continua y portador de núcleo (n=10). El método de activación más eficaz, que surgió como resultado de la primera parte de este estudio, se utilizó como método de irrigación final en el experimento de la técnica de obturación. Luego, todas las raíces se seccionaron en muestras de 1mm de espesor. En términos de profundidad y porcentaje de penetración del material, CNI exhibió significativamente los valores más bajos y no se encontraron diferencias significativas entre los demás. Además, no hubo diferencias significativas entre los métodos de obturación. En conclusión, XP-Endo Finisher y PUI son más efectivos que CNI en la penetración del irrigante. La penetración del sellador en los túbulos dentinarios es independiente de las técnicas de obturación.

Postoperative Endodontic Pain after Treatment Using XP-endo Finisher: A Randomized Clinical Trial.

Introduction: This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps. Materials and Methods: Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (n=30), FE (Foraminal Enlargement) (n=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (n=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (n=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%. Results: The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (P<0.05). In the other groups, the pain was mild, only with different time intervals (P>0.05). Conclusions: Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain.

Comparable Effectiveness of Photon-Induced Photoacoustic Streaming with XP-Endo Finisher and Passive Ultrasonic Irrigation on Removing Residual Root Canal Filling Materials from Oval Canals.

Objective: This study aimed to evaluate the effectiveness of photon-induced photoacoustic streaming (PIPS), XP-endo Finisher (XPF), and passive ultrasonic irrigation (PUI) for the removal of root canal filling materials from oval root canals. Background: Various adjunctive irrigation techniques following mechanical preparation have been applied to enhance removal of fillings during root canal retreatment. However, whether there is superiority of one approach over others remains controversial. Methods: Thirty extracted single-rooted teeth with oval-shaped canals were instrumented with the ProTaper Next (PTN) system and obturated with the warm vertical compaction technique. After storage at 37°C for 1 month, retreatment was performed with the PTN system up to size X4. The teeth were then randomly assigned into three groups (n = 10) that were, respectively, subjected to supplementary irrigation with different protocols: PIPS, PUI, and XPF, followed by measurement of filling material volumes using high-resolution micro-computed tomography. Results: The PTN preparation resulted in significant reductions in residual filling materials (p < 0.05), whereas PIPS, PUI, and XPF moderately improved the removal of the remnants (p > 0.05). The residual filling materials after supplementary irrigation ranged from 0.384 ± 0.181 to 0.421 ± 0.143 mm3 in oval canals. There was no significant difference in the effectiveness among the PIPS, PUI, and XPF approaches (p > 0.05). Conclusions: Mechanical preparations are useful for removing most root fillings during retreatment in oval-shaped canals. PIPS can reduce residual root-filling materials to the similar extent as PUI and XPF.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) - Bio-C Temp and Ultracal - after different activation protocols in teeth with simulated internal root resorption. Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05). There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05). Due to this, it can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.

DOES THE ACTIVATION OF ROOT CANAL DRESSINGS IMPROVE THEIR FILLING QUALITY ON TEETH WITH SIMULATED INTERNAL ROOT RESORPTION?

Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption

Is XP-endo Finisher a better treatment option for its efficacy against intracanal bacteria for post-treatment apical periodontitis cases than EndoActivator?

To investigate the efficacy of the supplementary use of a rotary agitation method [XP-endo Finisher (XPF)] and sonically-activated irrigation [EndoActivator (EA)], using droplet digital PCR (ddPCR) on reducing the bacterial load in previously root canal treated teeth with apical periodontitis. Twenty patients with post-treatment apical periodontitis were allocated into two groups according to the irrigation activation method used: XPF and EA group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation, and after final irrigation activation (S3) by means of ddPCR. The bacterial copy numbers were compared between groups using the Friedman test (Nonparametric Repeated Measures ANOVA). When the groups were examined in terms of gender, age, number of root canals, periapical index score, sterility control total bacteria (SCTB), S1- and S2-total bacteria copy number, it was found that there was no statistical difference between the XPF group and the EA group (p > 0.05). Subsequent activation (S3) resulted in a significant microbial reduction in both XPF and EA groups, both of which reduced significantly more bacteria than chemomechanical instrumentation (S2) (p < 0.0001). On the contrary, S3-total bacteria copy number of the EA group was lower than the XPF group (p < 0.0147). There was no statistical difference between the XPF group and the EA group in terms of E. faecalis copy number (p > 0.05). Although both the XPF and the EA optimised the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis, a lower total bacterial copy number was achieved with the EA application than the XPF application.

Effect of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo finisher in removing intracanal Vitapex paste.

