In vitro analysis of two irrigation activation systems for cleaning mesial canals in lower molars
DOI:
https://doi.org/10.17533/udea.rfo.v36n1a4Keywords:
edetic acid, ultrasonics, root canal preparation, endodontic, smear layerAbstract
Introduction: this study aimed to compare the efficacy of two different endodontic activation systems in removing debris from the mesial canals of mandibular molars across root thirds. Methods: the mesial canals of fifteen human mandibular first molars were prepared with files, irrigated with 2.5 % sodium hypochlorite and 17 % EDTA, and divided into three groups (n=5) based on the type of activation: Control (activation with master cone), Ultrasound Irrigation (UI), and Ultra X (Passive Ultrasonic Irrigation - PUI). The roots were sectioned into thirds (cervical, mid, and apical), exposing root canals, and prepared for scanning electron microscopy. A total of 135 microphotographs (3 microphotographs for each root level) were obtained. To determine the most effective activation system, three calibrated endodontic specialists evaluated all images. Data were analyzed using the Kruskal-Wallis test (95 %). Results: the PUI system demonstrated the highest efficacy, followed by UI, while the control was the least efficient (p<0.001). Significant differences were found between PUI and the other systems at each root level: Control (p=0.039), UI (p=0.327), and PUI (p=0.024). Root canal cleaning decreased from cervical to apical in all groups, with the UI group showing a more regular cleaning pattern at all levels. Conclusion: the PUI system was the most effective, followed by UI. The efficacy of the activation systems decreased as the working depth increased.
Downloads
References
Nogo-Živanović D, Kanjevac T, Bjelović L, Ristić V, Tanasković I. The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin. Microsc Res Tech. 2019; 82(6): 923–30. DOI: https://doi.org/10.1002/jemt.23239
Labarta AB, Sierra LG. Remoción del barro dentinario y erosión sobre el sustrato al utilizar diferentes soluciones ácidas. Odontol Sanmarquina. 2018; 21(2): 103-12. DOI: https://doi.org/10.15381/os.v21i2.14775
Victor C, Van der Vyver PJ, Vorster M, Vally ZI. Root canal preparation with reciprocating instruments: a literature review and clinical application. S Afr dent j. 2020; 75(9): 493–504. DOI: https://doi.org/10.17159/2519-0105/2020/v75no9a4
Haapasalo M, Ørstavik D. In vitro infection and of dentinal tubules. J Dent Res. 1987; 66(8): 1375-9. DOI: https://doi.org/10.1177/00220345870660081801
Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH. A new system for classifying root and root canal morphology. Int Endod J. 2017; 50(8): 761-70. DOI: https://doi.org/10.1111/iej.12685
Bryce G, O’Donnell D, Ready D, Ng Y ling, Pratten J, Gulabivala K. Contemporary root canal irrigants are able to disrupt and eradicate single- and dual-species biofilms. J Endod. 2009; 35(9): 1243-8. DOI: https://doi.org/10.1016/j.joen.2009.05.034
Christo JE, Zilm PS, Sullivan T, Cathro PR. Efficacy of low concentrations of sodium hypochlorite and low‐powered Er,Cr: YSGG laser activated irrigation against an Enterococcus faecalis biofilm. Int Endod J. 2016; 49(3): 279–86. DOI: https://doi.org/10.1111/iej.12447
Mozo S, Llena C, Forner L. Review of ultrasonic irrigation in endodontics: Increasing action of irrigating solutions. Med Oral Patol Oral Cir Bucal. 2012; 17(3): e512-6. DOI: https://doi.org/10.4317/medoral.17621
Yu Q. [Scavenging strategy for root canal infection]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2018; 53(6): 381-5. DOI: https://doi.org/10.3760/cma.j.issn.1002-0098.2018.06.004
García Delgado A, Martín-González J, Castellanos-Cosano L, Martín Jiménez M, Segura-Egea JJ. Sistemas ultrasónicos para la irrigación del sistema de conductos radiculares. Av Odontoestomatol. 2014; 30(2): 79–94.
Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A. Antibacterial efficacy of a new sonic irrigation device for root canal disinfection. J Endod. 2016; 42(12): 1799-803. DOI: https://doi.org/10.1016/j.joen.2016.08.024
Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod. 2016; 42(4): 659-63. DOI: https://doi.org/10.1016/j.joen.2016.01.016
Martins Justo A, Abreu da Rosa R, Santini MF, Cardoso Ferreira MB, Pereira JR, Húngaro Duarte MA, et al. Effectiveness of final irrigant protocols for debris removal from simulated canal irregularities. J Endod. 2014; 40(12): 2009-14. DOI: https://doi.org/10.1016/j.joen.2014.08.006
Jasrotia A, Bhagat K, Bhagat N, Bhagat R. Comparison of five different irrigation techniques on smear layer removal in apical thirds of root canals of mandibular first premolar: a scanning electron microscopic study. J Int Soc Prev Community Dent. 2019; 9(6): 630-36. DOI: https://doi.org/10.4103/jispcd.jispcd_267_19
Rome WJ, Doran JE, Walker WA. The effectiveness of Gly-Oxide and sodium hypochlorite in preventing smear layer formation. J Endod. 1985; 11(7): 281-8. DOI: https://doi.org/10.1016/s0099-2399(85)80158-8
Urban K, Donnermeyer D, Schäfer E, Bürklein S. Canal cleanliness using different irrigation activation systems: a SEM evaluation. Clin Oral Investig. 2017; 21(9): 2681-7. DOI: https://doi.org/10.1007/s00784-017-2070-x
Jena A, Sahoo SK, Govind S. Root canal irrigants: a review of their interactions, benefits, and limitations. Compend Contin Educ Dent. 2015; 36(4): 256-61.
