An ex vivo antimicrobial evaluation after the preparation with XP-Endo Shaper and Trunatomy systems

AIM. The aim of this study was to evaluate bacterial reduction in root canals with the XP-Endo Shaper (XP) and Trunatomy (TN) systems.

MATERIALS AND METHODS. Twenty-eight permanent human type I, oval-shaped Vertucci premolars and straight root canals were contaminated with Enterococcus faecalis for 30 days at 37°C. Samples were collected prior to instrumentation. The teeth were divided into two groups (n = 14) and processed with the tested groups at 37°C: XP group – (30/0.04) and TN group – Small (20/0.04) and Prime (26/0.04). Biological samples before and after instrumentation were collected using a sterile paper cone inserted into the canal for one minute. Bacteria were counted using colony forming units (CFU/mL) and results were subjected to Kruskal-Wallis test at 5 level of significance.

RESULTS. Both the XP and TN systems significantly reduced bacterial counts (p < 0.0001), but did not eliminate bacteria in the root canals.

CONCLUSIONS. Both the Trunatomy and XP-Endo Shaper systems were similar in terms of antimicrobial efficacy, but neither system was able to eliminate bacteria from the root canals.

1. Siqueira J.F. Jr, Rôças I.N. A critical analysis of research methods and experimental models to study the root canal microbiome. Int Endod J. 2022;55(Suppl. 1):46–71. https://doi.org/10.1111/iej.13656

2. Nakamura V.C., Candeiro G.T., Cai S., Gavini G. Ex vivo evaluation of three instrumentation techniques on E. faecalis biofilm within oval shaped root canals. Braz Oral Res. 2015;29(1):1–7. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0027

3. Gomes B.P., Berber V.B., Kokaras A.S., Chen T., Paster B.J. Microbiomes of endodontic-periodontal lesions before and after chemomechanical preparation. J Endod. 2015;41(12):1975–1984. https://doi.org/10.1016/j.joen.2015.08.022

4. Matos Neto M., Santos S.S., Leão M.V., Habitante S.M., Rodrigues J.R., Jorge A.O. Effectiveness of three instrumentation systems to remove Enterococcus faecalis from root canals. Int Endod J. 2012;45(5):435–438. https://doi.org/10.1111/j.1365-2591.2011.01994.x

5. Evans M., Davies J.K., Sundqvist G., Figdor D. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. Int Endod J. 2002;35(3):221–228. https://doi.org/10.1046/j.1365-2591.2002.00504.x

6. Kayaoglu G., Ørstavik D. Virulence factors of Enterococcus faecalis: relationship to endodontic disease. Crit Rev Oral Biol Med. 2004;15(5):308–320. https://doi.org/10.1177/154411130401500506

7. Marceliano-Alves M.F.V., Ronquete V., Coutinho T.M.C., Boukpessi T., Salvioni A.L.F., Goulart P.A.S.R. et al. Unprepared areas and centralization of oval canals prepared with WaveOne Gold or XP-endo Shaper: microcomputed tomographic analyses. Acta Odontol Latinoam. 2023;36(3):177–182. https://doi.org/10.54589/aol.36/3/177

8. Versiani M.A., Pécora J.D., de Sousa-Neto M.D. Flatoval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod. 2011;37(7):1002–1007. https://doi.org/10.1016/j.joen.2011.03.017

9. Neves M.A.S., Provenzano J.C., Rôças I.N., Siqueira J.F. Jr. Clinical antibacterial effectiveness of root canal preparation with reciprocating single-instrument or continuously rotating multi-instrument systems. J Endod. 2016;42(1):25–29. https://doi.org/10.1016/j.joen.2015.09.019

10. Aksoy Ç., Keriş E.Y., Yaman S.D., Ocak M., Geneci F., Çelik H.H. Evaluation of XP-endo Shaper, Reciproc Blue, and ProTaper Universal NiTi systems on dentinal microcrack formation using micro-computed tomography. J Endod. 2019;45(3):338–342. https://doi.org/10.1016/j.joen.2018.12.005

11. Macedo F.P.G., Soares A.J., Marceliano-Alves M.F.V., Martinez E., Lopes R., Bastos L.F. et al. The effect of root canal preparation tapers on planktonic bacteria and biofilm reduction in the apical third: A correlative microtomography and microbiological laboratory study. Int Endod J. 2024;57(6):700–712. https://doi.org/10.1111/iej.14052

12. Lacerda M.F.L.S., Marceliano-Alves M.F., Pérez A.R., Provenzano J.C., Neves M.A.S., Pires F.R. et al. Cleaning and shaping oval canals with 3 instrumentation systems: a correlative micro-computed tomographic and histologic study. J Endod. 2017;43(11):1878–1884. https://doi.org/10.1016/j.joen.2017.06.032

13. Elnaghy A.M., Elsaka S.E., Mandorah A.O. In vitro comparison of cyclic fatigue resistance of TruNatomy in single and double curvature canals compared with different nickel-titanium rotary instruments. BMC Oral Health. 2020;20:38. https://doi.org/10.1186/s12903-020-1027-7