To compare the efficiency of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo Finisher in removing Vitapex paste from root canals. The root canals of human single-rooted teeth were prepared and obturated with Vitapex paste. After 2 weeks, the 48 teeth were randomly allocated into four groups: conventional needle irrigation (CNI) group, passive ultrasonic irrigation (PUI) group, sonic irrigation (SI) group and XP-endo Finisher (XP) group. The specimens of four groups were scanned using a micro-computed tomography after the Vitapex pastes was removed. The results showed that more residual paste was left in the CNI group than in the other three groups (p < 0.05). There was no significant difference among the PUI, SI and XP group (p > 0.05). And, the majority of the residual Vitapex was found in the apical third, with a small amount in the middle third after using any of the three agitated irrigation techniques.

Shaping ability of non-adaptive and adaptive core nickel-titanium single-file systems with supplementary file in ribbon-shaped canals analysed by micro-computed tomography.

This study compared shaping ability between two single-file systems and before/after using supplementary file in untouched area, volume of removed dentin, maximum cut depth (the highest cut depth by main file) and remaining thinnest dentin (the thinnest root dentin after preparation). Ribbon-shaped distal canals of mandibular molars were prepared with non-adaptive core (WaveOne Gold) or adaptive core (XP-endo Shaper) files (n = 15/group) and additionally prepared with a supplementary file (XP-endo Finisher), and the shaping ability was investigated using micro-computed tomography. XP-endo Shaper group demonstrated significantly less overall untouched area than WaveOne Gold group (38.21 ± 6.98% vs. 47.68 ± 9.16%) (p < 0.05). No significant difference was detected between XP-endo Shaper and WaveOne Gold groups in volume of removed dentin (1.85 ± 0.53 vs. 1.66 ± 0.33 mm3 ), maximum cut depth (0.10-0.28 vs. 0.10-0.29 mm) and remaining thinnest dentin (0.66-0.80 vs. 0.78-0.88 mm). Supplementary XP-endo Finisher treatment significantly decreased untouched area (11%-23% reduction) (p < 0.05) with minimally cut root dentin (0.01-0.02 mm).

The efficiency of different irrigation activation techniques in the removal of calcium silicate-based endodontic sealer from artificially created groove.

This study evaluated the removal of a calcium silicate-based sealer (EndoSeal MTA) with needle irrigation (NI), passive ultrasonic irrigation (PUI), XP-endo Finisher (XPF) and EDDY. A total of 56 human mandibular premolars were instrumented up to size 40.04 taper. The roots were separated longitudinally, and grooves were prepared with an ultrasonic tip at one-half of each root canal. The grooves were covered with EndoSeal MTA and re-attached roots were investigated based on the activation techniques applied. The results showed that significantly more material (p < 0.05) was removed in the EDDY group compared to the NI, PUI and XPF groups in the apical region. In the coronal region, no significant difference was observed between EDDY, XPF and PUI (p > 0.05), whereas all the latter were significantly more effective than NI (p < 0.05). These findings show that the removal of EndoSeal MTA can be more effective with EDDY compared to XPF, PUI and NI in the apical region.

Regenerative endodontic treatment of immature permanent teeth after mechanical instrumentation with XP-Endo Finisher.

INTRODUCTION: The traditional treatment of immature permanent teeth with necrotic pulp involves creating an apical barrier by using calcium hydroxide or an MTA plug for an extended period of time. A novel therapeutic approach called regenerative endodontic procedures (REP) is used to allow root development to continue.

Passive ultrasonic irrigation, EndoActivator system and XP-endo Finisher R as additional cleaning techniques to remove residual filling materials from flattened root canals.

Background: The effectiveness of endodontic retreatment essentially depends on the cleaning and/or disinfection processes. In this context, the removal of root canal filling materials plays a crucial role. Aims: To assess the efficacy of passive ultrasonic irrigation (PUI), EndoActivator system (EAS), and XP-endo Finisher R (XPEFR) as additional cleaning techniques to remove the remaining root canal filling materials from flattened root canals. Subjects and Methods: Thirty-six similar flattened distal root canals of extracted human first lower molars were selected by micro-computed tomography (micro-CT) and then instrumented and filled. After the initial retreatment procedures, the residual volume of root canal filling materials was assessed by micro-CT (V1). Then, the specimens were divided into three groups (n. 12), according to the additional cleaning technique and submitted to another micro-CT scan (V2). Statistical Analysis Used: Analysis of variance and Games-Howell tests (P < 0.05). Results: The percentage reduction in the residual volume of root canal filling materials reached by PUI, EAS, and XPEFR was 28.38%, 28.12%, and 43.52%, respectively, considering the total space of the root canal (P > 0.05). In the apical third, these values were 20.05%, 21.54%, and 48.82% (P < 0.05). Conclusions: Additional cleaning techniques enabled removing a greater amount of root canal filling material from flattened distal root canals of extracted human first lower molars. Considering the total space of the root canal, there were no statistically relevant differences among the groups. In the apical third, XPEFR performed better.

