Canal Debris Research Articles

Surgical and dermatological management of asymptomatic congenital ear canal atresia in a male Wirehaired Pointing Griffon dog

AbstractA 1‐year‐old, male, entire Wirehaired Pointing Griffon was evaluated for asymptomatic right congenital ear canal atresia. Head computed tomography confirmed congenital ear canal atresia diagnosis. Surgical resection and anastomosis of the ear canal followed by video otoscopy was performed. An intact, but flaccid tympanic membrane, suspected from impacted ear canal debris, was identified. One week postoperatively, bilateral yeast otitis externa was diagnosed and successfully treated with topical anti‐fungal therapy. Five months postoperatively, the stoma remained patent, the dog was asymptomatic, and computed tomography with video otoscopy revealed a taut tympanic membrane bulging into the horizontal ear canal. Myringotomy, cytology, bacterial cultures, susceptibility testing, middle ear saline lavage and pre‐emptive topical antibiotic therapy were pursued. Cultures yielded no bacterial growth. Four weeks later, the tympanic membrane was visibly normal, and the stoma was unchanged. This case report is the first to describe interdisciplinary management of asymptomatic congenital ear canal atresia and might support early surgical intervention as a reasonable option.

In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis.

This study aimed to assess the efficacy of root canal debris removal in primary teeth through irrigation using the Endo-Irrigator Plus (CWAIS). A total of 25 primary mandibular first molars were divided into five groups, with five teeth in each group. After determining the working length and performing biomechanical preparation, groups I and II were subjected to hand and rotary instrumentation (ProTaper, Dentsply, United States of America) with conventional syringe irrigation with positive pressure, while groups III and IV were instrumented using hand and rotary instrumentation with positive and negative pressure irrigation employing the Endo-Irrigator Plus (CWAIS) system. Sodium hypochlorite (5.25%) and ethylenediaminetetraacetic acid (EDTA) (17%) were used as irrigants. Group V served as the control group, undergoing only root canal access opening. The removal of the smear layer was analyzed at the cervical, middle, and apical thirds of the canal using environmental scanning electron microscopy (SEM). Statistical significance was set at p < 0.05. Statistically significant differences were observed among all groups at the cervical, middle, and apical levels (p < 0.05). Groups III and IV exhibited significantly lower smear scores at all levels, particularly in the apical third, as observed through SEM examination. The use of the Endo-Irrigator Plus (CWAIS) system demonstrated superior debridement of intracanal debris in primary teeth compared to the positive pressure irrigation method. Badnaware SD, Kakade A, Takate V, et al. In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis. Int J Clin Pediatr Dent 2024;17(6):653-657.

A Prototype 3D Printed Suction Port Adapter for a Wireless Otoendoscope

ABSTRACTObjective: To design and fabricate a suction port adapter to use various sizes of suction cannulaswith a wireless otoendoscope enabling ear cleaning under endoscopic guidance demonstrated using an ear examination simulator. Methods:Design: Instrument InnovationSetting: Tertiary Private Training HospitalPatient: Ear Examination Simulator Results: The fabricated suction port adapters were able to hold the wireless otoendoscope and suction cannulas together, allowing simultaneous inspection of the ear canal and suctioning of ear canal debris using the Ear Examination Simulator Conclusion: Our prototype 3D-printed suction port adapters for a wireless otoendoscope mayimprove ear cleaning by enhancing the accuracy of suctioning debris and decreasing durationsince they hold the suction cannulas in place under endoscopic guidance. They may aid ENTphysicians in easier visualization and simultaneous ear cleaning of patients and improve earcleaning techniques and times, especially among less experienced physicians, but actual clinicaltrials are needed to confirm this.