Vouzara T, Koulaouzidou E, Ziouti F, Economides N. Combined and independent cytotoxicity of sodium hypochlorite, ethylenediaminetetraacetic acid and chlorhexidine. Int Endod J. 2016; 49(8): 764-73. DOI: https://doi.org/10.1111/iej.12517
Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivatorTM System, the F FileTM, ultrasonic irrigation, and NaOCl irrigation alone after hand-rotary instrumentation in human Mandibular molars. J Endod. 2010; 36(8): 1367-71. DOI: https://doi.org/10.1016/j.joen.2010.03.022
Curtis TO, Sedgley CM. Comparison of a continuous ultrasonic irrigation device and conventional needle irrigation in the removal of root canal debris. J Endod. 2012; 38(9): 1261-4. DOI: https://doi.org/10.1016/j.joen.2012.05.012
Kumar RS, Ankola A, Peerzade M, Sankeshwari R, Hampiholi V, Khot AP, et al. Comparative efficacy of different irrigant activation techniques for irrigant delivery up to the working length of mature permanent teeth: a systematic review and meta-analysis. Eur Endod J. 2023; 8(1): 1-19. DOI: https://doi.org/10.14744/eej.2022.87587
Boutsioukis C, Arias-Moliz MT. Present status and future directions: irrigants and irrigation methods. Int Endod J. 2022; 55(Suppl 3): 588-612. DOI: https://doi.org/10.1111%2Fiej.13739
Paixão S, Rodrigues C, Grenho L, Fernandes MH. Efficacy of sonic and ultrasonic activation during endodontic treatment: a meta-analysis of in vitro studies. Acta Odontol Scand. 2022; 80(8): 588-95. DOI: https://doi.org/10.1080/00016357.2022.2061591
Munoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod. 2012; 38(4): 445-8. DOI: https://doi.org/10.1016/j.joen.2011.12.007
Niu L, Luo X, Li G, Bortoluzzi EA, Mao J, Chen J, et al. Effects of different sonic activation protocols on debridement efficacy in teeth with single-rooted canals. J Dent. 2014; 42(8): 1001-9. DOI: https://doi.org/10.1016/j.jdent.2014.05.007
Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H, et al. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod. 2010; 36(5): 884–9. DOI: https://doi.org/10.1016/j.joen.2009.12.010
Tay FR, Gu L, Schoeffel GJ, Wimmer C, Susin L, Zhang K, et al. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010; 36(4): 745–50. DOI: https://doi.org/10.1016/j.joen.2009.11.022
Arul B, Suresh N, Sivarajan R, Natanasabapathy V. Influence of volume of endodontic irrigants used in different irrigation techniques on root canal dentin microhardness. Indian J Dent Res. 2021; 32(2): 230-5. DOI: https://doi.org/10.4103/ijdr.ijdr_709_18
Scelza MFZ, Pierro V, Scelza P, Pereira M. Effect of three different time periods of irrigation with EDTA-T, EDTA, and citric acid on smear layer removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98(4): 499-503. DOI: https://doi.org/10.1016/j.tripleo.2004.03.027
Zhou N, Huang Z, Yu M, Deng S, Fu B, Jin H. Influence of needle working length and root canal curvature on irrigation: a computational fluid dynamics analysis based on a real tooth. BMC Oral Health. 2022; 22(1): 179. DOI: https://doi.org/10.1186/s12903-022-02205-2
Gündüz H, Özlek E. The effects of laser and ultrasonic irrigation activation methods on smear and debris removal in traditional and conservative endodontic access cavities. Lasers Med Sci. 2023; 38(1): 1-9. DOI: https://doi.org/10.1007/s10103-023-03816-z
Hu S, Duan L, Wan Q, Wang J. Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model. Biomed Eng Online. 2019; 18(1): 52.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Revista Facultad de Odontología Universidad de Antioquia
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright Notice
Copyright comprises moral and patrimonial rights.
1. Moral rights: are born at the moment of the creation of the work, without the need to register it. They belong to the author in a personal and unrelinquishable manner; also, they are imprescriptible, unalienable and non negotiable. Moral rights are the right to paternity of the work, the right to integrity of the work, the right to maintain the work unedited or to publish it under a pseudonym or anonymously, the right to modify the work, the right to repent and, the right to be mentioned, in accordance with the definitions established in article 40 of Intellectual property bylaws of the Universidad (RECTORAL RESOLUTION 21231 of 2005).
2. Patrimonial rights: they consist of the capacity of financially dispose and benefit from the work trough any mean. Also, the patrimonial rights are relinquishable, attachable, prescriptive, temporary and transmissible, and they are caused with the publication or divulgation of the work. To the effect of publication of articles in the journal Revista de la Facultad de Odontología, it is understood that Universidad de Antioquia is the owner of the patrimonial rights of the contents of the publication.
The content of the publications is the exclusive responsibility of the authors. Neither the printing press, nor the editors, nor the Editorial Board will be responsible for the use of the information contained in the articles.
I, we, the author(s), and through me (us), the Entity for which I, am (are) working, hereby transfer in a total and definitive manner and without any limitation, to the Revista Facultad de Odontología Universidad de Antioquia, the patrimonial rights corresponding to the article presented for physical and digital publication. I also declare that neither this article, nor part of it has been published in another journal.
Open Access Policy
The articles published in our Journal are fully open access, as we consider that providing the public with free access to research contributes to a greater global exchange of knowledge.
Creative Commons License
The Journal offers its content to third parties without any kind of economic compensation or embargo on the articles. Articles are published under the terms of a Creative Commons license, known as Attribution – NonCommercial – Share Alike (BY-NC-SA), which permits use, distribution and reproduction in any medium, provided that the original work is properly cited and that the new productions are licensed under the same conditions.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
