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Root canal cleaning in roots with complex canals using agitated irrigation fluids.
Kiran Kumar1, Yu-Yao Teoh1, Laurence J Walsh1
1School of Dentistry, The University of Queensland, Herston, Queensland, Australia.
Summary
Laser agitation of sodium hypochlorite shows limited effectiveness in removing root canal biofilms, particularly in complex isthmus regions. Enhanced cleaning of canal walls correlates with better isthmus cleaning, but complete eradication remains a challenge.
Area of Science:
- Endodontics
- Biomaterials Science
- Laser Dentistry
Background:
- Root canal anatomy presents complex challenges for microbial deposit removal.
- Enhanced irrigation protocols, including laser-activated systems, aim to improve biofilm eradication.
- Sodium hypochlorite is a key irrigant in endodontic treatment.
Purpose of the Study:
- To evaluate the efficacy of different laser-agitated sodium hypochlorite protocols in removing multispecies biofilms from mesial root canals of first molars.
- To compare laser agitation methods with passive ultrasonic agitation and needle irrigation.
Main Methods:
- Laboratory study using permanent first molar mesial roots with induced multispecies biofilms.
- Tested laser groups: 940 nm diode, 1064 nm Nd:YAG, 2940 nm Er:YAG (SWEEPS protocol).
- Controls: Passive ultrasonic agitation (28 kHz) and needle irrigation (2 min).
- Biofilm assessment via confocal microscopy at 1, 4, and 7 mm from the apex.
Main Results:
- No tested method completely eradicated biofilms from confined root canal areas.
- Isthmus regions posed the greatest cleaning challenge.
- Effective cleaning of root canal walls positively correlated with isthmus cleaning effectiveness.
- Wider isthmuses were cleaned more effectively than long, narrow ones.
Conclusions:
- Laser-agitated irrigation and ultrasonic agitation show limitations in completely disinfecting complex root canal systems, especially isthmuses.
- Isthmus morphology significantly impacts cleaning efficacy.
- Further advancements in irrigation techniques are needed for comprehensive root canal disinfection.
