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Erschienen in: Clinical Oral Investigations 7/2016

04.11.2015 | Original Article

Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning

verfasst von: Mário Tanomaru-FIlho, Fernanda Ferrari Esteves Torres, Gisselle Moraima Chávez-Andrade, Lucas Martinati Miano, Juliane Maria Guerreiro-Tanomaru

Erschienen in: Clinical Oral Investigations | Ausgabe 7/2016

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Abstract

Objectives

The aim of this study was to evaluate the efficacy of two passive ultrasonic irrigation (PUI) methods and conventional manual irrigation (CMI) in root canal system (RCS) cleaning.

Materials and methods

Artificial single-rooted teeth were used. Four lateral canals were made 2 and 7 mm short from the apex. Root canals were filled with a contrast solution. The specimens were divided into four groups (n = 8): PUI1—intermittent flushing; PUI2—continuous flushing; CMI1—at 1 mm; and CMI2—at 3 mm. Micro-computed tomographic images were obtained. New images were taken after the irrigation protocols enabling the evaluation of the contrast solution volume (in mm3) within RCS (main and lateral root canals) in comparison to the initial analysis. The comparison among groups was performed using ANOVA and Tukey’s tests with 5 % significance level.

Results

There was no difference among PUI1, PUI2, and CMI1 regarding the contrast solution removal from RCS (p > 0.05). These methods demonstrated greater cleaning than CMI2. At the apical third, CMI2 showed lower cleaning capacity when compared to the other methods (p < 0.05).

Conclusions

PUI with intermittent or continuous flushing and CMI with the needle placed 1 mm from the working length were efficient in cleaning the main and lateral root canals.

