Micro-CT Evaluation of Different Final Irrigation Protocols on The Removal of Hard-tissue Debris from Isthmus-containing Mesial Root of Mandibular Molars

E.J.N.L. Silva, C.R. Carvalho, F.G. Belladonna, M.C. Prado, R.T. Lopes, G. De-Deus, E.J.L. Moreira

Clinical Oral Investigations. 2018; [Epub ahead of print]



OBJECTIVES: This study aimed to compare four final irrigation protocols (passive ultrasonic irrigation [PUI], EndoVac, Self-Adjusting File [SAF] and EasyClean) on the removal of accumulated hard-tissue debris (AHTD) from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis.

MATERIALS AND METHODS: Forty mesial roots of mandibular molars presenting isthmuses type I or III were scanned in a micro-CT device and instrumented up to Reciproc R40 instrument. After the completion of canal preparations, root canals of each group were submitted to a final rinse using 20 mL of solution (16 mL of 5.25% NaOCl and 4 mL of 17% EDTA) in a total time of 5 min according to one of the four final irrigation protocols (n = 10): PUI, EndoVac, SAF and EasyClean operated at reciprocating motion. The sample was scanned again after canal preparation and after the use of the final irrigation protocols, and the registered data sets were examined to evaluate the percentage of AHTD. Data were statistically compared using the Tukey test with a significance level set at 5%.

RESULTS: All groups presented a decrease on the accumulation of hard-tissue debris after the use of the final irrigation protocols (P < 0.05). No significant differences in the removal of AHTD were observed among the final irrigation protocols (P > 0.05).

CONCLUSIONS: All final irrigation protocols showed the same effectiveness in the removal of AHTD. None of them was able to render mesial canals of mandibular molars completely free from packed debris.

CLINICAL RELEVANCE: This study highlighted that all final irrigation protocols (PUI, EndoVac, SAF, and EasyClean) promoted a similar removal of AHTD. However, none of the final irrigation protocols was able to render mesial canals of mandibular molars completely free from packed debris.


The full article is available online: Researchgate

Silva de deus debris packing cleaning CLOI 2018


Additional Info

  • ReDent Nova’s note:

    The Self-Adjusting File was used as a "finisher", and not according to its designated purpose. Large reciprocating instruments such as Reciproc R40 were shown in many researches to pack debris and extrude debris more than conventional rotary instruments, due to their mode of rotation. Using such instruments in narrow canals, such a mesial canals on mandibular molars, is bound to pack the debris so forcefully that the SAF System, or any other technique, as shown in this article, is unable to remove the debris.

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  • View abstract on PubMed. PMID: 29744723