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CC BY-NC-ND 4.0 · Eur J Dent 2021; 15(04): 707-713
DOI: 10.1055/s-0041-1729454
Original Article

Effect of Irrigating Agitation after Root End Preparation on the Wall Cleaning and Bond Strength of Calcium Silicate Material in Retrograde Obturation

Yahir Muñoz Valencia
1   Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Gislene Cristina Vertuan 
1   Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Murilo Priori Alcalde
1   Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Rodrigo Ricci Vivan
1   Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Marcus Vinícius Reis Só
2   Department of Dentistry, University Federal of the Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
,
Marco Antonio Hungaro Duarte
1   Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
› Author Affiliations Funding This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) - Finance Code 001 and the São Paulo Research Foundations (FAPESP) - Process 2017/22364-5.
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Abstract

Objective This study aimed to evaluate the cleaning efficacy of irrigant activation with a new ultrasonic tip in root-end preparations and to determine its influence on the bond strength of calcium silicate-based material.

Materials and Methods Maxillary canines were prepared and filled, and their root ends resected. Root-end cavities were ultrasonically prepared and randomly distributed into four groups according to the final irrigation protocols: G1 (ultrasonic irrigation [UI] + saline solution [SS]), G2 (syringe irrigation [SI] + SS), G3 (UI + ethylenediaminetetraacetic acid [EDTA]), and G4 (SI + EDTA). Cleaning efficacy analysis employed 72 specimens (n = 18) split longitudinally for imaging of the same areas by scanning electron microscopy (SEM). The percentage of dentinal tubules opened before and after irrigation was used as evaluation parameter. Push-out testing employed 40 specimens (n = 10) sectioned apical region perpendicularly, which slice was placed on a testing machine for the bond strength measurement and failure mode was assessed by SEM. The data were statistically analyzed (α ≤ 0.05).

Results G3 (UI + EDTA) removed the smear layer more effectively, showed the best tubule opening (p < 0.05), and presented the highest mean bond strength values (p < 0.05). Failure modes were predominantly adhesive, except for the G3 (UI + EDTA) group, in which they were mainly mixed (80%).

Conclusion The results of this study suggest that EDTA 17% agitation promoted better cleaning and smear layer removal, improving the push-out bond strength of calcium silicate material in retrograde obturation.

Keywords

smear layer - bond strength - root-end cavity - retrograde filling - scanning electron microscopy - push-out


