Liu Chun-Hui, Li Qiang, Zou Xiao-Ying, Yue Lin
First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
PeerJ. 2025 May 12;13:e19445. doi: 10.7717/peerj.19445. eCollection 2025.
Infection control is important in root canal treatment. Effective cleaning and shaping are challenging due to complex anatomy, particularly in the isthmus-narrow connections between canals that can harbor bacteria. Conventional needle irrigation (CNI) is inadequate in this region, prompting the use of passive ultrasonic irrigation (PUI) and high-frequency acoustic instruments like EDDY. This study evaluates the cleaning effects of four irrigation protocols using 3D-printed isthmus models.
Sixty digital root canal models with isthmuses in the coronal, middle, and apical thirds were designed using Ansys 19.0 and 3D printer (20 specimens per isthmus location). Specimens were prepared to 30#, 0.04 without irrigation. Debris accumulation in the isthmus was photographed and analyzed using Image J to calculate the initial debris area (S1). Specimens were then irrigated using CNI, low-frequency sonic irrigation (EndoActivator, EA; Dentsply, Charlotte, NC, USA), PUI, or high-frequency sonic irrigation (EDDY), followed by re-imaging to calculate remaining debris area (S2). Debris reduction percentage was determined using the formula: (S1-S2)/S1 × 100%.
Debris reduction varied with isthmus position. In the coronal third, EDDY achieved the highest debris reduction (86.18 ± 2.25%), followed by PUI, EA, and CNI, with significant differences among groups ( < 0.05). The same trend was observed in the middle third, with EDDY showing the highest efficacy (73.96 ± 6.75%). In the apical third, debris reduction was lower overall, with no significant difference between EDDY and PUI, but both outperformed EA and CNI.
Our results showed that EDDY demonstrated superior debris removal in the coronal and middle thirds, but all irrigation protocols showed limited efficacy in the apical third.
感染控制在根管治疗中很重要。由于根管解剖结构复杂，尤其是在可能藏有细菌的根管峡部狭窄连接处，有效的清洁和塑形具有挑战性。传统的针管冲洗（CNI）在该区域效果不佳，促使人们使用被动超声冲洗（PUI）以及如EDDY等高频声学器械。本研究使用3D打印的峡部模型评估四种冲洗方案的清洁效果。
使用Ansys 19.0和3D打印机设计了60个在冠部、中部和根尖三分之一处有峡部的数字根管模型（每个峡部位置20个样本）。样本预备至30#，0.04，未进行冲洗。对峡部的碎屑堆积情况进行拍照，并使用Image J进行分析以计算初始碎屑面积（S1）。然后对样本分别使用CNI、低频声波冲洗（EndoActivator，EA；美国北卡罗来纳州夏洛特市登士柏公司）、PUI或高频声波冲洗（EDDY）进行冲洗，随后再次成像以计算剩余碎屑面积（S2）。使用公式：(S1 - S2)/S1×100%确定碎屑减少百分比。
碎屑减少情况因峡部位置而异。在冠部三分之一处，EDDY的碎屑减少率最高（86.18±2.25%），其次是PUI、EA和CNI，各组间差异有统计学意义（<0.05）。在中部三分之一处观察到相同趋势，EDDY显示出最高疗效（73.96±6.75%）。在根尖三分之一处，总体碎屑减少率较低，EDDY和PUI之间无显著差异，但二者均优于EA和CNI。
我们的结果表明，EDDY在冠部和中部三分之一处的碎屑清除效果更佳，但所有冲洗方案在根尖三分之一处的疗效均有限。
