Tiscareño Alissa, Ortolani-Seltenerich P S, Ramírez-Muñoz Ana, Pérez-Ron Omar, Mendez S Pedro M, Leal-Moya Carmen, Malvicini Giulia, Vieira Gaya C S, Pérez Alejandro R
Centro Universitario de los Altos, Guadalajara University, Tepatitlán 47600, Mexico.
Department of Dental Pathology and Therapeutics, Faculty of Dentistry, UCAM, 30107 Murcia, Spain.
Dent J (Basel). 2025 Apr 27;13(5):192. doi: 10.3390/dj13050192.
This study aimed to evaluate the efficacy of cleaning in minimally shaped mesial and oval distal canals of 3D models of mandibular molars, focusing on positive pressure irrigation, wireless and conventional passive ultrasonic irrigation (PUI), and diode laser (DL) at 980 nm. Forty-four 3D-printed resin models, based on eleven natural mandibular molars (each with mesial and distal canals), were divided into four groups ( = 11 per group) to evaluate different irrigation methods. A total of 22 mesial canals (size 20/.04) and 11 oval distal canals (size 25/.04) were analyzed per group. Each root canal was uniformly filled with an artificial hydrogel to simulate a biofilm mixture. Following this preparation, the specified irrigation techniques were applied to the respective groups. Quantitative evaluations of pre- and post-irrigation images were performed to assess the efficiency of tissue removal along the entire length of the canal and in the apical, middle, and coronal thirds. The findings revealed no significant differences in the initial amount of tissue between the samples, indicating uniform filling. In the apical region of mesial canals, conventional PUI showed the highest cleaning efficiency (14.1% residual tissue), significantly outperforming the other methods ( < 0.05). Cordless PUI and DL also surpassed positive pressure irrigation, leaving 30.4% and 29.3% residual tissue, respectively, compared to 42.2% with positive pressure. In the middle third, all methods tested performed better than needle irrigation ( < 0.05), but there were no significant differences in the coronal third or over the full canal length. Distal oval canals showed no significant differences in cleaning effectiveness among methods. Although no single method was superior regarding the full canal length, supplementary techniques such as PUI and DL offer potential benefits over conventional irrigation methods, particularly in the apical third of the canal. Complementary approaches such as conventional PUI and diode laser at 980 nm showed superior cleaning efficiency, particularly in the apical third. These results suggest their integration could improve the effectiveness of cleaning in minimally instrumented mesial canals.
本研究旨在评估在下颌磨牙三维模型的近中根管呈最小形态且远中根管呈椭圆形的情况下，清洁的效果，重点关注正压冲洗、无线和传统被动超声冲洗（PUI）以及980纳米二极管激光（DL）。基于11颗天然下颌磨牙（每颗有近中根管和远中根管）制作的44个3D打印树脂模型被分为四组（每组n = 11），以评估不同的冲洗方法。每组共分析22个近中根管（20/.04号）和11个椭圆形远中根管（25/.04号）。每个根管均均匀填充人工水凝胶以模拟生物膜混合物。在此准备之后，将特定的冲洗技术应用于相应组。对冲洗前后的图像进行定量评估，以评估沿根管全长以及根尖、根管中部和冠部三分之一处组织清除的效率。研究结果显示，样本之间初始组织量无显著差异，表明填充均匀。在近中根管的根尖区域，传统PUI显示出最高的清洁效率（残留组织14.1%），显著优于其他方法（P < 0.05）。无线PUI和DL也超过了正压冲洗，分别留下30.4%和29.3%的残留组织，而正压冲洗为42.2%。在根管中部三分之一处，所有测试方法均比针管冲洗效果更好（P < 0.05），但在冠部三分之一处或整个根管长度上无显著差异。远中椭圆形根管在不同方法之间的清洁效果无显著差异。尽管在整个根管长度上没有单一方法具有优越性，但PUI和DL等辅助技术相对于传统冲洗方法具有潜在优势，尤其是在根管的根尖三分之一处。传统PUI和980纳米二极管激光等互补方法显示出更高的清洁效率，尤其是在根尖三分之一处。这些结果表明，它们的结合可以提高在最少预备的近中根管中的清洁效果。
