Review of root canal irrigant delivery techniques and devices

Yeon-Jee Yoo; Su-Jeong Shin; Seung-Ho Baek

doi:10.5395/JKACD.2011.36.3.180

Articles

Page Path: HOME > Restor Dent Endod > Volume 36(3); 2011 > Article

Review Article Review of root canal irrigant delivery techniques and devices: Yeon-Jee Yoo, DDS, Su-Jeong Shin, DDS, Seung-Ho Baek, DDS, PhD; Journal of Korean Academy of Conservative Dentistry 2011;36(3):180-187.
DOI: https://doi.org/10.5395/JKACD.2011.36.3.180
Published online: May 31, 2011

Department of Conservative Dentistry and Dental Research Institute, College of Dentistry, Seoul National University, Seoul, Korea.

Correspondence to Seung-Ho Baek, DDS, PhD. Associate Professor, Department of Conservative Dentistry, Seoul National University School of Dentistry, 28 Yeongon-dong, Jongno-gu, Seoul, Korea 110-768. TEL, +82-2-2072-3815; FAX, +82-2-2072-3850; shbaek@snu.ac.kr

• Received: April 25, 2011 • Revised: May 2, 2011 • Accepted: May 2, 2011

15 Views
0 Download

prev next

Full Article

Download PDF

Abstract
REFERENCES

Abstract

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.
Keywords: EndoVac; Laser; Irrigant delivery devices; Irrigant delivery techniques; Root canal irrigation; Ultrasonics

