CC BY 4.0 · Eur J Dent 2024; 18(03): 827-833
DOI: 10.1055/s-0043-1774325
Original Article

A Comparative Evaluation of the Cleaning Efficacy of Five Different Root Canal Irrigation Devices: A Histological Study

Alper Akçay
1   Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkiye
,
Melahat Gorduysus
2   Apollon Dental Center, Antalya, Turkiye
,
Mehmet Omer Gorduysus
3   Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
,
4   Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
5   Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
,
Sevda Müftüoglu
6   Department of Histology and Embryology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye
› Author Affiliations

Abstract

Objectives This study is aimed to evaluate the cleaning efficacy of five different irrigation systems as SonicMax, RinsEndo, EndoVac, passive ultrasonic irrigation (PUI), and manual needle irrigation (MNI) to histologically evaluate the presence of organic structures and the penetration of irrigation solution.

Materials and Methods Forty-two single-rooted, extracted human mandibular premolars were used in the study. Each tooth was decoronated at the cementoenamel junction and the root canals were instrumented using ProTaper rotary instruments in a crown-down manner. The specimens were randomly divided into five experimental groups (n = 7) Group (1) SonicMax, group (2) RinsEndo,group (3) EndoVac, group (4) PUI, group (5) MNI, and the control groups (n = 7). Each system used 2.5% sodium hypochlorite (NaOCl), 17% ethylenediamine tetraacetic acid (EDTA), and 2.5% NaOCl, respectively, in the experimental groups. The control group did not receive any final irrigation.

The measurements were analyzed by employing two-way analysis of variance multivariate results to show significant differences between the length of the dentin tubules in the apical, middle, and coronal of the six groups. The post-hoc test was used when groups were compared by pairs.

Results The results of this study indicate that among the five groups, the RinsEndo and EndoVac were found to be most effective in the cleaning of root canals. The RinsEndo shows highly significant results in the cleaning efficiency of the coronal and middle parts compared with the other groups. The cleaning efficiency in the apical area was the same for RinsEndo and EndoVac.

Conclusion The result of our study indicates that RinsEndo and EndoVac may be more effective in clinical practice.



