Background/Aim: The aim of this study was to evaluate the efficacy of new rotary NiTi instrument XP- endo SHAPER (XPS) used with two irrigation protocols on the root canal cleaning in the apical area.
Material and Methods: The research was conducted on 30 single-rooted teeth extracted for orthodontic reasons which were divided into the two groups. Instrumentation of the canals was conducted with XPS instrument and 2% solution of NaOCl was used as irrigant. Instrumentation in the first group was performed using a conventional continuous irrigation, in the second group, protocol of final irrigation was performed intermittently in 3 cycles. The SEM analysis of the apical third of the canal was performed on longitudinal root cross-section standardized photomicrography with a magnification of 2000X.
Results: Results showed that a thicker smear layer was observed in the first group and with continuous irrigation protocol (2,10) in relation to the intermittent irrigation protocol in 3 cycles (1,96), but without significant differences.The walls of the root canal in the apical third of the samples of the second group were slightly cleaner (73.3%) in comparison with the teeth of the first group (64, 7%), but also without significant differences.
Conclusions: The use of XPS and 2% solution of NaOCl in the root canal enables efficient cleaning of the apical third of tooth. The final irrigation protocol in three cycles improves the efficiency of the smear layer removal in the apical segment of the canal.
1. Bao P, Shen Y, Lin J, Haapasalo M. In Vitro Efficacy of XP-endo Finisher with 2 Different Protocols on Biofilm Removal from Apical Root Canals. J Endod, 2017;43:321-325.
2. Metzger Z, Teperovich E, Cohen R, Zary R, Paqué F, Hülsmann M. The self-adjusting file (SAF). Part 3: removal of debris and smear layer-A scanning electron microscope study. J Endod, 2010;36:697-702.
3. Gulabivala K, Patel B, Evans G, Yuan Ling Ng. Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics, 2005;10:103-122.
4. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod, 2004;30:559-567.
5. Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Topics, 2005;10:30-76.
6. Herrera DR, SantosZT, Tay LY, Silva EJ, Loguercio AD, Gomes BPFA. Efficacy of different final irrigant activation protocols on smear layer removal by EDTA and citric acid. Microsc Res Tech, 2013;76:364-369.
7. Kokkas AB, Boutsioukis ACh, Vassiliadis LP, Stavrianos CK. The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: an in vitro study. J Endod, 2004;30:100-102.
8. De Vasconcelos BC, Luna-Cruz SM, De-Deus G, de Moraes IG, Maniglia-Ferreira C, Gurgel-Filho ED. Cleaning ability of chlorhexidine gel and sodium hypochlorite associated or not with EDTA as root canal irrigants: a scanning electron microscopy study. J Appl Oral Sci, 2007;15:387-391.
9. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod, 2009;35:791-804.
10. Jaju S, Jaju PP. Newer Root Canal Irrigants in Horizon: A Review. Int J Dent, 2011;851359.
11. Siqueira JF Jr, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod, 2000;26:331-334.
12. Zehnder M, Kosicki D, Luder H, Sener B, Waltimo T. Tissue-dissolving capacity and antibacterial effect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002;94:756-762.
13. Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidinegluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod, 2004;30:84-87.
14. Shen Y, Qian W, Chung C, Olsen I, Haapasalo M. Evaluation of the effect of two chlorhexidine preparations on biofilm bacteria in vitro: a three-dimensional quantitative analysis. J Endod, 2009;35:981-985.
15. Blank-Gonçalves LM, Nabeshima CK, Martins GH, Machado ME. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: conventional irrigation versus activation systems. J Endod, 2011;37:1268-1271.
16. Haapasalo M, Wang Z, Shen Y, Curtis A, Patel P, Khakpour M. Tissue dissolution by a novel multisonicultracleaning system and sodium hypochlorite. J Endod, 2014;40:1178-1181.
17. Živković S, Nešković J, Jovanović-Medojević M, Popović-Bajić M, Živković-Sandić M. XP-endo Finisher: a new solution for smear layer removal. Serb Dent J, 2015;62:122-129.
18. 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.
19. Crumpton BJ, Goodell GG, McClanahan SB. Effects on smear layer and debris removal with varying volumes of 17% REDTA after rotary instrumentation. J Endod, 2005;31:536-538.
20. Khedmat S, Shokouhinejad N. Comparison of the efficacy of three chelating agents in smear layer removal. J Endod, 2008;34:599-602.
21. FKG Dentaire SA. The XP Endo Shaper File Brochure.
23. 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;23:301-306.
24. Lim TS, Wee TY, Choi MY, Koh WC, Sae-Lim V. Light and scanning electron microscopic evaluation of Glyde File Prep in smear layer removal. Int Endod J, 2003;36:336-343.
25. Guerreiro-Tanomaru JM, Loiola LE, Morgental RD, Leonardo Rde T, Tanomaru-Filho M. Efficacy of four irrigation needles in cleaning the apical third of root canals. Braz Dent J, 2013;24:21-24.
26. Živković S, Nešković J, Jovanović-Medojević M, Popović-Bajić M, Živković-Sandić M. The efficacy of XPendo Shaper (XPS) in the cleaning the apical third of the root canal. Serb Dent J, 2017;64:171-175.
27. Hülsmann M, Rödig T, Nordmeyer S. Complications during root canal irrigation. Endod Topics, 2007;16:27-63.
28. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the cleaning and shaping of root canals: a digital subtraction radiographic study. Int Endod J, 2010;43:275-282.
29. Macedo RG, Verhaagen B, Wesselink PR, Versluis M, Sluis LWM. Influence of refreshment/activation cycles and temperature rise on the reaction rate of sodium hypochlorite with bovine dentine during ultrasonic activated irrigation. Int Endod J, 2014;47:147-154.
30. Schäfer E, Vlassis M. Comparative investigation of two rotary nickel-titanium instruments: ProTaper versus RaCe. Part 2. Cleaning effectiveness and shaping ability in severely curved root canals of extracted teeth. Int Endod J, 2004;37:239-248.
31. Neves MA, Provenzano JC, Rôças IN, Siqueira JF Jr. Clinical Antibacterial Effectiveness of Root Canal Preparation with Reciprocating Single-instrument or Continuously Rotating Multi-instrument Systems. J Endod, 2016;42:25-29.
32. Alves FR, Almeida BM, Neves MA, Rôças IN, Siqueira JF. Time-dependent antibacterial effects of the self-adjusting file used with two sodium hypochlorite concentrations. J Endod, 2011;37:1451-1455.