Evaluation of Residual Root Canal Sealer Removal Efficacy of Different Irrigation Activation Techniques by Confocal Laser Microscopy Analysis

Year 2023, Volume: 13 Issue: 2, 274 - 278, 15.06.2023

Zeliha Uğur Aydın , Demet Altunbaş , Sevim Koşumcu , Büşra Meşeci Tülin Doğan

https://doi.org/10.33808/clinexphealthsci.871991

Abstract

Objective: The purpose of this study was to use confocal laser microscopy analysis to evaluate the effectiveness of conventional needle irrigation (CNI), EndoActivator (EA), and EDDY during endodontic retreatment.
Methods: This study included 45 maxillary incisor teeth with a single root and canal. Root canals were prepared with ProTaper Universal files (Dentsply Sirona, Ballaigues, Switzerland) and obturated with labeled sealer mixed with 0.1% Rhodamine B and gutta percha according to single cone techniques. Initial root canal filling material was removed using ProTaper Universal Retreatment files and F4 files. Teeth randomly were divided into 3 groups (n = 15) depending on the activation technique: CNI, EA (Dentsply, Tulsa Dental Specialties, Tulsa, OK), and EDDY (VDW, Munich, Germany). Confocal laser microscopy was used to evaluate the penetration area, depth, and percentage of the residual sealer in the apical, middle, and coronal sections after irrigation activation.
Results: In all sections, the EDDY group had a lower penetration area of residual sealer than the CNI group (P< .05). In comparison to the coronal section, the penetration percentage of the CNI and EA groups was lower in the apical section (P< .05). In the CNI group, the penetration depth was higher at the coronal section than at the apical and middle sections (P< .05), and it was higher at the coronal section than at the apical section.
Conclusion: Within the limitations of this study, none of the activation systems tested could completely remove the residual sealer. However, the lowest residual sealer was seen after using EA and EDDY.

Keywords

confocal laser microscopy, EDDY, EndoActivator, Residual sealer

References

• Jayasenthil A, Sathish ES, Prakash P. Evaluation of manual and two-rotary niti retreatment systems in removing guttapercha obturated with two root canal sealers. ISRN Dent. 2012;2012:208241. DOI: 10.5402/2012/208241
• Yilmaz K, Ozyurek T. Apically extruded debris after retreatment procedure with reciproc, protaper next, and twisted file adaptive instruments. J Endod. 2017;43(4):648-651. DOI: 10.1016/j.joen.2016.12.003
• Keles A, Arslan H, Kamalak A, Akcay M, Sousa-Neto MD, Versiani MA. Removal of filling materials from oval-shaped canals using laser irradiation: a micro-computed tomographic study. JEndod. 2015;41(2):219-224. DOI: 10.1016/j.joen.2014.09.026
• Schirrmeister JF, Meyer KM, Hermanns P, Altenburger MJ, Wrbas KT. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J. 2006;39(2):150-156. DOI: 10.1111/j.1365-2591.2006.01066.x
• Boutsioukis C, Tzimpoulas N. Uncontrolled removal of dentin during in vitro ultrasonic irrigant activation. J Endod. 2016;42(2):289-293. DOI: 10.1016/j.joen.2015.09.017
• Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Investig. 2018;22(2):655-670. DOI: 10.1007/s00784.018.2345-x
• Jain M, Singhal A, Gurtu A, Vinayak V. Influence of ultrasonic irrigation and chloroform on cleanliness of dentinal tubules during endodontic retreatment-an invitro sem study. J Clin Diagn Res. 2015;9(5):ZC11-15. DOI: 10.7860/JCDR/2015/12127.5864
• Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L. 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. J Endod. 2013;39(11):1456-1460. DOI: 10.1016/j.joen.2013.07.028
• Topcuoglu HS, Tuncay O, Demirbuga S, Dincer AN, Arslan H. The effect of different final irrigant activation techniques on the bond strength of an epoxy resin-based endodontic sealer: a preliminary study. J Endod. 2014;40(6):862-866. DOI: 10.1016/j.joen.2013.10.012
• Generali L, Cavani F, Serena V, Pettenati C, Righi E, Bertoldi C. Effect of different irrigation systems on sealer penetration into dentinal tubules. J Endod. 2017;43(4):652-656. DOI: 10.1016/j.joen.2016.12.004
• Huffaker SK, Safavi K, Spangberg LS, Kaufman B. Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: A clinical study. J Endod. 2010;36(8):1315-1318. DOI: 10.1016/j.joen.2010.04.024
• Urban K, Donnermeyer D, Schafer E, Burklein S. Canal cleanliness using different irrigation activation systems: A SEM evaluation. Clin Oral Investig. 2017;21(9):2681-2687. DOI: 10.1007/s00784.017.2070-x
• Ordinola-Zapata R, Bramante CM, Graeff MS, del Carpio Perochena A, Vivan RR, Camargo EJ, Brandão Garcia R, Bernardineli N, Gutmann JL, Gomes de Moraes I. Depth and percentage of penetration of endodontic sealers into dentinal tubules after root canal obturation using a lateral compaction technique: a confocal laser scanning microscopy study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(3):450-457. DOI: 10.1016/j.tripleo.2009.04.024
• Tedesco M, Chain MC, Bortoluzzi EA, da Fonseca Roberti Garcia L, Alves AMH, Teixeira CS. Comparison of two observational methods, scanning electron and confocal laser scanning microscopies, in the adhesive interface analysis of endodontic sealers to root dentine. Clin Oral Investig. 2018;22(6):2353-2361. DOI: 10.1007/s00784.018.2336-y
• Da Rosa RA, Santini MF, Cavenago BC, Pereira JR, Duarte MA, So MV. Micro-CT Evaluation of root filling removal after three stages of retreatment procedure. Braz Dent J. 2015;26(6):612-618. DOI: 10.1590/0103.644.0201300061
• Martins MP, Duarte MA, Cavenago BC, Kato AS, da Silveira Bueno CE. Effectiveness of the protaper next and reciproc systems in removing root canal filling material with sonic or ultrasonic irrigation: A micro-computed tomographic study. J Endod. 2017;43(3):467-471. DOI: 10.1016/j.joen.2016.10.040
• Bernardes RA, Duarte MAH, Vivan RR, Alcalde MP, Vasconcelos BC, Bramante CM. Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. Int Endod J. 2016;49(9):890-897. DOI: 10.1111/iej.12522
• Cavenago BC, Ordinola-Zapata R, Duarte MA, del Carpio-Perochena AE, Villas-Boas 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;47(11):1078-1083. DOI: 10.1111/iej.12253
• Grischke J, Muller-Heine A, Hulsmann M. The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig. 2014;18(7):1845-1851. DOI: 10.1007/s00784.013.1161-6
• Ugur Aydin Z, Kosumcu S, Meseci B. Effect of different irrigation activation techniques on sealer penetration: A confocal laser microscopy study. Chin J Dent Res. 2021;24(2):113-118. DOI: 10.3290/j.cjdr.b1530507
• Akcay M, Arslan H, Durmus N, Mese M, Capar ID. Dentinal tubule penetration of AH Plus, iRoot SP, MTA fillapex, and guttaflow bioseal root canal sealers after different final irrigation procedures: a confocal microscopic study. Lasers Surg Med. 2016;48(1):70-76. DOI: 10.1002/lsm.22446
• Kara Tuncer A, Tuncer S. Effect of different final irrigation solutions on dentinal tubule penetration depth and percentage of root canal sealer. J Endod. 2012;38(6):860-863. DOI: 10.1016/j.joen.2012.03.008