Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies

Abstract

Activation of irrigants with ultrasonic brings about significant bacterial reduction from the root canal systems compared to other methods of irrigant activation and conventional syringe irrigation. This might help in improving the outcome of root canal treatment.

Sonic irrigant activation for root canal disinfection: power modes matter!

“…In the present investigation, an established in vitro model with extracted teeth with closed-end root canals was used in order to have a standardized and reproducible setup and to replicate in vivo scenarios as closely as possible [5,11]. It is important to give due consideration to the inherent strengths and limitations of this model and the microbiological methods that were employed.…”

“…The root curvature affects the effectiveness of activation methods that rely on the insertion of an instrument in the root canal [5,20]. To decrease the potential for confounding, the study material comprised exclusively of roots with no pronounced curvatures.…”

“…Therefore, the results of this study are not directly translatable to situations where multispecies biofilm are present. Biofilm formation and maturity have a determining influence on the antimicrobial effectiveness of irrigation protocols [5]. While biofilms grown from oral bacteria are quite susceptible to antimicrobial agents within the first two weeks of growth, more mature biofilms are more resistant and so the same antimicrobial agents are considerably less effective after three weeks [27].…”

“…The present study used two different maturation timelines for the biofilm models in order to take account of the different degrees in biofilm resistance. In line with methodological recommendations, the microbial purity of the contaminated roots was strictly monitored throughout the experiments to rule out any contamination [5]. The extent of microbial growth on the root canal walls and in dentinal tubules was not assessed by microscopic imaging or histology.…”

“…The uninstrumented portions of the root canal system and anatomical complexities, such as accessory canals, apical ramifications, fins and isthmus areas, can harbor tissue debris as well as microorganisms and their deleterious byproducts in spite of thorough chemomechanical disinfection [1]. Supplementary irrigation methods such as irrigant activation techniques are therefore needed to enhance the elimination of endodontic biofilms [5].…”