Luigi Cianconi

A comparative study of smear layer removal and erosion in apical intraradicular dentine with three irrigating solutions: a scanning electron microscopy evaluation.

INTRODUCTION This study compared the efficacy of BioPure MTAD (Dentsply Tulsa, Tulsa, OK), 17% EDTA, and 42% citric acid in endodontic smear layer removal and degree of erosion in the apical third of endodontic canals. METHODS Ninety-six extracted single-rooted human teeth were randomized into four groups (n = 24) and instrumented using System GT nickel-titanium rotary instruments (Dentsply Tulsa, Tulsa, OK). Each canal was irrigated with one of the following solutions: BioPure MTAD, 17% EDTA, 42% citric acid, or 5.25% NaOCl (control). Next, all specimens were irrigated with 5.25% NaOCl. RESULTS Evaluation by scanning electron microscopy showed no significant differences among test irrigants in removing the smear layer. However, the efficacy of BioPure MTAD and 17% EDTA in removing the smear layer was significantly greater than 5.25% NaOCl (control). The erosive effects of irrigating solutions could not be evaluated. CONCLUSIONS In conclusion, the protocols used in this study were not sufficient to completely remove the smear layer in the apical third of prepared root canals.

Accuracy of Three Electronic Apex Locators Compared with Digital Radiography: An Ex Vivo Study

INTRODUCTION This study compared (1) the accuracy of three different electronic apex locators (EALs) in detecting the apical foramen ex vivo under clinical conditions; (2) the accuracy of digital radiography and EALs in determining the working length (WL) with visible control under a microscope; and (3) the precision of #10, #15, and #20 K-files in electronic measurements. METHODS The length of 101 extracted human teeth was measured with three different EALs (Endex [Osada Electric Co, Tokyo, Japan], ProPex II [Dentsply-Maillefer, Ballaigues, Switzerland], and Root ZX [J. Morita Co, Tustin, CA]), with radio videography (RVG) and compared with the actual length. An endodontic training kit (Pro-Train; Simit Dental, Mantova, Italy) was used during the experimental procedures. RESULTS Statistical analysis showed that Endex and ProPex II were more accurate than Root ZX in determining the WL. The paired sample t test showed no statistically significant difference between the accuracy of the two radiographic planes examined. The t test showed no significant difference between the three different K-file sizes measurements. CONCLUSIONS Endex and ProPex II were more accurate than Root ZX in determining the actual WL. Instrument sizes of hand files did not affect the accuracy of EALs. EALs showed to be more accurate in determining the WL than RVG.

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.

INTRODUCTION The purpose of this study was to evaluate the effectiveness of different irrigating methods in removing the smear layer at 1, 3, 5, and 8 mm from the apex of endodontic canals. METHODS Sixty-five extracted single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer, Ballaigues, Switzerland) and irrigated with 5.25% NaOCl at 37°C. Teeth were divided into 5 groups (2 control groups [n = 10] and 3 test groups [n = 15]) according to the final irrigant activation/delivering technique (ie, sonic irrigation, passive ultrasonic irrigation [PUI], or apical negative pressure). Root canals were then split longitudinally and observed by field emission scanning electron microscopy. The presence of debris and a smear layer at 1, 3, 5, and 8 mm from the apex was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. RESULTS The EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK) was significantly more efficient than PUI and the control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System (Discus Dental, Culver City, CA) removed statistically significantly more smear layer than all groups at 1, 3, 5, and 8 mm from the apex. At 5 and 8 mm from the apex, PUI and the EndoVac did not differ statistically significantly, but both performed statistically better than the control groups. CONCLUSIONS In our study, none of the activation/delivery systems completely removed the smear layer from the endodontic dentine walls; nevertheless, the EndoActivator and EndoVac showed the best results at 3, 5, and 8 mm (EndoActivator) and 1, 3, 5, and 8 mm (EndoVac) from the apex.

Accuracy of three electronic apex locators in anterior and posterior teeth: an ex-vivo study.

INTRODUCTION The aim of this study was to determine in anterior teeth, bicuspids, and molars (1) the accuracy of 3 different electronic apex locators (EALs) in detecting the apical foramen and (2) the accuracy of digital radiography in determining the working length (WL), compared with visible control under a microscope. METHODS By using radiovideography (RVG), we measured the lengths of 120 root canals with 3 different EALs (Endex, ProPex II, and Root ZX) and compared them with the actual lengths. The accuracy of EALs and RVG was related to each dental category. An endodontic training kit (Pro-Train) was used during experimental procedures. RESULTS Statistical analysis showed that the 3 EALs and RVG were less accurate in anterior teeth and molars than in bicuspids. The paired-sample t test showed no statistically significant difference between mesiodistal plane and buccolingual plane digital radiography in all groups. CONCLUSIONS The 3 EALs tested were more accurate in detecting the apical foramen in bicuspids than in both molars and anterior teeth. Radiographic measurements were not reliable for determining WL in all dental groups in both radiographic planes.