A quantitative and qualitative analysis of ultrasonic versus sonic endodontic systems on canal cleanliness and obturation

Kanter, Valerie; Weldon, Emily; Nair, Uma; Varella, Claudio; Kanter, Keith; Anusavice, Kenneth J.; Pileggi, Roberta

doi:10.1016/j.tripleo.2011.06.002

Cited by 40 publications

(39 citation statements)

References 25 publications

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“…33 Concerning organic debris, EndoActivator showed the best results in the whole canal area, especially in the apical and middle thirds ( p < 0.001). Our findings are in agreement with those obtained in previous published studies, 34,35 where sonic activation of the irrigant resulted in significantly more debris removal and in better obturation of lateral and accessory canals than syringe irrigation in straight root canals.…”

Section: Discussionsupporting

confidence: 93%

Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: a scanning electron microscope study

Castagnola

Lajolo

Minciacchi

et al. 2014

Giornale Italiano di Endodonzia

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Aim: Aim of this study was to compare the removal of smear layer and organic debris within the tooth canal among conventional needle irrigation, EndoVac and Endoactivator.\ud Methodology: Eighty single-rooted extracted human teeth were prepared with rotary NiTi instrumentation and randomly separated into 4 groups. Twenty teeth were used as positive control (Group 1), irrigated with only saline. Teeth assigned to Group 2 (n = 20) received irrigation with a conventional syringe and a 30-gauge needle (NaviTip, Ultradent, South Jordan, UT); samples in Group 3 (n = 20) were rinsed with an irrigation device based on apical negative pressure (EndoVac, Discus Dental, Culver City, CA) and teeth in Group 4 (n = 20) were treated with a sonic irrigation system (EndoActivator, Dentsply Tulsa Dental, Tulsa, OK, USA). The amount of residual smear layer and debris was evaluated under a scanning electron microscope, and a semi- quantitative score was assigned to each root at the coronal, middle and apical thirds; the chi- square test was used to compare the results of the S.E.M. analysis.\ud Results: EndoActivator performed the best cleansing for both smear layer and organic debris in all root canal thirds, followed by EndoVac and conventional irrigation ( p > 0.001). EndoVac and conventional irrigation showed better cleaning in the coronal area, whereas EndoActivator performed an homogeneous cleansing at all levels.\ud Conclusions: The EndoVac system and the EndoActivator system demonstrated significantly more efficacy in cleansing root canal walls than conventional needle irrigation

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Section: Discussionsupporting

confidence: 93%

Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: a scanning electron microscope study

Castagnola

Lajolo

Minciacchi

et al. 2014

Giornale Italiano di Endodonzia

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“…Another study also reported on the efficacy of the Endovage syringe, a syringe that automatically aspirates following irrigation when pressure on the plunger is released; the results showed that at the 1-mm-level in the mesial roots of extracted molars, this system created superior canal cleanliness when compared to other syringe irrigation needles (85). Some recent literature has found sonic activation to be more effective than ultrasonic activation in removing debris in instrumented and extracted teeth at all levels in the canal (92). The physical process behind the principle of using sonic and ultrasonic agitation is the phenomenon of acoustic micro-streaming.…”

Section: Agitation During Irrigationmentioning

confidence: 99%

Irrigation of the apical root canal

Park¹,

Shen²,

Haapasalo³

2012

Endodontic Topics

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Effective apical irrigation is one of the most important root canal procedures that has stood as a long‐standing challenge for the clinician. Despite the myriad of technological advances seen in the last few decades such as nickel–titanium rotary files of various designs and new irrigation delivery systems, very few seem to reliably impact upon a clinician's ability to deliver and replenish irrigant in the most apical part of a root canal. Replenishing irrigant in the apical third is complicated by the multitude of factors that affect the efficacy of this procedure. The current research provides detailed insight on how the principles of fluid mechanics work to explain the physical impediments to thorough irrigation, and how the biological impediments, in the form of biofilm, prevent disinfection despite adequate irrigation. The recent introduction of new irrigation and agitation modalities, coupled with a new understanding of the old problem through novel research techniques, provides a vision to the future and will establish a new standard of irrigation in this field.

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“…17 Studies on the smear layer and debris debridement efficacy of this sonic irrigant activation device yielded dichotomous results. Although some studies reported enhanced smear layer or debris removal with the adjunctive use of this device over needle delivery of irrigants without agitation, 18–22 other studies reported no significant improvement in the cleanliness of root canals when the device was used concomitantly with needle delivery of irrigants. 23–27 Whilst these conflicting results may have arisen from the different study designs employed in the aforementioned studies, it is also apparent that different sonic activation protocols were used in those studies.…”

Section: Introductionmentioning

confidence: 97%

Effects of different sonic activation protocols on debridement efficacy in teeth with single-rooted canals

Niu¹,

Luo²,

Li³

et al. 2014

Journal of Dentistry

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Objectives The effects of different EndoActivator® (EA) sonic activation protocols on root canal debridement efficacy were examined. Methods Root canals in 48 single-rooted teeth were instrumented, irrigated initially with NaOCl and divided into 6 groups (N=8) based on the application time of QMix (antimicrobial calcium-chelating irrigant), and the time and sequence of EA irrigant activation - Positive Control: 90 sec QMix; Negative Control: 90 sec saline; Group 1A: 15 sec QMix + 15 sec QMix with EA-activation; Group 1B: 30 sec QMix + 30 sec of QMix with EA-activation; Group 2A: 15 sec QMix with EA-activation + 15 sec QMix; Group 2B: 30 sec QMix with EA-activation + 30 sec QMix. Split roots were examined with scanning electron microscopy for assignment of smear and debris scores in locations along the coronal, middle and apical thirds of the canals. The overall cleanliness of pooled canal locations in the Positive Control and the 4 experimental groups were compared with chi-square tests. Results Significant differences were detected among the 5 groups (p<0.001). Post-hoc pairwise comparisons indicated that the overall canal cleanliness was in the order (from best to worst): 1B = 2B > 2A > 1A > Positive Control. Completely clean canals could not be achieved due to the absence of continuous irrigant flow for EA to clear intraradicular debris. Conclusions Irrespective of the sonic activation sequence, irrigant activation for 30 seconds during a 60-second period of QMix application appears to maximize the smear layer and debris removal potential of the EndoActivator® system.

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A quantitative and qualitative analysis of ultrasonic versus sonic endodontic systems on canal cleanliness and obturation

Cited by 40 publications

References 25 publications

Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: a scanning electron microscope study

Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: a scanning electron microscope study

Irrigation of the apical root canal

Effects of different sonic activation protocols on debridement efficacy in teeth with single-rooted canals

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