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EDDY, Endoaktivatör, Ultrasonik İrrigasyon ve Manuel Dinamik Aktivasyonun Apikalden Çıkan Debris Miktarına Etkisi

Year 2025, Volume: 35 Issue: 1, 36 - 40, 20.01.2025
https://doi.org/10.17567/currresdentsci.1437596

Abstract

Amaç : Bu çalışmanın amacı, farklı irrigasyon aktivasyon tekniklerinin apikalden ekstrüze olan debris miktarına etkisini incelemektir.
Yöntemler : Yetmiş adet çekilmiş mandibular molar dişin mesial kökleri çalışmaya dahil edildi. Mesiobukkal kökler, resiprokal hareketle çalışan eğe sistemi ile 40/06 boyutunda prepare edildi ve final irrigasyon aktivasyon tekniklerine göre beş gruba ayrıldı: EDDY, Endoaktivatör (EA), ultrasonik irrigasyon (UI), manuel dinamik aktivasyon (MDA) ve iğneli irrigasyon (NI). Ekstrüze debris Eppendorf tüplerine toplandı ve eppendorf tüpleri beş gün boyunca 70 °C'de bir inkübatörde bekletildi. İstatistiksel analiz için Kruskal-Wallis testi kullanıldı. (p = 0.05).
Bulgular : EDDY ve EA, diğer aktivasyon tekniklerine göre önemli ölçüde daha fazla debris ekstrüzyonuna neden oldu (p<0.05). EDDY ve EA arasında istatistiksel olarak anlamlı bir fark yoktu (p>0.05). En az debris ekstrüzyonu NI’da gözlendi ancak PUI, MDA ve NI arasında istatistiksel bir fark yoktu (p>0.05).
Sonuç : EDDY ve EA, diğer gruplara göre daha yüksek derecede apikal debris ekstrüzyonuna neden oldu.

