title: Canal and isthmus debridement efficacy of the VPro EndoSafe negative-pressure irrigation technique.
abstract: BACKGROUND
  This study compared canal and isthmus debridement efficacies between side-vented needle irrigation (SNI) and the VPro EndoSafe (VPro) negative-pressure device (Vista Dental, Racine, WI) in mesial roots of mandibular first molars with narrow isthmuses in a closed-canal design.
  
  
  METHODS
  Twenty teeth with narrow isthmuses were selected using micro-computed tomography scanning. Collagen solution was reconstituted with 1% NH(4)OH to simulate debris and injected into canals via vacuum. Canals were instrumented to size 40/.04. Final irrigation was performed with 17% EDTA and 6% NaOCl using SNI with a 30-G needle or the VPro system. Roots were demineralized, and Masson trichrome-stained sections were prepared at 1.2 to 3.2 mm from the anatomic apex for a total of 6 canal levels. Debris-filled areas within the canals and isthmuses were measured using ImageJ software (National Institutes of Health, Bethesda, MD) and statistically analyzed using repeated-measures analysis.
  
  
  RESULTS
  There was no significant difference between techniques and debridement efficacy among the 6 levels within the canal (P = .108). The debridement efficacy at 1.6 mm differed significantly from that at 3.2 mm. VPro had significantly more debris at isthmus levels 2.0 and 2.4 mm than SNI (P = .009). A significant difference was observed between the canal and the isthmus (P < .001). Neither VPro nor SNI removed debris completely from the apical third or isthmus.
  
  
  CONCLUSIONS
  VPro EndoSafe did not differ significantly from SNI in the overall debridement efficacy in the apical third of mesial roots of mandibular first molars.
authors.affiliation: United States Army Dental Activity, Fort Gordon, Augusta, Georgia 30905, USA.
authors.forename: Michelle U
authors.initials: MU
authors.lastname: Sarno
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Sidow
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Looney
authors.forename: Kimberly W
authors.initials: KW
authors.lastname: Lindsey
authors.forename: Li-na
authors.initials: LN
authors.lastname: Niu
authors.forename: Franklin R
authors.initials: FR
authors.lastname: Tay
mesh_terms: D001391:Azo Compounds; D003094:Collagen; D004396:Coloring Agents; D003646:Debridement; D003786:Dental Pulp Cavity / Q000033:anatomy & histology*; D004492:Edetic Acid / Q000008:administration & dosage; D004801:Eosine Yellowish-(YS); D004867:Equipment Design; D006801:Humans; D008422:Materials Testing; D008739:Methyl Green; D008963:Molar / Q000033:anatomy & histology; D009339:Needles; D011312:Pressure; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000592:standards*; D016369:Smear Layer; D012973:Sodium Hypochlorite / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D019227:Tooth Apex / Q000033:anatomy & histology; D014092:Tooth Root / Q000033:anatomy & histology; D055114:X-Ray Microtomography
chemical_list: D001391:Azo Compounds; D004396:Coloring Agents; D012388:Root Canal Irrigants; C017768:trichrome stain; D008739:Methyl Green; D003094:Collagen; D004492:Edetic Acid; D012973:Sodium Hypochlorite; D004801:Eosine Yellowish-(YS)