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Randomized Controlled Trial
. 2024 Jun 15;28(7):376.
doi: 10.1007/s00784-024-05758-4.

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial

Mehmet Umutcan Doğan  1 , Banu Arıcıoğlu  2 , Taha Emre Köse  1 , Ahter Şanal Çıkman  1 , Merve Çoban Öksüzer  3
Affiliations
Randomized Controlled Trial

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial

Mehmet Umutcan Doğan et al. Clin Oral Investig. .

Abstract

Objectives: The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment.

Materials and methods: A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone-beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven's criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05.

Results: In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were 'totally healed', and 39 teeth were 'reduced' on PA radiographs. No 'enlargement' was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05).

Conclusions: Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems.

Clinical relevance: In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.

Keywords: CBCT; Irrigation agitation; LAI; PUI; Periapical healing; SWEEPS.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Consolidated Standards of Reporting Trials (CONSORT) flow diagram for patients included in this study
Fig. 2
Fig. 2
Staining of the patient’s lesion in the ITK SNAP program and obtaining a 3D image
See this image and copyright information in PMC

References

    1. Ricucci D, Siqueira JF Jr. (2010) Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod 36(8):1277–1288 - PubMed
    1. Peters OA, Schönenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34(3):221–230 - PubMed
    1. Basrani B (2011) Irrigation in endodontic treatment. Alpha Omegan 104(1–2):18–25 - PubMed
    1. de Gregorio C et al (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36(7):1216–1221 - PubMed
    1. Gu L-s et al (2009) Review of Contemporary Irrigant Agitation techniques and devices. J Endod 35(6):791–804 - PubMed

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