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Effects of Irrigation Protocols on Dentin-Root Interface Integrity and Sealer Penetration after Minimally Invasive
Iandara L Scardini1, Anelise V Masiero2, Marcelo Dos Santos1
1Department of Operative Dentistry, Faculty of Dentistry, University of Sao Paulo.
Introduction:
This study compared the effects of ultrasonic activation (UA), laser-activated irrigation (LAI), and the GentleWave® system (GW) on root dentin and sealer penetration (SP) after minimally invasive (MI) and conventional (CT) instrumentation techniques.
Methods:
One hundred extracted human mandibular premolars were allocated according to the instrumentation technique. Forty teeth (n=20) were analyzed for root dentin morphology using scanning electron microscopy (SEM), and 60 teeth (n=30) were assessed for SP using confocal laser scanning microscopy (CLSM). For SEM analysis, specimens were further subdivided by irrigation protocol, including a negative control group (n=5). For SP evaluation, teeth were subdivided by irrigation protocol (n=10) and obturated with EndoSequence® BC Sealer labeled with 0.003% Fluo-3. Data were analyzed using the Kruskal-Wallis test and Dunn's post hoc test (p < 0.05).
Results:
No significant differences in smear layer (SL) scores were found between CT and MI when the same irrigation technique was compared. In CT-prepared teeth, the control group exhibited higher SL than the irrigation groups, except in the middle third, where the results were comparable to those of UA. In MI-prepared teeth, GW showed lower SL scores than LAI in the cervical third (p < 0.05). In the apical third of MI-prepared canals, GW and LAI were associated with greater sealer penetration area and maximum depth than UA (p < 0.05). Dentin erosion was observed in 15 of 120 (12.5%) imageswith 10 images from the UA group and 5 from the LAI group. No erosion was observed in the GW group.
Conclusions:
Under the experimental conditions evaluated, no morphological signs of dentin erosion were observed with the GW protocol, and GW and LAI were associated with greater apical SP than UA following MI instrumentation. Because the protocols differed in irrigant volume, exposure time, and sequence, these findings cannot be attributed specifically to the activation technologies.