Effectiveness of Xp-Endo Finisher, Endoactivator, and Pui Agitation in the Penetration of Intracanal Medicaments Into Dentinal Tubules: a Confocal Laser Scanning Microscope Analysis

Abstract

Background. This investigation assessed the impact of irrigation activation systems on the depth of penetration of intracanal medicaments into dentinal tubules. Methods. Ninety-six mandibular premolar teeth were prepared using ProTaper Next up to size X3. The teeth were randomly divided into four groups based on the final irrigation activation systems (n = 24): group 1: EndoActivator, group 2: XP-Endo Finisher, group 3: Passive ultrasonic irrigation (PUI), and group 4: control. After the final irrigation, all the samples were divided into two subgroups (n = 12): subgroup A: calcium hydroxide (Ca(OH)2) and subgroup B: modified triple antibiotic paste (mTAP). Statistical analysis involved three-way analysis of variance (ANOVA). Results. EndoActivator, XP-Endo Finisher, and PUI activation methods significantly increased the penetration of intracanal medicaments compared to conventional needle irrigation (P < 0.05). The XP-Endo Finisher group exhibited the highest penetration percentage and maximum penetration depth, showing a statistically significant difference from the EndoActivator group (P < 0.001). No significant difference was observed between XP-Endo Finisher and PUI, nor between PUI and EndoActivator (P > 0.05). mTAP showed a higher percentage of dentinal tubule penetration than Ca(OH)2, although no significant difference was found in maximum penetration depth. The coronal region demonstrated the highest penetration percentage and depth, while the apical region showed the lowest. Conclusion. This study showed the effectiveness of XP-Endo Finisher in improving the penetration of intracanal medicaments into dentinal tubules. The findings emphasize the importance of selecting appropriate irrigation activation systems to improve treatment outcomes in endodontics. By demonstrating the effectiveness of advanced systems like XP-Endo Finisher, this research supports their integration into routine clinical practice for better endodontic success. © 2024 The Author(s).