Restorative Dentistry & Endodontics

Research Article

Multivariate analysis of the cleaning efficacy of different final irrigation techniques in the canal and isthmus of mandibular posterior teeth: Yeon-Jee Yoo, WooCheol Lee, Hyeon-Cheol Kim, Won-Jun Shon, Seung-Ho Baek; Restor Dent Endod 2013;38(3):154-159. Published online August 23, 2013; DOI: https://doi.org/10.5395/rde.2013.38.3.154

Abstract PDF PubReader ePub: Objectives
The aim of this study was to compare the cleaning efficacy of different final irrigation regimens in canal and isthmus of mandibular molars, and to evaluate the influence of related variables on cleaning efficacy of the irrigation systems.
Materials and Methods
Mesial root canals from 60 mandibular molars were prepared and divided into 4 experimental groups according to the final irrigation technique: Group C, syringe irrigation; Group U, ultrasonics activation; Group SC, VPro StreamClean irrigation; Group EV, EndoVac irrigation. Cross-sections at 1, 3 and 5 mm levels from the apex were examined to calculate remaining debris area in the canal and isthmus spaces. Statistical analysis was completed by using Kruskal-Wallis test and Mann-Whitney U test for comparison among groups, and multivariate linear analysis to identify the significant variables (regular replenishment of irrigant, vapor lock management, and ultrasonic activation of irrigant) affecting the cleaning efficacy of the experimental groups.
Results
Group SC and EV showed significantly higher canal cleanliness values than group C and U at 1 mm level (p < 0.05), and higher isthmus cleanliness values than group U at 3 mm and all levels of group C (p < 0.05). Multivariate linear regression analysis demonstrated that all variables had independent positive correlation at 1 mm level of canal and at all levels of isthmus with statistical significances.
Conclusions
Both VPro StreamClean and EndoVac system showed favorable result as final irrigation regimens for cleaning debris in the complicated root canal system having curved canal and/or isthmus. The debridement of the isthmi significantly depends on the variables rather than the canals.

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Review Article

Review of root canal irrigant delivery techniques and devices: Yeon-Jee Yoo, Su-Jeong Shin, Seung-Ho Baek; J Korean Acad Conserv Dent 2011;36(3):180-187. Published online May 31, 2011; DOI: https://doi.org/10.5395/JKACD.2011.36.3.180

Abstract PDF PubReader ePub: Introduction
Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics.
Review
The contents of this paper include as follows;

- syringe-needle irrigation, manual dynamic irrigation, brushes

- sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser
Conclusion
Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation.

The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

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Original Articles

A COMPARISON OF THE IRRIGATION SYSTEMS IN CALCIUM HYDROXIDE REMOVAL: Jae-Seung Eun, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim; J Korean Acad Conserv Dent 2009;34(6):508-514. Published online January 14, 2009; DOI: https://doi.org/10.5395/JKACD.2009.34.6.508

Abstract PDF PubReader ePub: Abstract
The purposes of this study were to compare the efficacy of irrigation systems by removing a calcium hydroxide (Ca(OH)₂) paste from the apical third of the root canal and the effect of the patency file. Sixty single rooted human teeth were used in this study. The canals were instrumented by a crown-down manner with .04 taper ProFile to ISO #35. Ca(OH)2 and distilled water were mixed and placed inside the root canals. The teeth were divided into 6 groups according to the root canal irrigation system and the use of patency file as follows: group 1 - conventional method; group 2 - EndoActivator^®; group 3 - EndoVac^®; group 4 - conventional method, patency; group 4 - EndoActivator^®, patency; group 6 - EndoVac^®, patency. All teeth were irrigated with sodium hypochlorite. After the root canal irrigation, the teeth were split in bucco-lingual aspect. Percentage of the root canal surface coverage with residual Ca(OH)2 until 3 mm from working length was analyzed using Image Pro Plus ver. 4.0. Statistical analysis was performed using the One-way ANOVA, t-test and Scheffe's post-hoc test. Conventional groups had significantly more Ca(OH)2 debris than EndoActivator^®, EndoVac^® groups. There was no significant difference between EndoActivator^® and EndoVac^® groups. Groups with patency file showed more effective in removing Ca(OH)₂ paste than no patency groups, but, it was no significant difference. This study showed that EndoActivator^® and EndoVac^® systems were more effective in removing Ca(OH)2 paste from the apical third of the root canal than conventional method.

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EVALUATION OF ENTEROCOCCUS FAECALIS REMOVAL EFFICACY OF THE ENDOVAC^® AND ENDOACTIVATOR^® INTRACANAL IRRIGATION METHODS: Seung-Gon Song, Kyung-Mo Cho, Jin-Woo Kim; J Korean Acad Conserv Dent 2009;34(5):390-396. Published online January 14, 2009; DOI: https://doi.org/10.5395/JKACD.2009.34.5.390

Abstract PDF PubReader ePub: Abstract
The aim of this study was to evaluate endodontic irrigation methods with EndoVac^® and EndoActivator^® in the elimination of Enterococcus faecalis from the root canals. Extracted 70 human single-rooted teeth were used. The canals were instrumented by a crown-down technique with .04 taper ProFile to ISO size 40. After the teeth were autoclaved, the canals were inoculated with E. faecalis and incubated for 48 h. The teeth were randomly divided into three experimental groups of 20 teeth each according to canal irrigation methods and two control groups as follows: group 1 - EndoVac^®; group 2 - EndoActivator^®; group 3 - Conventional needle irrigation method. After canal irrigation using 2.5% NaOCl, first samples (S1) were taken using sterile paper point. And the canals were filled with sterile brain heart infusion (BHI) broth and incubated for 24 h, then second samples (S2) were taken. The samples were cultured on BHI agar plate to determine the numbers of colony forming units (CFU). In first sampling (S1), only one canal of conventional method among the all experimental groups was positive cultured. In second sampling (S2), EndoVac^® group showed the least positive culture numbers of E. faecalis. There was statistically significant difference between the EndoVac^® and conventional needle irrigation methods in the mean value of Log CFU. According to the results of this study, EndoVac^® showed better efficacy than conventional needle irrigation method in the elimination of E. faecalis from the root canal.

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