Canal Segment Research Articles

The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers.

This study aimed to compare the effect of 4 different intracanal medicaments on the push-out bond strength of two sealers (AH Plus and MTA Fillapex). 100 single-rooted extracted premolar teeth were divided into 5 groups, with 20 samples in each group, one group being the control group. After cleaning and shaping procedures, the canals were filled with 4 different medicaments: calcium hydroxide, tri-antibiotic paste (TAP), Metapex, or Chlorhexidine (2%) gel for 2 weeks. Following this, the medicaments were rinsed away, and the samples in those sub-groups were obturated with gutta-percha/AH Plus or MTA Fillapex sealers. After 2 weeks of incubation, a 2-mm-thick middle section from each root was evaluated to test push-out strength. The obtained data were tabulated, and appropriate statistical analysis was performed (two-way ANOVA and LSD test). When comparing the average values, the bond strength values of AH Plus were significantly higher than those of MTA Fillapex (p<0.05) in all medicament groups. Based on the findings, we concluded that AH Plus had comparatively higher bond strength than MTA Fillapex. We also observed that AH Plus had higher bond strength in the presence of calcium hydroxide, whereas MTA Fillapex in the presence of Chlorhexidine. A comparison of the push-out bond strength shows that irrespective of the root canal segment or the final irrigant used, AH Plus showed higher values among all groups. The limitation of the current study was that the effect of TAP on the bond strength of endodontic sealers was not negative.

Study on the Performance of the Hydraulics System Planning of Swampy Irrigation Area of Dadahup, Kapuas District, Central Kalimantan Province

Swampy Irrigation Area (DIR) Technical Implementation Unit (UPT) Dadahup is a swampy irrigation area that needs serious handling of flood control. This flood is resulting in crop failure in several blocks. Furthermore, the malfunctioning of the main gates in controlling the entry and exit of water resulted in a long-standing inundation for the land. This paper presents the hydraulic system of the irrigation network of DIR UPT Dadahup by reviewing secondary data and documentation of field observations. Based on these parameters, the authors simulate the main primary channel using HEC-RAS to perform hydraulic analysis. The flow simulation results show that water entering the land inundated the three canal segments. One has the highest embankment elevation of 1,778 m, with the highest tide on the channel section of 2.25 m. Other results showed that water entering the land also inundated one channel section. The highest embankment elevation was 1,233 m, with the highest tide on the channel section being 1.4 m. From these results, the overflow of water was then eliminated by the heightening of the embankment.

Study on the Influence of Sudden Change of Water Level on High Fill Canal Segment

Extreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. In this paper, numerical method is used to study the influence of water level sudden change on seepage characteristics of high fill canal segment. HyperMesh software is used to establish the finite element model of typical high fill canal segment under complex foundation conditions. Through the combination of secondary development program and fluid-structure coupling calculation method, the fluid structure cou-pling effect of canal under sudden change of water level is analyzed in ABAQUS. The results show that when the water level changes suddenly, the pore pressure below the free water surface and the velocity near the free surface will be greatly affected.

The utilization pattern of east flood canal as public open space in urban area

East Flood Canal is one of the manmade waterfront public open spaces in Jakarta which is often visited by residents. The existence of the public open space is very important for society. The purpose of the study is to identify the utilization pattern of public open space on canal banks and analyze the problems related to the utilization of this space. Method used place-centered mapping to identify physical characteristic of public open space and patterns of activity that occur in the study area. The study is conducted in the segment East Flood Canal on Jl. Kolonel Sugiono, Duren Sawit sub-district, East Jakarta. The result is the pattern of utilizing public open space in the four zones in the East Flood Canal segment is linear because the pattern follows the physical setting of pedestrian circulation paths and bicycle lanes. This study suggests both two circulation pathways (pedestrian and bicycle) need to be designed continuously along the canal and equipped with adequate facilities. Improvement of the planning, design, and maintenance of public open space in the segment of canal will have many benefits to increase social interaction, recreational activities, educational communication, and also a concern for the hydrological aspects of the canal.

