title: A comparative study of the debridement efficacy and apical extrusion of dynamic and passive root canal irrigation systems.
abstract: BACKGROUND
  Root canal irrigation carries a risk of extrusion of irrigant into the periapical tissues which can be associated with pain, swelling, and tissue damage. Studies have shown less extrusion with sonic or apical negative pressure devices compared with syringe and side-port needle or passive ultrasonic irrigation with continuous irrigant flow. This study aimed to evaluate the effectiveness of the EndoVac irrigation system, regarding 1) debris removal and 2) the control of apically extruded irrigating solution.
  
  
  METHODS
  Fifty extracted human single-rooted teeth were used in this study. The teeth were then randomly divided into three experimental groups according to the type of irrigation used and one control group. In group 1, irrigation was performed using the EndoVac irrigation system. In group 2, irrigation was performed using a 30-gauge, tip-vented irrigation needle. In group 3, irrigation was performed using a 30-gauge, side-vented irrigation needle. The control group received instrumentation with no irrigation to serve as a control for cleaning efficiency. Root canal instrumentation was performed using the Profile NiTi rotary system with a crown-down technique. All of the experimental teeth were irrigated with the same amount of 5.25% sodium hypochlorite. The amount of extruded irrigating solution was then measured by subtracting the post-instrumentation weight from the pre-instrumentation weight using an electronic balance. The cleanliness of debris removal was evaluated using scanning electron microscopy.
  
  
  RESULTS
  EndoVac irrigation had the least amount of extrusion followed by the side-vented and tip-vented method. The difference between the groups was statistically significant (P <0.01). As for the cleaning results, the debris collection in the EndoVac and tip-vented groups was the least in the apical third. In the control and the side-vented groups, the debris was the greatest in the apical third, but this difference was not significant among the three experimental groups.
  
  
  CONCLUSIONS
  The EndoVac irrigation system extruded significantly less irrigant solution than either needle irrigation system. Debris collection was the least in the apical third for the EndoVac irrigation system. No significant difference was found in the cleaning efficiency among the three irrigation systems.
authors: Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. ksucod@gmail.com.
authors: Ahmed
authors: A
authors: Alkahtani
authors: Tala D
authors: TD
authors: Al Khudhairi
authors: Sukumaran
authors: S
authors: Anil
mesh_terms: D003646:Debridement / Q000379:methods*; D003786:Dental Pulp Cavity / Q000648:ultrastructure; D004867:Equipment Design; D006801:Humans; D008855:Microscopy, Electron, Scanning; D009339:Needles; D010486:Periapical Tissue / Q000187:drug effects; D012388:Root Canal Irrigants / Q000009:adverse effects / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D016369:Smear Layer; D012973:Sodium Hypochlorite / Q000009:adverse effects / Q000627:therapeutic use; D013499:Surface Properties; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D019227:Tooth Apex / Q000473:pathology*; D014618:Vacuum
chemical_list: D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite