J Korean Acad Conserv Dent.  2009 May;34(3):215-222. 10.5395/JKACD.2009.34.3.215.

In vitro evaluation of cleaning efficacy of various irrigation methods in mandibular molars

• Lee SY
• Son WJ
• Lee W
• Kum KY
• Bae KS
• Baek SH

• KMID: 2176147
• DOI: http://doi.org/10.5395/JKACD.2009.34.3.215

Abstract

The aim of this in vitro study was to evaluate the cleaning efficacy of various irrigation methods in the mandibular mesial roots. The forty five mesial root canals were shaped by Profile .06 instruments to apical size #30 and irrigated with 5 ml of 3.5% NaOCl. The teeth were divided into 3 groups and irrigated finally for 1 minute; Group 1: syringe irrigation, Group 2: ultrasonic irrigation, Group 3: RinsEndo irrigation. After histological processing, the cross sections of apical 1, 3, and 5 mm level were examined with an optical microscope. The cleanliness values of canals and isthmuses were calculated and analyzed by Mann-Whitney U test. 1. There were no significant differences in both canal and isthmus cleanliness between syringe irrigation and ultrasonic irrigation except 5 mm level of isthmus. 2. RinsEndo irrigation had significantly higher canal cleanliness values than syringe irrigation at 1 mm and 3 mm levels (p < 0.05). Also, RinsEndo irrigation had significantly higher isthmus cleanliness values than syringe irrigation at all levels evaluated (p < 0.05). 3. There were no statistical differences in both canal and isthmus cleanliness between ultrasonic irrigation and RinsEndo irrigation except 3 mm level of canal. From this study, RinsEndo irrigation can be useful as an additional irrigation procedure.

Keyword

canal irrigation; cleanliness; mesial canal

MeSH Terms

Dental Pulp Cavity
Molar
Syringes
Tooth
Ultrasonics

Figure

• 

  Figure 1. Graph of mean percentage of canal cleanliness at 1, 3, and 5 mm levels

• 

  Figure 2. Graph of mean percentage of isthmus cleanliness at 1, 3, and 5 mm levels

• 

  Figure 3. Photomicrograph of cross section of the mesial root at the 5 mm level (group 1): 100% mesiobuccal canal (right) and 100% mesiolingual canal (left) cleanliness, with 41.1% isthmus cleanliness (40×, H&E stain)

• 

  Figure 4. Photomicrograph of cross section of the mesial root at the 1 mm level (group 2): 100% mesiobuccal canal (right) and 100% mesiolingual canal (left) cleanliness, with 89.2% isthmus cleanliness (40×, H&E stain)

• 

  Figure 5. Photomicrograph of cross section of the mesial root at the 1 mm level (group 3): 100% mesiobuccal canal (right) and 100% mesiolingual canal (left) cleanliness, with 100% isthmus cleanliness (40×, H&E stain)

Reference

References

1. Baugh D, Wallace J. The role of apical instrumentation in root canal treatment: A review of the literature. J Endod. 31(5):333–340. 2005.

2. Grossman LI. Endodontic practice. 7^th ed.Philadelphia: Lea & Febiger;1970.

3. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 18(2):269–290. 1974.

4. Wu MK, Wesselink PR. A primary observation on the preparation and obturation of oval canals. Int Endod J. 34(2):137–141. 2001.

5. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 30(8):559–567. 2004.

6. Wu MK, van der Sluis LWM, Wesselink PR. The capability of two hand instrumentation techniques to remove the inner layer of dentin in oval canals. Int Endod J. 36(3):218–224. 2003.

7. Meyer BE, Peters OA, Barbakow F. Effects of rotary instruments and ultrasonic irrigation on debris and smear layer score: a scanning electron microscopic study. Int Endod J. 35(7):582–589. 2002.

8. Teixeira FB, Sano CL, Gomes BPFA, Zaia AA, Ferraz CCR, Souza Filho FJ. A preliminary in vitro study of the incidence and position of the root canal isthmus in maxillary and mandibular first molars. Int Endod J. 36(4):276–280. 2003.

9. Hwang HK, Bae SC, Cho YL. The irrigating effect before and after coronal flaring. J Kor Acad Cons Dent. 28(1):72–79. 2003.