Clinical relevance

Root canal irrigation plays an important role in cleaning and disinfection of the RCS. Effective apical irrigation is an important procedure during root canal treatment. PUI and CMI (at 1 mm short) were effective in cleaning of the main and simulated lateral root canals.
Literatur
1.
Zurück zum Zitat Beus C, Safavi K, Stratton J, Kaufman B (2012) Comparison of the effect of two endodontic irrigation protocols on the elimination of bacteria from root canal system: a prospective, randomized clinical trial. J Endod 38:1479–1483CrossRefPubMed Beus C, Safavi K, Stratton J, Kaufman B (2012) Comparison of the effect of two endodontic irrigation protocols on the elimination of bacteria from root canal system: a prospective, randomized clinical trial. J Endod 38:1479–1483CrossRefPubMed
2.
Zurück zum Zitat Castelo-Baz P, Martin-Biedma B, Cantatore G, Ruiz-Pinon M, Bahillo J, Rivas-Mundina B, Varela-Patino P (2012) In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod 38:688–691CrossRefPubMed Castelo-Baz P, Martin-Biedma B, Cantatore G, Ruiz-Pinon M, Bahillo J, Rivas-Mundina B, Varela-Patino P (2012) In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod 38:688–691CrossRefPubMed
3.
Zurück zum Zitat Guerreiro-Tanomaru JM, Loiola LE, Morgental RD, Leonardo Rde T, Tanomaru-Filho M (2013) Efficacy of four irrigation needles in cleaning the apical third of root canals. Braz Dent J 24:21–24CrossRefPubMed Guerreiro-Tanomaru JM, Loiola LE, Morgental RD, Leonardo Rde T, Tanomaru-Filho M (2013) Efficacy of four irrigation needles in cleaning the apical third of root canals. Braz Dent J 24:21–24CrossRefPubMed
4.
Zurück zum Zitat Peeters HH, Mooduto L (2013) Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er,Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig 17:2105–2112CrossRefPubMed Peeters HH, Mooduto L (2013) Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er,Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig 17:2105–2112CrossRefPubMed
5.
Zurück zum Zitat de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36:1216–1221CrossRefPubMed de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36:1216–1221CrossRefPubMed
6.
Zurück zum Zitat Helvacioglu Kivanc B, Deniz Arisu H, Yanar NO, Silah HM, Inam R, Gorgul G (2015) Apical extrusion of sodium hypochlorite activated with two laser systems and ultrasonics: a spectrophotometric analysis. BMC Oral Health 15:71CrossRefPubMedPubMedCentral Helvacioglu Kivanc B, Deniz Arisu H, Yanar NO, Silah HM, Inam R, Gorgul G (2015) Apical extrusion of sodium hypochlorite activated with two laser systems and ultrasonics: a spectrophotometric analysis. BMC Oral Health 15:71CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Sedgley CM, Nagel AC, Hall D, Applegate B (2005) Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 38:97–104CrossRefPubMed Sedgley CM, Nagel AC, Hall D, Applegate B (2005) Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 38:97–104CrossRefPubMed
8.
Zurück zum Zitat Uzunoglu E, Gorduysus M, Gorduysus O (2015) A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 7:e218–e223CrossRefPubMedPubMedCentral Uzunoglu E, Gorduysus M, Gorduysus O (2015) A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 7:e218–e223CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Grischke J, Muller-Heine A, Hulsmann M (2014) The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig 18:1845–1851CrossRefPubMed Grischke J, Muller-Heine A, Hulsmann M (2014) The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig 18:1845–1851CrossRefPubMed
10.
11.
Zurück zum Zitat van der Sluis LW, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40:415–426CrossRefPubMed van der Sluis LW, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40:415–426CrossRefPubMed
12.
Zurück zum Zitat van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR (2010) Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 36:737–740CrossRefPubMed van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR (2010) Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 36:737–740CrossRefPubMed
13.
Zurück zum Zitat Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR (2009) Review of contemporary irrigant agitation techniques and devices. J Endod 35:791–804CrossRefPubMed Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR (2009) Review of contemporary irrigant agitation techniques and devices. J Endod 35:791–804CrossRefPubMed
14.
Zurück zum Zitat van der Sluis L, Wu MK, Wesselink P (2009) Comparison of 2 flushing methods used during passive ultrasonic irrigation of the root canal. Quintessence Int 40:875–879PubMed van der Sluis L, Wu MK, Wesselink P (2009) Comparison of 2 flushing methods used during passive ultrasonic irrigation of the root canal. Quintessence Int 40:875–879PubMed
15.
Zurück zum Zitat Macedo RG, Verhaagen B, Wesselink PR, Versluis M, van der Sluis LW (2014) 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 47:147–154CrossRefPubMed Macedo RG, Verhaagen B, Wesselink PR, Versluis M, van der Sluis LW (2014) 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 47:147–154CrossRefPubMed
16.
