Abstract

The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques. Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A-conventional needle (CN), Group B-side-vented needle (SVN), Group C-manual dynamic agitation (MDA), and Group D-EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups. Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05). It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.

Highlights

  • It was evident that irrigant penetration was best achieved with the use of an EA followed by manual dynamic agitation (MDA), side-vented needle (SVN), and the conventional needle (CN) when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system

  • Disinfection is an integral part of root canal treatment along with cleaning and shaping

  • Irrigation protocol is followed, which provides for chemical dissolution of the pulp tissue, removal of smear layer, dentin debris/shavings, and mechanical uncoupling of biofilm thereby reducing the number of microorganisms.[1]

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Summary

Introduction

Disinfection is an integral part of root canal treatment along with cleaning and shaping. The root morphology of teeth varies, and to obtain adequate disinfection root canal, irrigant plays a vital role. Irrigation protocol is followed, which provides for chemical dissolution of the pulp tissue, removal of smear layer, dentin debris/shavings, and mechanical uncoupling of biofilm thereby reducing the number of microorganisms.[1] The activity of the best irrigant is obtained only when it reaches the site of the bacteria within the canal and fulfills its required goal of disinfection. Adequate and effective delivery of the irrigant and activation/agitation of technique play a pivotal role to guarantee adequate quantity is delivered within the root canal and adequately replenished to maintain the desired concentration of the irrigant. The irrigation technique used should bring about a flow property that pushes out the microorganisms, biofilm, and tissue remnants out of the canal[2] in the coronal direction. Irrigants used should provide adequate disinfection, and it should not alter the physical and chemical properties of dentin.[3,4]

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