Evaluation of Root Canal Cleanliness on Using a Novel Irrigation Device with an Ultrasonic Activation Technique: An Ex Vivo Study (original) (raw)
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Clinical oral investigations, 2018
Reduction of microbial load from the root canal systems is a pre-requisite for healing of lesions of endodontic origin. Such microbial reduction is influenced by the method of irrigant delivery and activation. The aim of this systematic review was to compare the effect of ultrasonically activated irrigation (UAI) with other irrigation techniques on the reduction of microorganisms during root canal disinfection. The research question was created based on the PICO strategy. Two reviewers independently performed a comprehensive literature search in electronic databases. Following application of inclusion and exclusion criteria to the selected articles, a systematic data extraction sheet was constructed. The selected articles were assessed using methodological quality scoring protocol. The risk of bias in selected studies was critically assessed by two reviewers. A total of 15 articles were included for the systematic review. The included studies were heterogeneous in study design; henc...
Effect of Different Final Irrigation Activation Methods on Root Canal Cleanliness
2021
Aim: to evaluate canal cleanliness after using manual dynamic activation, passive ultrasonic irrigation and photoactivated disinfection in comparison with conventional needle irrigation, using scanning electron microscopy Methods: Sixty single rooted human premolars with nearly straight single canal were collected, the crowns of all teeth were removed near the level of cementoenamel junction to obtain approximately 15 ±1 mm uniform root lengths. After instrumentaion with ProTaper Next files up to X4 (40/06), roots were randomly divided into 4 equal groups (n=15) according to the method of final irrigation activation. Group I: Conventional needle and syringe irrigation. Group II: Manual dynamic activation. Group III: passive ultrasonic irrigation. Group IV: photoactivated disinfection. Canal cleanliness was evaluated with SEM using different magnification (X350- X1000). Results: Group III had the best cleanliness of the root canal while Group I had the worst cleanliness, there were s...
RSBO
The ultrasonic agitation was introduced as an adjuvant to conventional chemo-mechanical debridement during endodontic treatment to overcome the persistence of biofilms. Objective: To verify the cleaning of root canals irrigated with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), with or without an ultrasonic agitation, using different time periods and images obtained by scanning electron microscope (SEM). Material and methods: Forty mandibular incisors were cleaned, shaped and randomly divided into five groups according to the final irrigation protocol: SH10 group (ultrasonic agitation with NaOCl for 10 s), SH30 group (ultrasonic agitation with NaOCl for 30 s), SHE30 group (ultrasonic agitation with NaOCl and EDTA for 10 s), SHE90 group (ultrasonic agitation with NaOCl and EDTA for 30 s), and control group (NaOCl and EDTA without ultrasonic agitation). The teeth were prepared and analyzed by SEM at ×2000. The Kruskal–Wallis test was used with a 5% level of s...
Deleted Journal, 2024
The study's objective was to compare passive ultrasonic activation (PUI) and photon-induced photoacoustic streaming (PIPS) laser-activated irrigation methods for disinfecting the root canal. Materials and methods: E. faecalis and Candida albicans were injected into Forty-five single-rooted upper anterior human teeth to create a biofilm, then randomly divided into four groups that differ in the activation method (PIPS group, PUI group, and a control group that employs syringe irrigation without activation). A confocal scanning electron microscope (CLSM) was then used to evaluate and compare groups in terms of bacterial reduction. Results: The various test groups differed statistically significantly from one another (p<0.001). The mean value of PIPS was (57.34±3.70), while the lowest value was found in the PUI group (41.40±6.38). Comparisons between pairs showed that the PIPS group had a value that was significantly higher when compared to other groups (p<0.001). Conclusions: The biofilm elimination capacity of sodium hypochlorite irrigant was improved by activating it with an Er:YAG laser using the PIPS approach, showing the best biofilm eradication in the apical third. However, None of the root canal disinfection techniques achieved full eradication.
BRITISH DENTAL JOURNAL, 2019
Objectives To evaluate the effectiveness of passive ultrasonic irrigation (PUI) compared with non-activated irrigation (NAI) on periapical healing and root canal disinfection. Data source A comprehensive search without restrictions was performed in the following systematic electronic databases: PubMed, Scopus, Cochrane, Web of Science, ScienceDirect and OpenGrey. Additional studies were sought through hand-searching in the main endodontic journals. Data selection We included clinical trials that compared PUI and NAI clinical success and root canal disinfection outcomes. The risk of bias was assessed based on the Cochrane Collaboration common scheme for bias assessment. The power analysis of each study was calculated based on the disinfection rates and sample size, and the evidence was qualified using the GRADE tool. Data synthesis A total of 346 non-duplicated studies were retrieved in the systematic search. One study that assessed the clinical success rate through periapical radiographic healing evaluation and two studies that evaluated root canal disinfection through bacterial growth were considered eligible. These three studies were classified as low risk of bias. The study evaluating radiographic treatment outcome showed no statistical difference (P >0.05). The studies demonstrated large variability among methodology and, in general, low power and moderate evidence. Inconclusive results were reported regarding root canal disinfection when comparing PUI to NAI strategies. Conclusions Based on the findings, there was no evidence of effectiveness improvement on periapical healing and bacterial disinfection that supports the use of PUI over the NAI in clinical practice.
