Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Endodontics, Faculty of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Rio de Janeiro, Brazil.
J Endod. 2023 Sep;49(9):1183-1190. doi: 10.1016/j.joen.2023.06.017. Epub 2023 Jul 6.
This study compared disinfection and shaping after root canal preparation with either XP-endo Shaper or TruNatomy instrument systems, supplemented by ultrasonic activation of sodium hypochlorite (NaOCl) with either stainless-steel (SS) or nickel-titanium (NiTi) inserts.
Mesial roots from mandibular molars with Vertucci class II configuration were divided into 2 groups (n = 24) based on anatomically paired micro-computed tomography (micro-CT) analyses. Pre and postpreparation micro-CT scans were obtained to evaluate the shaping performance. The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation with either XP-endo Shaper or TruNatomy instruments using NaOCl irrigation. Supplementary ultrasonic activation of NaOCl was conducted using either an SS (TruNatomy group) or NiTi (XP-endo Shaper group) insert. Bacteriological samples were taken from the canals before preparation (S1), after preparation (S2), and after the supplementary approach (S3). Bacterial reduction was evaluated using a quantitative real-time polymerase chain reaction.
Preparation with both instrument systems significantly reduced bacterial counts (P < .01). After preparation, 36% (TruNatomy) and 35% (XP-endo Shaper) were negative for bacteria. These values increased to 59% and 65% after ultrasonic activation with the SS and NiTi inserts, respectively. The quantitative data in S2 showed that XP-endo Shaper promoted a significantly higher bacterial reduction than TruNatomy (P < .05). No significant intragroup differences were observed after ultrasonic activation (P > .05), probably because the SS insert promoted a significantly higher S2-to-S3 reduction than the NiTi insert (P < .01). Micro-CT analysis revealed no significant differences in the unprepared areas between the groups (P > .05).
The XP-endo Shaper caused a significantly higher bacterial reduction than TruNatomy in Vertucci class II canals. Better antibacterial results after ultrasonic activation were observed for the SS ultrasonic inserts than for the NiTi inserts.
本研究比较了 XP-endo Shaper 或 TruNatomy 器械系统根管预备后的消毒和成形效果，两种器械系统均辅以不锈钢（SS）或镍钛（NiTi）锉的超声激活，同时使用次氯酸钠（NaOCl）冲洗。
根据解剖学配对的微计算机断层扫描（micro-CT）分析，将下颌磨牙具有 Vertucci Ⅱ类形态的近中根分为 2 组（n=24）。分别在预备前和预备后进行 micro-CT 扫描，以评估成形效果。用混合细菌培养物污染根管 30 天，然后用 XP-endo Shaper 或 TruNatomy 器械预备，用 NaOCl 冲洗。用 SS（TruNatomy 组）或 NiTi（XP-endo Shaper 组）锉进行 NaOCl 的补充超声激活。在预备前（S1）、预备后（S2）和补充处理后（S3）从根管中采集细菌样本。使用实时聚合酶链反应定量评估细菌减少率。
两种器械系统的预备均显著降低了细菌计数（P<0.01）。预备后，36%（TruNatomy）和 35%（XP-endo Shaper）的细菌为阴性。用 SS 和 NiTi 锉进行超声激活后，这些值分别增加到 59%和 65%。S2 的定量数据显示，XP-endo Shaper 比 TruNatomy 促进了更高的细菌减少率（P<0.05）。超声激活后，组内无显著差异（P>0.05），可能是因为 SS 锉比 NiTi 锉促进了更高的 S2 到 S3 的减少率（P<0.01）。Micro-CT 分析显示两组之间未经预备的区域无显著差异（P>0.05）。
XP-endo Shaper 在 Vertucci Ⅱ类根管中比 TruNatomy 引起了更高的细菌减少率。SS 超声锉的抗菌效果优于 NiTi 锉。