Publication History

Article published online:
24 July 2021

© 2021. European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Chan S, Glickman GN, Woodmansey KF, He J. Retrospective analysis of root-end microsurgery outcomes in a postgraduate program in endodontics using calcium silicate-based cements as root-end filling materials. J Endod 2020; 46 (03) 345-351
    CrossrefPubMedGoogle Scholar
  • 2 Çalışkan MK, Tekin U, Kaval ME, Solmaz MC. The outcome of apical microsurgery using MTA as the root-end filling material: 2- to 6-year follow-up study. Int Endod J 2016; 49 (03) 245-254
    CrossrefPubMedGoogle Scholar
  • 3 Camargo Villela Berbert FL, de Faria-Júnior NB, Tanomaru-Filho M. et al An in vitro evaluation of apicoectomies and retropreparations using different methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (04) e57-e63
    CrossrefPubMedGoogle Scholar
  • 4 Rosales-Leal JI, Olmedo-Gaya V, Vallecillo-Capilla M, Luna-del Castillo JD. Influence of cavity preparation technique (rotary vs. ultrasonic) on microleakage and marginal fit of six end-root filling materials. Med Oral Patol Oral Cir Bucal 2011; 16 (02) e185-e189
    CrossrefPubMedGoogle Scholar
  • 5 Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94 (06) 658-666
    CrossrefPubMedGoogle Scholar
  • 6 Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endod Dent Traumatol 1990; 6 (04) 142-149
    CrossrefPubMedGoogle Scholar
  • 7 Gutmann JL, Saunders WP, Nguyen L, Guo IY, Saunders EM. Ultrasonic root-end preparation. Part 1. SEM analysis. Int Endod J 1994; 27 (06) 318-324
    CrossrefPubMedGoogle Scholar
  • 8 Ricucci D, Loghin S, Siqueira JF Jr. Exuberant Biofilm infection in a lateral canal as the cause of short-term endodontic treatment failure: report of a case. J Endod 2013; 39 (05) 712-718
    CrossrefPubMedGoogle Scholar
  • 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; 39 (09) 1179-1184
    CrossrefPubMedGoogle Scholar
  • 10 Torabinejad M, Khademi AA, Babagoli J. et al A new solution for the removal of the smear layer. J Endod 2003; 29 (03) 170-175
    CrossrefPubMedGoogle Scholar
  • 11 Reyes-Carmona JF, Felippe MS, Felippe WT. The biomineralization ability of mineral trioxide aggregate and Portland cement on dentin enhances the push-out strength. J Endod 2010; 36 (02) 286-291
    CrossrefPubMedGoogle Scholar
  • 12 Marques JHS, Silva-Sousa YTC, Rached-Júnior FJA. et al New methodology to evaluate bond strength of root-end filling materials. Braz Dent J 2015; 26 (03) 288-291
    CrossrefPubMedGoogle Scholar
  • 13 Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006; 32 (07) 601-623
    CrossrefPubMedGoogle Scholar
  • 14 Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera 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 (04) 398-406
    CrossrefPubMedGoogle Scholar
  • 15 Alakshar A, Saleh ARM, Gorduysus MO. Debris and smear layer removal from oval root canals comparing XP-Endo Finisher, EndoActivator, and manual irrigation: A SEM evaluation. Eur J Dent 2020; 14 (04) 626-633
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Căpută PE, Retsas A, Kuijk L, Chávez de Paz LE, Boutsioukis C. Ultrasonic irrigant activation during root canal treatment: a systematic review. J Endod 2019; 45 (01) 31-44.e13
    CrossrefPubMedGoogle Scholar
  • 17 Basturk FB, Nekoofar MH, Gunday M, Dummer PM. Effect of varying water-to-powder ratios and ultrasonic placement on the compressive strength of mineral trioxide aggregate. J Endod 2015; 41 (04) 531-534
    CrossrefPubMedGoogle Scholar
  • 18 Martins Justo A, Abreu da Rosa R, Santini MF. et al Effectiveness of final irrigant protocols for debris removal from simulated canal irregularities. J Endod 2014; 40 (12) 2009-2014
    CrossrefPubMedGoogle Scholar
  • 19 Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation. J Endod 1997; 23 (05) 301-306
    CrossrefPubMedGoogle Scholar
  • 20 Rodrigues CT, Duarte MAH, Guimarães BM, Vivan RR, Bernardineli N. Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment. Braz Oral Res 2017; 31: e113
    CrossrefPubMedGoogle Scholar
  • 21 Marciano MA, Guimarães BM, Amoroso-Silva P, Camilleri J, Hungaro Duarte MA. Physical and chemical properties and subcutaneous implantation of mineral trioxide aggregate mixed with propylene glycol. J Endod 2016; 42 (03) 474-479
    CrossrefPubMedGoogle Scholar
  • 22 Vivan RR, Guerreiro-Tanomaru JM, Bernardes RA. Reis JM, Hungaro Duarte MA, Tanomaru-Filho M. Effect of ultrasonic tip and root-end filling material on bond strength. Clin Oral Investig 2016; 20 (08) 2007-2011
    CrossrefPubMedGoogle Scholar
  • 23 Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007; 33 (04) 472-475
    CrossrefPubMedGoogle Scholar
  • 24 Chopra S, Murray PE, Namerow KN. A scanning electron microscopic evaluation of the effectiveness of the F-file versus ultrasonic activation of a K-file to remove smear layer. J Endod 2008; 34 (10) 1243-1245
    CrossrefPubMedGoogle Scholar
  • 25 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; 35 (03) 393-396
    CrossrefPubMedGoogle Scholar
  • 26 Lee YL, Lin FH, Wang WH, Ritchie HH, Lan WH, Lin CP. Effects of EDTA on the hydration mechanism of mineral trioxide aggregate. J Dent Res 2007; 86 (06) 534-538
    CrossrefPubMedGoogle Scholar
  • 27 Verhaagen B, Boutsioukis C, van der Sluis LW, Versluis M. Acoustic streaming induced by an ultrasonically oscillating endodontic file. J Acoust Soc Am 2014; 135 (04) 1717-1730
    CrossrefPubMedGoogle Scholar
  • 28 Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009; 35 (06) 791-804
    CrossrefPubMedGoogle Scholar
  • 29 Reyes-Carmona JF, Felippe MS, Felippe WT. Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid. J Endod 2009; 35 (05) 731-736
    CrossrefPubMedGoogle Scholar
  • 30 Dammaschke T, Gerth HU, Züchner H, Schäfer E. Chemical and physical surface and bulk material characterization of white ProRoot MTA and two Portland cements. Dent Mater 2005; 21 (08) 731-738
    CrossrefPubMedGoogle Scholar
  • 31 Duarte MAH, Alves de Aguiar K, Zeferino MA. et al Evaluation of the propylene glycol association on some physical and chemical properties of mineral trioxide aggregate. Int Endod J 2012; 45 (06) 565-570
    CrossrefPubMedGoogle Scholar
  • 32 Salem Milani A, Froughreyhani M, Charchi Aghdam S, Pournaghiazar F, Asghari Jafarabadi M. Mixing with propylene glycol enhances the bond strength of mineral trioxide aggregate to dentin. J Endod 2013; 39 (11) 1452-1455
    CrossrefPubMedGoogle Scholar
  • 33 Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysis. Int Endod J 2005; 38 (05) 285-290
    CrossrefPubMedGoogle Scholar
  • 34 Siqueira Jr JF, Batista MM, Fraga RC, de Uzeda M. Antibacterial effects of endodontic irrigants on black-pigmented gram-negative anaerobes and facultative bacteria. J Endod 1998; 24 (06) 414-416
    CrossrefPubMedGoogle Scholar
  • 35 Nery MJ, De Souza V, Holland R. Reação do coto pulpar e tecidos periapicais de dentes de cães a algumas substâncias empregadas no preparo biomecânico dos canais radiculares. Rev Fac Odontol Aracatuba 1974; 3 (02) 245-259
    PubMedGoogle Scholar
  • 36 Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J 2018; 51 (12) 1367-1388
    CrossrefPubMedGoogle Scholar
  • 37 Akcay H, Arslan H, Akcay M, Mese M, Sahin NN. Evaluation of the bond strength of root-end placed mineral trioxide aggregate and Biodentine in the absence/presence of blood contamination. Eur J Dent 2016; 10 (03) 370-375
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Islam I, Chng HK, Yap AU. Comparison of the physical and mechanical properties of MTA and portland cement. J Endod 2006; 32 (03) 193-197
    CrossrefPubMedGoogle Scholar
  • 39 Hwang YC, Lee SH, Hwang IN. et al Chemical composition, radiopacity, and biocompatibility of Portland cement with bismuth oxide. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107 (03) e96-e102
    CrossrefPubMedGoogle Scholar
  • 40 Vivan RR, Zapata RO, Zeferino MA. et al Evaluation of the physical and chemical properties of two commercial and three experimental root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (02) 250-256
    CrossrefPubMedGoogle Scholar