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

Abstract

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.

RETRACTED: Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review

“…Clinicians advise heated NaOCl intracanal ultrasonic activation because it achieves superior dentin tubule penetration and canal purity compared to syringe activation or ultrasonic activation alone [61]. In the side dentin tubules that remained contaminated after using either ultrasonic activation or thermal activation alone, better pulp dissolution was obtained when thermal and ultrasonic activation were combined [70].…”

Histological evaluation of the debris removal efficiency of activation of sodium hypochlorite solution at different concentrations

“…In recent years, researchers have shown interest in increasing the efficiency of NaOCl through heating. Heating the NaOCI solution enhances its flow and reaction rate, resulting in increased antimicrobial activity and tissue dissolution effect[ 11 , 25 ]. There are two methods of heating NaOCI in the root canal: extra-oral heating, where the solution is heated outside the canal, and intracanal heating, where heat carriers are used to heat the solution after it is placed in the canal.…”

“…Another study by Damade et. [ 25 ] compared the amount of debris removal using intracanal and extra-orally heated NaOCI solutions with and without ultrasonic activation. They found that intracanal heating removed more debris and had a significant effect.…”