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Ex Vivo Scanning Electron Microscopy Evaluation of Cleaning Efficacy Following In Vivo Endodontic Treatment: A Report of 2 Cases

Enrico E DiVito and Shahriar A Rassoulian

In endodontic therapy, thorough cleaning of the root canal system which results in the complete or near elimination of diseased or necrotic pulp tissue and resident microorganisms is the most critical factor in ensuring a favorable outcome. Removal of both debris and the smear layer from the canals is important, since organic matter from these materials may promote bacterial growth and inhibit obturation materials from having proper contact with the canal wall. This report of two cases is the first known presentation of teeth receiving in vivo treatment and then analyzed post extraction via ex vivo scanning electron microscopy (SEM).

The two cases describe patients with similar clinical presentation and diagnoses who required single-tooth extractions. The treating clinician provided in vivo chairside endodontic therapy using two different available treatment modalities: standard root canal treatment and the GentleWave® Procedure. The teeth were then extracted and underwent ex vivo SEM analyses as part of an ongoing clinical study. Similarities and differences in the level of debridement in the root canal systems were observed between the two cases, with greater reduction in accumulated debris and smear layer scores present in the tooth treated with the GentleWave Procedure. Further research is ongoing to provide additional evidence-based data regarding outcomes related to the cleaning efficacy of different endodontic therapies.