Addokhi Ali, Rahoma Ahmed, Hanna Neveen M A, Alonaizan Faisal, Farooqi Faraz, Rifaat Shimaa
Endodontic Fellowship Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Dent J (Basel). 2025 Jun 29;13(7):295. doi: 10.3390/dj13070295.
Successful root canal therapy relies on thorough cleaning and disinfection to eliminate microorganisms and residual pulp tissue. Advanced irrigation activation techniques, including Sonic, Ultrasonic, and Diode Laser activation, have improved cleaning efficacy, bacterial reduction, smear layer removal, and irrigant hydrodynamics. On the other hand, these irrigation activation techniques may lead to a temperature rise that may risk the surrounding periodontal tissue. Thus, this study aimed to investigate the temperature rise during different irrigation activation techniques at various time intervals and evaluate the efficacy of these techniques in removing biofilm-mimicking hydrogel BMH of a simulated root canal system in 3D-printed tooth models. Ten extracted human mandibular premolars, prepared to size 40/0.04 taper, and a hundred 3D-printed resin premolars with simulated main (0.25 mm) and lateral canals (0.15 mm at 3, 7, 11 mm from apex) were used; 50 of them were filled with biofilm-mimicking hydrogel (BMH). Five irrigation activation techniques were evaluated: Diode Laser, Ultrasonic, Sonic, XP-Finisher, and Control ( = 10). Temperature rises were measured on the extracted premolars after 30 and 60 s of activation using a thermographic camera in a controlled environment (23 ± 2 °C). Irrigant penetration, with and without BMH, was assessed in 3D-printed premolars using a 2.5% sodium hypochlorite-contrast medium mixture, visualized with a CMOS radiographic sensor. Penetration was scored (main canal: 3 points; lateral canals: 0-2 points) and analyzed with non-parametric tests. Diode Laser activation technique resulted in the highest temperature rise on the external root surface, followed by the Ultrasonic, with no statistically significant difference observed among the remaining groups. In terms of efficacy, Ultrasonic and Sonic activation achieved significantly greater irrigant penetration in samples without BMH, and greater BMH removal in samples with BMH, compared to Diode Laser, XP-Finisher, and Control groups. In this in vitro study, Diode Laser caused the highest temperature rise, followed by Ultrasonic, with significant increases from 30 to 60 s. Temperature rise did not significantly affect penetration or BMH removal. Ultrasonic and Sonic irrigation techniques achieved the highest depth of penetration (without BMH) and biofilm-mimicking Hydrogel removal (with BMH) compared to Diode Laser, XP-Finisher, and Control.
成功的根管治疗依赖于彻底的清洁和消毒，以消除微生物和残留牙髓组织。先进的冲洗激活技术，包括声波、超声波和二极管激光激活，提高了清洁效果、细菌减少、玷污层去除和冲洗液流体动力学。另一方面，这些冲洗激活技术可能导致温度升高，这可能会对周围的牙周组织造成风险。因此，本研究旨在调查不同冲洗激活技术在不同时间间隔内的温度升高情况，并评估这些技术在去除3D打印牙齿模型中模拟根管系统的生物膜模拟水凝胶（BMH）方面的效果。使用了10颗拔除的人类下颌前磨牙，预备至40/0.04锥度，以及100颗3D打印的树脂前磨牙，带有模拟的主根管（0.25毫米）和侧支根管（距根尖3、7、11毫米处为0.15毫米）；其中50颗填充有生物膜模拟水凝胶（BMH）。评估了五种冲洗激活技术：二极管激光、超声波、声波、XP-Finisher和对照组（每组n = 10）。在受控环境（23±2°C）中，使用热成像相机在激活30秒和60秒后测量拔除前磨牙的温度升高。使用2.5%次氯酸钠-造影剂混合物评估3D打印前磨牙中有无BMH时冲洗液的渗透情况，用CMOS射线传感器进行可视化。对渗透情况进行评分（主根管：3分；侧支根管：0 - 2分），并采用非参数检验进行分析。二极管激光激活技术导致牙根外表面温度升高最高，其次是超声波，其余组之间未观察到统计学显著差异。在效果方面，与二极管激光、XP-Finisher和对照组相比，超声波和声波激活在无BMH的样本中实现了显著更大的冲洗液渗透，在有BMH的样本中实现了更大的BMH去除。在这项体外研究中，二极管激光导致的温度升高最高，其次是超声波，从30秒到60秒有显著升高。温度升高并未显著影响渗透或BMH去除。与二极管激光、XP-Finisher和对照组相比，超声波和声波冲洗技术实现了最高的渗透深度（无BMH）和生物膜模拟水凝胶去除（有BMH）。
