title: Investigation of the Efficacy of Passive Ultrasonic Irrigation Versus Irrigation with Reciprocating Activation: An Environmental Scanning Electron Microscopic Study.
abstract: BACKGROUND
  The objective of this ex vivo study was to compare the efficacy of passive ultrasonic irrigation (PUI) versus a new activation system using reciprocating motion (EasyClean [EC]; Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) to remove debris from the root canal walls at 6 predetermined apical levels using environmental scanning electron microscopy.
  
  
  METHODS
  Mesiobuccal root canals of 10 mandibular molars were prepared with a 30/.05 final instrument. The specimens were embedded in flasks containing heavy body silicone, cleaved longitudinally, and 6 round indentations were made into the apical region of the buccal half at 1-mm intervals. The same specimens were used to prepare a blank control group (no debris), a negative control group (completely covered by debris), and 2 experimental groups: PUI and irrigation with reciprocating activation. Standardized images of the indentations were obtained under environmental scanning electron microscopy and assessed by 2 examiners. The amount of debris was then classified using a 4-category scoring system. The kappa test was applied to determine interexaminer agreement, whereas the Kruskal-Wallis, Dunn, and Friedman tests were used to compare scores.
  
  
  RESULTS
  The EC group had results statistically similar to those of the blank control group for all 6 root levels examined. The PUI group had results statistically similar to those of the negative control group for the 3 most apical levels and similar to those of the blank control group for the 3 most cervical levels.
  
  
  CONCLUSIONS
  Activating the irrigant with a reciprocating system (EC) promoted more effective debris removal from the more apical regions of the root canal when compared with PUI.
authors.affiliation: Department of Endodontics, São Leopoldo Mandic Center for Dental Research, Campinas, São Paulo, Brazil. Electronic address: endo.kato@gmail.com.
authors.forename: Augusto Shoji
authors.initials: AS
authors.lastname: Kato
authors.affiliation: Division of Endodontics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Rodrigo Sanches
authors.initials: RS
authors.lastname: Cunha
authors.affiliation: Department of Endodontics, São Leopoldo Mandic Center for Dental Research, Campinas, São Paulo, Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: da Silveira Bueno
authors.affiliation: Department of Endodontics, São Leopoldo Mandic Center for Dental Research, Campinas, São Paulo, Brazil.
authors.forename: Rina Andrea
authors.initials: RA
authors.lastname: Pelegrine
authors.affiliation: Department of Endodontics, São Leopoldo Mandic Center for Dental Research, Campinas, São Paulo, Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Fontana
authors.affiliation: Department of Endodontics, São Leopoldo Mandic Center for Dental Research, Campinas, São Paulo, Brazil.
authors.forename: Alexandre Sigrist
authors.initials: AS
authors.lastname: de Martin
mesh_terms: D003646:Debridement / Q000379:methods; D003786:Dental Pulp Cavity / Q000648:ultrastructure; D003804:Dentin / Q000648:ultrastructure; D006801:Humans; D008855:Microscopy, Electron, Scanning / Q000379:methods*; D012388:Root Canal Irrigants / Q000737:chemistry*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D012390:Root Canal Therapy / Q000295:instrumentation / Q000379:methods; D012973:Sodium Hypochlorite / Q000737:chemistry; D007507:Therapeutic Irrigation / Q000379:methods*; D019227:Tooth Apex / Q000648:ultrastructure; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*
chemical_list: D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite
keywords: Debris; endodontic irrigation; environmental scanning electron microscopy; reciprocating motion; ultrasonics