Dominique Linden1, Matthieu Boone2, Mieke De Bruyne1, Roeland De Moor1, Marco A Versiani3, Maarten Meire4. 1. Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium. 2. Centre for X-ray Tomography, Department Physics and Astronomy, Ghent University, Ghent, Belgium. 3. Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil. 4. Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium. Electronic address: Maarten.Meire@ugent.be.
Abstract
INTRODUCTION: This in vitro study sought to compare the efficacy of a sonic irrigant activation device with ultrasonic activation and needle irrigation, in removing hard-tissue debris (HTD) from anatomical complexities of the root canal system. METHODS: Twenty-seven mesial roots of extracted human mandibular molars with two canals connected by an isthmus were selected based on micro-CT scans (12 μm voxel size). The mesial canals were mechanically prepared to ProTaper Next X3 and anatomically distributed into 3 groups (n=9), according to the final irrigation protocol: sonically activated irrigation (SAI) using EDDY system for 3x20s, ultrasonically activated irrigation (UAI) using a size 20 Irrisafe tip for 3x20s, and a conventional irrigation using a 30-gauge needle adapted to a syringe (SNI). Micro-CT scans were taken after instrumentation and after supplementary activation of the irrigant. After reconstruction and co-registration, the volume filled with hard tissue debris (vol% HTD) before and after irrigant activation was calculated, and the mean %HTD reduction after final irrigation was compared within and among groups using paired sample t-test and one-way ANOVA post hoc Tukey test, respectively (α=5%). RESULTS: A significant reduction in vol% HTD after irrigant activation was observed in all groups (P<.05). Percentage reduction of HTD in the UAI group (66.8%) was significantly higher than that in the SAI group (36.4%) (P<.05), while the SNI group result (43.7%) did not differ statistically from UAI or SAI groups (P>.05). CONCLUSIONS: All tested supplementary irrigation steps significantly reduced the amount of debris created during root canal preparation. Ultrasonic activation resulted in the highest mean debris reduction.
INTRODUCTION: This in vitro study sought to compare the efficacy of a sonic irrigant activation device with ultrasonic activation and needle irrigation, in removing hard-tissue debris (HTD) from anatomical complexities of the root canal system. METHODS: Twenty-seven mesial roots of extracted human mandibular molars with two canals connected by an isthmus were selected based on micro-CT scans (12 μm voxel size). The mesial canals were mechanically prepared to ProTaper Next X3 and anatomically distributed into 3 groups (n=9), according to the final irrigation protocol: sonically activated irrigation (SAI) using EDDY system for 3x20s, ultrasonically activated irrigation (UAI) using a size 20 Irrisafe tip for 3x20s, and a conventional irrigation using a 30-gauge needle adapted to a syringe (SNI). Micro-CT scans were taken after instrumentation and after supplementary activation of the irrigant. After reconstruction and co-registration, the volume filled with hard tissue debris (vol% HTD) before and after irrigant activation was calculated, and the mean %HTD reduction after final irrigation was compared within and among groups using paired sample t-test and one-way ANOVA post hoc Tukey test, respectively (α=5%). RESULTS: A significant reduction in vol% HTD after irrigant activation was observed in all groups (P<.05). Percentage reduction of HTD in the UAI group (66.8%) was significantly higher than that in the SAI group (36.4%) (P<.05), while the SNI group result (43.7%) did not differ statistically from UAI or SAI groups (P>.05). CONCLUSIONS: All tested supplementary irrigation steps significantly reduced the amount of debris created during root canal preparation. Ultrasonic activation resulted in the highest mean debris reduction.