14. Loyola-Fonseca S.C., Campello A.F., Rodrigues R.C.V., Alves F.R.F., Brasil S.C., Vilela C.L.S. et al. Disinfection and shaping of Vertucci class ii root canals after preparation with two instrument systems and supplementary ultrasonic activation of sodium hypochlorite. J Endod. 2023;49(9):1183–1190. https://doi.org/10.1016/j.joen.2023.06.017

15. Silva E.J.N.L., Lima C.O., Barbosa A.F.A., Lopes R.T., Sassone L.M., Versiani M.A. The impact of Tru-Natomy and ProTaper gold instruments on the preservation of the periradicular dentin and on the enlargement of the apical canal of mandibular molars. J Endod. 2022;48(5):650–658. https://doi.org/10.1016/j.joen.2022.02.003

16. Oliveira S.C.A., Bueno C.E.D.S., Pelegrine R.A., Fontana C.E., Martin A.S., Stringheta C.P. Debridement ability of the WaveOne Gold and TruNatomy systems in the apical third of root canals: ex vivo assessment. Braz Dent J. 2024;35:5773. https://doi.org/10.1590/0103-6440202405773

17. Nagendrababu V., Murray P.E., Ordinola-Zapata R., Peters O.A., Rôças I.N., Siqueira J.F. Jr et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: A consensus-based development. Int Endod J. 2021;54(9):1482–1490. https://doi.org/10.1111/iej.13542

18. Colak M., Evcil S., Bayindir Y.Z., Yigit N. The effectiveness of three instrumentation techniques on the elimination of Enterococcus faecalis from a root canal: an in vitro study. J Contemp Dent Pract. 2005;6(1):94–106. https://doi.org/10.5005/jcdp-6-1-94

19. Machado M.E., Sapia L.A., Cai S., Martins G.H., Nabeshima C.K. Comparison of two rotary systems in root canal preparation regarding disinfection. J Endod. 2010;36(7):1238–1240. https://doi.org/10.1016/j.joen.2010.03.012

20. Schneider S.W. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271–275. https://doi.org/10.1016/0030-4220(71)90230-1

21. Jou Y.T., Karabucak B., Levin J., Liu D. Endodontic working width: current concepts and techniques. Dent Clin North Am. 2004;48(1):323–335. https://doi.org/10.1016/j.cden.2003.12.006

22. Haapasalo M., Shen Y., Qian W., Gao Y. Irrigation in endodontics. Dent Clin North Am. 2010;54(2):291–312. https://doi.org/10.1016/j.cden.2009.12.001

23. Xu J., Gao Y., Meng Y., Wu W., Tsauo C., Guo T. et al. Mechano-chemical coupling of irrigation enhances endodontic biofilm debridement. Biofouling. 2020;36(7):792–799. https://doi.org/10.1080/08927014.2020.1814753

24. Pinheiro E.T., Gomes B.P., Ferraz C.C., Sousa E.L., Teixeira F.B., Souza-Filho F.J. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J. 2003;36(1):1–11. https://doi.org/10.1046/j.1365-2591.2003.00603.x

25. Stuart C.H., Schwartz S.A., Beeson T.J., Owatz C.B. Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment. J Endod. 2006;32(2):93–98. https://doi.org/10.1016/j.joen.2005.10.049

26. Wang Z., Shen Y., Haapasalo M. Effectiveness of endodontic disinfecting solutions against young and old Enterococcus faecalis biofilms in dentin canals. J Endod. 2012;38(10):1376–1379. https://doi.org/10.1016/j.joen.2012.06.035

27. Fernandes K.G.C., Silva B.B.D., Boer N.C., Mandarini D.R., Moreti L.C.T., Kato A.S. The effectiveness of three irrigation systems in the enterococcus faecalis reduction after instrumentation with a reciprocating instrument. Eur J Dent. 2020;14(4):539–543. https://doi.org/10.1055/s-0040-1714760

28. Soares J.A., Santos Soares S.M.C., Santos César C.A., de Carvalho M.A.R., Brito-Júnior M., de Sousa G.R. et al. Monitoring the effectiveness of photodynamic therapy with periodic renewal of the photosensitizer on intracanal Enterococcus faecalis biofilms. Photodiagnosis Photodyn Ther. 2016;13:123–127. https://doi.org/10.1016/j.pdpdt.2016.01.002

29. Usta S.N., Solana C., Ruiz-Linares M., Baca P., Ferrer-Luque C.M., Cabeo M., Arias-Moliz M.T. Effectiveness of conservative instrumentation in root canal disinfection. Clin Oral Investig. 2023;27(6):3181–3188. https://doi.org/10.1007/s00784-023-04929-z

30. Alves F.R.F., Paiva P.L., Marceliano-Alves M.F., Cabreira L.J., Lima K.C., Siqueira J.F. Jr et al. Bacteria and hard tissue debris extrusion and intracanal bacterial reduction promoted by XP-endo shaper and reciproc instruments. J Endod. 2018;44(7):1173–1178. https://doi.org/10.1016/j.joen.2018.04.007