Effectiveness of Various Final Irrigation Techniques on Sealer Penetration in Curved Roots: A Confocal Laser Scanning Microscopy Study

Abstract

Objective: To compare the efficacy of various techniques used for final irrigation on sealer penetration in the apical one-third of curved root canals. Material and Methods. Sixty-five freshly extracted maxillary first molar teeth with mesiobuccal roots having more than 20° of root curvature were used. The root canals were instrumented and randomly divided into four experimental groups and one control group. In the 4 experimental groups, 3 ml of 17% EDTA followed by 3 ml of 5.25% NaOCl was delivered with the use of the following protocols: Group 1: manual dynamic activation (MDA), Group 2: sonic irrigation (SI), Group 3: passive ultrasonic irrigation (PUI), and Group 4: conventional needle irrigation (CI). All teeth were obturated with gutta-percha and AH Plus sealer labeled with fluorescent dye. Transverse sections at 2 mm and 4 mm distance from the root apex were examined with the aid of confocal laser scanning microscopy. Total percentage (%) and maximum depth (μm) of sealer penetration were measured.

Results: All the experimental groups exhibited significantly higher penetration rates than the control group at both sections (p < 0.05). However, no significant differences were found in the penetration depth and percentage among the four experimental groups evaluated at both sections (p > 0.05).

Conclusion: PUI, SI, and MDA did not significantly improve sealer penetration in the apical portion of curved root canals when compared to conventional needle irrigation.

Figure 1

The confocal laser scanning microscopic images from selected samples at the 2 and 4 mm sections representing different irrigation methods.