10. Cunningham WT, Martin H, Forrest WR. Evaluation of root canal debridement by the endosonic ultrasonic synergistic system. Oral Surg Oral Med Oral Pathol. 53(5):401–404. 1982.

11. Walters MJ, Baumgatner JC, Marshall JG. Efficacy of irrigation with rotary instrumentation. J Endod. 28(12):837–839. 2002.

12. Lee SJ, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentin debris from different sized simulated plastic root canals. Int Endod J. 37(9):607–612. 2004.

13. Lee SJ, Wu MK, Wesselink PR. The ability of using syringe irrigation and ultrasound irrigation to remove dentin debris from simulated extensions and irregularities in root canals. J Kor Acad Cons Dent. 28(3):289. 2003.

14. Cunningham WT, Martin H. A scanning electron microscope evaluation of root canal debridement with the endosonic ultrasonic synergistic system. Oral Surg Oral Med Oral Pathol. 53(5):527–531. 1982.

15. Lumley PJ, Walmsley AD, Walton RE, Rippin JW. Cleaning oval canals using ultrasonic and sonic instrumentation. J Endod. 19(9):453–457. 1993.

16. Lee SJ, Wu MK, Wesselink PR. The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J. 37(10):672–678. 2004.

17. Goodman A, Reader A, Beck M, Melfi R, Meyers W. An in vitro comparison of the efficacy of the step-back technique versus a step-back/ultrasonic technique in human mandibular molars. J Endod. 11(6):249–256. 1985.

18. Haidet J, Reader A, Beck M, Meyers W. An in vivo comparison of the step-back technique versus a step-back/ultrasonic technique in human mandibular molars. J Endod. 15(5):195–199. 1989.

19. Archer R, Reader A, Nist R, Beck M, Meyers W. An in vivo evaluation of the efficacy of ultrasound after step-back preparation in mandibular molars. J Endod. 18(11):549–552. 1992.

20. Gutarts R, Nusstein J, Reader A, Beck M. In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 31(3):166–170. 2005.

21. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 32(2):271–275. 1971.

22. Weller NR, Niemczyk SP, Kim S. Incidence and position of the canal isthmus. Part 1. Mesiobuccal root of maxillary first molar. J Endod. 21(7):380–383. 1995.

23. Hwang HK, Shin YG. The effectiveness of obturating techniques in sealing isthmuses. J Kor Acad Cons Dent. 26(6):499–506. 2001.

24. Hsu Y, Kim S. The resected root surface: the issue of canal isthmuses. Dent Clin North Am. 41(3):529–540. 1997.

25. Nair PNR. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 15(6):348–381. 2004.

26. Mannocci F, Peru M, Sherriff M, Cook R, Pitt Ford TR. The isthmuses of the mesial root of mandibular molars: a micro-computered tomographic study. Int Endod J. 38(8):558–563. 2005.

27. Ram Z. Effectiveness of root canal irrigation. Oral Surg Oral Med Oral Pathol. 44(2):306–312. 1977.

28. Weller RN, Brady JM, Bernier WE. Efficacy of ultrasonic cleaning. J Endod. 6(9):740–743. 1980.

29. Ahmad M, Pitt Ford TR, Crum LA. Ultrasonic debridement of root canals: acoustic streaming and its possible role. J Endod. 13(10):490–499. 1987.

30. van der Sluis LWM, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 40(6):415–426. 2007.

31. Moorer WR, Wesselink PR. Factors promoting the tissue dissolving capacity of sodium hypochlorite. Int Endod J. 15(4):187–196. 1982.

32. Hulsmann M, Hahn W. Complications during root canal irrigation - literature review and case reports. Int Endod J. 33(3):186–193. 2000.

33. Gernhardt CR, Eppendorf K, Kozlowski A, Brandt M. Toxicity of concentrated sodium hypochlorite used as endodontic irrigant. Int Endod J. 37(4):272–280. 2004.

34. Hauser V, Braun A Frentzen. Penetration depth of a dye marker into dentine using a novel hydrodynamic system (RinsEndo). Int Endod J. 40(8):644–652. 2007.