Publication History

Article published online:
23 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 McGurkin-Smith R, Trope M, Caplan D, Sigurdsson A. Reduction of intracanal bacteria using GT rotary instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2 . J Endod 2005; 31 (05) 359-363
  • 2 Peters OA, Schönenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 2001; 34 (03) 221-230
  • 3 Vera J, Siqueira Jr JF, Ricucci D. et al. One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study. J Endod 2012; 38 (08) 1040-1052
  • 4 Zehnder M. Root canal irrigants. J Endod 2006; 32 (05) 389-398
  • 5 Pérez AR, Alves FRF, Marceliano-Alves MF. et al. Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine removal: a micro-computed tomography study. Int Endod J 2018; 51 (06) 684-690
  • 6 Moon YM, Shon WJ, Baek SH, Bae KS, Kum KY, Lee W. Effect of final irrigation regimen on sealer penetration in curved root canals. J Endod 2010; 36 (04) 732-736
  • 7 Caron G, Nham K, Bronnec F, Machtou P. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod 2010; 36 (08) 1361-1366
  • 8 Middha M, Sangwan P, Tewari S, Duhan J. Effect of continuous ultrasonic irrigation on postoperative pain in mandibular molars with nonvital pulps: a randomized clinical trial. Int Endod J 2017; 50 (06) 522-530
  • 9 Topçuoğlu HS, Topçuoğlu G, Arslan H. The effect of different irrigation agitation techniques on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis: a randomized clinical trial. J Endod 2018; 44 (10) 1451-1456
  • 10 Liang YH, Jiang LM, Jiang L. et al. Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: a randomized controlled trial. J Endod 2013; 39 (10) 1218-1225
  • 11 Tang Z, Wang H, Jiang S. Clinical study of single-visit root canal treatment with a nickel-titanium (Ni-Ti) rotary instrument combined with different ultrasonic irrigation solutions for elderly patients with chronic apical periodontitis. Biomed Mater Eng 2015; 26 (Suppl. 01) S311-S318
  • 12 Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94 (06) 658-666
  • 13 Troiano G, Dioguardi M, Cocco A. et al. Centering ability of ProTaper Next and WaveOne Classic in J-shape simulated root canals. ScientificWorldJournal 2016; 2016: 1606013
  • 14 Troiano G, Dioguardi M, Cocco A. et al. Influence of operator's experience on the shaping ability of Protaper Universal and Waveone Systems: a comparative study on simulated root canals. Open Dent J 2016; 10 (01) 546-552
  • 15 Dovgyallo GI, Migun NP, Prokhorenko PP. The complete filling of dead-end conical capillaries with liquid. J Eng Phys 1989; 56 (04) 395-397
  • 16 Gomes BPFA, Vianna ME, Zaia AA, Almeida JFA, Souza-Filho FJ, Ferraz CCR. Chlorhexidine in endodontics. Braz Dent J 2013; 24 (02) 89-102
  • 17 Susila A, Minu J. Activated irrigation vs. conventional non-activated irrigation in endodontics - a systematic review. Eur Endod J 2019; 4 (03) 96-110
  • 18 Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello S. Irrigating solutions and activation methods used in clinical endodontics: a systematic review. Front Oral Health 2022; 3: 1-13
  • 19 Rödig T, Sedghi M, Konietschke F, Lange K, Ziebolz D, Hülsmann M. Efficacy of syringe irrigation, RinsEndo and passive ultrasonic irrigation in removing debris from irregularities in root canals with different apical sizes. Int Endod J 2010; 43 (07) 581-589
  • 20 Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009; 35 (06) 791-804
  • 21 Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L. Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. J Endod 2013; 39 (11) 1456-1460
  • 22 Sabins RA, Johnson JD, Hellstein JW. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 2003; 29 (10) 674-678
  • 23 Thulaseedharan S, Kabbinale P, Vallabhdas AK, Ninge Gowda VKC, Chandrashekar KS, Marulappa R. In vitro comparative evaluation of effectiveness of sodium hypochlorite with conventional irrigation method versus EndoVac and Ultrasonic Irrigation in the elimination of Enterococcus faecalis from root canals. J Pharm Bioallied Sci 2020; 12 (Suppl. 01) S105-S108
  • 24 Pawar R, Alqaied A, Safavi K, Boyko J, Kaufman B. Influence of an apical negative pressure irrigation system on bacterial elimination during endodontic therapy: a prospective randomized clinical study. J Endod 2012; 38 (09) 1177-1181
  • 25 Miller TA, Baumgartner JC. Comparison of the antimicrobial efficacy of irrigation using the EndoVac to endodontic needle delivery. J Endod 2010; 36 (03) 509-511
  • 26 Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivator system, the F file, ultrasonic irrigation, and NaOCl irrigation alone after hand-rotary instrumentation in human mandibular molars. J Endod 2010; 36 (08) 1367-1371
  • 27 Khaord P, Amin A, Shah MB. et al. Effectiveness of different irrigation techniques on smear layer removal in apical thirds of mesial root canals of permanent mandibular first molar: a scanning electron microscopic study. J Conserv Dent 2015; 18 (04) 321-326
  • 28 Kungwani ML, Prasad KP, Khiyani TS. Comparison of the cleaning efficacy of EndoVac with conventional irrigation needles in debris removal from root canal. An in-vivo study. J Conserv Dent 2014; 17 (04) 374-378
  • 29 Akçay A, Gorduysus M, Aydin B, Gorduysus MO. Evaluation of different irrigation techniques on dentin erosion and smear layer removal: a scanning electron microscopy study. J Conserv Dent 2022; 25 (03) 311-316
  • 30 Li Q, Zhang Q, Zou X, Yue L. Evaluation of four final irrigation protocols for cleaning root canal walls. Int J Oral Sci 2020; 12 (01) 29
  • 31 de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 2010; 36 (07) 1216-1221