title: Efficacy and safety of various active irrigation devices when used with either positive or negative pressure: an in vitro study.
abstract: BACKGROUND
  The purpose of this in vitro study was to evaluate and compare the efficacy and safety of different devices available for canal cleansing.
  
  
  METHODS
  The following systems were tested: passive ultrasonic irrigation, EndoVac (Discus Dental, Culver City, CA), and the irrigation ultrasonic needle (ProUltra PiezoFlow Irrigation Ultrasonic Needle; Dentsply Tulsa Dental Specialties, Tulsa, OK) used in both the injection mode (IUNI) and the aspiration mode (IUNA). In the control group, traditional irrigation with a syringe and side-vented needle was used. A resin model was used with 4 lateral canals (respectively at 2, 5, 8, and 11 mm from the apical foramen) filled with bovine pulp stained with fuchsin. The model also included a 2-mm chamber in communication with the apex, again filled with bovine pulp, which enabled the measurement of the extrusion of NaOCl beyond the apex.
  
  
  RESULTS
  With regard to efficacy, the most effective systems were found to be those using the ultrasonic needle, either in aspiration or injection modes; EndoVac was the least effective. Conversely, IUNI was found to bring the highest risk with regard to the extrusion of sodium hypochlorite beyond the apex. EndoVac was the safest but only by a slight margin compared with IUNA and passive ultrasonic irrigation.
  
  
  CONCLUSIONS
  Based on this study, the system that best reconciles efficacy and safety appears to be IUNA.
authors.affiliation: School of Dentistry, Catholic University, Rome, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Malentacca
authors.forename: Umberto
authors.initials: U
authors.lastname: Uccioli
authors.forename: Dario
authors.initials: D
authors.lastname: Zangari
authors.forename: Carlo
authors.initials: C
authors.lastname: Lajolo
authors.forename: Cristiano
authors.initials: C
authors.lastname: Fabiani
mesh_terms: D000818:Animals; D002417:Cattle; D004396:Coloring Agents; D003782:Dental Pulp / Q000033:anatomy & histology; D003786:Dental Pulp Cavity / Q000033:anatomy & histology; D004526:Efficiency; D007267:Injections / Q000295:instrumentation; D008422:Materials Testing; D008953:Models, Anatomic; D009339:Needles; D010486:Periapical Tissue / Q000033:anatomy & histology; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000295:instrumentation*; D012394:Rosaniline Dyes; D012449:Safety; D012973:Sodium Hypochlorite / Q000008:administration & dosage; D013396:Suction / Q000295:instrumentation; D013594:Syringes; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D019227:Tooth Apex / Q000033:anatomy & histology; D014465:Ultrasonics / Q000295:instrumentation
chemical_list: D004396:Coloring Agents; D012388:Root Canal Irrigants; D012394:Rosaniline Dyes; D012973:Sodium Hypochlorite