The Effect of XP-endo Finisher R and PIPS Technique Using Er: YAG Laser on Removal of Gutta-percha in Root Canals Obturated with Two Different Obturation Techniques

Year 2024, Volume: 11 Issue: 1, 23 - 26, 26.04.2024

Gözde Akbal Dinçer , Ali Türkyılmaz , Dilek Hançerlioğulları , Gülşen Ermiş , Ali Erdemir

https://doi.org/10.15311/selcukdentj.1188720

Abstract

Background: The aim of this study is to compare the efficacy of XP-endo finisher R file and PIPS technique using Er: YAG laser on removal of gutta-percha in root canals obturated with two different obturation techniques.
Methods: The root canals of sixty single-rooted teeth were prepared with ProTaper Next Rotary instruments up to X3 (Dentsply, Ballaigues, Switzerland). Half of the root canals were obturated with cold lateral condensation technique and the other half with System B technique (Kerr Corporation, CA, USA) and BioRoot RCS sealer (Setodent, Louisville, USA) was used in all groups as a root canal sealer. After one week, all root canals were retreated using Protaper Universal retreatment instruments (Dentsply, Ballaigues, Switzerland) and enlarged to ProTaper Next X5 File at the working length. Both groups were divided into 3 subgroups according to the additional cleaning methods: control group without an additional cleaning method, XP-endo Finisher R or PIPS technique using Er: YAG laser. Finally, all teeth were split longitudinally and images were taken using an operation microscope (Carl Zeiss, Heidelberg, Germany). The images were analyzed by Image J program. Two-way ANOVA and Tukey tests were used for statistical analysis.
Results: There was a statistically significant difference between the canal filling techniques applied in the evaluation of remnants (p=0.010). There was no significant difference between additional cleaning methods (p=0.196).
Conclusion: Within the limitations of this study, cleanliness is more difficult in root canals obturated with System B technique. Use of additional cleaning method was not effective in removal of root canal filling materials.

Keywords

XP-endo Finisher R, Er: YAG laser, PIPS, retreatment, BioRoot RCS, endodontics

Ethical Statement

This article is not the version of a presentation. This article has not been prepared on the basis of a master’s/ doctoral thesis. It is declared that during the preparation process of this study, scientific and ethical principles were followed and all the studies benefited are stated in the bibliography.

İki Farklı Obturasyon Tekniği ile Doldurulan Kök Kanallarından Güta-perka Uzaklaştılmasında XP-endo Finisher R ve Er: YAG Lazer ile PIPS Tekniğinin Etkisi.

Abstract

Arka plan: Bu çalışmanın amacı, iki farklı obturasyon tekniği ile doldurulan kök kanallarında güta-perka çıkarılmasında Er: YAG lazer kullanılarak PIPS tekniğinin ve XP-endo Finisher R eğesinin etkinliğini karşılaştırmaktır.
Yöntemler: Altmış tek köklü dişin kök kanalları X3'e kadar (Dentsply, Ballaigues, İsviçre) ProTaper Next Rotary aletleri ile şekilledirildi. Kök kanallarının yarısı soğuk lateral kondenzasyon tekniği ile diğer yarısı System B tekniği (Kerr Corporation, CA, ABD) ile dolduruldu ve tüm gruplarda kök kanal patı olarak BioRoot RCS patı (Setodent, Louisville, ABD) kullanıldı. Bir hafta sonra tüm kök kanallarından Protaper Universal retreatment eğeleri (Dentsply, Ballaigues, İsviçre) kullanılarak gutta perka uzaklaştırıldı ve kök kanalları çalışma uzunluğunda ProTaper Next X5’ kadar şekillendildi. Her iki grup da ek temizleme yöntemlerine göre 3 alt gruba ayrıldı: Ek temizleme yöntemi olmayan kontrol grubu, XP-endo Finisher R veya Er:YAG lazer kullanılarak PIPS tekniği. Son olarak tüm dişler uzunlamasına ayrıldı ve operasyon mikroskobu (Carl Zeiss, Heidelberg, Almanya) kullanılarak görüntüler alındı. Görüntüler Image J programı ile analiz edildi. İstatistiksel analiz için iki yönlü ANOVA ve Tukey testleri kullanıldı.
Bulgular: Güta perka uzaklaştırılmasında uygulanan kanal doldurma teknikleri arasında istatistiksel olarak anlamlı fark vardı (p=0.010). Ek temizleme yöntemleri arasında anlamlı bir fark yoktu (p=0,196).
Sonuç: Bu çalışmanın sınırları dahilinde System B tekniği ile doldurulan kök kanallarında güta perka uzaklaştırmak daha zordur. Kanal dolgu malzemelerinin çıkarılmasında ek temizleme yönteminin kullanılması etkili olmamıştır.