Effectiveness of Ultrasonic, F-File, and NaviTip FX Needle Agitation Techniques on Removal of Root Canal Debris and Smear Layer Using Two Different Irrigants: A Scanning Electron Microscopy Study

Introduction: For successful endodontics, there should be proper cleaning and shaping of the canal before the obturation. Various agitation techniques help in the removal of the debris and smear layer. With the removal of this debris and smear layer, there will be a better opening of dentinal tubules and penetration of sealer in the tubule. Aim: To evaluate the effectiveness of removal of debris and smear layer from prepared root canals by comparing ultrasonic agitation, F-file agitation, and NaviTip FX needle agitation using Sodium hypochlorite (NaOCl) and SmearClear as irrigants. Materials and Methods: The present in-vitro study included 60 bilaterally matched pairs of extracted human premolar teeth with single canal and mature apices, were collected. All teeth were decoronated at the cementoenamel junction. The teeth were grooved longitudinally on the buccal and lingual surfaces. Instrumentation was done using K3 rotary files up to #40 and irrigation was carried out using 2 mL syringes mounted with Max-i-probe needles. Agitation procedure (n=10 for each group) was done as follows. Group 1: Ultrasonic agitation of 2.5% NaOCl for 30 seconds. Group 2: F-file agitation of 2.5% NaOCl for 30 seconds Group 3: NaviTip FX agitation of 2.5% NaOCl for one minute continuously. Group 4: Ultrasonic agitation of SmearClear for 30 seconds. Group 5: F-file agitation of SmearClear for 30 seconds. Group 6: NaviTip FX agitation of SmearClear for one minute continuously. The roots were split into two halves using a chisel and mallet. The amount of debris and smear layer was assessed using SEM at 1000X magnification at each root canal’s coronal, middle, and apical areas. Statistical analysis was done using Kruskal-Wallis and Mann-Whitney U test. Results: Statistically significant difference was obtained in the reduction of debris and smear layer between 2.5% NaOCl and SmearClear. Ultrasonic agitation of SmearClear was better than F-file agitation and NaviTip FX. In both debris and smear layer removal (p-value &lt;0.05). Conclusion: Ultrasonic agitation of SmearClear was better than F-file agitation and NaviTip FX agitation. SmearClear produced better removal of debris and smear layer than 2.5% NaOCl.

Benign Paroxysmal Positional Vertigo: Is It Really an Otolith Disease?

The current theory in physiopathology of benign paroxysmal positional vertigo is the mechanical theory, namely the cupulolithiasis–canalolithiasis theory. Repositioning maneuvers based on this theory has now taken place in therapy. However, mechanical theory is insufficient to explain some clinical situations and cannot fully enlighten the physiopathology. Mechanical theory is based on very few histological studies. Currently, these few articles are still used for reference. Anatomically, there are uncertainties that need to be explained in this theory. In this literature review, the histological and anatomical evidence is reviewed and the value of mechanical theory in benign paroxysmal positional vertigo physiopathology has been questioned. Studies suggest that the debris in the semicircular canals is caused by degeneration due to aging and may not be responsible for the symptoms in benign paroxysmal positional vertigo. Some patients with debris in semicircular canals do not have benign paroxysmal positional vertigo symptomatology, while some patients without debris may have benign paroxysmal positional vertigo symptomatology. Experimental and histological findings suggest that vestibulopathy due to inflammation caused by neurotropic viruses may lead to benign paroxysmal positional vertigo picture. For all these reasons, in benign paroxysmal positional vertigo physiopathology, there must be other factors besides particle debris in semicircular canals.

Influence of different reciprocating systems on the apical extrusion of debris in flat-oval canals

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p&gt;0.05) and 1 mm (p&gt;0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p&lt;0.05), with PDR differing significantly from the other systems (p&lt;0.05). Conclusion: The extrusion of debris occurred regardless of the group, with higher values at 1 mm. However, using PDR at 1 mm from the apical foramen showed the highest values of extrusion.

Effect of M-pro Versus ProTaper Next Rotary Instrumentation Systems on Apically Extruded Debris in Single Canals (A Comparative &lt;i style="font-style:italic;"&gt;In Vitro&lt;/i&gt; Study)

Effect of M-pro Versus ProTaper Next Rotary Instrumentation Systems on Apically Extruded Debris in Single Canals (A Comparative &lt;i style="font-style:italic;"&gt;In Vitro&lt;/i&gt; Study)

To Evaluate the Efficacy of New Brush Covered Irrigation Needle in Removing Root Canal Debris In Vitro: A Scanning Electron Microscopy Study

To Evaluate the Efficacy of New Brush Covered Irrigation Needle in Removing Root Canal Debris In Vitro: A Scanning Electron Microscopy Study

Comparative Analysis of Root Canal Filling Debris and Smear Layer Removal Efficacy Using Various Root Canal Activation Systems during Endodontic Retreatment.