The evaluation of facial nerve canal diameter in patients with ipsilateral recurrent idiopathic peripheral facial paralysis.

This study evaluated the effects of the diameter of facial canal segments on the ipsilateral recurrence of idiopathic peripheral facial paralysis. This study enrolled 20 patients with ipsilateral recurrent idiopathic peripheral facial paralysis. Measurements were made at the meatal foramen and mid-level of the labyrinthine segment and the narrowest and widest diameters of the mastoid and tympanic segments using the curved planar reformation technique with high-resolution computed tomography. The diameters of the labyrinthine segment measured at the meatal foramen and mid-level segments and the narrowest and widest diameters of the tympanic and mastoid segments on the recurrent paralytic side were significantly smaller than the diameters of the segments on the healthy side. The narrowness of the facial canal segments may be a risk factor in recurrent idiopathic peripheral facial paralysis.

Cerebrospinal fluid dynamics along the optic nerve in patients with spontaneous cerebrospinal fluid rhinorrhea: a retrospective computed tomographic cisternography study.

Spontaneous cerebrospinal fluid (CSF) rhinorrhea is related to intracranial pressure (ICP) and dynamic changes. This study investigated CSF dynamics along the optic nerve (ON) in patients with spontaneous CSF rhinorrhea. The computed tomographic (CT) cisternographies of 66 patients (132 eyes) with spontaneous CSF rhinorrhea were analysed. The contrast-loaded CSF (CLCSF) density was measured in Hounsfield units (HU) at three regions of interest (ROIs) along the ON and adjusted by the basal cistern density. The CLCSF density and ON sheath diameter (ONSD) were analysed between both sides in the different ICP groups. When comparing the density of CLCSF along the ON, no significant differences were found between the ipsilateral and contralateral sides of the leakage. The distribution of CLCSF along the ON showed a highly significant density reduction from the canalicular segment to the bulbar segment on both sides. The CLCSF density significantly decreased on the ipsilateral ON in the canalicular segment and tended to decrease on the ipsilateral ON in thebulbar and canal segments compared with that on the contralateral ON in the low-ICP group. The ONSD tended to decrease on the ipsilateral side of leakage. According to the CLCSF density on CT cisternography, CSF dynamics along the ON may bilaterally decrease from the optic canal to the retrobulbar segment. Cerebrospinal fluid (CSF) dynamics are possibly influenced by differences in ICP, and a lower ICP may cause more obvious differences or impairments in CSF dynamics along the ipsilateral ON.

Root canal debridement efficacy of heated sodium hypochlorite in conjunction with passive ultrasonic agitation: An ex vivo study.

Background. This study aimed to investigate the endodontic debridement efficacy of different sodium hypochlorite (NaOCl) irrigation regimens with and without ultrasonic agitation, followed by ethylenediaminetetraacetic acid (EDTA) via scanning electron microscopy (SEM) after using a rotary instrumentation system. Methods. Mandibular premolars (n=50) were randomly divided into five experimental groups (n=10) for root canal instrumentation with ProTaper Universal rotary system up to F3. The root canal system was treated with intracanal-heated NaOCl (100°C) or preheated NaOCl (55°C), followed by ultrasonic agitation and EDTA treatment. Samples irrigated with conventional needle irrigation (CNI) using normal saline solution were used as controls. Debridement efficacy was analyzed by SEM. A five-point scale was used to estimate the presence/absence of debris for each canal segment (coronal, middle, and apical). The results were analyzed using one-way ANOVA and post hoc Tukey tests (P<0.05). Results. The experimental groups exhibited less debris compared to CNI with saline (P<0.05). The amount of debris decreased significantly for the group with NaOCl intracanal heating compared to extraoral heating. Ultrasonic agitation further enhanced the root canal debridement efficacy of NaOCl. Conclusion. In summary, intracanal heating of NaOCl with and without ultrasonic agitation followed by EDTA appears to be a promising method to flush debris from the root canal system.

