title: New Technologies to Improve Root Canal Disinfection.
abstract: Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice.
authors.affiliation: Department of Endodontics, Sapienza University of Rome, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Plotino
authors.affiliation: Department of Endodontics, Sapienza University of Rome, Rome, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Cortese
authors.affiliation: Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Grande
authors.affiliation: Department of Dentistry, Universidade Positivo, Curitiba, PR, Brazil.
authors.forename: Denise P
authors.initials: DP
authors.lastname: Leonardi
authors.affiliation: Department of Endodontics, Sapienza University of Rome, Rome, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Di Giorgio
authors.affiliation: Department of Endodontics, Sapienza University of Rome, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Testarelli
authors.affiliation: Department of Endodontics, Sapienza University of Rome, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gambarini
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004203:Disinfection; D006801:Humans; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D012388:Root Canal Irrigants