Research Article
No access
Published Online: 12 August 2022

The Impact of Laser-Activated and Conventional Irrigation Techniques on Sealer Penetration into Dentinal Tubules

Publication: Photobiomodulation, Photomedicine, and Laser Surgery
Volume 40, Issue Number 8

Abstract

Objective: The present study was aimed at comparing the efficacy of 1-hydroxyethylidene-1, 1-diphosphonic acid (HEDP) and ethylenediaminetetraacetic acid (EDTA) by using various final irrigation techniques on penetration of sealer.
Background: Traditional irrigation of root canals with a syringe limits the ability of sealer penetration. Various irrigants and activation techniques, including sonic and ultrasonic devices and various kinds of lasers, have been introduced to improve penetration of sealers into dentinal tubules.
Methods: One hundred mandibular premolars were selected. Final irrigation was performed with HEDP or EDTA by conventional syringe irrigation (CI), EndoActivator (EA), passive ultrasonic irrigation (PUI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS) methods (n = 10). After obturation of root canals with the EndoSequence BC Sealer, samples were evaluated using a confocal laser scanning microscope (CLSM), which enabled measurement of the maximum depth, percentage, and penetration area. Tests performed for analysis included the Kruskal–Wallis H and Mann–Whitney U tests.
Results: In the EA method, the penetration percentage achieved using HEDP was significantly higher than EDTA at both sections (p < 0.05). Irrespective of the final irrigation solution employed, the PUI, PIPS, and SWEEPS techniques exhibited greater tubule penetration values compared with the CI and EA techniques (p < 0.05).
Conclusions: HEDP and EDTA showed similar effects on the amount of penetrated sealer into the dentinal tubules, and the PUI, PIPS and SWEEPS methods provided enhanced EndoSequence BC Sealer penetration compared with the CI and EA methods.
This study was approved by the Near East University institutional review board (#2020/86-1225).

Get full access to this article

View all available purchase options and get full access to this article.

