Comparative Analysis of the Smear Layer Removal Capability between EndoVac and Endoactivator Endodontic Irrigation Systems at the Root Canal System and Isthmus: A Micro-Computed Tomography Analysis

Abstract

The aim of this comparative study is to analyze the efficacy of EndoVac and Endoactivator endodontic irrigation systems for removing the endodontic smear layer present in the coronal, middle, and apical root third of the root canal system (RCS) and the isthmus from mesial roots from the first lower molar teeth using micro-computed tomography (micro-CT) analysis. The study was performed on 40 mesial roots that were randomly assigned to the following groups: Group A, EndoVac endodontic irrigation system (EV) (n = 10); Group B, Endoactivator endodontic irrigation system (EA) (n = 10); Group C, Root canal systems performed with F2 ProTaper Gold endodontic rotary system but not irrigated (Positive control) (n = 10); Group D, Root canal systems not performed or irrigated (Negative control) (n = 10). The samples were exposed to micro-CT analysis and the mesial roots were segmented using an advanced image segmentation technique based on partial differential equations (ROI: 10 × 10 × 10 mm) and the root canal systems and isthmus were reconstructed at a resolution of 25 microns per voxel. The EA study group showed statistically significant different residual endodontic smear layer volume (0.48 ± 0.24 mm3) compared to the EV study group (0.18 ± 0.15 mm3) (p = 0.016). The EV endodontic irrigation system performed a higher smear layer removal at coronal and middle root thirds, compared to the EA endodontic irrigation system; however, the EA endodontic irrigation system performed a higher smear layer removal at the apical root third, compared to the EV endodontic irrigation system.

Comparative Analysis of Ease of Removal of Fractured NiTi Endodontic Rotary Files from the Root Canal System—An In Vitro Study

“…The scan was performed using the following exposure parameters: 88 µA, 360° rotation, 90 kV, and isotropic resolution of 50 μm. The 3D tomographic images of the entire tooth had a total of 512 slices, with isotropic 50-micron voxels and a 512 × 512 resolution, according to a previous study [ 23 ].…”

Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis

“…Its success depends on broader principles, for which sufficient mechanical preparation, thorough disinfection and obturation with no voids are important [ 1 , 2 ]. Accumulated hard tissue debris (AHTD) is produced during the mechanical preparation process and pile up in the root canal system, which usually compromise the success of endodontic treatment [ 3 , 4 ]. Research has shown that root canal irrigation helps to remove AHTD; however, no irrigation protocol has been found to completely remove AHTD due to the anatomical complexity of the root canal system, especially in isthmus and apical regions [ 5 , 6 ].…”

Efficacy of Apple Vinegar as Root Canal Irrigant in Removing Smear Layer in Curved Canals Using EndoVac Irrigation System

“…One of the new devices, that can achieve the required negative pressure, is the EndoVac irrigation system. This system induces negative pressure at the apical part of the root canal whereby the irrigation solution is directed down the canal and subsequently back up via a small special cannula (8,(16)(17)(18) . EndoVac system is effective in removing debris and necrotic pulp tissues accumulated during root canal instrumentation with less risk of periapical extrusion than the conventional irrigation method.…”