Optimasi operasi irigasi pada kondisi darurat pasca bencana gempa di Daerah Irigasi Gumbasa, Sigi, Sulawesi Tengah

KKejadian bencana gempa di Kabupaten Sigi, Sulawesi Tengah telah merusak Daerah Irigasi Gumbasa. Rehabilitasi jaringan irigasi akan dilaksanakan secara bertahap dimulai pada tahap I dari bendung hingga ke ruas saluran di BGKn 8 (Sibalaya) yang terdampak likuifaksi. Operasi irigasi perlu dilakukan secara bertahap pada jaringan irigasi yang telah selesai direhabilitasi dan siap diairi sehingga masyarakat sekitar dapat segera bercocok tanam dan tidak kehilangan mata pencaharian. Namun demikian, luas layanan dan debit yang diperlukan jauh lebih rendah dibandingkan desain sehingga akan mengakibatkan beberapa kendala distribusi air. Penelitian ini untuk merumuskan pola operasi irigasi DI Gumbasa pada kondisi darurat dimana debit yang dialirkan jauh lebih kecil dibandingkan debit rencana. Penelitian dilakukan dalam bentuk pengumpulan data dan perumusan skenario operasi irigasi melalui analisis hidraulik. Skenario yang disimulasikan adalah operasi tanpa optimasi, optimasi dengan menggunakan pintu sorong eksisting, dan optimasi menggunakan skotbalok. Berdasarkan hasil permodelan, operasi irigasi tanpa optimasi tidak dapat di lakukan karena elevasi air tidak dapat naik dan mengalir ke saluran sekunder dikarenakan besarnya dimensi saluran primer. Optimasi penggunakan pintu sorong hanya dapat meninggikan elevasi air sebesar ±1 m dari dasar saluran. Selain itu jika optimasi dilakukan dengan penutupan pintu sorong secara total dapat mengakibatkan air melimpas keluar di beberapa lokasi. Pada skenario terakhir pemanfaatan skot balok untuk optimasi merupakan solusi yang terbaik. Skot balok dapat meninggikan air pada ketinggian yang dibutuhkan. Skot balok adalah bangunan yang cukup baik untuk pengatur muka air sementara dimana ketinggian muka air dapat diatur walaupun debit yang mengalir relatif kecil.

Distribution of sodium hypochlorite throughout the mesial root canal system of mandibular molars after adjunctive irrigant activation procedures: a micro-computed tomographic study.

To evaluate and compare irrigant distribution throughout the root canal system of mesial roots of mandibular molars after application of distinct adjunctive irrigant activation procedures. Fifteen extracted mandibular molars presenting Fan's type II, III, or IV isthmus configurations were selected. The canals were initially enlarged and cleaned. The same specimens were subjected to conventional positive pressure irrigation (PPI) followed by adjunctive irrigation approaches: passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher instrument, and a control group in which the irrigant remained in the canal with no activation. Retention time for the irrigant was the same for all groups. Sodium hypochlorite mixed with a contrast medium (Omnipaque 300) was used as the irrigant. Before and immediately after the adjunctive irrigation, micro-computed tomographic (micro-CT) scans were taken to evaluate the volume of the entire root canal system that was filled by the irrigant. An exclusive analysis was also done for the isthmus area. Analysis of the entire root canal system showed that the XP-endo Finisher instrument promoted better distribution of the irrigant than PUI and the control group (p < 0.01). PUI was not significantly different from the control group (p > 0.05). A separate analysis of the isthmus area showed no significant difference between the adjunctive irrigation methods and the control (p > 0.05). The XP-endo Finisher instrument promoted better distribution of irrigant throughout the root canal system, especially in the apical canal segment, when compared to PUI. However, the tested approaches did not differ as to the ability to drive irrigants into the isthmus area. This study highlighted that the XP-endo Finisher instrument presented a better performance to distribute irrigant throughout the root canal system, especially in the apical canal segment compared to positive pressure irrigation and PUI.

