Apically Extruded Debris Using Passive Ultrasonic Irrigation Associated with Different Root Canal Irrigants

Area of Science:

• Endodontics
• Dental Materials Science

Background:

• Apical extrusion of debris during root canal chemo-mechanical preparation (CMP) is a concern in endodontic treatment.
• Passive ultrasonic irrigation (PUI) is employed to enhance cleaning and disinfection, but its effect on debris extrusion requires evaluation.

Purpose of the Study:

• To evaluate the amount of apically extruded debris following chemo-mechanical preparation (CMP) combined with passive ultrasonic irrigation (PUI).
• To compare the efficacy of four different root canal irrigants in minimizing debris extrusion: 6% sodium hypochlorite (NaOCl), 2% chlorhexidine gel + saline solution (2% CHXg+SS), 2% chlorhexidine solution (2% CHXs), and saline solution (SS) alone.

Main Methods:

• Sixty mandibular premolars with single, straight root canals were used.
• Teeth were randomly assigned to four groups (n=15) receiving PUI with one of the four irrigants.
• Reciproc® R25 files were used for CMP, and extruded debris was collected, dried, and weighed using an analytical microbalance.

Main Results:

• Apical debris extrusion occurred in all experimental groups.
• The 2% chlorhexidine gel + saline solution group exhibited significantly lower debris extrusion compared to the other irrigant groups (p<0.05).
• No significant differences in debris extrusion were found between 6% NaOCl, 2% CHXs, and SS groups.

Conclusions:

• Passive ultrasonic irrigation (PUI) does not completely prevent the apical extrusion of debris during root canal preparation.
• Utilizing 2% chlorhexidine gel combined with saline solution during PUI significantly minimizes apically extruded debris compared to 6% sodium hypochlorite, 2% chlorhexidine solution, or saline solution alone.