REFERENCES

1. Weller RN, Brady JM, Bernier WE. Efficacy of ultrasonic cleaning. J Endod. 1980;6: 740-743.Article PubMed
2. Schäfer E, Zapke K. A comparative scanning electron microscopic investigation of the efficacy of manual and automated instrumentation of root canals. J Endod. 2000;26: 660-664.Article PubMed
3. Gutarts R, Nusstein J, Reader A, Beck M. In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 2005;31: 166-170.Article PubMed
4. Ciucchi B, Khettabi M, Holz J. The effectiveness of different endodontic irrigation procedures on the removal of the smear layer: a scanning electron microscopic study. Int Endod J. 1989;22: 21-28.Article PubMed
5. Zehnder M. Root canal irrigants. J Endod. 2006;32: 389-398.Article PubMed
6. Naenni N, Thoma K, Zehnder M. Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod. 2004;30: 785-787.Article PubMed
7. Zamany A, Safavi K, Spångberg LS. The effect of chlorhexidine as an endodontic disinfectant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96: 578-581.Article PubMed
8. Ram Z. Effectiveness of root canal irrigation. Oral Surg Oral Med Oral Pathol. 1977;44: 306-312.Article PubMed
9. Chow TW. Mechanical effectiveness of root canal irrigation. J Endod. 1983;9: 475-479.Article PubMed
10. Sedgley CM, Nagel AC, Hall D, Applegate B. Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J. 2005;38: 97-104.Article PubMed
11. van der Sluis LW, Gambarini G, Wu MK, Wesselink PR. The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J. 2006;39: 472-476.Article PubMed
12. Sedgley C, Applegate B, Nagel A, Hall D. Real-time imaging and quantification of bioluminescent bacteria in root canals in vitro. J Endod. 2004;30: 893-898.PubMed
13. Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H, Haapasalo M. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod. 2010;36: 884-889.Article PubMed
14. Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. J Endod. 1983;9: 137-142.Article PubMed
15. Huang TY, Gulabivala K, Ng YL. A bio-molecular film ex-vivo model to evaluate the influence of canal dimensions and irrigation variables on the efficacy of irrigation. Int Endod J. 2008;41: 60-71.Article PubMed
16. Falk KW, Sedgley CM. The influence of preparation size on the mechanical efficacy of root canal irrigation in vitro. J Endod. 2005;31: 742-745.Article PubMed
17. Albrecht LJ, Baumgartner JC, Marshall JG. Evaluation of apical debris removal using various sizes and tapers of ProFile GT files. J Endod. 2004;30: 425-428.Article PubMed
18. Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, Arun SN, Kim J, Looney SW, Pashley DH. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010;36: 745-750.Article PubMed PMC
19. McGill S, Gulabivala K, Mordan N, Ng YL. The efficacy of dynamic irrigation using a commercially available system (RinsEndo) determined by removal of a collagen 'bio-molecular film' from an ex vivo model. Int Endod J. 2008;41: 602-608.Article PubMed
20. Tronstad L, Barnett F, Schwartzben L, Frasca P. Effectiveness and safety of a sonic vibratory endodontic instrument. Endod Dent Traumatol. 1985;1: 69-76.Article PubMed
21. Ruddle CJ. Endodontic disinfection: tsunami irrigation. Endo Prac. 2008;11: 7-16.Article
22. Rödig T, Döllmann S, Konietschke F, Drebenstedt S, Hu¨lsmann M. Effectiveness of different irrigant agitation techniques on debris and smear layer removal in curved root canals: a scanning electron microscopy study. J Endod. 2010;36: 1983-1987.Article PubMed
23. Huffaker SK, Safavi K, Spangberg LS, Kaufman B. Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod. 2010;36: 1315-1318.Article PubMed
24. Uroz-Torres D, Gonzàlez-Rodríguez MP, Ferrer-Luque CM. Effectiveness of the EndoActivator System in removing the smear layer after root canal instrumentation. J Endod. 2010;36: 308-311.Article PubMed
25. Sabins RA, Johnson JD, Hellstein JW. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod. 2003;29: 674-678.Article PubMed
26. Stamos DE, Sadeghi EM, Haasch GC, Gerstein H. An in vitro comparison study to quantitate the debridement ability of hand, sonic, and ultrasonic instrumentation. J Endod. 1987;13: 434-440.Article PubMed
27. Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod. 1999;25: 735-738.Article PubMed
28. Richman MJ. The use of ultrasonics in root canal therapy and root resection. J Dent Med. 1957;12: 12-18.
29. Martin H, Cunningham WT, Norris JP, Cotton WR. Ultrasonic versus hand filing of dentin: a quantitative study. Oral Surg Oral Med Oral Pathol. 1980;49: 79-81.Article PubMed
30. Ahmad M, Pitt Ford TR, Crum LA. Ultrasonic debridement of root canals: an insight into the mechanisms involved. J Endod. 1987;13: 93-101.Article PubMed
31. Reynolds MA, Madison S, Walton RE, Krell KV, Rittman BR. An in vitro histological comparison of the step-back, sonic, and ultrasonic instrumentation techniques in small, curved root canals. J Endod. 1987;13: 307-314.Article PubMed
