Impact of the final agitation system in the irrigant diffusion inside the root canal: A micro-CT analysis
Victor de Moraes Cruz1, Marco Antônio Húngaro Duarte1, Augusto Shoji Kato1
1Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Abstract:
This study evaluated, through micro-computed tomography (micro-CT), the volume of irrigant diffusion by different techniques of final agitation. Sixty mesiobuccal canals were scanned in a micro-CT and standardised according to the volume. They were instrumented with the MTwo 40/04 system and using the Terebrix 35 contrast solution as irrigant, were divided into six groups (n = 10): Conventional irrigation with syringe and needle (CI), EndoActivator (EA), EasyClean (EC), RinsEndo (RE), Utrasonic agitation (UI) and XP-Clean (XP). A second micro-CT scan was performed and the total irrigant volume and in the final 3 mm apical were determined. The data were analysed using the Anova, Kruskal-Wallis and Dunn tests (p < 0.05). UI and XP showed a higher percentage of total diffusion than CI, EA and RS groups (p < 0.05). In apical diffusion, there was no significant difference between groups (p > 0.05). The final agitation system increases the diffusion of irrigating agents inside the root canal.
Insights
Final agitation techniques significantly enhance irrigant diffusion within root canals. Ultrasonic agitation (UI) and XP-Clean (XP) showed superior diffusion compared to conventional methods, though apical diffusion remained consistent across all tested techniques.
Area of Science:
- Endodontics
- Dental Materials Science
- Biomedical Imaging
Background:
- Effective root canal irrigation is crucial for disinfection and treatment success.
- Limited understanding exists regarding the comparative efficacy of various final irrigation agitation techniques on irrigant diffusion.
- Optimizing irrigant delivery is essential to overcome limitations of intracanal disinfection.
Purpose of the Study:
- To evaluate and compare the irrigant diffusion volume within root canals using different final agitation techniques.
- To quantify the impact of techniques like ultrasonic agitation and XP-Clean on irrigant distribution.
- To determine if final agitation influences irrigant penetration in the apical 3mm.
Main Methods:
- Micro-computed tomography (micro-CT) was used to assess irrigant volume before and after agitation.
- Sixty mesiobuccal canals were instrumented and divided into six groups: Conventional Irrigation (CI), EndoActivator (EA), EasyClean (EC), RinsEndo (RE), Ultrasonic Agitation (UI), and XP-Clean (XP).
- Terebrix 35 contrast solution was used as the irrigant, and data were statistically analyzed using ANOVA, Kruskal-Wallis, and Dunn tests.
Main Results:
- Ultrasonic Agitation (UI) and XP-Clean (XP) demonstrated a significantly higher percentage of total irrigant diffusion compared to Conventional Irrigation (CI), EndoActivator (EA), and RinsEndo (RE) groups.
- No statistically significant differences in irrigant diffusion were observed within the apical 3mm across all tested groups.
- The study confirmed that final agitation systems generally enhance the diffusion of irrigating agents within the root canal system.
Conclusions:
- Final agitation techniques, particularly Ultrasonic Agitation (UI) and XP-Clean (XP), significantly improve the overall diffusion of irrigating solutions in root canals.
- While overall diffusion is enhanced, the tested agitation methods did not significantly alter irrigant penetration in the apical 3mm.
- These findings suggest that incorporating specific final agitation systems can optimize intracanal disinfection by increasing irrigant volume and flow.
