Download PDF
CC BY-NC-ND 4.0 · Eur J Dent 2021; 15(03): 551-556
DOI: 10.1055/s-0041-1726160
Original Article

Efficacy of Handpiece Mounted Continuous Irrigation System for the Removal of Residual Pulpal Debris During Root Canal Preparation

Huma Sarwar
1   Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
2   Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
,
Fazal Qazi
1   Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
2   Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
,
Shahbaz Ahmed
1   Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
2   Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
,
Yawar Abidi
3   Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
,
Meshal Naeem
1   Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
2   Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
,
Juzer Shabbir 
3   Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
,
Zohaib Khurshid 
5   Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Objective The removal of residual pulpal debris (RPD) from the root canal walls, especially in necrotic teeth is important for successful endodontic outcome. The aim of this study was to evaluate the RPD removal efficacy of handpiece mounted continuous irrigation with simultaneous root canal preparation from the apical third of root canals as compared to conventional syringe irrigation (SI).

Materials and Methods Ninety extracted teeth were randomly divided into three groups: SI; handpiece mounted continuous irrigation (CI); and both syringe and continuous irrigation (CI+SI). After root canal preparation, roots were sectioned at 1 (a), 3 (b) and 5 (c) mm from apex and prepared for Hematoxylin-Eosin staining. Sections were microscopically examined for presence of RPD.

Statistical Analysis Intergroup difference in average percentage of RPD at different root levels was calculated by using analysis of variance test (ANOVA). Tuckey test was used for pairwise comparison.

Results ANOVA showed significant difference between all three groups (p < 0.05). SI group showed a significantly higher percentage of RPD as compared with CI and CI+ SI groups at all root levels (p < 0.01). At root level a, CI showed a significantly higher percentage of RPD as compared with CI+SI (p < 0.01).

Conclusion Handpiece mounted CI during rotary instrumentation showed a significant reduction in RPD as compared with conventional syringe irrigation. This technique was found to be an effective method for an enhanced root canal debridement.

Keywords

continuous irrigation - debridement - dentin debris - root canal - sodium hypochlorite - syringe irrigation