Background and objectives: The complete removal of obturation material can be a challenge in nonsurgical root canal retreatment. The insufficient removal of obturation material is a reason for root canal retreatment failure. Materials and Methods: The purpose of this study was to assess the efficacy of different final root canal irrigation activation methods in removing debris and smear layers in the apical and middle portions of root canals during retreatment. Sixty-six distal roots of freshly extracted molars were randomly divided into six groups: (1) primary root canal treatment with no obturation (negative control); (2) retreatment with only conventional instrumentation and irrigation (positive control); (3) retreatment with additional ultrasonic irrigation using the Piezon Master 700; (4) ultrasonic irrigation with the ENDOSONIC Blue; (5) sonic irrigation with the EDDY; and (6) multisonic irrigation with the GentleWave system. Roots were split and prepared for scanning electron microscopic (SEM) evaluation. Acquired images were assessed to quantify the amount of debris and smear remaining. Results: Among the treatment groups, Group 6 had a significantly lower debris score than Group 2 (positive control) in both the middle and apical regions (p = 0.004, p = 0.012). All treatment groups showed significantly lower smear scores than Group 2 in the middle and apical regions (p < 0.05). Conclusions: The GentleWave multisonic System showed a more optimal cleaning efficacy of the root canal debris but did not differ significantly with the tested passive ultrasonic or sonic irrigation method.

Symptom: Conductive Hearing Loss after Cholesteatoma Surgery

Symptom: Conductive Hearing Loss after Cholesteatoma Surgery

Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review

Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction.

Improvements in Cognition, Chronic Migraine Headaches with Aura and Benign Paroxysmal Positional Vertigo (BPPV) in a 35-year-old Female Patient Following Neurological and Vestibular Rehabilitation.

Event Abstract Back to Event Improvements in Cognition, Chronic Migraine Headaches with Aura and Benign Paroxysmal Positional Vertigo (BPPV) in a 35-year-old Female Patient Following Neurological and Vestibular Rehabilitation. Trevor D. Eason1* 1 Carrick Institute, United States Presentation: A 35-year-old female patient presented with cognitive decline, persistent episodes of benign paroxysmal positional vertigo, and chronic, persistent migraine headaches. The history included episodes of chronic migrainous headaches originating when she was 12-years-old. The migraine headaches are normally preceded by scintillations. The patient stated that she had never been able to ride in the back of a car, participate at amusement parks and has frequent dizziness and described oscillopsia. The origination of the episodes of benign paroxysmal positional vertigo occurred 2 years ago spontaneously upon arising one morning. The patient stated that medication she has been prescribed does not have the same effect as it once did concerning her migraine episodes. Findings: During neurocognitive testing on the C3 Logix program, upon intake, Trails A time was measured at 40.8 seconds while Trails B time was measured at 45.2 seconds. Her simple reaction time was 383 milliseconds and her choice reaction time was 411 milliseconds. Her initial symptom severity score was 86% based on the associated subjective questionnaire where 0% is no symptoms. A Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing the patient's balance and stability, on both a solid and foamed surface, with his eyes opened, eyes closed, and with multiple head positions. Her average balance and stability score on intake was calculated as 27.12%. Videonystagography (VNG®) demonstrated mixed torsional, geotropic, upbeat nystagmus when placed in a Dix-Halpike maneuver for the right posterior canal. A 2-3 Hz. left beat nystagmus was also observed with gaze fixation eliminated in primary position. Methods: A 12-day multi-modal neurological rehabilitation program was administered in 12 one-hour treatment sessions (Carrick, 2017). Initial treatment consisted of an Epley maneuver to alleviate the right posterior canal debris. Each session after consisted of neurological and vestibular rehabilitation exercises directed towards the right vestibular apparatus and cerebellum integration, somatosensory evoked potentials, cognitive exercises, orthoptic training, and off-vertical axis rotation (Gdowski 1999) using a multi-axis rotational chair. Initially, she was placed on a paleo diet and a supplement protocol. Based on clinical symptoms indicating alterations in energy production, she was placed on multiple nutrient formulas containing Vitamin E (11 mg), docosahexaenoic acid (1200 mg), Phosphatidylcholine (60 mg) 1 x daily. CoQ10 (200 mg) and Pyrroloquinoline quinone disodium salt (PQQ) (5 mg) were also administered in a 5 ml. dose 1 x daily. She was advised to reduce smoking and enroll in smoking cessation counseling. Outcomes: Upon discharge, Trails A time decreased to 23.5 seconds (-42.4%), and Trails B time decreased to 32.7 seconds (-27.7%). Simple reaction time decreased to 277 seconds (-27.7%), and choice reaction time decreased to 312 seconds(-24.1%). Symptom severity score decreased to 7 (-91.9%) where 0 is no symptoms. The average balance and stability score improved resulting in a score of 85.37% (+214.9%). Upon Videonystagography (VNG®), no mixed torsional, geotropic, upbeat nystagmus was observed when placed in a Dix-Halpike maneuver for the right posterior canal. No nystagmus was observed with gaze fixation eliminated in a neutral gaze or primary ocular position. Concurrently, full resolution of her migraine headaches occurred after the BPPV was eliminated. Conclusions: The author suggests further investigation into the use of multi-modal neurological, vestibular rehabilitation strategies and supplemental clinical nutrition strategies for the treatment of BPPV, and migraine headaches with aura. The author also suggests further investigation into multi-modal, intensive approaches to improve stability scores, simple and choice reaction times, symptom severity scores and stability of eye movements associated with proper neurological and vestibular function. Acknowledgements The author would like to thank and acknowledge Professor Frederick Carrick and his pioneering work in the field of clinical neuroscience. The author would also like to thank the Carrick Institute for providing the education utilized to create the multi-modal treatments implemented in this case study.

