Skip to main content

Advertisement

SpringerLink
Log in

Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals.

Materials and methods

Thirty-four mandibular molars with Vertucci’s type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%.

Results

Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05).

Conclusions

Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05).

Clinical relevance

None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data available on request from the authors.

References

  1. Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Perez AR, Rocas IN, Versiani MA, Sousa-Neto MD, Provenzano JC, Siqueira JF Jr (2016) Adjunctive steps for disinfection of the mandibular molar root canal system: a correlative bacteriologic, micro-computed tomography, and cryopulverization approach. J Endod 42:1667–1672. https://doi.org/10.1016/j.joen.2016.08.003

    Article  PubMed  Google Scholar 

  2. Ricucci D, Siqueira JF Jr (2010) Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod 36:1277–1288. https://doi.org/10.1016/j.joen.2010.04.007

    Article  PubMed  Google Scholar 

  3. Tahmasbi M, Jalali P, Nair MK, Barghan S, Nair UP (2017) Prevalence of middle mesial canals and isthmi in the mesial root of mandibular molars: an in vivo cone-beam computed tomographic study. J Endod 43:1080–1083. https://doi.org/10.1016/j.joen.2017.02.008

    Article  PubMed  Google Scholar 

  4. Versiani MA, Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Provenzano JC, Rocas IN, Sousa-Neto MD, Siqueira JF Jr (2016) Micro-CT evaluation of the efficacy of hard-tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J 49:1079–1087. https://doi.org/10.1111/iej.12559

    Article  PubMed  Google Scholar 

  5. Bryce G, MacBeth N, Gulabivala K, Ng YL (2018) The efficacy of supplementary sonic irrigation using the EndoActivator((R)) system determined by removal of a collagen film from an ex vivo model. Int Endod J 51:489–497. https://doi.org/10.1111/iej.12870

    Article  PubMed  Google Scholar 

  6. Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S (2018) Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 51:605–621. https://doi.org/10.1111/iej.12877

    Article  PubMed  Google Scholar 

  7. Paque F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047. https://doi.org/10.1016/j.joen.2009.04.026

    Article  PubMed  Google Scholar 

  8. Yang Q, Liu MW, Zhu LX, Peng B (2020) Micro-CT study on the removal of accumulated hard-tissue debris from the root canal system of mandibular molars when using a novel laser-activated irrigation approach. Int Endod J 53:529–538. https://doi.org/10.1111/iej.13250

    Article  PubMed  Google Scholar 

  9. Alves FRF, Paiva PL, Marceliano-Alves MF, Cabreira LJ, Lima KC, Siqueira JF Jr, Rocas IN, Provenzano JC (2018) Bacteria and hard tissue debris extrusion and intracanal bacterial reduction promoted by XP-endo shaper and reciproc instruments. J Endod 44:1173–1178. https://doi.org/10.1016/j.joen.2018.04.007

    Article  PubMed  Google Scholar 

  10. Vertucci FJ (1984) Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 58:589–599

    Article  PubMed  Google Scholar 

  11. Schneider SW (1971) A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 32:271–275

    Article  PubMed  Google Scholar 

  12. de Pablo OV, Estevez R, Peix Sanchez M, Heilborn C, Cohenca N (2010) Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 36:1919–1931. https://doi.org/10.1016/j.joen.2010.08.055

    Article  PubMed  Google Scholar 

  13. Passalidou S, Calberson F, De Bruyne M, De Moor R, Meire MA (2018) Debris removal from the mesial root canal system of mandibular molars with laser-activated irrigation. J Endod 44:1697–1701. https://doi.org/10.1016/j.joen.2018.06.007

    Article  PubMed  Google Scholar 

  14. De-Deus G, Belladonna FG, de Siqueira ZA, Perez R, Carvalho MS, Souza EM, Lopes RT, Silva E (2019) Micro-CT comparison of XP-endo Finisher and Passive Ultrasonic Irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals. Clin Oral Investig 23:3087–3093. https://doi.org/10.1007/s00784-018-2729-y

    Article  PubMed  Google Scholar 

  15. Siqueira JF Jr, Perez AR, Marceliano-Alves MF, Provenzano JC, Silva SG, Pires FR, Vieira GCS, Rôças IN, Alves FRF (2018) What happens to unprepared root canal walls: a correlative analysis using micro-computed tomography and histology/scanning electron microscopy. Int Endod J 51:501–508. https://doi.org/10.1111/iej.12753

    Article  PubMed  Google Scholar 

  16. Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Perez AR, Ricucci D (2018) Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 32:e65. https://doi.org/10.1590/1807-3107bor-2018.vol32.0065

    Article  PubMed  Google Scholar 

  17. van der Sluis LW, Gambarini G, Wu MK, Wesselink PR (2006) The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J 39:472–476. https://doi.org/10.1111/j.1365-2591.2006.01108.x

    Article  PubMed  Google Scholar 

  18. Perez R, Neves AA, Belladonna FG, Silva E, Souza EM, Fidel S, Versiani MA, Lima I, Carvalho C, De-Deus G (2017) Impact of needle insertion depth on the removal of hard-tissue debris. Int Endod J 50:560–568. https://doi.org/10.1111/iej.12648

    Article  PubMed  Google Scholar 

  19. Campello AF, Marceliano-Alves MF, Siqueira JF Jr, Fonseca SC, Lopes RT, Alves FRF (2021) Unprepared surface areas, accumulated hard tissue debris, and dentinal crack formation after preparation using reciprocating or rotary instruments: a study in human cadavers. Clin Oral Investig 25:6239–6248. https://doi.org/10.1007/s00784-021-03922-8

