Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;49(1):56-65.
doi: 10.1111/aej.12646. Epub 2022 Jun 30.

Root canal cleaning in roots with complex canals using agitated irrigation fluids

Kiran Kumar  1 , Yu-Yao Teoh  1 , Laurence J Walsh  1
Affiliations

Root canal cleaning in roots with complex canals using agitated irrigation fluids

Kiran Kumar et al. Aust Endod J. 2023 Apr.

Abstract

The internal topography of the root canal is complex, especially for the mesial root of the permanent first molar. In response to such challenges, enhanced irrigation protocols have been developed, using laser pulses to agitate fluids and enhance the removal of microbial deposits. The aim of this laboratory study was to assess the effectiveness of laser agitation of sodium hypochlorite in removing multispecies biofilms grown in the mesial root of the permanent first molars. The five agitation groups (N = 12 roots for each) were: 940 nm diode laser (superpulsed mode, 50 μs/pulses at 20 Hz using 20 mJ/pulse); 1064 nm Nd: YAG laser (200 μs/pulse at 20 Hz using 20 mJ/pulse); 2940 nm Er: YAG laser (50 μs/pulse at 15 Hz using a 400/14 conical tip in the SWEEPS protocol, with 20 mJ/pulse); passive ultrasonic agitation at 28 kHz (positive control); and irrigation with a 27-gauge side vented needle for 2 min per canal (negative control). Biofilm removal was assessed by confocal microscopic imaging of root slices at 1, 4 and 7 mm from the root apex. None of the tested methods were effective in completely eradicating biofilm from the most confined regions of the root canal system. The greatest challenge was cleaning the isthmus regions. There was a positive correlation between canal cleaning and isthmus cleaning, suggesting that increased effectiveness in cleaning root canal walls is associated with more effective isthmus cleaning. Wider and narrow isthmuses were cleaned better than long and narrow isthmuses.

Keywords: agitation; biofilm; irrigation; isthmus; laser; sodium hypochlorite.

PubMed Disclaimer

References

REFERENCES

    1. Nair PNR. Light and electron microscopic studies of root canal flora and periapical lesions. J Endod. 1987;13(1):29-39.
    1. Carr GB, Schwartz RS, Schaudinn C, Gorur A, Costerton JW. Ultrastructural examination of failed molar retreatment with secondary apical periodontitis: an examination of endodontic biofilms in an endodontic retreatment failure. J Endod. 2009;35(9):1303-9.
    1. Tsesis I, Elbahary S, Venezia NB, Rosen E. Bacterial colonization in the apical part of extracted human teeth following root-end resection and filling: a confocal laser scanning microscopy study. Clin Oral Investig. 2018;22(1):267-74.
    1. Iqbal M, Chan S, Ku J. Relative frequency of teeth needing conventional and surgical endodontic treatment in patients treated at a graduate endodontic clinic - a Penn Endo database study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(1):e62-7.
    1. de Pablo OV, Estevez R, Sanchez MP, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod. 2010;36(12):1919-31.

LinkOut - more resources