Morphometric properties of the facial canal in children: A retrospective computed tomography study

PurposeThe main objective of the study was to examine the morphometric development of the facial canal in temporal bones aged from one to 18 years for pediatric otosurgeons and neurosurgeons. MethodsThe study was performed on 41 patients including cochlear implantation cases (20 females and 21 males) with a mean age of 6.44 ± 5.79 years. All the measurements belonging to the facial canal including the length, width and angles of its segments were performed using the data of computed tomography assessment. ResultsThe numerical data of the facial canal segments were not different in terms of sexes or sides, statistically (p > 0.05). The width of the labyrinthine segment (p = 0.145), the length of the tympanic segment (p = 0.555), the first (p = 0.067) and second (p = 0.060) genu angles seemed to reach adult size at two years of age. In addition, the length of the labyrinthine segment (p = 0.064) and the width of the mastoid segment (p = 0.264) seemed to attain adult size at four years, while the width of the meatal foramen (p = 0.264) seemed to arrive adult size at seven years. However, the length of the mastoid segment and the width of the tympanic segment were developing independently of increasing age between 1 and 18 years. ConclusionOur data suggested that, contrary to the general acceptance in the literature, the dimension of the facial canal segments show remarkable changes during the transition from intrauterine life to adult life. The regression equations representing the facial canal growth dynamic in children may be useful for otosurgeons to estimate the size of its segments and to prevent iatrogenic injury during early childhood surgeries such as cochlear implantation.

MRI features and differential diagnoses of congenital vaginal atresia

Objective: To investigate the MRI manifestations of congenital vaginal atresia, analyze its imaging features, and improve the understanding of the disease.Methods: MRI findings and clinical data of 12 patients with congenital vaginal atresia confirmed by hysteroscopy and laparoscopic surgery were retrospectively analyzed. Vaginal atresia was classified according to vaginal dysplasia in AFS female genital malformation classification system.Results: In this study, 12 cases of congenital vaginal atresia were diagnosed by combined preoperative MRI with operative diagnosis. Among them, 10 patients all had type-I congenital vaginal atresia, and their uterus and cervix were normal (1 patient had ectopic renal malformation combined with left ovarian endometriosis cyst and 1 patient with uterine empyema). The other two cases were diagnosed congenital vaginal atresia type II (1 case merged with residual uterus, 1 case with cervical dysplasia). MRI mainly manifested as dilatation and hemorrhage in the uterine cavity, cervical canal and vaginal upper segment. T1WI showed high signal, T2WI showed slightly lower and slightly higher signal. The dilated vagina was above the perineal level.Conclusion: MRI features of congenital vaginal atresia have certain characteristics. MRI cannot only accurately assess the type of vaginal dysplasia and its associated complications, but also make objective evaluation and diagnosis, so it can be used as the best effective preoperative image evaluation.

Radiocesium (137Cs) accumulation by fish within a legacy reactor cooling canal system on the Savannah River Site

The aquatic cooling canal system associated with a nuclear reactor built in the early 1950s received accidental releases of radiocesium (137Cs) from the reactor between 1954 and 1964, resulting in the dispersion of ~8.2 × 1012 Bq of 137Cs into the associated canals and ponds. The primary purpose of this study was to document concentrations of 137Cs in littoral zone fish currently occupying components of the cooling canal system, 3 canals and 2 impoundments, to determine how concentrations varied among these various components. Secondarily, we examined for potential influence of weirs within the canal system on concentrations in fish as well as the potential relationship between fish species and body size and on 137Cs concentrations in fish. We collected samples of sediment, biofilm, and fish from each component of the R-Reactor cooling system and compared 137Cs among sites and species in individual sites. Concentrations of 137Cs in sediments, biofilms and mosquitofish varied significantly among sampling areas with higher concentrations in RCAN1, a canal segment that was the closest to the reactor and received reactor effluent for a longer period than other components. Comparisons among other components of the cooling system, and species comparisons relative to presumed trophic positions and fish length were not consistent. However, littoral zone fish in the cooling canal system continue to bioaccumulate 137Cs >50 years after the original releases of contamination.

Rate of Spiral Ganglion Cell Loss in Idiopathic Sudden Sensorineural Hearing Loss.

