Investigation of the Efficacy of Passive Ultrasonic Irrigation Versus Irrigation with Reciprocating Activation: An Environmental Scanning Electron Microscopic Study

J Endod. 2016 Apr;42(4):659-63. doi: 10.1016/j.joen.2016.01.016. Epub 2016 Feb 20.

Abstract

Introduction: The objective of this ex vivo study was to compare the efficacy of passive ultrasonic irrigation (PUI) versus a new activation system using reciprocating motion (EasyClean [EC]; Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) to remove debris from the root canal walls at 6 predetermined apical levels using environmental scanning electron microscopy.

Methods: Mesiobuccal root canals of 10 mandibular molars were prepared with a 30/.05 final instrument. The specimens were embedded in flasks containing heavy body silicone, cleaved longitudinally, and 6 round indentations were made into the apical region of the buccal half at 1-mm intervals. The same specimens were used to prepare a blank control group (no debris), a negative control group (completely covered by debris), and 2 experimental groups: PUI and irrigation with reciprocating activation. Standardized images of the indentations were obtained under environmental scanning electron microscopy and assessed by 2 examiners. The amount of debris was then classified using a 4-category scoring system. The kappa test was applied to determine interexaminer agreement, whereas the Kruskal-Wallis, Dunn, and Friedman tests were used to compare scores.

Results: The EC group had results statistically similar to those of the blank control group for all 6 root levels examined. The PUI group had results statistically similar to those of the negative control group for the 3 most apical levels and similar to those of the blank control group for the 3 most cervical levels.

Conclusions: Activating the irrigant with a reciprocating system (EC) promoted more effective debris removal from the more apical regions of the root canal when compared with PUI.

Keywords: Debris; endodontic irrigation; environmental scanning electron microscopy; reciprocating motion; ultrasonics.

MeSH terms

  • Debridement / methods
  • Dental Pulp Cavity / ultrastructure
  • Dentin / ultrastructure
  • Humans
  • Microscopy, Electron, Scanning / methods*
  • Root Canal Irrigants / chemistry*
  • Root Canal Preparation / instrumentation
  • Root Canal Preparation / methods*
  • Root Canal Therapy / instrumentation
  • Root Canal Therapy / methods
  • Sodium Hypochlorite / chemistry
  • Therapeutic Irrigation / methods*
  • Tooth Apex / ultrastructure
  • Ultrasonic Therapy / instrumentation
  • Ultrasonic Therapy / methods*

Substances

  • Root Canal Irrigants
  • Sodium Hypochlorite