Abstract

Root canal cleaning plays an important role in endodontics. In most cases, root canal cleaning is performed using irrigants, such as sodium hypochlorite or EDTA (ethylenediaminetetraacetic acid). The efficacy of these irrigants may be compromised by different phenomena, such as vapor lock. Different methods can be used to overcome this problem; in this paper, we compare the efficacy of two such methods: manual dynamic agitation (MDA) and passive ultrasonic irrigation (PUI). We shaped 50 endo training blocks, which were divided into two groups of 25 samples each, into MDA or PUI groups. In both groups, the vapor lock was produced by delivering a watery solution using a disposable syringe with a tip-opened needle. Using the MDA technique, vapor lock was removed in 15/25 cases. The PUI technique produced the same results in 17/25 cases, where vapor lock was only reduced, not removed. The MDA method produced an average reduction in vapor lock of 80%, whereas the PUI method yielded a 55% reduction. The differences among groups were assessed through a Mann–Whitney U test, and the results had a p-value of 0.0013, which was considered to be statistically significant. The MDA method was able to effectively remove vapor lock. PUI, however, was only able to reduce but not remove vapor lock.

Highlights

  • Endodontic treatment involves a procedure composed of the following sequence of steps: tooth anesthesia, operative field isolation, opening of the pulp chamber, canal scouting, shaping and cleansing of the canals, and three-dimensional (3D) obturation [1]

  • The vapor lock effect appears on close-ended root canal systems; in daily practice, it is less frequent because irrigation is performed inside open-ended root canal systems

  • The comparison between the data gathered from the international literature and our experiment on endo training blocks confirmed that the passive ultrasonic irrigation (PUI) method is not able to remove the vapor lock effect but can only reduce fragmenting bubbles, whereas manual dynamic agitation (MDA) is an effective system

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Summary

Introduction

Endodontic treatment involves a procedure composed of the following sequence of steps: tooth anesthesia, operative field isolation, opening of the pulp chamber, canal scouting, shaping and cleansing of the canals, and three-dimensional (3D) obturation [1]. These phases lead to root canal disinfection, shaping [2,3], and filling [4]. Sci. 2019, 9, 5411 mechanical and performed with endodontic instruments during the shaping phase [6], or it can be chemical and performed with irrigants [7].

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