To calculate the spiral ganglion neural decay rate among patients diagnosed with idiopathic sudden sensorineural hearing loss (ISSNHL). Retrospective. Temporal bone histopathology bank. Subjects diagnosed during life with unrecovered unilateral ISSNHL. Spiral ganglion cell count in the bilateral reconstructed Rosenthal canal. Decay rate of spiral ganglion cells. Nine patients were enrolled. The average age of ISSNHL diagnosis and death was 52 and 63 years, respectively. The total and segmental SGCC decay shows a temporal dependency. The time lag between the ISSNHL event and death was linearly proportional to the SGCC decay. Subjects who died less than 5 years from diagnosis of ISSNHL had no more than 13% loss of their total SGCC, and no more than 14% of SGCC per Rosenthal canal segment. When a longer period passed from ISSNHL diagnosis to death (19-20 yr), a loss of 16% and 13 to 18% of total and segmental SGCC occurred, respectively. SGCC decline from ISSNHL diagnosis through life.

The disuse effect on canal network structure and oxygen supply in the cortical bones of rats.

In this study, based on the measurements of intracortical vascular canal structure, we investigated the disuse effect on local O2 supply in the cortical bones of growing rats. Hindlimb disuse was produced by unilateral sciatic neurectomy (SN) at 4weeks age. The canal network structures within tibial cortical bone were evaluated in 8- and 12-week-old rats undergoing SN or no treatment (control) by synchrotron radiation micro-CT. Additionally, we developed an intracortical network model by combining the imaged-based canal network with a bone matrix containing theoretical lacunar-canalicular network, and determined the distribution of O2 concentration in bone tissue numerically. In the control bone, canal network was reduced with growth, resulting in decreased blood flow and averaged O2 concentration and increased spatial heterogeneity in tissue O2 concentration. Disuse reduced the canal network, leading to a lower flow rate, lower average O2 concentration and higher heterogeneity of O2 concentrations. However, the rarefaction of the canal network with growth was smaller under the disuse condition, and accordingly, the flow rate, the average O2 concentration and the heterogeneity of O2 concentrations remained stable. In particular, although the fraction of the canal volume was smaller, the densities of canal segments and bifurcation points under disuse condition tended to be higher than those of the control bone. The heterogeneity of O2 concentration was lower. Our results indicated that the disuse may lead to more uniformity in the canal network structure and thereby uniform O2, possibly contributing to O2 supply efficiency.

New species of Trichomycterus (Siluriformes: Trichomycteridae) from the High Andean Plateau of Argentina.

Trichomycterus varii new species, is described from a small tributary of the High Andean Plateau Region, Jujuy, Argentina. The new species is distinguished from other species of Trichomycterus by the following characters: the caudal peduncle expanded in the area of procurrent caudal-fin rays, distal tip of pelvic fin not reaching the anus when depressed, the presence of fronto-lachrymal tendon bone without lateral process, the first pectoral-fin ray terminating at the margin of the fin, the distal margin of pectoral-fin rounded, seven pectoral fin rays, 15-19 interopercular odontodes, the supraorbital sensory canal with the presence of pore s3, the infraorbital sensory canal segment with the presence of pores i1 and i3, the laterosensory canal of trunk with three sensory pores, 16 pairs of ribs, 11 precaudal vertebrae, and 25 caudal vertebrae. It closely resembles T. yuska and T. pseudosilvinichthys from northwestern Argentina and western Bolivia, but differs in head canal sensory pattern.

Shaping Ability of Superelastic and Controlled Memory Nickel-Titanium File Systems: An In Vitro Study.