Effect of 830 nm Diode Laser Irradiation of Root Canal on Bond Strength of Metal and Fiber Post.

The correct selections of the cementing agent, the endodontic post material and placement protocol are critical to provide an increased longevity of the teeth that went through endodontic treatment. The irradiation with diode laser before post cementation, can promote an antimicrobial effect. However, there is a lack of information about the effect of 830 nm diode laser on the post bond strength. This study analyzed the effect of dentin root canal irradiation with high-intensity diode laser, at 830 nm, operating in continuous or pulsed mode, on the retention of metal or fiber posts, cemented with self-etching resinous composite (Panavia F) and zinc phosphate cement (ZnPO4). Human roots were irradiated with diode laser (continuous and pulsed mode). The fiber posts were luted with Panavia F and the metal posts with Panavia F or ZnPO4 cement. Specimens were sectioned into three sections (cervical, middle, and apical). The bond strength was measured by a push-out mechanical analysis. For the statistical analysis, a three-way ANOVA test was applied following a Tukey's pairwise comparison with a significance level of p = 0.05. The irradiated groups presented higher bond strength compared with nonirradiated group (p < 0.05), and the cervical and middle thirds presented higher on bond strength than the apical. The association of metal post and Panavia F presented higher bond strength when irradiated on continuous mode (p < 0.05). Fiber post and Panavia F presented higher bond strength associated to pulsed mode. The mode seems not to make a significant difference. These results corroborate the importance of the post bond to dentin and root canal debris removal to increase the tooth longevity. It was shown that the dentin to post bond strength were enhanced by the diode laser irradiation either on continuous or pulsed modes.

A scanning electron microscope evaluation of efficacy of sodium hypochlorite and Allium sativum in smear layer removal in root canals with the use of modified evacuation system: An ex vivo study.

Context:Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant. Although it fulfills most of the requisites of an ideal irrigant, it has certain drawbacks, chiefly severe soft-tissue damage. Allium sativum (garlic extract) is a proven antimicrobial agent that has the ability to dissolve inorganic tissue with minimal toxicity. However, its ability to remove smear layer (SL) is not known. Conventional hand-held syringe irrigation is ineffective in removing canal debris. The use of newer irrigation systems is limited owing to their high cost. Modified evacuation system (MES) may prove to be an effective yet economical alternative.Aims:This study aims to evaluate the SL removing capacity of garlic extract as an alternative to 5% NaOCl and the use of modified evacuation system for removal of irrigant along with debris from root canals.Settings and Design:Sixty-eight single-rooted mandibular premolars were divided into 8 Groups: Two control Groups A and B (4 samples each) and six experimental Groups C to H (10 samples each). Garlic extract was prepared at a concentration of 64 mg/ml. MES was set up using 21-gauge flat-end needle fixed onto chair side high-volume evacuation system.Subjects and Methods:Control groups were irrigated with normal saline, Groups C and D with 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA), Groups E and F with garlic extract and 17% EDTA and Groups G and H with plain garlic extract. MES was used in Groups B, D, F, and H. Scanning electron microscope analysis was done to view SL at coronal, middle, and apical thirds.Statistical Analysis Used:Chi-square test.Results:Groups A and B showed least scores. At coronal and middle thirds, Group D shows better results, followed by Groups F and H. Apically, Group F showed better results. Groups C and H, and E and G showed similar results. All groups with MES showed better results.Conclusions:A. sativum has an SL removal capacity. MES is effective in debris removal.

