Efficacy of a novel remotely‐generated ultrasonic root canal irrigation system for removing biofilm‐mimicking hydrogel from a simulated isthmus model

Abstract

Aim To evaluate the efficacy of a novel ultrasonic irrigation device, remotely‐generated irrigation with a non‐invasive sound field enhancement (RINSE) system, in removing biofilm‐mimicking hydrogel from a simulated isthmus model and compare it with sonically‐ and ultrasonically‐activated irrigation systems. Methodology A polycarbonate root canal model containing two standardized root canals (apical diameter of 0.20 mm, 4% taper, 18 mm long with a coronal reservoir) connected by three isthmuses (0.40 mm deep, 2 mm high, 4 mm long) was used as the test model. The isthmuses were filled with a hydroxyapatite powder‐containing hydrogel. The canals were filled with irrigant, and the models were randomly assigned to the following activation groups (n = 15): EndoActivator (EA), ultrasonically activated irrigation (UAI), and RINSE system (RS). Syringe irrigation (SI) with a 30G needle served as the control. Standardized images of the isthmuses were taken before and after irrigation, and the amount of hydrogel removed was determined using image analysis software and compared across groups using anova (p < .05). Results Hydrogel removal was significantly higher with the RS (83.7%) than with UAI, EA, or SI (p ≤ .01). UAI (69.2%) removed significantly more hydrogel than SI and EA (p < .05), while there was no significant difference between SI (24.3%) and EA (25.7%) (p = .978). Conclusions RINSE system resulted in the most hydrogel removal, performing better than UAI or EA. The effect of RS was also not reliant on the insert or tip entering the pulp chamber or root canal, making it particularly useful in conservative endodontics.

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

“…The differences between closed and open systems have been highlighted recently (Al‐Jadaa et al., 2023; Tay et al., 2010). The biofilm mimicking hydrogel is well‐established (Park et al., 2023; Robberecht et al., 2023; Swimberghe et al., 2019), and the present study used an artificial biofilm as a natural biofilm substitute (Macedo et al., 2014). Hydrogels are physically or chemically cross‐linked into a 3D network, are insoluble in water (Gun'ko et al., 2017), and thus guarantee maintaining the system integrity in the present setup.…”