Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal

Baran Can Sağlam; Ecehan Hazar; Sibel Koçak; Mustafa Murat Koçak

doi:10.7126/cumudj.490589

EN

Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal

Abstract

Objectives: The aim of this study was to compare conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF) techniques in terms of modified triple antibiotic paste (mTAP) removal.

Materials and Methods: A total of 30 mandibular premolars were instrumented to a size F3 file. A mixture of mTAP was prepared by mixing 3 antibiotics, including 250 mg ciprofloxacin, 250 mg metronidazole, and 150 mg clindamycin, with 1 ml distilled water and applied into the root canals. The teeth were allocated into 3 equal groups, irrigation/agitation was performed and teeth were divided into two halves. The removal of mTAP was evaluated with a scanning electron microscope by using the 4 grade scoring system.

Results: In the apical thirds, significant difference was found between PUI and CNI groups (p<0.05), whilst no significant difference was found among the other irrigation activation regimens (p> 0.05). No statistically significant difference was found between all groups in the middle third. In the coronal thirds, XPF removed significantly more mTAP than the CNI group (p<0.05). However, no difference was recorded among other groups (p>0.05).

Conclusions: Passive ultrasonic irrigation and XPF file agitation demonstrated superior efficacy in removing mTAP from root canals compared to CNI.

Keywords

Root canal therapy,ultrasonics,root canal medicaments

References

1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965;20:340–349.
2. Hülsmann M, Peters O, Dummer P. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Topics 2005;10(1):30-76. 3. Byström A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Dent Traumatol 1985;1(5):170–175.
4. Kamocki K, Nör JE, Bottino MC. Dental pulp stem cell responses to novel antibiotic-containing scaffolds for regenerative endodontics. Int Endod J 2015;48:1147-56.
5. Hoshino E, Kurihara-Ando N, Sato I et al. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 1996;29(2):125–30.
6. McTigue DJ, Subramanian K, Kumar A. Management of immature permanent teeth with pulpal necrosis: a case series. Pediatr Dent 2013;35(1):55-60.
7. Yujeong Kim, Seonmi Kim, Namki Choi. Regenerative endodontic treatment without discoloration of infected immature permanent teeth using retro MTA: Two case reports. J Korean Acad Pediatr Dent 2014;41(4):335-343.
8. Zhu W, Zhu X, Huang GT, et al. Regeneration of dental pulp tissue in immature teeth with apical periodontitis using platelet-rich plasma and dental pulp cells. Int Endod J 2013;46(10):962–70.
9. Tawfik H, Abu-Seida AM, Hashem AA, Nagy MM. Regenerative potential following revascularization of immature permanent teeth with necrotic pulps. Int Endod J 2013;46(10):910–22.

10. Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A. Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod 2012;38(10):1372–5.
11. Berkhoff JA, Chen PB, Teixeira FB, Diogenes A. Evaluation of triple antibiotic paste removal by different irrigation procedures. J Endod 2014;40(8):1172-7. 12. FKG Dentaire SA The XP-endo Finisher file brochure. (Home page). Cited: September 1, 2018. Available from: http://www.fkg.ch/ products/endodontics/final preparation/ XP-endo-finisher.
13. Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J 2014;216(6):299-303.
14. Casamassimo PS, Fields HW, McTigue DJ, Nowak A: Pediatric Dentistry: Infancy Through Adolescence. 5th edition. W.B. Sauders, Elsevier Science Health div, Philadelphia, 507-508, 2012.
15. Salgado RJ, Moura-Netto C, Yamazaki AK, Cardoso LN, de Moura AA, Prokopowitsch I. Comparison of different irrigants on calcium hydroxide medication removal: Microscopic cleanliness evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107(4):580-4.
16. Gokturk H, Ozkoçak I, Buyukgebiz F, Demir O. An in vitro evaluation of various irrigation techniques for the removal of double antibiotic paste from root canal surfaces. J Appl Oral Sci 2016 Nov-Dec;24(6):568-574.
17. Arslan H, Capar ID, Saygili G, Uysal B, Gok T, Ertas H, Topcuaglu HS. Efficacy of various irrigation protocols on the removal of triple antibiotic paste. Int Endod J 2014 Jun;47(6):594-9.
18. Akman M, Akbulut MB, Aydınbelge HA, Belli S. Comparison of different irrigation activation regimens and conventional irrigation techniques for the removal of modified triple antibiotic paste from root canals. J Endod 2015;41(5):720-724.
19. Montero-Miralles P, Martín-González J, Alonso-Ezpeleta O, Jiménez-Sánchez MC, Velasco-Ortega E, Segura-Egea JJ. Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review. Int Endod J 2018 Sep;51(9):981-988.
20. Lin J, Zeng Q, Wei X et al. (2017) Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis: a prospective randomized controlled study. J Endod 2017;43(11):1821–7.
21. Arslan H, Akcay M, Capar ID, Ertas H, Ok E, Uysal B. Efficacy of needle irrigation, EndoActivator, and photon-initiated photoacoustic streaming technique on removal of double and triple antibiotic pastes. J Endod 2014;40(9):1439-42.
22. Dumani A, Yilmaz S, Yoldas O, Bek ZG. Effect of irrigation technique for removal of triple antibiotic paste on bond strength of MTA to root dentin. Braz Oral Res 2016;30(1):e62.
23. Turkaydin D, Demir E, Basturk FB, Sazak Övecoglu H. Efficacy of XP-endo Finisher in the removal of triple antibiotic paste from immature root canals. J Endod. 2017 Sep;43(9):1528-1531.
24. 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(2):321-325.
25. Wigler R, Dvir R, Weisman A, Matalon S, Kfir A. Efficacy of XP-endo finisher files in the removal of calcium hydroxide paste from artificial standardized grooves in the apical third of oval root canals. Int Endod J 2017;50(7):700-705.
26. Jiang LM, Verhaagen B, Versluis M, van der Sluis LW. Influence of the oscillation direction of an ultrasonic file on the cleaning efficacy of passive ultrasonic irrigation. J Endod 2010;36(8):1372–6.
27. 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):1456-60.

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Baran Can Sağlam ^*
0000-0002-2090-5304
Türkiye

Ecehan Hazar
0000-0002-7610-9622
Türkiye

Sibel Koçak
0000-0003-2354-7108
Türkiye

Mustafa Murat Koçak
0000-0003-3881-589X
Türkiye

Publication Date

March 13, 2019

Submission Date

November 30, 2018

Acceptance Date

February 15, 2019

Published in Issue

Year 2019 Volume: 22 Number: 1

DOI

https://doi.org/10.7126/cumudj.490589

IZ

https://izlik.org/JA46XM99MB

Cite

RIS / Bibtex

EndNote

Sağlam BC, Hazar E, Koçak S, Koçak MM (March 1, 2019) Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal. Cumhuriyet Dental Journal 22 1 108–113.