title: Effect of Different Agitation Techniques on the Penetration of Irrigant and Sealer into Dentinal Tubules.
abstract: OBJECTIVE
  The aim of this study was to compare the effectiveness of five intracanal agitation techniques on the penetration of irrigant and sealer into dentinal tubules.
  
  
  BACKGROUND
  Intracanal agitation techniques could promote chemomechanical debridement and the sealing of root canals during endodontic treatment. However, there is limited evidence for the agitation effect of Nd:YAP laser.
  
  
  METHODS
  Human maxillary premolars with single straight canals (N = 60) were prepared with ProTaper Next®NiTi rotary files (Dentsply Maillefer) up to X4 (ISO 40 size). Rhodamine B-labeled sodium hypochlorite was used for final irrigation together with the conventional syringe (control), sonic, ultrasonic, Nd:YAP laser, or V-Clean™ endodontic agitation system. All canals were obturated with gutta-percha and fluorescein isothiocyanate-labeled AH Plus sealer. Transverse sections were obtained at 2, 5, and 8 mm from the apex and observed under confocal laser scanning microscopy. Maximum penetration depth and penetration percentage of both irrigant and sealer were recorded. Kruskal-Wallis and Mann-Whitney tests were performed for multiple comparisons. The Spearman coefficient was calculated to confirm correlations between irrigant and sealer penetration.
  
  
  RESULTS
  Laser agitation attained the most irrigant and sealer penetration depth and penetration percentage (p < 0.05). Sonic and ultrasonic agitation attained significantly more penetration percentage than the control group at 2 mm from the apex (p < 0.05). Patterns of irrigant and sealer penetration correlated significantly for all agitation techniques (p < 0.001).
  
  
  CONCLUSIONS
  Nd:YAP laser was superior to other agitation techniques in dentinal tubule penetration of irrigant and sealer at one or more sectioned levels from the apex.
authors.affiliation: 1 Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry , Seoul, Republic of Korea.|2 Department of Conservative Dentistry, School of Stomatology, Shandong University , Jinan, China .
authors.forename: Yu
authors.initials: Y
authors.lastname: Gu
authors.affiliation: 3 Schulich School of Medicine and Dentistry, University of Western Ontario , London, Canada .
authors.forename: Hiran
authors.initials: H
authors.lastname: Perinpanayagam
authors.affiliation: 4 Department of Biology, Siena College , Loudonville, New York.
authors.forename: David J W
authors.initials: DJ
authors.lastname: Kum
authors.affiliation: 1 Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry , Seoul, Republic of Korea.
authors.forename: Yeon-Jee
authors.initials: YJ
authors.lastname: Yoo
authors.affiliation: 5 Department of Advanced General Dentistry, Yonsei University Medical Center, Oral Science Institute, College of Dentistry, Yonsei University , Seoul, Republic of Korea.
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Jeong
authors.affiliation: 1 Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry , Seoul, Republic of Korea.
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Lim
authors.affiliation: 6 Department of Conservative Dentistry, School of Dentistry, Kyung Hee University , Seoul, Republic of Korea.
authors.forename: Seok-Woo
authors.initials: SW
authors.lastname: Chang
authors.affiliation: 1 Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry , Seoul, Republic of Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Baek
authors.affiliation: 7 Division of Endodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center , School of Dental Medicine, Farmington, Connecticut.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: 1 Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry , Seoul, Republic of Korea.
authors.forename: Kee-Yeon
authors.initials: KY
authors.lastname: Kum
mesh_terms: D001641:Bicuspid / Q000601:surgery; D003804:Dentin / Q000737:chemistry / Q000187:drug effects*; D004853:Epoxy Resins; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D018613:Microscopy, Confocal / Q000379:methods; D012388:Root Canal Irrigants / Q000494:pharmacology*; D018915:Root Canal Preparation / Q000379:methods; D012680:Sensitivity and Specificity; D012973:Sodium Hypochlorite / Q000494:pharmacology
chemical_list: D004853:Epoxy Resins; D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite
keywords: Nd:YAP laser; confocal laser scanning microscope; dentinal tubule; intracanal agitation; penetration depth; penetration percentage