32. Walker TL, del Rio CE. Histological evaluation of ultrasonic and sonic instrumentation of curved root canals. J Endod. 1989;15: 49-59.PubMed
33. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35: 791-804.Article PubMed
34. Walker TL, del Rio CE. Histological evaluation of ultrasonic debridement comparing sodium hypochlorite and water. J Endod. 1991;17: 66-71.Article PubMed
35. Lee SJ, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different-sized simulated plastic root canals. Int Endod J. 2004;37: 607-612.Article PubMed
36. Sjögren U, Sundqvist G. Bacteriologic evaluation of ultrasonic root canal instrumentation. Oral Surg Oral Med Oral Pathol. 1987;63: 366-370.PubMed
37. Ahmad M. Effect of ultrasonic instrumentation on Bacteroides intermedius. Endod Dent Traumatol. 1989;5: 83-86.Article PubMed
38. DeNunzio MS, Hicks ML, Pelleu GB Jr, Kingman A, Sauber JJ. Bacteriological comparison of ultrasonic and hand instrumentation of root canals in dogs. J Endod. 1989;15: 290-293.PubMed
39. Siqueira JF Jr, Machado AG, Silveira RM, Lopes HP, de Uzeda M. Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal, in vitro. Int Endod J. 1997;30: 279-282.Article PubMed
40. Weber CD, McClanahan SB, Miller GA, Diener-West M, Johnson JD. The effect of passive ultrasonic activation of 2% chlorhexidine or 5.25% sodium hypochlorite irrigant on residual antimicrobial activity in root canals. J Endod. 2003;29: 562-564.PubMed
41. Cameron JA. The synergistic relationship between ultrasound and sodium hypochlorite: a scanning electron microscope evaluation. J Endod. 1987;13: 541-545.Article PubMed
42. Alaçam T. Scanning electron microscope study comparing the efficacy of endodontic irrigating systems. Int Endod J. 1987;20: 287-294.PubMed
43. Huque J, Kota K, Yamaga M, Iwaku M, Hoshino E. Bacterial eradication from root dentine by ultrasonic irrigation with sodium hypochlorite. Int Endod J. 1998;31: 242-250.Article PubMed
44. Cheung GS, Stock CJ. In vitro cleaning ability of root canal irrigants with and without endosonics. Int Endod J. 1993;26: 334-343.PubMed
45. Abbott PV, Heijkoop PS, Cardaci SC, Hume WR, Heithersay GS. An SEM study of the effects of different irrigation sequences and ultrasonics. Int Endod J. 1991;24: 308-316.Article PubMed
46. van der Sluis L, Wu MK, Wesselink P. Comparison of 2 flushing methods used during passive ultrasonic irrigation of the root canal. Quintessence Int. 2009;40: 875-879.PubMed
47. Jiang LM, Verhaagen B, Versluis M, Zangrillo C, Cuckovic D, van der Sluis LW. An evaluation of the effect of pulsed ultrasound on the cleaning efficacy of passive ultrasonic irrigation. J Endod. 2010;36: 1887-1891.Article PubMed
48. Ruddle CJ. Microbrush for endodontic use. 2001;Washington DC: United States Patent; 179. 617.
49. Weise M, Roggendorf MJ, Ebert J, Petschelt A, Frankenberger R. Four methods for cleaning simulated lateral extensions of curved root canals: a SEM evaluation. Int Endod J. 2007;40: 991-992.
50. Garip Y, Sazak H, Gunday M, Hatipoglu S. Evaluation of smear layer removal after use of a canal brush: an SEM study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110: e62-e66.Article PubMed
51. Lee SY, Son WJ, Lee WC, Kum KY, Bae KS, Baek SH. In vitro evaluation of cleaning efficacy of various irrigation methods in mandibular molars. J Korean Acad Conserv Dent. 2009;34: 215-222.Article
52. Hauser V, Braun A, Frentzen M. Penetration depth of a dye marker into dentine using a novel hydrodynamic system (RinsEndo). Int Endod J. 2007;40: 644-652.Article PubMed
53. Nielsen BA, Craig Baumgartner J. Comparison of the EndoVac system to needle irrigation of root canals. J Endod. 2007;33: 611-615.PubMed
54. Siu C, Baumgartner JC. Comparison of the debridement efficacy of the EndoVac irrigation system and conventional needle root canal irrigation in vivo. J Endod. 2010;36: 1782-1785.Article PubMed
55. Miller TA, Baumgartner JC. Comparison of the antimicrobial efficacy of irrigation using the EndoVac to endodontic needle delivery. J Endod. 2010;36: 509-511.Article PubMed
56. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009;35: 545-549.Article PubMed
57. De Moor RJ, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod. 2010;36: 1580-1583.PubMed
58. Hmud R, Kahler WA, George R, Walsh LJ. Cavitational effects in aqueous endodontic irrigants generated by near-infrared lasers. J Endod. 2010;36: 275-278.Article PubMed
59. de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J. 2009;42: 1077-1083.Article PubMed
60. George R, Walsh LJ. Apical extrusion of root canal irrigants when using Er:YAG and Er,Cr:YSGG lasers with optical fibers: an in vitro dye study. J Endod. 2008;34: 706-708.Article PubMed

Tables & Figures

REFERENCES

Citations

Citations to this article as recorded by

ePub Link

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Review of root canal irrigant delivery techniques and devices

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

XML Download

Review of root canal irrigant delivery techniques and devices