Debris Removal by Activation of Endodontic Irrigants in Complex Root Canal Systems: A Standardized In-Vitro-Study

Abstract

Aim of the study was to develop a standardized model system to investigate endodontic irrigation techniques and assess the efficiency of different activation methods on the removal of hard tissue debris in complex root canal systems. Mesial roots of mandibular molars were firstly scanned by micro-computed tomography (µCT) and allocated to three groups of irrigant activation: sonic activation (EDDY, VDW, Munich, Germany), laser activation (AutoSWEEPS, FOTONA, Ljubljana, Slovenia) and conventional needle irrigation (control). Roots were fixed in individual 3D-printed holders to facilitate root canal enlargement under constant irrigation with NaOCl (5%). To enable standardized quantification of remaining debris, BaSO4-enriched dentine powder was compacted into the canals, followed by another µCT-scan. The final irrigation was performed using 17% ethylenediaminetetraacetic acid (EDTA) and 5% sodium hypochlorite (NaOCl) with the respective activation method, and the volume of remaining artificial debris was quantified after a final µCT-scan. The newly developed model system allowed for reliable, reproducible and standardized assessment of irrigation methods. Activation of the irrigant proved to be significantly more effective than conventional needle irrigation regarding the removal of debris, which persisted particularly in the apical third of the root canal in the control group. The efficiency of irrigation was significantly enhanced with laser- and sonic-based activation, especially in the apical third.

Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology

“…Firstly, anatomical variations such as the dimensions of root canals and isthmuses have an impact on AHTD removal as penetration of the irrigant is reduced in narrow isthmuses [ 62 ]. To overcome anatomical variations, 3D-printed root canal models were recently introduced to allow a reproducible and standardized assessment of different irrigation techniques [ 72 , 75 ]. However, substitution of dentine by artificial root canals may also affect irrigant penetration since the surface properties of dentine are different from those of hydrophobic resins [ 56 , 76 ].…”

Evaluation of pH and Optical Properties of Dual Rinse HEDP Irrigating Solution

“…The effect of LAI is based on cavitation, a physical phenomenon that induces the formation and implosion of vapor bubbles at the fiber tip, causing very rapid fluid movement in the canal [25,26]. LAI has been shown to have a greater efficacy in the removal of canal debris and greater antibacterial effect than other activation techniques [44][45][46]. For LAI to be effective, the high absorption of laser energy into the irrigating liquid is necessary.…”

The Evaluation of SWEEPS Plus Antimicrobial Photodynamic Therapy with Indocyanine Green in Eliminating Enterococcus faecalis Biofilm from Infected Root Canals: An In Vitro Study

“…According to their study, another advantage of the SWEEPS technique is that the in-and-out movement of the liquid, which resembles inhalation and exhalation, generates alternating shear stresses in the root canal, which plays a pivotal role in improving the quality of the debridement process. No risk of intracanal instrument fracture is another advantage of the SWEEPS technique, since in this technique the tip of the handpiece is positioned in the access cavity and above the root canals, whereas in sonic and ultrasonic techniques, the instrument is introduced into the canal and proceeds to the apex for the activation of the intracanal irrgant [28]. In addition, a previous study has shown that photosensitizer extrusion is not harmful [29].…”