Antibacterial Efficacy of a New Sonic Irrigation Device for Root Canal Disinfection
Introduction: Passive ultrasonic irrigation (PUI) is the most widespread method used to activate irrigation solutions. Concerns have been raised that PUI is less effective in curved root canals and is not passive at all. Our aim was to compare a novel passive sonic irrigation (PSI) device (6000 Hz) with PUI and manual irrigation (MI) with respect to their efficiency in removing different endodontic microorganisms from curved and straight root canals. Methods: We performed 2 experiments as follows. In a 3-day infection model, we included 8 groups of single or dual microbial species that were rinsed with 0.9% sodium chloride using PSI, PUI, or MI. Colony-forming units (CFUs) were counted after incubation , and log 10 transformations were performed for statistical comparisons. In a 21-d infection model, we tested the same irrigation protocols on 4 groups of microorganisms and used 1.5% sodium hypochlorite as an irrigant. Infection control samples were taken at day 0, 3, 5, and 7 after treatment and were subsequently reincubated. Results: Using sodium chloride as an irri-gant, the amount of reduction in CFUs compared with the negative control was approximately 3 log 10 units for PSI at 6000 Hz, 2 log 10 units for PUI, and 1 log 10 unit for MI. PSI reduced the microorganism CFUs significantly better than PUI. Using sodium hypochlorite led to a significant reduction in microorganism CFUs even with MI. After 3 days, compared with MI, microorganism re-growth significantly reduced after PSI and PUI treatment , but in these groups, in at least half of the samples, microorganisms were detectable after 7 days. Conclusions: PSI at 6000 Hz might be at least equal to PUI with respect to reduction of the microbial load in curved and straight root canals. (J Endod 2016;-:1–5)
The Influence of the Ultrasonic Intensity on the Cleaning Efficacy of Passive Ultrasonic Irrigation
Journal of Endodontics, 2011
Introduction: It is not clear whether increasing the ultrasonic intensity would enhance the cleaning efficacy of passive ultrasonic irrigation (PUI) inside a root canal. The aim of this study was to evaluate the effect of the ultrasonic intensity on PUI to remove dentin debris and whether there is any lateral effect beyond the ultrasonic tip. Methods: Each of 15 in vitro root canal models with four standard depressions in the apical part of one canal wall were filled with dentin debris and received PUI repeatedly. The most apical depression was localized apically from the ultrasonic tip. The highest intensity was applied in group 1, the lowest intensity was applied in group 3, and syringe irrigation was performed in group 4 as a control. Before and after irrigation, images of the canal wall with depressions were taken and compared. The removal of dentin debris in the depressions was categorized as clean or not clean. The data were analyzed by means of the chi-square test. The oscillation amplitude of the ultrasonic file at each intensity was recorded in vitro using timeresolved high-speed imaging. Results: Group 1 (highest intensity) exhibited significantly better cleaning than all the other groups (P < .05); no significant difference was found between the four levels of the depressions within any of the four groups. High-speed imaging showed that the amplitude of the oscillating file increased as the intensity went up, which leads to a higher velocity of the irrigant around the file. Conclusions: Higher ultrasonic intensity resulted in a higher amplitude of the oscillating file and, consequently, enhanced the cleaning efficacy of PUI.
Applied Sciences, 2021
The removal of necrotic and vital pulp substrates and microorganisms and their toxins from the root canal system (RCS) has been found to be the basis for a successful endodontic treatment. In this study, our aim was to evaluate the effect of passive ultrasonic irrigation (PUI) on the elimination of the organic remnant tissue from infected, narrow and curved mandibular root canals during their instrumentation. For this purpose, mesiobuccal canals from mandibular first molars were instrumented with the RaCe rotary system, using PUI activation or conventional irrigation (CI) and two apical diameters (#25 and #35). The root canal cleanness of the samples was evaluated by microscopy and using a modified Langeland’s ordinal scale. Parametric and non-parametric statistical analyses and principal coordinates analysis (PCoA) of the samples were performed. When PUI was used, there was a significant reduction of the organic remnant in the apical enlargement of 25 at 2 mm from the apex (p < ...
Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions
Medicina Oral Patología Oral y Cirugia Bucal, 2012
Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies. Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics. Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant literature on passive ultrasonic irrigation is reviewed. Information from original scientific papers or reviews listed in MEDLINE and Cochrane were included in the review. Results: The use of ultrasound in the irrigation procedure results in improved canal cleanliness, better irrigant transfer to the canal system, soft tissue debridement, and removal of smear layer and bacteria. There are many in vitro studies, but there is a need to standardize protocols, and correlate the clinical efficacy of ultrasonic devices with improved treatment outcomes. Understanding the basis of ultrasonic irrigation is fundamental for clinicians and researchers to improve the design and use of ultrasonic irrigation.
Journal of Endodontics, 2011
Introduction: The complex anatomy of the root canal system has been shown to limit the penetration of irrigating solutions into the apical third; hence, the aim of this study was to determine whether the use of a patency file is related to the presence of a radiopaque irrigating solution in the apical third of human root canals after using passive ultrasonic activation in vivo. Methods: Forty human root canals were randomly divided into two groups. Apical patency was maintained in one group (n = 21) during shaping and cleaning procedures with a no. 10 K-file 1 mm beyond the working length (WL) but not in the other group (n = 19). In both groups, the canals were shaped with the Pro Taper system (Dentsply-Maillefer, Ballaigues, Switzerland). Irrigation was performed with 1 mL of a solution prepared with a radiopaque contrast medium and sodium hypochlorite 5.25%, and then passive ultrasonic irrigation (PUI) was applied after the shaping procedure. Digital images were taken, and a calibrated reader determined the presence or absence of the irrigating solution in the apical third. Results: There were significantly more canals with irrigant in the apical third after PUI when apical patency was maintained with a no. 10 file 1 mm beyond the WL than when apical patency was not maintained throughout the cleaning and shaping procedures (P = .02). Conclusions: Maintaining apical patency and then using PUI improves the delivery of irrigants into the apical third of human root canals.