Sonic versus ultrasonic activation in calcium hydroxide removal in curved canals: an in-vitro study.
Abstract
Objective: Compare the area of calcium hydroxide (Ca(OH)2) remaining in the apical third of curved canals after sonic and ultrasonic activation using Scanning Electron Microscope (SEM). Methodology: Permanent mandibular molars were collected. Were included mesial roots that radiographically presented a curvature between 15° and 30°. 39 mesiolinguales root canal were instrumented rotary ProTaper and filled with Ca(OH)2 mixed with propylene glycol. They were randomly divided into 3 groups according to the type of removal. Group I, three inserts with lime F2 irrigating with 2 mL of sodium hypochlorite (NaOCl) 5.25% for each insertion. Group II, three sonic activations, irrigating with 2 mL 5.25% NaOCl between activations. Group III, three ultrasonic activations irrigating with 2 mL 5.25% NaOCl between activations. were left 3 root canal and other 3, unfilled and with total filling respectively as positive and negative controls. After longitudinally fractured obtaining two sections, the apical third of the root canal of each section is microfotografió SEM and then in an area of 100.000 um2, the surface with Ca(OH)2 remaining in both sections is measured using ImageJ 1.47. Were analyzed with one-way ANOVA using GraphPad Prism 5.01. Results: The percentage of area with Ca(OH)2 remaining in group I was 62.93%. Group II, 51.77%. Group III 58.90%. There was no significant difference between the three groups (P> 0.01) Conclusion: No significant differences in the percentage of area with Ca(OH)2 remaining in the apical third of curved canals, comparing sonic ultrasonic activation using SEM.
Keywords: Endodontics, Calcium Hydroxide, Removal, Sonic, Ultrasonics.
Activación sónica versus ultrasónica en remoción de hidróxido de calcio en conductos curvos: estudio in-vitro.
Objetivo: Comparar el área de hidróxido de calcio (Ca(OH)2) remanente en el tercio apical de conductos curvos, tras activación sónica y ultrasónica, utilizando Microscopio Electrónico de Barrido (MEB).Metodología: Se recolectaron molares mandibulares permanentes. Se incluyeron los que en la raíz mesial presentron radiográficamente una curvatura entre 15º y 30°. Se instrumentaron 39 conductos mesiolinguales con ProTaper rotatorio y se rellenaron con Ca(OH)2 mezclado con propilenglicol. Se dividieron aleatoriamente en 3 grupos de acuerdo al tipo de remoción. Grupo I: tres inserciones con lima F2 irrigando con 2 mL de hipoclorito de sodio (NaOCl) 5.25% entre cada inserción. Grupo II: tres activaciones sónicas, irrigando con 2 mL NaOCl 5.25% entre activaciones. Grupo III: tres activaciones Ultrasónicas irrigando con 2 mL NaOCl 5.25% entre activaciones. Se dejaron 3 conductos sin rellenar y otros 3 con relleno total como controles positivo y negativo respectivamente. Luego se fracturaron longitudinalmente obteniendo 2 secciones, se microfotografió el tercio apical del conducto radicular de cada sección con MEB y posteriormente en un área de 100.000 um2, se midió la superficie con Ca(OH)2 remanente de ambas secciones usando ImageJ 1.47. Se analizó con ANOVA de una vía usando GraphPad-Prism 5.01.Resultados: El porcentaje de área con Ca(OH)2 remanente del grupo I fue 62.93%. Grupo II, 51.77%. Grupo III 58.90%. No hubo diferencia significativa entre los tres grupos (P>0.01)Conclusión: No hay diferencias significativas en el porcentaje de área con Ca(OH)2 remanente del tercio apical de conductos curvos, al comparar la activación sónica con la ultrasónica, utilizando MEB.
Palabras clave: Endodoncia, Hidróxido de Calcio, Remoción, Sónico, Ultrasonico.
References
2. Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011; 44(8): 697-730
3. Margelos J, Eliades G, Verdelis C, Palaghias G. Interaction of calcium hydroxide with zinc oxide-eugenol type sealers: a potential clinical problem. J Endod. 1997; 23(1): 43-48.
4. Kim SK, Kim YO. Influence of calcium hydroxide intracanal medication on apical seal. Int Endod J. 2002; 35(7): 623-628.
5. Hosoya N, Kurayama H, Iino F, Arai T. Effects of calcium hydroxide on physical and sealing properties of canal sealers. Int Endod J. 2004; 37(3): 178-184.
6. Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure?. J Am Dent Assoc. 2005;136(2):187-193
7. Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod. 2011; 37(11): 1516-1519.
8. Balvedi RP, Versiani MA, Manna FF, Biffi JC. A comparison of two techniques for the removal of calcium hydroxide from root canals. Int Endod J. 2010; 43(9): 763-768.
9. Da Silva JM, Andrade Junior CV, Zaia AA, Pessoa OF. Microscopic cleanliness evaluation of the apical root canal after using calcium hydroxide mixed with chlorhexidine, propylene glycol, or antibiotic paste. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111(2): 260-264.
10. De Faria-Júnior NB, Keine KC, Só MV, Weckwerth PH, Guerreiro-Tanomaru JM, Kuga MC. Residues of calcium hydroxide-based intracanal medication associated with different vehicles: a scanning electron microscopy evaluation. Microsc Res Tech. 2012; 75(7): 898-902.
11. Van der Sluis LW, Wu MK, Wesselink PR. The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J. 2007; 40(1): 52-57.
12. 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): 580-584.
13. Tasdemir T, Celik D, Er K, Yildirim T, Ceyhanli KT, Yeşilyurt C. Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals. Int Endod J. 2011; 44(6): 505-509.
14. Da Silva JM, Silveira A, Santos E, Prado L, Pessoa OF. Efficacy of sodium hypochlorite, ethylenediaminetetraacetic acid, citric acid and phosphoric acid in calcium hydroxide removal from the root canal: a microscopic cleanliness evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112(6): 820-824.
15. Rao SA, Manasa N. Effect of irrigants using ultrasonics on intracanal calcium hydroxide removal – an in vitro comparative evaluation. Braz J Oral Sci. 2012; 11(1): 52-55
16. Sağsen B, Ustün Y, Aslan T, Canakçi BC. The effect of peracetic acid on removing calcium hydroxide from the root canals. J Endod. 2012; 38(9): 1197-1201.
17. Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD. Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod. 2011; 37(2): 235-238.
18. Khaleel H, Al-Ashaw A, Yang Y, Pang A, Ma J. Quantitative comparison of calcium hydroxide removal by EndoActivator, Ultrasonic and ProTaper File Agitation Techniques: An in vitro study. J Huazhong Univ Sci Technolog Med Sci. 2013; 33(1): 142-145
19. Maalouf L, Zogheib C, Naaman A. Removal efficiency of calcium hydroxide dressing from the root canal without chemically active adjuvant. J Contemp Dent Pract. 2013;14(2):188-192.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. © 2024.
