Comparison of triple antibiotic paste removal by different irrigation techniques

Area of Science:

• Endodontics
• Dental Materials Science

Background:

• Triple antibiotic paste (TAP) is used for disinfection in root canal treatments.
• Effective removal of TAP is crucial to prevent persistent infection and ensure treatment success.
• Various irrigation techniques exist, but their efficacy in removing TAP varies.

Purpose of the Study:

• To compare the efficacy of different irrigation techniques for removing triple antibiotic paste (TAP) from root canals.
• To evaluate the performance of NaviTip FX (NFX) and Vibringe (V) in TAP removal.
• To assess the effectiveness of these techniques in different regions of the root canal.

Main Methods:

• Fifty-six maxillary anterior teeth were filled with TAP for 28 days.
• Teeth were divided into groups using Syringe Irrigation (SI), NaviTip FX (NFX), Vibringe-Syringe irrigation (V-SI), NaviTip FX-Vibringe (V-NFX), and Passive Ultrasonic Irrigation (PUI).
• Remaining TAP was evaluated using a 4-grade scoring system.

Main Results:

• NaviTip FX with Vibringe (V-NFX) and NaviTip FX (NFX) showed comparable efficacy.
• V-NFX was significantly more effective than SI and PUI in all root canal parts.
• V-SI and PUI were less effective in the apical region compared to NFX and V-NFX.

Conclusions:

• Brush-based irrigation delivery, with or without sonic activation (V-NFX), enhances TAP removal from root canals.
• V-NFX demonstrates superior efficacy over ultrasonic activation, syringe irrigation, or sonic activation alone.
• Techniques incorporating brush agitation are more effective, particularly in challenging apical areas.