Influence of an apical negative pressure irrigation system on bacterial elimination during endodontic therapy: a prospective randomized clinical study.
BACKGROUND
Recent in vitro studies that use an apical negative pressure irrigation system, EndoVac, have demonstrated promising results in the production of debris-free root canals, while also preventing potential extrusion of irrigants into the periapical region. We conducted a randomized, controlled, prospective clinical study to determine whether the use of EndoVac irrigation (EndoVac group) was more efficient compared with standard needle irrigation (control group) in obtaining canals from which microbes could not be cultivated.


METHODS
Routine endodontic therapy was performed in 48 patients with necrotic, single-rooted, single-canal teeth. The patients were randomly assigned to either the EndoVac group (n = 25) or control group (n = 23). Irrigation with either method was carried out with 0.5% sodium hypochlorite. After surface disinfection, before instrumentation and on completion of chemomechanical preparation, intracanal microbial samples were obtained and cultured under anaerobic conditions. The frequency of microbial cultivability by using either irrigation system was analyzed.


RESULTS
The frequency of obtaining culture-negative root canals was 90.9% and 82.6% for the control group and EndoVac group, respectively. There was no significant difference in the antimicrobial efficacy of either control group or EndoVac group (Fisher exact test, P = .665). Furthermore, no significant association between study variables and the irrigation systems' antimicrobial efficacy was found (P > .05).


CONCLUSIONS
The results of this prospective in vivo study demonstrate that the antimicrobial efficacy of EndoVac irrigation is comparable to that of standard irrigation.
Division of Endodontology, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
Rekha
R
Pawar
Abdullah
A
Alqaied
Kamran
K
Safavi
Jennifer
J
Boyko
Blythe
B
Kaufman
D001419:Bacteria / Q000187:drug effects*; D001431:Bacteriological Techniques; D002126:Calcium Hydroxide / Q000008:administration & dosage; D019551:Dental Disinfectants / Q000627:therapeutic use; D003786:Dental Pulp Cavity / Q000382:microbiology*; D003790:Dental Pulp Necrosis / Q000382:microbiology / Q000628:therapy; D004203:Disinfection / Q000379:methods; D004492:Edetic Acid / Q000008:administration & dosage; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use; D008845:Microinjections / Q000295:instrumentation; D010485:Periapical Periodontitis / Q000382:microbiology / Q000628:therapy; D011446:Prospective Studies; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D012973:Sodium Hypochlorite / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
D019551:Dental Disinfectants; D012388:Root Canal Irrigants; D004492:Edetic Acid; D006861:Hydrogen Peroxide; D012973:Sodium Hypochlorite; D002126:Calcium Hydroxide