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Influence of apical enlargement and complementary canal preparation with the Self‐Adjusting File on endotoxin reduction in retreatment cases
Author(s) -
Silva E. J. N. L.,
Ferreira V. M.,
Silva C. C.,
Herrera D. R.,
DeDeus G.,
Gomes B. P.
Publication year - 2017
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.12677
Subject(s) - reduction (mathematics) , dentistry , materials science , medicine , biomedical engineering , mathematics , geometry
Aim To compare the effectiveness of large apical preparations and complementary canal preparation with the Self‐Adjusting File ( SAF ) in removing endotoxins from the root canal of teeth with apical periodontitis. Methodology Ten single‐rooted and single‐canaled teeth with post‐treatment apical periodontitis were selected. Endotoxin samples were taken after removal of the root filling (S1), after chemomechanical preparation ( CMP ) using 2.5% Na OC l and an R25 file (S2), after CMP using 2.5% Na OC l and an R40 file (S3) and after complementary CMP using the SAF system (S4). Limulus amebocyte lysate ( LAL ) was used to measure endotoxin levels. The Friedman and Wilcoxon tests were used to compare endotoxin levels at each clinical intervention ( P < 0.05). Results After root filling removal, endotoxin was detected in 100% of the root canals (S1, 4.84 EU mL −1 ). CMP with the R25 file was able to significantly reduce endotoxin levels ( P < 0.05). Increased levels of endotoxin removal were achieved by apical preparation with the R40 file ( P < 0.05). Complementary CMP with SAF did not significantly reduce endotoxin levels ( P > 0.05) following the use of the R40 instrument. Conclusions Apical enlargement protocols were effective in significantly reducing endotoxin levels. Complementary preparation with the SAF system failed to eliminate residual endotoxin contents beyond those obtained with the R40 instrument.