title: Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems.
abstract: BACKGROUND
  The purpose of this study was to evaluate the canal isthmus debridement efficacy of a new modified EndoVac (Discus Dental, Culver City, CA) irrigation protocol in comparison with EndoVac, passive ultrasonic irrigation (PUI), and conventional needle irrigation in mesial roots of mandibular molars.
  
  
  METHODS
  The mesial roots of 64 extracted mandibular molars mounted in resin using Kuttler's endodontic cube, sectioned at 2 and 4 mm from the working length, were randomly divided into 4 groups (n = 16): group 1: Max-I-Probe (Dentsply Tulsa Dental, York, PA), group 2: EndoVac (EVI), group 3: modified EndoVac, and group 4: PUI. The specimens were reassembled and instrumented. A standard irrigation protocol was used during cleaning and shaping and final irrigation with the 4 irrigation/agitation techniques. Images of the isthmus region were taken before and after cleaning and shaping and after final irrigation. The percentage reduction of debris in the isthmus region was calculated by using the software program Image J (v1.43; National Institutes of Health, Bethesda, MD). Intergroup analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Intragroup analysis was performed using Friedman and Wilcoxon signed rank tests. The level of significance was set at P < .05.
  
  
  RESULTS
  Intragroup analysis revealed a statistically significant difference in the percentage reduction of debris after cleaning and shaping and after final irrigation protocol in all the groups (P < .001). The final irrigation protocol produced significantly cleaner canal isthmuses in all the groups (P < .001). On intergroup analysis, the modified EVI group performed significantly better than the other groups. The EVI and PUI groups performed better than the Max-I-Probe group. There was no statistical significance between the EVI and PUI groups.
  
  
  CONCLUSIONS
  Canal isthmuses were significantly cleaner with the modified EndoVac irrigation technique when compared with the cleanliness seen with the other irrigation systems.
authors: Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India. Electronic address: anchurachel@gmail.com.
authors: Anchu Rachel
authors: AR
authors: Thomas
authors: Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India.
authors: Natanasabapathy
authors: N
authors: Velmurugan
authors: Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India.
authors: Surendran
authors: S
authors: Smita
authors: Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India.
authors: Sundaramurthy
authors: S
authors: Jothilatha
mesh_terms: D003786:Dental Pulp Cavity / Q000033:anatomy & histology*; D004492:Edetic Acid / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008963:Molar / Q000033:anatomy & histology; D009339:Needles; D011897:Random Allocation; D012388:Root Canal Irrigants / Q000008:administration & dosage; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D016369:Smear Layer / Q000473:pathology; D012973:Sodium Hypochlorite / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods
chemical_list: D012388:Root Canal Irrigants; D004492:Edetic Acid; D012973:Sodium Hypochlorite
keywords: EndoVac; K-Kube; Max I Probe; isthmus; passive ultrasonic irrigation