title: In Vitro Efficacy of XP-endo Finisher with 2 Different Protocols on Biofilm Removal from Apical Root Canals.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effectiveness of the XP-endo Finisher (XPF; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) in biofilm removal in comparison with conventional needle irrigation (CNI) and passive ultrasonic irrigation (PUI) using an infected tooth model with an artificial apical groove.
  
  
  METHODS
  Fifty-four extracted human single-rooted premolars were selected. Each tooth was split longitudinally into 2 halves, with a groove made in the apical segment of the canal wall. After growing mixed bacteria biofilm for 4 weeks, the split halves were reassembled and instrumented using Vortex Blue files (Dentsply Tulsa Dental, Tulsa, OK) to size 40/.06. The instrumented teeth were randomly assigned to 6 groups (n = 8) according to the final irrigation protocol. Three different techniques (CNI, PUI, and XPF) were performed each with either continuous irrigation or 3-step irrigation. Scanning electron microscopic images were taken to evaluate the amount of residual biofilm inside and outside the groove.
  
  
  RESULTS
  Robust growth of biofilm was observed in each canal of the controls after 4 weeks. XPF showed the best biofilm removal efficacy inside and outside the groove followed by PUI and CNI (P < .05). The XPF 2 group using the 3-step protocol showed better antibiofilm efficiency than the XPF 1 group with continuous irrigation inside the groove (P < .05).
  
  
  CONCLUSIONS
  The XP-endo Finisher, as an irrigation agitation technique, may help to remove biofilm from hard-to-reach areas in the root canal system. The 3-step irrigation protocol was more effective than continuous irrigation when XPF was used.
authors.affiliation: Department of Endodontics, Tianjin Stomatological Hospital, Nankai University, Tianjin, China; Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Pingping
authors.initials: P
authors.lastname: Bao
authors.affiliation: Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Ya
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Lin
authors.affiliation: Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: markush@dentistry.ubc.ca.
authors.forename: Markus
authors.initials: M
authors.lastname: Haapasalo
mesh_terms: D018441:Biofilms; D006801:Humans; D066298:In Vitro Techniques; D008855:Microscopy, Electron, Scanning; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000379:methods*; D019227:Tooth Apex; D016896:Treatment Outcome
chemical_list: D012388:Root Canal Irrigants
keywords: Biofilm; XP-endo Finisher; conventional needle irrigation; root canal irrigation; ultrasonic