Abstract Context: Evaluating the efficacy of sonic activation in root canal cleaning using an Endocator adenosine triphosphate (ATP) tester. Aim: The aim of this study was to assess the cleaning efficacy of needle irrigation and sonic activation by measuring ATP values and colony-forming units (CFUs) during root canal procedure. Settings and Design: The design of the study is an in vitro study. Materials and Methods: Eighty (n = 80) extracted mandibular molars were selected, and distal root canals were enlarged to F2 with ProTaper Gold rotary files. Canals were rinsed with 2 mL of 5.25% sodium hypochlorite (NaOCl), 2 mL of 17% ethylenediaminetetraacetic acid, and 2 mL of distilled water. Samples are sterilized, Enterococcus faecalis is inoculated and incubated at 37° for 4 weeks. Baseline ATP values and CFU are measured. Samples are divided into four groups of n = 20 and are irrigated. Group 1:2 mL of distilled water for 30 s. Group 2: 2 mL of distilled water activated with SmartLite Pro EndoActivator (SLP-EA) for 30 s. Group 3: 2 mL of 1% NaOCl for 30 s. Group 4: 2 mL of 1% NaOCl activated with SLP-EA for 30 s. The irrigation procedure was repeated for nine cycles. ATP values and CFU are recorded after each cycle. Friedman, Kruskal–Wallis, Wilcoxon, and Tukey’s post hoc tests are used for statistical evaluation. Results: A significant decrease in ATP values and CFU from baseline to residual level is observed in all groups (P ≤ 0.05). Microbial load reduction is significant in Group 4, followed by Groups 2 and 3. Conclusions: 1% NaOCl + SLP-EA showed better efficacy by recording lower ATP values and CFU.
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