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CC BY-NC-ND 4.0 · Eur J Dent 2021; 15(01): 090-095
DOI: 10.1055/s-0040-1715985
Original Article

Effect of a Modified Irrigation Protocol on the Cleanliness of Moderately Curved Canals

Garance Voegeli
1   University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
,
Enrico Di Bella
2   Department of Economics and Business Studies, Faculty of Economics, University of Genoa, Genoa, Italy
,
Mustapha Mekki
3   Biomaterials Unit, Section of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
,
Pierre Machtou
4   Faculty of Odontology, Paris, France
,
Serge Bouillaguet
1   University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Abstract

Objectives This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals.

Materials and Methods Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).

Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX).

Statistical Analysis Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (p < 0.05).

Results In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (p < 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin.

Conclusions Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.

Keywords

EDTA - endodontic - irrigation - NaOCl - smear layer


Publication History

Article published online:
01 October 2020

© 2020. European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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