Effectiveness of passive ultrasonic irrigation on periapical healing and root canal disinfection:  a systematic review

AIM: The aim of this study was to evaluate the efficacy of different lengths of time of passive ultrasonic irrigation (PUI) in removing calcium hydroxide (CH) paste from root canal, using scanning electron microscopy and energy dispersive spectrometry (SEM/EDS). MATERIAL AND METHODS: Fifty-four human premolars were used. After coronal access, a size #15 K-file was used to obtain apical patency. Root canal preparation was performed using WaveOne 40.08 instruments. CH paste was placed into the root canal. Specimens were stored in a humid environment, and after seven days, they were divided into five groups (n=12) according to the irrigation protocols: Manual– a size #40 K-file; PUI/1– 1 min; PUI/2– 2 min; PUI/3– 3 min; and Control– without CH paste. An elementary chemical microanalysis (SEM/EDS) was performed to quantify the presence of calcium on the dentinal walls. RESULTS: The percentage of calcium was higher in all experimental groups when compared to the control group (P < 0.05); but no differences among them were found (P > 0.05). CONCLUSION: The amount of calcium hydroxide paste on the dentinal walls was not dependent on length of time of ultrasonic activation. SEM/EDS analysis seems to be a reliable method to assess CH paste removal from the root canals.

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Comparison of different irrigation and agitation methods for the removal of two types of calcium hydroxide medicaments from the root canal wall: An in-vitro study

Medicine and Pharmacy Reports ◽

10.15386/cjmed-737 ◽

2017 ◽

Vol 90 (3) ◽

pp. 327-332 ◽

Cited By ~ 1

Author(s):

Deepak Singh Kirar ◽

Pradeep Jain ◽

Pallav Patni

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Positive Control ◽

Positive Control Group ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Ultrasonic Irrigation ◽

Group 2 ◽

Group 1

Background and aim: Comparison of different irrigation and agitation methods for the removal of two types of calcium hydroxide medicaments from the root canal walls.Methods: Fifty extracted single rooted teeth were selected for this study. After decoronation, the root canals of these teeth were prepared to the size F3 (30 no.) using rotary ProTaper file system. These samples were randomly divided into four groups. Group 1 (n=20) were filled completely with water based calcium hydroxide (CH), Group 2 (n=20) were filled with oil based CH using lentulo spiral, Group 3 (n=5) - the positive control group received the CH as intracanal medication, but no subsequent removal, Group 4 (n=5) - the negative control did not receive CH placement. Further on, Group 1 and Group 2 were divided into four sub-groups (n=5). In sub-group A we performed conventional syringe irrigation with side-vented needle sub-group B) manual dynamic agitation, sub-group C sonic agitation using endoactivator, sub-group D passive ultrasonic irrigation (PUI). Roots were split longitudinally into mesial and distal halves. Digital images of the root canal walls were acquired by a Dental Operating Microscope (DOM) and assessed by using a scoring criteria at different thirds (coronal, middle and apical) of the root canal as follows: score 1, score 2, score 3, and score 4. Data were analyzed applying one-way analysis of variance (ANOVA) and Tukey’s multiple comparison tests at a 95% confidence interval (P < 0.05).Results: Statistically significant differences were not found between the experimental groups and the negative group in any one third of the root canal (P>0.05). However, a difference did exist between the experimental groups and the positive control group (P<0.05). None of the experimental groups totally removed CH substances from root canal walls.Conclusion: Among all experimental groups, removal of CH was best achieved by sonic agitation using endoactivator followed by passive ultrasonic irrigation (PUI), manual dynamic agitation and conventional syringe irrigation with side-vented needle.

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

Clinical Oral Investigations ◽

10.1007/s00784-018-2345-x ◽

2018 ◽

Vol 22 (2) ◽

pp. 655-670 ◽

Cited By ~ 13

Author(s):

Venkateshbabu Nagendrababu ◽

Jayakumar Jayaraman ◽

Anand Suresh ◽

Senthilnayagam Kalyanasundaram ◽

Prasanna Neelakantan

Keyword(s):

Systematic Review ◽

Root Canal ◽

In Vitro Studies ◽

Root Canal Disinfection

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Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review

Applied Sciences ◽

10.3390/app9235001 ◽

2019 ◽

Vol 9 (23) ◽

pp. 5001

Author(s):

Lauritano ◽

Moreo ◽

Carinci ◽

Della Vella ◽

Di Spirito ◽

...

Keyword(s):

Systematic Review ◽

Root Canal ◽

Complete Removal ◽

Endodontic Treatment ◽

Filling Material ◽

Debris Removal ◽

Activation Procedure ◽

Ultrasonic Irrigation ◽

Maximum Root ◽

Cleaning Efficacy

Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction.