A modified dentine infection model with fluorescent lipopolysaccharide and lipopolysaccharides sampling technique to compare XP-Endo finisher and passive ultrasonic irrigation.

AIM: The lipopolysaccharides-dentine-infection (LPS-dentine-infection) models and sampling techniques frequently used to evaluate LPS disinfection have limitations. In this study, a LPS-dentine-infection model was devised using fluorescent conjugate LPS. Secondly, a sampling technique using cryogenic grinding for intraradicular LPS analysis was evaluated. Thirdly, the effectiveness of the XP-endo Finisher (XP-EF) was compared with passive ultrasonic irrigation (PUI) in removing LPS from root canal system. METHODOLOGY: Sixty-nine mandibular premolars were submitted to dentine pretreatment and inoculated with fluorescent LPS conjugate (Alexa Fluor® 594). Twenty-three teeth were analysed under confocal laser scanning microscopy (CLSM) to validate this modified LPS-dentine-infection model. Forty-six teeth were randomly divided into two experimental groups: XP-EF (n = 23) and PUI (n = 23). All teeth were instrumented with XP-endo shaper (XPS; FKG Dentaire) and 2.5% NaOCl. The root canals were sampled with paper points before (s1) and after (s2) instrumentation and after supplemental treatment (s3) with XP-EF and PUI. After s3, all roots were cryogenically ground for intraradicular LPS analysis (s4). Limulus amebocyte lysate assay was used for LPS quantification. The Friedman test was used for differences in LPS among four time-points (s1, s2, s3, and s4). Dunn's test was used for pairwise testing of time-points. The significance level was set at 5% (p < .05). RESULTS: Fluorescent LPS conjugate was detected in 100% of the samples under CLSM with a penetration depth of approximately 400 µm into dentine. Chemo-mechanical preparation using XPS files significantly reduced LPS levels (p < .05). Both the XPS and PUI improved the LPS disinfection (p < .05), with no difference between them (p > .05). LPS was recovered from all samples after cryogenic grinding. The residual amount of LPS detected using the cryogenically sampling technique at s4 was approximately three times greater than with the paper-point sampling technique at s3. CONCLUSION: This study established a modified LPS-dentine-infection model using fluorescent conjugate LPS, and validated a LPS sampling technique for using cryopulverization intraradicular LPS analysis. Moreover, both the XP-EF and PUI further improved LPS disinfection from the root canals, and the innovative XP-EF was as effective as PUI.

Preparation and filling of small oval root canals: influence of file system and sealer.

OBJECTIVE: To carry out a morphometric analysis of small oval root canals prepared with different instruments (part 1) and filled with different sealers (part 2). METHOD AND MATERIALS: Ninety extracted mandibular incisors with small oval root canals were instrumented with Self-Adjusting File (n = 45), XP-endo Finisher (n = 15), GentleFile (n = 15), or Reciproc (n = 15). All groups of part 1 were filled with AH Plus (n = 15 each). For part 2 (including group Self-Adjusting File/AH Plus) teeth instrumented with Self-Adjusting File were additionally filled with GuttaFlow Bioseal (n = 15) or Total Fill BC sealer (n = 15). All sealers were placed with a lentulo and filled with master point and additional points. Serial cuts were made at 1-mm intervals up to 10 mm. Total root canal area, percentage of gutta-percha filled area (PGFA), sealer, voids, and debris were evaluated using interactive image analysis software. RESULTS: Preparation with Reciproc caused significantly wider canals than with Self-Adjusting File, GentleFile, or XP-endo Finisher, but also resulted in the greatest PGFA and lowest percentage of sealer (P ≤ .05). Following XP-endo Finisher, the significantly greatest percentage of debris (30%) was found 1 mm from the apex (P ≤ .05). Regarding different sealers, only minor differences were found (GuttaFlow Bioseal: less percentage of sealer at 2 and 3 mm levels [P ≤ .05]). CONCLUSION: Within the limits of this study Reciproc caused the greatest substance loss, but also the most favorable PGFA. The apical debris accumulation with XP-endo Finisher needs further investigation. The sealers under investigation performed equally well.