Keywords

XP-endo Finisher R, Er: YAG laser, PIPS, retreatment, BioRoot RCS, endodonti

Ethical Statement

Bu makale, sempozyum ya da kongrede sunulan bir tebliğin içeriği geliştirilerek ve kısmen değiştirilerek üretilmemiştir. Bu çalışma, yüksek lisans ya da doktora tezi esas alınarak hazırlanmamıştır. Bu çalışmanın hazırlanma sürecinde bilimsel ve etik ilkelere uyulduğu ve yararlanılan tüm çalışmaların kaynakçada belirtildiği beyan olunur.

References

• 1. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011;44(7):610-625.
• 2. Khedmat S, Azari A, Shamshiri AR, Fadae M, Fakhar HB. Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals. Iran Endod J. 2016;11(3):184-187.
• 3. Zuolo AS, Mello Jr JE, Cunha RS, Zuolo ML, Bueno CES. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J. 2013;46(10):947-53.
• 4. Pinto de Oliveira D, Vicente Baroni Barbizam J, Trope M, Teixeira FB. Comparison between gutta-percha and resilon removal using two different techniques in endodontic retreatment. J Endod. 2006;32(4):362–4.
• 5. Alves FR, Marceliano-Alves MF, Sousa JCN, Silveira SB, Provenzano JC, Siqueira Jr, JF. Removal of root canal fillings in curved canals using either reciprocating single-or rotary multi-instrument systems and a supplementary step with the XP-Endo Finisher. J Endod. 2016;42(7):1114-1119.
• 6. Cavenago BC, Ordinola–Zapata R, Duarte MAH, del Carpio-Perochena AE, Villas-Boas MH, Marciano MA, et al. Efficacy of xylene and passive ultrasonic irrigation on remaining root filling material during retreatment of anatomically complex teeth. Int Endod J. 2014;47:1078–1083.
• 7. Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, de Sá Silva AS, et al. Micro–computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod. 2020;46(12):1901-1906.
• 8. Aksel H, Küçükkaya Eren S, Askerbeyli Örs S, Serper A, Ocak M, Çelik HH. Micro‐CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP‐Endo Finisher file. Int Endod J. 2019;52(7):1070-1076.
• 9. 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.
• 10. Karamifar K, Mehrasa N, Pardis P, Saghiri MA. Cleanliness of canal walls following gutta-percha removal with hand files, RaCe and RaCe plus XP-Endo finisher instruments: a photographic in vitro analysis. Iran Endod J. 2017;12(2):242.
• 11. Machado AG, Guilherme BPS, Provenzano JC, Marceliano‐Alves MF, Gonçalves LS, Siqueira Jr JF, et al. Effects of preparation with the self‐adjusting file, TRUS hape and XP‐endo shaper systems, and a supplementary step with XP‐endo finisher R on filling material removal during retreatment of mandibular molar canals. Int Endod J. 2019;52(5):709-715.
• 12. Tavares SJ, Gomes CC, Marceliano‐Alves MF, Guimaraes LC, Provenzano JC, Amoroso‐Silva P, et al. Supplementing filling material removal with XP‐Endo Finisher R or R1‐Clearsonic ultrasonic insert during retreatment of oval canals from contralateral teeth. Aust Endod J. 2021;47(2):188-194.
• 13. Rodig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hu ̈lsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J. 2014;47:942–948.
• 14. Rödig T, Hausdörfer T, Konietschke F, Dulin C, Hahn W, Hülsmann M. Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals: a micro-computed tomography study. Int Endod J. 2012;45:580–9.