Comparison of Apically Extruded Debris during Retreatment Procedure by Two Types of Endodontic Instruments

Abstract Introduction: During root canal treatment, canal debris is inadvertently extruded through the apex during shaping and cleaning. This happens not only during the routine endodontic cases, but also during the retreatment cases. Objective: This study analyzed in vitro the amount of debris extruded through the foramen using two instrumentation techniques during endodontic retreatment. Materials and methods: Sixty roots of mandibular first premolars were selected, instrumented with anatomical diameter up to size number 40 International Organization for Standardization (ISO) file, and then obturated with gutta-percha and zinc-oxide eugenol sealer by lateral condensation. They were then divided into two groups of 30 each. The first group was instrumented with ISO K-files for gutta-percha removal and the second group was instrumented with Protaper retreatment files and gutta-percha was removed. All teeth were irrigated with distilled water. The debris extruded through the foramen were collected and weighed by an analytical balance. Results: Group II had the lowest average for material extrusion through the foramen followed by group I. When Tukey test for statistical analysis was applied, significant differences among groups were found (p = 0.02). Conclusion: It can be concluded that Protaper retreatment files produce significantly less debris as compared with K-files.

A COMPARATIVE STUDY OF THE AMOUNT OF APICALLY EXTRUDED DEBRIS AFTER USING DIFFERENT TYPES OF GLIDE PATH FILES

INTRODUCTION: During root canal preparation; irrigants, dentin chips, pulp tissue and microorganisms may be extruded into the periradicular tissues which may cause postoperative pain and complications. OBJECTIVES: The aim of this study was to compare the amount of apically extruded debris in mesio-buccal canals of 30 extracted human mandibular molars instrumented with One-Shape file after preparing a proper glide path using G-files, ProGlider and K-files. MATERIALS AND METHOD: This study was conducted on the mesio-buccal roots of 30 human mandibular molars with curvature of 20 to 35 degrees. All specimens were divided into three groups according to the type of instrument used for glide path management. Group (1): manual instrumentation with K-files (#10, 15), Group (2): G-files: (G1: #0.12mm, G2: #0.17mm), and Group (3): ProGlider: single use rotary file. All teeth were instrumented using One-Shape file. Debris extruded apically from the teeth were collected into pre-weighed Eppendorf tubes. Three consecutive weights were obtained for each tube and the mean value was obtained. The weight of extruded debris was calculated as the difference between the pre and post instrumentation weights of the tubes. RESULTS: The highest amount of debris was found in the k-file group while the lowest amount with ProGlider group with significant differences between them. Moreover, significant difference was found between ProGlider and G -file while there was no significance between G-file and K -file groups. CONCLUSIONS: All techniques showed debris extrusion, although the use of NiTi rotary instruments may be rather beneficial.

Apical Extrusion of Debris Produced during Continuous Rotating and Reciprocating Motion.

This study aimed to analyse and compare apical extrusion of debris in canals instrumented with systems used in reciprocating and continuous motion. Sixty mandibular premolars were randomly divided into 3 groups (n = 20): the Reciproc (REC), WaveOne (WO), and HyFlex CM (HYF) groups. One Eppendorf tube per tooth was weighed in advance on an analytical balance. The root canals were instrumented according to the manufacturer's instructions, and standardised irrigation with 2.5% sodium hypochlorite was performed to a total volume of 9 mL. After instrumentation, the teeth were removed from the Eppendorf tubes and incubated at 37°C for 15 days to evaporate the liquid. The tubes were weighed again, and the difference between the initial and final weight was calculated to determine the weight of the debris. The data were statistically analysed using the Shapiro-Wilk, Wilcoxon, and Mann-Whitney tests (α = 5%). All systems resulted in the apical extrusion of debris. Reciproc produced significantly more debris than WaveOne (p < 0.05), and both systems produced a greater apical extrusion of debris than HyFlex CM (p < 0.001). Cross section and motion influenced the results, despite tip standardization.