    Article  PubMed  Google Scholar 

  20. de Mattos de Araujo BM, Cruz ATG, Piasecki L, Webber M, Carneiro E, Westphalen VPD and da Silva Neto UX (2022) Micro-CT evaluation of four final irrigation protocols on hard-tissue debris removal from mesial roots of mandibular molars containing isthmus. Clin Oral Investig 26:6121–6128. https://doi.org/10.1007/s00784-022-04561-3

  21. Siqueira JF Jr, Alves FR, Versiani MA, Rocas IN, Almeida BM, Neves MA, Sousa-Neto MD (2013) Correlative bacteriologic and micro-computed tomographic analysis of mandibular molar mesial canals prepared by self-adjusting file, reciproc, and twisted file systems. J Endod 39:1044–1050. https://doi.org/10.1016/j.joen.2013.04.034

    Article  PubMed  Google Scholar 

  22. Haupt F, Meinel M, Gunawardana A, Hulsmann M (2019) Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: a SEM evaluation. Aust Endod J. https://doi.org/10.1111/aej.12342

    Article  PubMed  Google Scholar 

  23. Linden D, Boone M, De Bruyne M, De Moor R, Versiani MA, Meire M (2020) Adjunctive steps for the removal of hard tissue debris from the anatomic complexities of the mesial root canal system of mandibular molars: a micro-computed tomographic study. J Endod 46:1508–1514. https://doi.org/10.1016/j.joen.2020.05.009

    Article  PubMed  Google Scholar 

  24. Chan R, Versiani MA, Friedman S, Malkhassian G, Sousa-Neto MD, Leoni GB, Silva-Sousa YTC, Basrani B (2019) Efficacy of 3 supplementary irrigation protocols in the removal of hard tissue debris from the mesial root canal system of mandibular molars. J Endod 45:923–929. https://doi.org/10.1016/j.joen.2019.03.013

    Article  PubMed  Google Scholar 

  25. Andreani Y, Gad BT, Cocks TC, Harrison J, Keresztes ME, Pomfret JK, Rees EB, Ma D, Baloun BL, Rahimi M (2021) Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals. (Smear layer removal from irrigant activation using SEM). Aust Endod J 47:143–149. https://doi.org/10.1111/aej.12482

    Article  PubMed  Google Scholar 

  26. Elnaghy AM, Mandorah A, Elsaka SE (2017) Effectiveness of XP-endo finisher, EndoActivator, and file agitation on debris and smear layer removal in curved root canals: a comparative study. Odontology 105:178–183. https://doi.org/10.1007/s10266-016-0251-8

    Article  PubMed  Google Scholar 

  27. Pereira EC, da Silveira Bueno CE, Kato AS, Fontana CE, Stringheta CP, Pelegrine RA (2021) Irrigant agitation techniques versus passive ultrasonic irrigation for removing debris from curved root canals: an environmental scanning electron microscopic Study. Iran Endod J 16:26–32. https://doi.org/10.22037/iej.v16i1.26741

    Article  PubMed  PubMed Central  Google Scholar 

  28. Zhao Y, Fan W, Xu T, Tay FR, Gutmann JL, Fan B (2019) Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C-shaped canals. Int Endod J 52:1354–1365. https://doi.org/10.1111/iej.13119

    Article  PubMed  Google Scholar 

  29. Pacheco-Yanes J, Provenzano JC, Marceliano-Alves MF, Gazzaneo I, Perez AR, Goncalves LS, Siqueira JF Jr (2020) Distribution of sodium hypochlorite throughout the mesial root canal system of mandibular molars after adjunctive irrigant activation procedures: a micro-computed tomographic study. Clin Oral Investig 24:907–914. https://doi.org/10.1007/s00784-019-02970-5

    Article  PubMed  Google Scholar 

  30. Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera JF, Pecora JD, Sousa-Neto MD (2017) 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 50:398–406. https://doi.org/10.1111/iej.12630

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Brazilian Governmental Institution.

Funding

This study was supported by grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazilian Governmental Institutions.

Author information

Authors and Affiliations

  1. Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil

    Warley Oliveira Silva, Pablo Amoroso-Silva, Patrícia Olivares & Flávio Rodrigues Ferreira Alves

  2. Federal University of Valley of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil

    Warley Oliveira Silva

  3. Faculty of Dentistry of Bauru, Department of Dentistry, Endodontics and Dental Materials, University of São Paulo, Bauru, SP, Brazil

    Murilo Priori Alcalde

  4. Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil

    Flávio Rodrigues Ferreira Alves & Marília Fagury Marceliano-Alves

Authors
  1. Warley Oliveira Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pablo Amoroso-Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrícia Olivares
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Murilo Priori Alcalde
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Flávio Rodrigues Ferreira Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marília Fagury Marceliano-Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Warley O. Silva — Teeth selection and preparation, root canal preparation, data collection, and manuscript writing (first draft).

Pablo Amoroso-Silva — Statistical analysis.

Patrícia Olivares — Teeth selection and preparation.

Murilo Priori Alcalde—Teeth selection and preparation.

Flávio R. F. Alves — writing and revision.

Marília F. Marceliano-Alves — Study concept/design, supervision, and microtomographic analyses.

Corresponding author

Correspondence to Marília Fagury Marceliano-Alves.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not applicable.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silva, W.O., Amoroso-Silva, P., Olivares, P. et al. Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation. Clin Oral Invest 27, 7523–7529 (2023). https://doi.org/10.1007/s00784-023-05342-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-023-05342-2

Keywords

Search

Navigation