(PR73) Clinical Evaluation of Finishing File Ability to Supplement Bacteria and Endotoxin Removal from Primarily Infected Root Canals (A Pilot Study)

Abstract: Although rotary endodontic files vary in cross-sectional design, all produce round outline forms. Since root canal morphology is more irregularly shaped, canal wall recesses are left uninstrumented, harboring debris and microbial byproducts. Modified nickel titanium alloy and a novel file design such as the XP-ENDO® Finisher (XPF; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) utilizes shape-memory principles to adapt to canal irregularities. The aim of this study was to evaluate the ability of the XP-ENDO Finisher® (XPF) to supplement bacteria and endotoxin removal from primary infected root canals after instrumentation. This randomized and blinded clinical study included eight teeth. Instrumentation was performed using Vortex Blue®(Dentsply Sirona, Charlotte, NC) or XP-ENDO® Shaper (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), followed by supplemental instrumentation with XPF. All canals were irrigated with 2.5% sodium hypochlorite. Bacterial and endotoxin samples were taken using sterile paper points. Samples were collected before and after instrumentation and after XPF. Bacteria was present in all root canals. After XPF, the bacterial mean was reduced from 255 +/- 311.82 CFU/mL to 2.5 +/- CFU mL (p=.056). Endotoxin was detected in all root canals by the kinetic chromogenic LAL method (KQCL). After XPF, the endotoxin mean was significantly reduced from 0.85 0.26 EU/mL to 0.03 +/0 0.01 EU/mL (p=0.00004). The findings of this study showed that supplemental use of XPF after root canal instrumentation was effective in significantly reducing endotoxin but not bacteria present in primary endodontic infections.