Publication History

Article published online:
11 May 2021

© 2021. European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Villalta-Briones N, Baca P, Bravo M. et al. A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid. Int Endod J 2021; 54 (02) 268-278 DOI: 10.1111/iej.13417.
    CrossrefPubMedGoogle Scholar
  • 2 Shabbir J, Qazi F, Farooqui W, Ahmed S, Zehra T, Khurshid Z. Effect of Chinese propolis as an intracanal medicament on post-operative endodontic pain: a double-blind randomized controlled trial. Int J Environ Res Public Health 2020; 17 (02) E445
    CrossrefPubMedGoogle Scholar
  • 3 Reem M, Dalia F. Apical debris extrusion and root canal cleanliness using several rotary nickel titanium files with different kinematics in round and oval canals. Dent Sci Updat 2020; 1 (01) 39-49
    CrossrefGoogle Scholar
  • 4 Walters MJ, Baumgartner JC, Marshall JG. Efficacy of irrigation with rotary instrumentation. J Endod 2002; 28 (12) 837-839
    CrossrefPubMedGoogle Scholar
  • 5 Yang Q, Liu MW, Zhu LX, Peng B. Micro-CT study on the removal of accumulated hard-tissue debris from the root canal system of mandibular molars when using a novel laser-activated irrigation approach. Int Endod J 2020; 53 (04) 529-538
    CrossrefPubMedGoogle Scholar
  • 6 Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2018; 51 (06) 605-621
    CrossrefPubMedGoogle Scholar
  • 7 Hussein Hussein A, Hameed Mohammed R. A study to compare the cleaning efficiency of different irrigation systems for macro debris removal in instrumented canals (An in vitro study).. J Baghdad Coll Dent 2015; 27 (02) 11-16
    CrossrefGoogle Scholar
  • 8 Molina B, Glickman G, Vandrangi P, Khakpour M. Evaluation of root canal debridement of human molars using the GentleWave system. J Endod 2015; 41 (10) 1701-1705
    CrossrefPubMedGoogle Scholar
  • 9 Boutsioukis C, Verhaagen B, Versluis M. Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010; 36 (05) 875-879
    CrossrefPubMedGoogle Scholar
  • 10 Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009; 35 (06) 791-804
    CrossrefPubMedGoogle Scholar
  • 11 Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod 2010; 36 (09) 1558-1562
    CrossrefPubMedGoogle Scholar
  • 12 del Carpio-Perochena A, Bramante CM, de Andrade FB. et al. Antibacterial and dissolution ability of sodium hypochlorite in different pHs on multi-species biofilms. Clin Oral Investig 2015; 19 (08) 2067-2073
    CrossrefPubMedGoogle Scholar
  • 13 Tay FR, Gu L-S, Schoeffel GJ. et al. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod 2010; 36 (04) 745-750
    CrossrefPubMedGoogle Scholar
  • 14 Pasricha SK, Makkar S, Gupta P. Pressure alteration techniques in endodontics- a review of literature. J Clin Diagn Res 2015; 9 (03) ZE01-ZE06
    PubMedGoogle Scholar
  • 15 de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 2010; 36 (07) 1216-1221
    CrossrefPubMedGoogle Scholar
  • 16 Shen Y, Zhou HM, Zheng YF, Peng B, Haapasalo M. Current challenges and concepts of the thermomechanical treatment of nickel-titanium instruments. J Endod 2013; 39 (02) 163-172
    CrossrefPubMedGoogle Scholar
  • 17 Dutner J, Mines P, Anderson A. Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod 2012; 38 (01) 37-40
    CrossrefPubMedGoogle Scholar
  • 18 Perez R, Neves AA, Belladonna FG. et al. Impact of needle insertion depth on the removal of hard-tissue debris. Int Endod J 2017; 50 (06) 560-568
    CrossrefPubMedGoogle Scholar
  • 19 Metzger Z. The self-adjusting file (SAF) system: an evidence-based update. J Conserv Dent 2014; 17 (05) 401-419
    CrossrefPubMedGoogle Scholar
  • 20 Konstantinidi E, Psimma Z, Chávez de Paz LE, Boutsioukis C. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system. Int Endod J 2017; 50 (11) 1034-1054
    CrossrefPubMedGoogle Scholar
  • 21 Neelakantan P, Khan K, Li KY, Shetty H, Xi W. Effectiveness of supplementary irrigant agitation with the Finisher GF brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments. Int Endod J 2018; 51 (07) 800-807
    CrossrefPubMedGoogle Scholar
  • 22 Haapasalo M, Shen Y, Wang Z. et al. Apical pressure created during irrigation with the GentleWave™ system compared to conventional syringe irrigation. Clin Oral Investig 2016; 20 (07) 1525-1534
    CrossrefPubMedGoogle Scholar
  • 23 Hu S, Duan L, Wan Q, Wang J. Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model. Biomed Eng Online 2019; 18 (01) 52
    CrossrefPubMedGoogle Scholar
  • 24 Petridis X, Busanello FH, So MVR, Dijkstra RJB, Sharma PK, van der Sluis LWM. Factors affecting the chemical efficacy of 2% sodium hypochlorite against oral steady-state dual-species biofilms: exposure time and volume application. Int Endod J 2019; 52 (08) 1182-1195
    CrossrefPubMedGoogle Scholar
  • 25 Agarwal A, Deore RB, Rudagi K, Nanda Z, Baig MO, Fareez MA. Evaluation of apical vapor lock formation and comparative evaluation of its elimination using three different techniques: an in vitro study. J Contemp Dent Pract 2017; 18 (09) 790-794
    CrossrefPubMedGoogle Scholar
  • 26 Keleş A, Alçin H, Sousa-Neto MD, Versiani MA. Supplementary steps for removing hard tissue debris from isthmus-containing canal systems. J Endod 2016; 42 (11) 1677-1682
    CrossrefPubMedGoogle Scholar
  • 27 Yaylali IE, Kececi AD, Ureyen Kaya B. Ultrasonically activated irrigation to remove calcium hydroxide from apical third of human root canal system: a systematic review of in vitro studies. J Endod 2015; 41 (10) 1589-1599
    CrossrefPubMedGoogle Scholar
  • 28 Bao P, Shen Y, Lin J, Haapasalo M. Lin James, Haapasalo Markus. In vitro efficacy of XP-endo finisher with 2 different protocols on biofilm removal from apical root canals. J Endod 2017; 43 (02) 321-325
    CrossrefPubMedGoogle Scholar
  • 29 de Hemptinne F, Slaus G, Vandendael M, Jacquet W, De Moor RJ, Bottenberg P. In vivo intracanal temperature evolution during endodontic treatment after the injection of room temperature or preheated sodium hypochlorite. J Endod 2015; 41 (07) 1112-1115
    CrossrefPubMedGoogle Scholar
  • 30 Chandler N, Chellappa D. Lubrication during root canal treatment. Aust Endod J 2019; 45 (01) 106-110
    CrossrefPubMedGoogle Scholar
  • 31 Bıçakcı H, Çapar İD, Genç S, İhtiyar A, Sütçü R. Influence of rotary instrumentation with continuous irrigation on pain and neuropeptide release levels: a randomized clinical trial. J Endod 2016; 42 (11) 1613-1619
    CrossrefPubMedGoogle Scholar
  • 32 Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J 2014; 216 (06) 299-303
    CrossrefPubMedGoogle Scholar
  • 33 Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivator system, the F file, ultrasonic irrigation, and NaOCl irrigation alone after hand-rotary instrumentation in human mandibular molars. J Endod 2010; 36 (08) 1367-1371
    CrossrefPubMedGoogle Scholar