Zurück zum Zitat Park E, Shen Y, Haapasalo M (2013) Irrigation of the apical root canal. Endod Top 27:54–73CrossRef Park E, Shen Y, Haapasalo M (2013) Irrigation of the apical root canal. Endod Top 27:54–73CrossRef
17.
Zurück zum Zitat Chávez-Andrade GM, Guerreiro-Tanomaru JM, Miano LM, Toledo RL, Tanomaru-Filho M (2014) Radiographic evaluation of root canal cleaning, main and laterals, using different methods of fi nal irrigation. Rev Odontol UNESP 43:333–337CrossRef Chávez-Andrade GM, Guerreiro-Tanomaru JM, Miano LM, Toledo RL, Tanomaru-Filho M (2014) Radiographic evaluation of root canal cleaning, main and laterals, using different methods of fi nal irrigation. Rev Odontol UNESP 43:333–337CrossRef
18.
Zurück zum Zitat Tanomaru-Filho M, Sant’anna-Junior A, Bosso R, Guerreiro-Tanomaru JM (2011) Effectiveness of gutta-percha and Resilon in filling lateral root canals using the Obtura II system. Braz Oral Res 25:205–209CrossRefPubMed Tanomaru-Filho M, Sant’anna-Junior A, Bosso R, Guerreiro-Tanomaru JM (2011) Effectiveness of gutta-percha and Resilon in filling lateral root canals using the Obtura II system. Braz Oral Res 25:205–209CrossRefPubMed
19.
Zurück zum Zitat Michelotto AL, Moura-Netto C, Araki AT, Akisue E, Moura AA, Sydney GB (2010) In vitro analysis of thermocompaction time and gutta-percha type on quality of main canal and lateral canals filling. Braz Oral Res 24:290–295CrossRefPubMed Michelotto AL, Moura-Netto C, Araki AT, Akisue E, Moura AA, Sydney GB (2010) In vitro analysis of thermocompaction time and gutta-percha type on quality of main canal and lateral canals filling. Braz Oral Res 24:290–295CrossRefPubMed
20.
Zurück zum Zitat Almeida JF, Gomes BP, Ferraz CC, Souza-Filho FJ, Zaia AA (2007) Filling of artificial lateral canals and microleakage and flow of five endodontic sealers. Int Endod J 40:692–699CrossRefPubMed Almeida JF, Gomes BP, Ferraz CC, Souza-Filho FJ, Zaia AA (2007) Filling of artificial lateral canals and microleakage and flow of five endodontic sealers. Int Endod J 40:692–699CrossRefPubMed
21.
Zurück zum Zitat Carvalho-Sousa B, Almeida-Gomes F, Carvalho PR, Maniglia-Ferreira C, Gurgel-Filho ED, Albuquerque DS (2010) Filling lateral canals: evaluation of different filling techniques. Eur J Dent 4:251–256PubMedPubMedCentral Carvalho-Sousa B, Almeida-Gomes F, Carvalho PR, Maniglia-Ferreira C, Gurgel-Filho ED, Albuquerque DS (2010) Filling lateral canals: evaluation of different filling techniques. Eur J Dent 4:251–256PubMedPubMedCentral
23.
Zurück zum Zitat Nielsen RB, Alyassin AM, Peters DD, Carnes DL, Lancaster J (1995) Microcomputed tomography: an advanced system for detailed endodontic research. J Endod 21:561–568CrossRefPubMed Nielsen RB, Alyassin AM, Peters DD, Carnes DL, Lancaster J (1995) Microcomputed tomography: an advanced system for detailed endodontic research. J Endod 21:561–568CrossRefPubMed
24.
Zurück zum Zitat Rhodes JS, Ford TR, Lynch JA, Liepins PJ, Curtis RV (1999) Micro-computed tomography: a new tool for experimental endodontology. Int Endod J 32:165–170CrossRefPubMed Rhodes JS, Ford TR, Lynch JA, Liepins PJ, Curtis RV (1999) Micro-computed tomography: a new tool for experimental endodontology. Int Endod J 32:165–170CrossRefPubMed
25.
Zurück zum Zitat Endal U, Shen Y, Knut A, Gao Y, Haapasalo M (2011) A high-resolution computed tomographic study of changes in root canal isthmus area by instrumentation and root filling. J Endod 37:223–227CrossRef Endal U, Shen Y, Knut A, Gao Y, Haapasalo M (2011) A high-resolution computed tomographic study of changes in root canal isthmus area by instrumentation and root filling. J Endod 37:223–227CrossRef
26.
Zurück zum Zitat Mirfendereski M, Roth K, Fan B, Dubrowski A, Carnahan H, Azarpazhooh A, Basrani B, Torneck CD, Friedman S (2009) Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: a microcomputed tomography analysis. J Endod 35:1512–1517CrossRefPubMed Mirfendereski M, Roth K, Fan B, Dubrowski A, Carnahan H, Azarpazhooh A, Basrani B, Torneck CD, Friedman S (2009) Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: a microcomputed tomography analysis. J Endod 35:1512–1517CrossRefPubMed
27.
Zurück zum Zitat Paque F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047CrossRefPubMed Paque F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047CrossRefPubMed
28.
Zurück zum Zitat Zogheib C, Naaman A, Sigurdsson A, Medioni E, Bourbouze G, Arbab-Chirani R (2013) Comparative micro-computed tomographic evaluation of two carrier-based obturation systems. Clin Oral Investig 17:1879–1883CrossRefPubMed Zogheib C, Naaman A, Sigurdsson A, Medioni E, Bourbouze G, Arbab-Chirani R (2013) Comparative micro-computed tomographic evaluation of two carrier-based obturation systems. Clin Oral Investig 17:1879–1883CrossRefPubMed
29.
Zurück zum Zitat Metzger Z, Zary R, Cohen R, Teperovich E, Paque F (2010) The quality of root canal preparation and root canal obturation in canals treated with rotary versus self-adjusting files: a three-dimensional micro-computed tomographic study. J Endod 36:1569–1573CrossRefPubMed Metzger Z, Zary R, Cohen R, Teperovich E, Paque F (2010) The quality of root canal preparation and root canal obturation in canals treated with rotary versus self-adjusting files: a three-dimensional micro-computed tomographic study. J Endod 36:1569–1573CrossRefPubMed