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Evaluation of the outcome of various laser therapy applications in root canal disinfection: A systematic review

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2019.101611 ◽

2020 ◽

Vol 29 ◽

pp. 101611 ◽

Cited By ~ 9

Author(s):

Ioana Roxana Bordea ◽

Reem Hanna ◽

Nasim Chiniforush ◽

Elena Grădinaru ◽

Radu Septimiu Câmpian ◽

...

Keyword(s):

Systematic Review ◽

Laser Therapy ◽

Root Canal ◽

Root Canal Disinfection

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The Effect of Photodynamic Therapy in Root Canal Disinfection: A Systematic Review

Journal of Endodontics ◽

10.1016/j.joen.2014.03.005 ◽

2014 ◽

Vol 40 (7) ◽

pp. 891-898 ◽

Cited By ~ 55

Author(s):

Vanessa Chrepa ◽

Georgios A. Kotsakis ◽

Tom C. Pagonis ◽

Kenneth M. Hargreaves

Keyword(s):

Systematic Review ◽

Photodynamic Therapy ◽

Root Canal ◽

Root Canal Disinfection

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Effect of Passive Ultrasonic Irrigation on Apical Extrusion of Irrigating Solution

European Journal of Dentistry ◽

10.1055/s-0039-1697378 ◽

2008 ◽

Vol 02 (03) ◽

pp. 198-203 ◽

Cited By ~ 13

Author(s):

Tamer Tasdemir ◽

Kursat Er ◽

Davut Celik ◽

Tahsin Yildirim

Keyword(s):

Stainless Steel ◽

Sodium Hypochlorite ◽

Root Canal ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Apical Extrusion ◽

Ultrasonic Irrigation ◽

The Mean ◽

Mandibular Incisors

ABSTRACTObjectives: To determine the influence of passive ultrasonic irrigation (PUI) on apical extrusion of irrigating solution.Methods: Twenty freshly extracted maxillary and mandibular incisors with single straight root canals were instrumented with ProTaper rotary files. During final irrigation, the root canals were filled with 2.5% sodium hypochlorite (NaOCl) solution and PUI was performed with a piezoelectronic unit. A stainless steel instrument (size 15) was inserted into the root canal and the irrigant was ultrasonically activated for one minute. This sequence was repeated three times, resultingin a total PUI time of three minutes. The volume of extruded irrigant was measured by Pipetman pipettes. The data were statistically analyzed with the Mann-Whitney U test.Results: The mean volume of apical extruded irrigant was 2.15 �L for the PUI group and 14 �L forthe control group. The experimentalgroup extruded significantly smaller amounts of irrigant than the control group (P<.05).Conclusions: The PUI procedure as a final irrigation was associated with less apical extrusion of the irrigating solution. (Eur J Dent 2008;2:198-203)

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Does the Use of Use of Continuous or Passive Ultrasonic Irrigation Protocols Improve the Removal of Smear Layer? A Scanning Electron Microscopic Study

10.21203/rs.3.rs-1118207/v1 ◽

2021 ◽

Author(s):

Ramón Miguéns-Vila ◽

Pablo Castelo-Baz ◽

Saleta Aboy-Pazos ◽

David Uroz-Torres ◽

Pablo Álvarez-Nóvoa ◽

...

Keyword(s):

Negative Pressure ◽

Root Canal ◽

Smear Layer ◽

Electron Microscopic ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Scanning Electron Microscopic Study ◽

Ultrasonic Irrigation ◽

Conventional Irrigation ◽

Scanning Electron

Abstract The aim of this study was to evaluate the effectiveness of smear layer removal after the use of different irrigation methods (passive ultrasonic irrigation [PUI], continuous ultrasonic irrigation [CUI], apical negative pressure irrigation and conventional irrigation) using the scanning electron microscopy (SEM) as an analytical tool. A total of 100 single-canal teeth were decoronated and randomly divided into five groups (n = 20) according to the irrigation method used: conventional irrigation with front outlet syringe, conventional irrigation with lateral outlet syringe, apical negative pressure irrigation (EndoVac), PUI with Irrisafe, and CUI with ProUltra PiezoFlow ultrasonic irrigation needle. Root canal preparation was performed with the ProTaper Gold system up to the F4 instrument and 5.25% NaOCl was used as an irrigant. After chemical-mechanical preparation, the roots were split longitudinally, and the coronal, middle and apical thirds examined. SEM digital photomicrographs were taken at ×1000 magnification to evaluate the amount of smear layer in each root canal third. CUI was more effective in removing the smear layer than the other irrigation protocols. However, none of the irrigation protocols were able to produce root canals completely free from smear layer.

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