Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

Abstract: The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.

摘要：本研究旨在比较两种冲洗技术与四种根管封闭剂（endodontic sealer）置入装置在牙本质小管（dentinal tubules）内的应用效果。本研究纳入99颗单根人牙（single-rooted human teeth），经根管预备后，根据冲洗方式分为对照组（CO，n=11）与实验组：注射器联合NaveTip针头组（syringe and NaveTip needle，NT，n=44）及EndoActivator装置组（EndoActivator，EA，n=44）。随后根据根管封闭剂置入方式进一步细分亚组：K型锉组（K-File，KF）、螺旋输送器组（lentulo spiral，LS）、Easy Clean组（EC）及EndoActivator亚组（EA）。此外，本研究分析了距根尖（apex）5mm与2mm处的封闭剂渗透情况。所有牙齿均采用AH Plus与GuttaCore X3完成根管充填。采用结合阴极发光（cathodoluminescence）的扫描电子显微镜（scanning electron microscopy）进行分析，测量封闭剂渗透百分比与最大渗透深度。采用三因素方差分析（three-way analysis of variance，ANOVA）与Games-Howell检验进行数据统计分析（p<0.05）。结果显示，EA组的封闭剂渗透百分比显著优于NT组；EC亚组的封闭剂渗透效果显著优于EA亚组，且二者相较LS组均能提升封闭剂渗透百分比。距根尖5mm处的封闭剂渗透效果更佳。声波冲洗激活（sonic irrigant activation）可显著改善牙本质小管内的根管封闭剂渗透情况。