• 15. Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment. J Endod. 2008;34(11):1381-4.
• 16. Taşdemir T, Yildirim T, Çelik D. Comparative study of removal of current endodontic fillings. J Endod. 2008;34(3):326-9.
• 17. De Carvalho Maciel A, Zaccaro Scelza M. Efficacy of automated versus hand instrumentation during root canal retreatment: an ex vivo study. Int Endod J. 2006;39(10):779-84.
• 18. Saghiri MA, Karamifar K, Mehrvazfar P, Asgar K, Gutmann JL, Lotfi M, et al. The efficacy of foam cleaners in removing debris from two endodontic instruments. Quintessence Int. 2012;43(9):811-7.
• 19. Schafer E, Olthoff G. Effect of three different sealers on the sealing ability of both thermafil obturators and cold laterally compacted Gutta-Percha. J Endod. 2002;28(9):638-642.
• 20. Peng L, Ye L, Tan H, Zhou X. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod. 2007;33(2):106-9.
• 21. Ma J, Al-Ashaw AJ, Shen Y, Gao Y, Yang Y, Zhang C, et al. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from oval root canals: A Micro–computed tomography study. J Endod. 2012;38(11):1516-1520.
• 22. Athkuri S, Mandava J, Chalasani U, Ravi RC, Munagapati VK, Chennareddy AR. Effect of different obturating techniques and sealers on the removal of filling materials during endodontic retreatment. J Conserv Dent. 2019;22(6):578.
• 23. de Siqueira Zuolo A, Zuolo ML, da Silveira Bueno CE, Chu R, Cunha RS. Evaluation of the Efficacy of TRUShape and Reciproc File Systems in the Removal of Root Filling Material: An Ex Vivo Micro-Computed Tomographic Study. J Endod. 2016;42(2):315-9.
• 24. Silva EJNL, Belladona FG, Zuolo AS, Rodrigues E, Ehrhardt IC, Souza EM, et al. Effectiveness of XP‐endo Finisher and XP‐endo Finisher R in removing root filling remnants: a micro‐CT study. Intl Endod J. 2018;51(1):86-91.
• 25. Kontogiannis TG, Kerezoudis NP, Kozyrakis K, Farmakis ETK. Removal ability of MTA-, bioceramic-, and resin-based sealers from obturated root canals, following XP-endo® Finisher R file: An ex vivo study. Saudi Endod J. 2019;9(1):8.
• 26. Ayranci LB, Arslan H, Akcay M, Capar ID, Gok T, Saygili G. Effectiveness of laser-assisted irrigation and passive ultrasonic irrigation techniques on smear layer removal in middle and apical thirds. Scanning. 2016;38:121–127.
• 27. Ozbay Y, Erdemir A. Effect of several laser systems on removal of smear layer with a variety of irrigation solutions. Microsc Res Tech. 2018;81(10):1214-1222.
• 28. Jiang S, Zou T, Li D, Chang JW, Huang X, Zhang C. Effectiveness of sonic, ultrasonic, and photon-induced photoacoustic streaming activation of NaOCl on filling material removal following retreatment in oval canal anatomy. Photomed Laser Surg. 2016.34(1):3-10.
• 29. Dönmez Özkan H, Kaval ME, Özkan G, Yiğit Özer S. Efficacy of Two Different Nickel-Titanium Rotary Systems in Retreatment Procedure With or Without Laser-Activated Irrigation: An In Vitro Study. Photomed Laser Surg. 2019;37(8):495-499
• 30. Keleş A, Arslan H, Kamalak A, Akçay M, Sousa-Neto MD, Versiani MA. Removal of filling materials from oval-shaped canals using laser irradiation: a micro–computed tomographic study. J Endod. 2015;41.2:219-224