Efficacy of Different Endodontic Irrigant Activation Techniques on Debris Removal from the Mesial Root Canal System of Mandibular Molars.

Abstract

AIM AND OBJECTIVE\nThis study was conducted to compare debris removal from the mesial canal system with four different irrigation techniques: sonic activation with EDDY, passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher (XPF), and manual dynamic irrigation (MDI) with gutta-percha.\n\n\nMATERIALS AND METHODS\nFifty-six extracted mandibular molars with isthmus in the apical 5 mm in mesial roots were sectioned horizontally at 3 mm and 5 mm from the apex. The sections were reassembled, and the mesial canals were prepared chemomecahanically. Specimens were allocated randomly into four groups according to the final irrigation technique. Standardized images of the coronal aspect of cross sections were obtained using a digital stereomicroscope before and after final irrigation protocols to calculate the percentage of debris elimination from the canal system after final irrigation.\n\n\nRESULTS\nThe use of EDDY, PUI, and XPF exhibited significant reductions in debris compared with MDI at 5 mm (p <0.00) and at 3 mm (p <0.00). Furthermore, no significant difference was noted among EDDY, PUI, and XPF. For intragroup analysis, no statistically significant difference in the percentage of debris elimination was noted between 3 mm and 5 mm in all four groups.\n\n\nCONCLUSION\nAll groups showed a reduction in debris after the final irrigation protocol. However, the use of EDDY, PUI, and XPF after cleaning and shaping yielded a significant reduction in debris compared with MDI.\n\n\nCLINICAL SIGNIFICANCE\nThe use of PUI, XPF, and EDDY as an adjunctive irrigation step presented similar results in improving canal cleanliness, which is hypothesized to affect the treatment outcome.