Department of Endodontics, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt.
BMC Oral Health. 2023 Mar 11;23(1):142. doi: 10.1186/s12903-023-02835-0.
This study compared in vitro the anastomosis cleaning efficacy of different irrigant activation techniques at different levels; control group non-activation (NA), passive ultrasonic irrigation (PUI) using Irrisafe, and EDDY sonic activation.
Sixty anastomosis-containing mesial roots of mandibular molars were mounted in resin, sectioned at 2, 4, and 6 mm from the apex. Then reassembled and instrumented in a copper cube. For the irrigation technique roots were randomly divided into 3 groups (n = 20): group 1: NA, group 2: Irrisafe, group 3: EDDY. Stereomicroscopic images of anastomoses were taken after instrumentation and after irrigant activation. ImageJ program was used to calculate the percentage of anastomosis cleanliness. The percentage of cleanliness was calculated before and after final irrigation within each group and were then compared using paired t-tests. Intergroup and intragroup analyses were performed to compare between different activation techniques at the same root canal level (2, 4 and 6 mm) (intergroup) and to evaluate if each technique had different cleanliness efficacy according to the root canal level (intragroup) using one-way analysis of variance and post hoc tests (p < 0.05).
All three irrigation techniques significantly improved anastomosis cleanliness (p < 0.001). Both activation techniques were significantly better than the control group at all levels. Intergroup comparison revealed that EDDY significantly achieved the best overall anastomosis cleanliness. The difference between EDDY and Irrisafe was significant in favor to EDDY at 2 mm and insignificant at 4 and 6 mm. The intragroup comparison showed that improvement in anastomosis cleanliness (i2-i1) in the needle irrigation without activation group (NA) was significantly higher in the apical 2 mm level compared to the 4 & 6 levels. While the difference in anastomosis cleanliness improvement (i2-i1) between levels in both Irrisafe and EDDY groups was insignificant.
Irrigant activation improves anastomosis cleanliness. EDDY was the most efficient in cleaning anastomoses located in the critical apical part of the root canal.
Cleaning and disinfection of the root canal system followed by apical and coronal sealing is the key for healing or prevention of apical periodontitis. Remnants of debris and microorganisms retained within the anastomoses (isthmuses), or other root canal irregularities may lead to persistent apical periodontitis. Proper irrigation and activation are essential for cleaning root canal anastomoses.
本研究比较了不同冲洗激活技术在不同水平下对吻合口清洁效果的差异，对照组为非激活（NA），使用 Irrisafe 的被动超声冲洗（PUI）和 EDDY 超声激活。
将 60 个下颌磨牙近中根的吻合口包含在树脂中，从根尖 2、4 和 6mm 处进行切割。然后重新组装并安装在铜立方体内。对于冲洗技术，将根随机分为 3 组（n=20）：组 1：NA，组 2：Irrisafe，组 3：EDDY。在器械处理后和冲洗剂激活后，对吻合口进行立体显微镜检查。使用 ImageJ 程序计算吻合口清洁度的百分比。在每组内比较每组内最后冲洗前后的清洁度百分比，并使用配对 t 检验进行比较。通过单向方差分析和事后检验（p<0.05），对不同激活技术在相同根管水平（2、4 和 6mm）（组间）之间进行组间和组内分析，以评估每种技术是否根据根管水平（组内）具有不同的清洁效果。
所有三种冲洗技术均显著提高了吻合口清洁度（p<0.001）。两种激活技术在所有水平上均明显优于对照组。组间比较显示，EDDY 总体上显著达到最佳吻合口清洁度。EDDY 与 Irrisafe 之间的差异在 2mm 时具有统计学意义，在 4mm 和 6mm 时无统计学意义。组内比较显示，在无激活的针状冲洗组（NA）中，吻合口清洁度（i2-i1）的改善在根尖 2mm 水平明显高于 4 和 6mm 水平。而 Irrisafe 和 EDDY 组之间在各个水平上的吻合口清洁度改善（i2-i1）之间的差异无统计学意义。
冲洗剂激活可提高吻合口清洁度。EDDY 是清洁位于根管根尖关键部位吻合口最有效的方法。
清洁和消毒根管系统，然后进行根尖和冠部密封，是愈合或预防根尖周炎的关键。残留在吻合口（峡部）内的碎屑和微生物，或其他根管不规则处可能导致持续的根尖周炎。适当的冲洗和激活对于清洁根管吻合口是必要的。