References

1. Piai GG, Duarte M, Nascimento A, et al. Penetrability of a new endodontic sealer: a confocal laser scanning microscopy evaluation. Microsc Res Tech 2018;81:1246–1249.
2. Turkel E, Onay EO, Ungor M. Comparison of three final irrigation activation techniques: effects on canal cleanness, smear layer removal, and dentinal tubule penetration of two root canal sealers. Photomed Laser Surg 2017;35:672–681.
3. Machado R, Garcia L, da Silva Neto UX, et al. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech 2018;81:275–282.
4. Galler KM, Grubmüller V, Schlichting R, et al. Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J 2019;52:1210–1217.
5. Demenech LS, Tomazinho FSF, Baratto-Filho F, et al. Biocompatibility of the 8.25% sodium hypochlorite irrigant solution in endodontics: an in vivo study. Microsc Res Tech 2021;84:1506–1512.
6. Matos FS, da Silva FR, Paranhos LR, et al. The effect of 17% EDTA and QMiX ultrasonic activation on smear layer removal and sealer penetration: ex vivo study. Sci Rep 2020;10:10311.
7. Ulusoy ÖI, Savur IG, Alaçam T, et al. The effectiveness of various irrigation protocols on organic tissue removal from simulated internal resorption defects. Int Endod J 2018;51:1030–1036.
8. Giardino L, Savadori P, Generali L, et al. Antimicrobial effectiveness of etidronate powder (Dual Rinse® HEDP) and two EDTA preparations against Enterococcus faecalis: a preliminary laboratory study. Odontology 2020;108:396–405.
9. Yilmaz A, Yalcin TY, Helvacioglu-Yigit D. Effectiveness of various final irrigation techniques on sealer penetration in curved roots: a confocal laser scanning microscopy study. Biomed Res Int 2020;2020:8060489.
10. Chaudhry S, Yadav S, Talwar S, et al. Effect of EndoActivator and Er,Cr:YSGG laser activation of Qmix, as final endodontic irrigant, on sealer penetration: a Confocal microscopic study. J Clin Exp Dent 2017;9:e218–e222.
11. Pérez-Alfayate R, Algar-Pinilla J, Mercade M, et al. Sonic activation improves bioceramic sealer's penetration into the tubular dentin of curved root canals: a confocal laser scanning microscopy investigation. Appl Sci (Basel) 2021;11:3902.
12. Larionova EV, Diachkova EY, Morozova EA, et al. Laser-assisted tooth extraction in patients with impaired hemostasis. Biomedicine (Taipei) 2021;11:47–54.
13. Scribante A, Gallo S, Pascadopoli M, et al. Management of periodontal disease with adjunctive therapy with ozone and photobiomodulation (pbm): a randomized clinical trial. Photonics 2022;9:138.
14. Shah D, Ponappa MC, Ponnappa KC. Evaluation of effect of low level laser therapy with intracanal medicament on periapical healing: a randomised control trial. Indian J Dent Res 2021;32:299–304.
15. Kirmizi D, Aksoy U, Orhan K. Efficacy of laser-activated irrigation and conventional techniques in calcium hydroxide removal from simulated internal resorption cavities: micro-CT study. Photobiomodul Photomed Laser Surg 2021;39:674–681.
16. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971;32:271–275.
17. Ateş AA, Arıcan B, Çiftçioğlu E, et al. Influence of different irrigation regimens on the dentinal tubule penetration of a bioceramic-based root canal sealer: a confocal analysis study. Lasers Med Sci 2021;36:1771–1777.
18. Aydın ZU, Özyürek T, Keskin B, et al. Effect of chitosan nanoparticle, QMix, and EDTA on TotalFill BC sealers' dentinal tubule penetration: a confocal laser scanning microscopy study. Odontology 2019;107:64–71.
19. Generali L, Cavani F, Serena V, et al. Effect of different irrigation systems on sealer penetration into dentinal tubules. J Endod 2017;43:652–656.
20. Orhan K, Jacobs R, Celikten B, et al. Evaluation of threshold values for root canal filling voids in micro-CT and nano-CT images. Scanning 2018;2018:9437569.
21. Akcay M, Arslan H, Durmus N, et al. Dentinal tubule penetration of AH Plus, iRoot SP, MTA fillapex, and guttaflowbioseal root canal sealers after different final irrigation procedures: a confocal microscopic study. Lasers Surg Med 2016;48:70–76.
22. Uysal BA, Kotan G, Guneser MB, et al. Investigation of the effect of different chelation solutions on penetration of resin-based and bioceramic sealers with a novel method. Microsc Res Tech 2021;84:1571–1576.
23. Gawdat SI, Bedier MM. Influence of dual rinse irrigation on dentinal penetration of a bioceramic root canal sealer: a Conofocal microscopic Analysis. Aust Endod J 2021 [Online ahead of print];.
24. Bolles JA, He J, Svoboda KK, et al. Comparison of Vibringe, EndoActivator, and needle irrigation on sealer penetration in extracted human teeth. J Endod 2013;39:708–711.
25. El Hachem R, Le Brun G, Le Jeune B, et al. Influence of the endoactivator irrigation system on dentinal tubule penetration of a novel tricalcium silicate-based sealer. Dent J (Basel) 2018;6:45.
26. Uroz-Torres D, González-Rodríguez MP, Ferrer-Luque CM. Effectiveness of the EndoActivator System in removing the smear layer after root canal instrumentation. J Endod 2010;36:308–311.
27. Machado R, Cruz A, de Araujo B, et al. Tubular dentin sealer penetration after different final irrigation protocols: a confocal laser scanning microscopy study. Microsc Res Tech 2018;81:649–654.
28. Oliveira KV, Silva B, Leonardi DP, et al. Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules. Braz Oral Res 2017;31:e114.
29. Aksel H, Küçükkaya-Eren S, Puralı N, et al. Efficacy of different irrigant protocols and application systems on sealer penetration using a stepwise CLSM analysis. Microsc Res Tech 2017;80:1323–1327.
30. Munoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod 2012;38:445–448.
31. Prado MC, Leal F, Simão RA, et al. The use of auxiliary devices during irrigation to increase the cleaning ability of a chelating agent. Restor Dent Endod 2017;42:105–110.
32. Eldeeb IM, Nawar NN, Saber SM, et al. Smear layer removal and sealer penetration with different tapers after using photon-initiated photoacousticstreaming technique. Clin Oral Investig 2021;25:5025–5032.
33. Al-Ali M, Sathorn C, Parashos P. Root canal debridement efficacy of different final irrigation protocols. Int Endod J 2012;45:898–906.
34. Al-Hadlaq SM, Al-Turaiki SA, Al-Sulami U, et al. Efficacy of a new brush-covered irrigation needle in removing root canal debris: a scanning electron microscopic study. J Endod 2006;32:1181–1184.
35. Tashkandi N, Alghamdi F. Effect of chemical debridement and irrigant activation on endodontic treatment outcomes: an updated overview. Cureus 2022;14:e21525.

Information & Authors

Information

Published In

cover image Photobiomodulation, Photomedicine, and Laser Surgery
Photobiomodulation, Photomedicine, and Laser Surgery
Volume 40Issue Number 8August 2022
Pages: 565 - 572
PubMed: 35917520

History

Published online: 12 August 2022
Published ahead of print: 2 August 2022
Published in print: August 2022
Accepted: 19 April 2022
Received: 25 February 2022

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
Fatma Basmacı
Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
Dilan Kırmızı
Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Cyprus.

Notes

Address correspondence to: Dilara Koruk, DDS, Department of Endodontics, Faculty of Dentistry, Near East University, Near East Boulevard, Nicosia 99138, Cyprus [email protected]

Authors' Contributions

D.K., F.B., and U.A. were involved in conceptualization; D.K., F.B., and U.A. were involved in methodology; D.K. and D.K. were involved in software; D.K., F.B., and U.A. were involved in validation; D.K. was involved in formal analysis; B.S. was involved in investigation; D.K. was involved in acquiring resources; D.K., F.B., and U.A. were involved in data curation; D.K., F.B., and U.A. were involved in writing—original draft preparation; D.K., D.K., U.A., and F.B. were involved in writing—review and editing; D.K. was involved in visualization; D.K. and F.B. were involved in supervision; D.K. and F.B. were involved in project administration; and D.K. was involved in funding acquisition.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

No funding was received for this article.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Figures

Tables

Media

Share

Share

Copy the content Link

Share on social media

Back to Top