Cleaning, Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro-computed Tomographic and Histobacteriologic Approach

Alejandro R Pérez; Domenico Ricucci; Gaya C S Vieira; José C Provenzano; Flávio R F Alves; Marília F Marceliano-Alves; Isabela N Rôças; José F Siqueira Jr

doi:10.1016/j.joen.2020.03.017

Cleaning, Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro-computed Tomographic and Histobacteriologic Approach

J Endod. 2020 Jun;46(6):846-857. doi: 10.1016/j.joen.2020.03.017. Epub 2020 Apr 30.

Authors

Alejandro R Pérez¹, Domenico Ricucci², Gaya C S Vieira¹, José C Provenzano¹, Flávio R F Alves³, Marília F Marceliano-Alves¹, Isabela N Rôças⁴, José F Siqueira Jr⁴

Affiliations

¹ Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
² Private Practice, Cetraro, Italy.
³ Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio, Duque de Caxias, Rio de Janeiro, Brazil. Electronic address: flavioferreiraalves@gmail.com.
⁴ Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio, Duque de Caxias, Rio de Janeiro, Brazil.

PMID: 32362378
DOI: 10.1016/j.joen.2020.03.017

Abstract

Introduction: This study assessed the cleaning, shaping, and disinfection abilities of 2 instrumentation systems in molar root canals using a novel correlative analytical approach.

Methods: The root canals from extracted mandibular and maxillary molars with apical periodontitis were pair matched according to anatomic similarities as determined by micro-computed tomographic analysis and prepared with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (n = 16) or Reciproc Blue (VDW, Munich, Germany) (n = 16) instruments and 2.5% sodium hypochlorite irrigation. Pre- and postpreparation micro-computed tomographic scans were used to identify and calculate the unprepared surface areas (shaping), which were histobacteriologically evaluated for the presence of residual bacteria (disinfection) and pulp tissue remnants (cleaning) in each canal third.

Results: Unprepared canal surface areas for XP-endo Shaper and Reciproc Blue in the full canal length were approximately 26% and 19% (P < .05), respectively (30% and 23% in the apical part of the canal, P > .05). Preparation with Reciproc Blue resulted in 37.5% canals free of bacteria in all sections examined and 56% in the apical sections only. XP-endo Shaper resulted in 44% canals free of bacteria in all sections, and 56% in the apical part of the canal only. Pulp tissue remnants were not observed in 31% (all canal sections) and 50% (apical canal sections) of specimens from both instrument systems. No significant differences were observed between instruments when comparing the amount of pulp tissue remnants and the number of cases negative for bacteria and tissue remnants (P > .05).

Conclusions: Although the Reciproc Blue instrument had superior shaping ability in comparison with XP-endo Shaper, both systems performed similarly in cleaning and disinfecting root canals. Irregular canals and difficult-to-reach areas were not thoroughly cleaned and disinfected by any of the tested systems.

Keywords: Apical periodontitis; bacterial persistence; histobacteriology; micro–computed tomography; root canal preparation.

MeSH terms

Dental Pulp Cavity
Humans
Molar
Periapical Periodontitis*
Root Canal Preparation*
X-Ray Microtomography