Apical extrusion of debris from root canals using reciprocating files associated with two irrigation systems.

To compare apical extrusion of debris in canals prepared with two reciprocating file systems and two different irrigation systems. Forty single straight root canals in human mandibular pre-molars were prepared using Reciproc R40 (REC) and WaveOne Large (WO) instruments. Before preparation, the dimensions of a size 40 instrument from each system were measured under scanning electron microscopy (SEM) at 80X. The teeth were randomly divided into four different groups of 10: REC and VPro EndoSafe (REC/VPro); WO/VPro; REC and conventional irrigation (REC/CI); and WO/CI Eppendorf tubes containing a single tooth were weighed on an analytical balance to the nearest 0.1 mg before instrumentation. Irrigation was performed with a total volume of 8 mL of 2.5% sodium hypochlorite. After instrumentation, the teeth were removed from the Eppendorf tube and incubated at 37 °C for 15 days to evaporate the liquid. The tubes were weighed again, and the difference between the initial and final debris weights was calculated and statistically evaluated using analysis of variance (two-way anova) with a significance level of 0.05. No significant difference was observed between the VPro and CI irrigation systems (P > 0.05). Apical extrusion of debris was confirmed in all samples, and extrusion was greater in the REC groups than in the WO groups (P < 0.05). The WO file had a 20% smaller diameter at the tip (D0 ) than the measurement provided by the manufacturer. All systems were associated with apical extrusion of debris. The WO system was associated with less extrusion than the REC system. The amount of extruded debris was independent of the irrigation system used and was related to the instrumentation technique. Morphological analysis of instruments using SEM revealed no correlation between the diameter provided by the manufacturer and the measured diameter for the WO Large file.

Corelation between machines assisted endodontic irrigant agitation and apical extrusion of debris and irrigant: a laboratory study.

Aims. To compare amount of root canal debris and irrigant extruded apically after irrigants agitation using closed and open chambers. Methods and Material. Sixty maxillary central incisors were selected, decoronated, and mounted in preweighed glass vials filled with distilled water. Biomechanical preparation was completed using ProTaper rotary files until number F4 and 1 mL of 3% NaOCl solution after each file use. Samples were randomly divided into closed or open chamber sets which were further subdivided into 6 groups, based on the agitation techniques: no agitation (control), canalBrush, lentulospiral, passive ultrasonic agitation (PUA), EndoActivator, and EndoVac. Canals were irrigated with 1 mL of 17% EDTA and agitated for 30 s and then flushed with 2 mL of distilled water. Apically extruded irrigant was measured and vials were kept in incubator for 5 days at 68°C for drying for weight calculation. Statistical Analysis. Analysis was done using Student's t-test, one-way ANOVA, and post-hoc. Results. All agitation techniques showed apical extrusion of the debris and irrigant. The closed chamber apparatus showed significantly less extrusion of debris and irrigant than open chamber (P < 0.05). Conclusions. EndoVac was found to be the safest agitation system among all test groups with regard to apical extrusion of debris and irrigant.

Comparison of the cleaning efficacy of EndoVac with conventional irrigation needles in debris removal from root canal. An in-vivo study.

Aim and Objective:The aims were to evaluate the root canal debris removal after irrigation with EndoVac system and to compare its efficacy with Max-i-Probe needles.Materials and Methods:Fifteen matched pairs of single canalled vital teeth with mature apices indicated for extraction were selected. After working length determination and biomechanical preparation, the teeth in the right quadrant were irrigated with EndoVac system and with Max-i-Probe needles in the left quadrant using 3% NaOCl and 17% ethylenediaminetetraacetic acid. Teeth were extracted and marked at 1 and 3 mm from working length and decalcified in Kristenson's solution. Stained histologic slides were observed under trinocular research microscope. Wilcoxon signed-rank test was used for statistical analysis. The statistical significance was set at P < 0.05 and the analysis was performed using SPSS version 11.0 software.Results:No statistical significant difference was found at 3 mm level between the groups. Group I had significantly less debris at 1 mm level.Conclusion:EndoVac performed better in removing debris from the apical thirds of root canals.