Improvements in the thermomechanical processing procedures of NiTi wires have led to the development of new NiTi instruments that compose mainly of martensite crystals, making the wire stable at clinical condition. This study aimed at comparing the shaping ability of two rotary nickel-titanium systems manufactured from different NiTi wires. Twenty simulated root canals each with a curvature of 35° in resin blocks were divided into two groups of 10 canals each. Canals in the first group were prepared with superelastic F360 instruments (Gebr. Brasseler, Germany) while canals in the second group were prepared using controlled memory HyFlex®CM™ instruments (Coltène Whaledent, Switzerland). Images were taken before canal preparation and after the use of each instrument. The assessment of the canal shapes was accomplished with a computer image analysis program. Data were statistically analyzed using SPSS program. Within the limitation of this in vitro study, HyFlex®CM™ instruments remained better centered in the apical third of the canals. In most canal segments, no significant differences were observed between either system in the amount of material removed. Both systems were comparable to each other in regards to their ability to enlarge root canal in the same way without procedural errors.

Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations.

Microscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view. An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n = 28) or a microscopic underlay technique (n = 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months' post-operatively. Graft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air-bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p > 0.05). Mean air-bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p > 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (both p < 0.05). The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.

An Open-Data Based Assessment of Expected Changes in Land Use and Water Availability as a Result of the Construction of the West Segment of the Nicaragua Interoceanic Canal

Nicaragua is preparing the construction of an interoceanic canal that will be the longest and largest canal on Earth. An environmental and social impact assessment was published in 2014 supporting a general viability of the canal. Nonetheless, several scientists and societal actors raised serious concerns regarding the social, economic, and ecological sustainability. Despite an open dispute within the Nicaraguan society, no independent, transparent, and scientifically sound assessment has been carried out. This article presents a transparently documented and comprehensible impact assessment of the West Canal Segment of the Nicaragua Canal. Based on publicly available data and scientifically sound and recognized methods, land use, hydrological (water availability), and socio-economic impacts (population, transportation/communication) are described, quantified, and compared with official declarations in the impact assessment. The examination of official declarations discloses significant ambiguities concerning the methodology and data used for the impact assessment. Consequently, the results presented are at least partly doubtful. When compared with official declarations, the main results of this study reveal: (1) significantly more forested areas (+53.7 km2) and areas of extensive agriculture/near nature (14.4 km2), but far less urban and intensively used areas (−39.6 km2) are affected by the canal; (2) A population of nearly 16,500, and several regional or locally unique transportation and communication routes are directly affected by the canal construction; and (3) a slightly lower water availability (−6.6%) and a much higher water demand for lock operations (+31.8%) were estimated. Accordingly, only about 20% of the lock water demand could be met by locally-available discharge.

The predictive nature of uterocervical angles in the termination of second trimester pregnancy

Aim: To establish how useful and the predictive capacity of uterocervical angles (UCA) in the termination of second trimester pregnancies.Material and methods: This prospective cohort study was conducted at a tertiary center with a total of 120 singleton pregnancies delivered between 14 and 24 gestational weeks. Before the beginning of misoprostol induction, patients were screened for both cervical length (CL) and uterocervical angles (UCA). The UCA is defined as an angle constructed by the measurement of the cervical canal and lower uterine segment. The study population was subdivided into four groups; successful and failed terminations at the end of 24 hours of induction and successful and failed terminations at the end of 48 hours of induction. We decided to further evaluate our study population based on their UCAs, and placed them into four categories; UCA ≥95°, UCA <95°, UCA ≥105°, and UCA <105°.Results: In the 24-hour time frame group, the mean UCA was 105.50 ± 15.38 degrees in the successful termination group and was 100.22 ± 11.12 degrees in the failed group (p = .001). In the 48-hour time frame group, the mean UCA was 104.19 ± 13.51° in the successful termination group and was 93.52 ± 7.84° in the failed group (p = .007). The mean hour of induction was shortest in the UCA ≥105° group.Conclusions: Regardless of the time frames, patients who had successful terminations had a broader angle, less amount of misoprostol use and shorter duration of induction as compared to the failed termination groups. What do the results of this study add? The uterocervical angle has never been measured in second trimester pregnancies to predict the timing of termination. Our study demonstrated the useful application of this ultrasonographic finding in the prediction of successful second trimester terminations.Trial registration: ClinicalTrials.gov identifier: NCT03220607.

Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis.

To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis. From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57/SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53/SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62/SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.