title: Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system.
abstract: OBJECTIVE
  To compare canal and isthmus debris debridement efficacies of the manual dynamic irrigation (MDI) and apical negative pressure (ANP) techniques in the mesial root of mandibular first molars with narrow isthmi, using a closed canal design.
  
  
  METHODS
  Micro-computed tomography was employed to select 20 teeth, each containing a narrow isthmus. Each root was sealed at the apex with hot glue and embedded in polyvinylsiloxane to simulate a closed canal system. The teeth were submitted to a standardized instrumentation protocol. Final irrigation was performed with either the MDI or the ANP technique using the EndoVac system (N=10). Masson trichrome-stained sections were prepared from completely demineralized roots at 10 canal levels between 1 and 2.8mm of the anatomical apices. Areas occupied by canals and isthmus of each root and debris in the corresponding regions were digitized by the NIH Image J software and statistically analysed using two-way repeated measures anova.
  
  
  RESULTS
  For the instrumented canals, there were no differences between the two groups (P=0.131) in the area occupied by debris at all canal levels (P=0.343). Conversely, for the isthmus, less debris was found in the ANP group (P<0.001) but no differences were seen in each group with respect to the 10 canal levels (P=0.352).
  
  
  CONCLUSIONS
  Neither technique completely removed debris from the isthmus regions. However, the EndoVac system, which encompasses the ANP concept, removed considerably more debris from narrow isthmi in mandibular mesial roots.
authors: Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta, GA 30912-1129, USA.
authors: L
authors: L
authors: Susin
authors: Y
authors: Y
authors: Liu
authors: J C
authors: JC
authors: Yoon
authors: J M
authors: JM
authors: Parente
authors: R J
authors: RJ
authors: Loushine
authors: D
authors: D
authors: Ricucci
authors: T
authors: T
authors: Bryan
authors: R N
authors: RN
authors: Weller
authors: D H
authors: DH
authors: Pashley
authors: F R
authors: FR
authors: Tay
mesh_terms: D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D003786:Dental Pulp Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D018915:Root Canal Preparation / Q000295:instrumentation*; D016369:Smear Layer; D007507:Therapeutic Irrigation / Q000379:methods*; D055114:X-Ray Microtomography