Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study

The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques.

Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A-conventional needle (CN), Group B-side-vented needle (SVN), Group C-manual dynamic agitation (MDA), and Group D-EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups.

Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05).

It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.