30.
Zurück zum Zitat Somma F, Cretella G, Carotenuto M, Pecci R, Bedini R, De Biasi M, Angerame D (2011) Quality of thermoplasticized and single point root fillings assessed by micro-computed tomography. Int Endod J 44:362–369CrossRefPubMed Somma F, Cretella G, Carotenuto M, Pecci R, Bedini R, De Biasi M, Angerame D (2011) Quality of thermoplasticized and single point root fillings assessed by micro-computed tomography. Int Endod J 44:362–369CrossRefPubMed
31.
Zurück zum Zitat Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD (2011) Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod 37:235–238CrossRefPubMed Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD (2011) Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod 37:235–238CrossRefPubMed
32.
Zurück zum Zitat Bronnec F, Bouillaguet S, Machtou P (2010) Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 43:663–672CrossRefPubMed Bronnec F, Bouillaguet S, Machtou P (2010) Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 43:663–672CrossRefPubMed
33.
Zurück zum Zitat Bhuva B, Patel S, Wilson R, Niazi S, Beighton D, Mannocci F (2010) The effectiveness of passive ultrasonic irrigation on intraradicular Enterococcus faecalis biofilms in extracted single-rooted human teeth. Int Endod J 43:241–250CrossRefPubMed Bhuva B, Patel S, Wilson R, Niazi S, Beighton D, Mannocci F (2010) The effectiveness of passive ultrasonic irrigation on intraradicular Enterococcus faecalis biofilms in extracted single-rooted human teeth. Int Endod J 43:241–250CrossRefPubMed
34.
Zurück zum Zitat Spoorthy E, Velmurugan N, Ballal S, Nandini S (2013) Comparison of irrigant penetration up to working length and into simulated lateral canals using various irrigating techniques. Int Endod J 46:815–822CrossRefPubMed Spoorthy E, Velmurugan N, Ballal S, Nandini S (2013) Comparison of irrigant penetration up to working length and into simulated lateral canals using various irrigating techniques. Int Endod J 46:815–822CrossRefPubMed
35.
Zurück zum Zitat Cavenago BC, Pereira TC, Duarte MA, Ordinola-Zapata R, Marciano MA, Bramante CM, Bernardineli N (2013) Influence of powder-to-water ratio on radiopacity, setting time, pH, calcium ion release and a micro-CT volumetric solubility of white mineral trioxide aggregate. Int Endod J 47:120–126CrossRefPubMed Cavenago BC, Pereira TC, Duarte MA, Ordinola-Zapata R, Marciano MA, Bramante CM, Bernardineli N (2013) Influence of powder-to-water ratio on radiopacity, setting time, pH, calcium ion release and a micro-CT volumetric solubility of white mineral trioxide aggregate. Int Endod J 47:120–126CrossRefPubMed
36.
Zurück zum Zitat Pereira ES, Peixoto IF, Nakagawa RK, Buono VT, Bahia MG (2012) Cleaning the apical third of curved canals after different irrigation protocols. Braz Dent J 23:351–356CrossRefPubMed Pereira ES, Peixoto IF, Nakagawa RK, Buono VT, Bahia MG (2012) Cleaning the apical third of curved canals after different irrigation protocols. Braz Dent J 23:351–356CrossRefPubMed
37.
Zurück zum Zitat Bertacci A, Baroni C, Breschi L, Venturi M, Prati C (2007) The influence of smear layer in lateral channels filling. Clin Oral Investig 11:353–359CrossRefPubMed Bertacci A, Baroni C, Breschi L, Venturi M, Prati C (2007) The influence of smear layer in lateral channels filling. Clin Oral Investig 11:353–359CrossRefPubMed
38.
Zurück zum Zitat Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW (2010) The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 36:1664–1668CrossRefPubMed Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW (2010) The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 36:1664–1668CrossRefPubMed
39.
Zurück zum Zitat Jiang LM, Lak B, Eijsvogels LM, Wesselink P, van der Sluis LW (2012) Comparison of the cleaning efficacy of different final irrigation techniques. J Endod 38:838–841CrossRefPubMed Jiang LM, Lak B, Eijsvogels LM, Wesselink P, van der Sluis LW (2012) Comparison of the cleaning efficacy of different final irrigation techniques. J Endod 38:838–841CrossRefPubMed
40.
Zurück zum Zitat Park E, Shen Y, Khakpour M, Haapasalo M (2013) Apical pressure and extent of irrigant flow beyond the needle tip during positive-pressure irrigation in an in vitro root canal model. J Endod 39:511–515CrossRefPubMed Park E, Shen Y, Khakpour M, Haapasalo M (2013) Apical pressure and extent of irrigant flow beyond the needle tip during positive-pressure irrigation in an in vitro root canal model. J Endod 39:511–515CrossRefPubMed
Metadaten
Titel
Intermittent or continuous ultrasonically activated irrigation: micro-computed tomographic evaluation of root canal system cleaning
verfasst von
Mário Tanomaru-FIlho
Fernanda Ferrari Esteves Torres
Gisselle Moraima Chávez-Andrade
Lucas Martinati Miano
Juliane Maria Guerreiro-Tanomaru
Publikationsdatum
04.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 7/2016
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-015-1645-7

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