Project Number

none

References

  • 1. Peters OA, Schönenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J. 2001;34(3):221-230. doi:10.1046/J.1365-2591.2001.00373.X
  • 2. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J. 2010;43(8):663-672. doi:10.1111/J.1365-2591.2010.01723.X
  • 3. Malentacca A, Uccioli U, Mannocci F, et al. The comparative effectiveness and safety of three activated irrigation techniques in the isthmus area using a transparent tooth model. Int Endod J. 2018;51 Suppl 1:e35-e41. doi:10.1111/IEJ.12748
  • 4. Caron G, Nham K, Bronnec F, MacHtou P. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod. 2010;36(8):1361-1366. doi:10.1016/J.JOEN.2010.03.037
  • 5. Rodríguez-Figueroa C, McClanahan SB, Bowles WR. Spectrophotometric determination of irrigant extrusion using passive ultrasonic irrigation, EndoActivator, or syringe irrigation. J Endod. 2014;40(10):1622-1626. doi:10.1016/J.JOEN.2014.03.017
  • 6. Van Der Sluis LWM, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007;40(6):415-426. doi:10.1111/J.1365-2591.2007.01243.X
  • 7. Garcia A, Fernandez R, Arias A, de Gregorio C. Efficacy of Different Irrigation Protocols for Removing Gutta-Percha and Sealer Remnants in Artificial Un-instrumented Areas. Eur Endod J. 2017;2(1). doi:10.5152/EEJ.2017.16033
  • 8. Neelakantan P, Devaraj S, Jagannathan N. Histologic Assessment of Debridement of the Root Canal Isthmus of Mandibular Molars by Irrigant Activation Techniques Ex Vivo. J Endod. 2016;42(8):1268-1272. doi:10.1016/J.JOEN.2016.05.005
  • 9. McGill S, Gulabivala K, Mordan N, Ng YL. The efficacy of dynamic irrigation using a commercially available system (RinsEndo) determined by removal of a collagen “bio-molecular film” from an ex vivo model. Int Endod J. 2008;41(7):602-608. doi:10.1111/J.1365-2591.2008.01408.X
  • 10. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009;35(4):545-549.
  • 11. Farmakis ETR, Palamidakis FD, Skondra FG, Nikoloudaki G, Pantazis N. Emergency care provided in a Greek dental school and analysis of the patients’ demographic characteristics: a prospective study. Int Dent J. 2016;66(5):280-286. doi:10.1111/IDJ.12245
  • 12. Haupt F, Meinel M, Gunawardana A, Hülsmann M. Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: a SEM evaluation. Aust Endod J. 2020;46(1):40-46. doi:10.1111/AEJ.12342
  • 13. Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A. Antibacterial Efficacy of a New Sonic Irrigation Device for Root Canal Disinfection. J Endod. 2016;42(12):1799-1803. doi:10.1016/J.JOEN.2016.08.024
  • 14. Mitchell RP, Baumgartner JC, Sedgley CM. Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod. 2011;37(12):1677-1681. doi:10.1016/J.JOEN.2011.09.004
  • 15. Kusxtarci A, Er K. Efficacy of Laser Activated Irrigation on Apically Extruded Debris with Different Preparation Systems. Photomed Laser Surg. 2015;33(7):384-389. doi:10.1089/PHO.2015.3900
  • 16. Nagendrababu V, Murray PE, Ordinola-Zapata R, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: A consensus-based development. Int Endod J. 2021;54(9):1482-1490. doi:10.1111/IEJ.13542
  • 17. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-275. doi:10.1016/0030-4220(71)90230-1
  • 18. Karatas E, Ozsu D, Arslan H, Erdogan AS. Comparison of the effect of nonactivated self-adjusting file system, Vibringe, EndoVac, ultrasonic and needle irrigation on apical extrusion of debris. Int Endod J. 2015;48(4):317-322. doi:10.1111/IEJ.12317
  • 19. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275-279. doi:10.1016/S0099-2399(06)81866-2
  • 20. Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent. 2023;26(1):31-35. doi:10.4103/JCD.JCD_378_22
  • 21. Siqueira JF, Rôças IN, Santos SRLD, Lima KC, Magalhães FAC, De Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002;28(3):181-184. doi:10.1097/00004770-200203000-00009
  • 22. İnce Yusufoglu S, Keskin NB, Saricam E, Bozkurt DA. Comparison of apical debris extrusion using EDDY, passive ultrasonic activation and photon-initiated photoacoustic streaming irrigation activation devices. Aust Endod J. 2020;46(3):400-404. doi:10.1111/AEJ.12429
  • 23. Al-Jadaa A, Saidi Z, Mahmoud M, Al-Taweel R, Zehnder M. Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems. J Endod. 2023;49(4):438-444.e6. doi:10.1016/J.JOEN.2023.01.002
  • 24. Pedullà E, Iacono F, Pitrolo M, Barbagallo G, La Rosa GRM, Pirani C. Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment. Aust Endod J. Published online September 5, 2023. doi:10.1111/AEJ.12795
  • 25. Gu L sha, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35(6):791-804. doi:10.1016/J.JOEN.2009.03.010
  • 26. Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J. 2014;47(5):487-496. doi:10.1111/IEJ.12176
  • 27. Shetty V, Naik B, Pachlag A, Yeli M. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: An in vitro study. J Conserv Dent. 2017;20(6):411-414. doi:10.4103/JCD.JCD_200_17
  • 28. İnce-Yusufoğlu S, Keskin NB, Uslu G, Helvacioglu-Yigit D. Effect of EDDY and manual dynamic activation techniques on postoperative pain in non-surgical retreatment: a randomized controlled trial. BMC Oral Health. 2023;23(1). doi:10.1186/S12903-022-02702-4
  • 29. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J. 2014;47(3):211-221. doi:10.1111/IEJ.12137
  • 30. Al Omari T, El-Farraj H, Arıcan B, Atav Ateş A. Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. Aust Endod J. 2022;48(2):245-250. doi:10.1111/AEJ.12540
  • 31. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275-279. doi:10.1016/S0099-2399(06)81866-2
  • 32. Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4). doi:10.1016/J.TRIPLEO.2011.03.044
  • 33. Karataslioglu E, Arslan H, Er G, Avci E. Influence of canal curvature on the amount of apically extruded debris determined by using three-dimensional determination method. Aust Endod J. 2019;45(2):216-224. doi:10.1111/AEJ.12311
  • 34. Peeters HH, Suardita K, Mooduto L, Gutknecht N. Extrusion of Irrigant in Open Apex Teeth with Periapical Lesions Following Laser-Activated Irrigation and Passive Ultrasonic Irrigation. Iran Endod J. 2018;13(2):169-175. doi:10.22037/IEJ.V13I2.17150
  • 35. Bürklein S, Hinschitza K, Dammaschke T, Schäfer E. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J. 2012;45(5):449-461. doi:10.1111/J.1365-2591.2011.01996.X

Comparison of Apical Debris Extrusion Using EDDY, EndoActivator, Ultrasonic Irrigation and Manual Dynamic Agitation

Year 2025, Volume: 35 Issue: 1, 36 - 40, 20.01.2025
https://doi.org/10.17567/currresdentsci.1437596

Abstract

Objective: This study was aimed to determine the amount of apically extruded debris using different final irrigation activation techniques.
Methods: The mesial roots of 70 extracted mandibular molar teeth were included. The mesiobuccal roots were instrumented to size 40/.06 with a reciprocal system file and divided into five groups according to the final irrigation activation technique used: EDDY, EndoActivator (EA), passive ultrasonic irrigation (PUI), manual dynamic agitation (MDA) or needle irrigation (NI). The extruded debris was collected in Eppendorf tubes and stored in an incubator at 70°C for 5 days. The results were analysed using the Kruskal–Wallis test (P=.05).
Results: EDDY and the EA caused significantly more apical debris extrusion (P < .05). There were no statistically significant differences between EDDY and the EA (P > .05). NI caused less extrusion, but there were no statistically significant differences between PUI, MDA and NI (P > .05).
Conclusion: EDDY and the EA were associated with significantly higher apical extrusion debris extrusion.
Keywords: debris extrusion, EDDY, Endoactivator, irrigation activation, manual dynamic agitation, ultrasonic irrigation.

Ethical Statement

Ethics committee approval was obtained from XXXXX University Local Ethics Committee (Date: 26.01.2022, Number: 2022-03/22)

Supporting Institution

none

Project Number

none

Thanks

none

References

  • 1. Peters OA, Schönenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J. 2001;34(3):221-230. doi:10.1046/J.1365-2591.2001.00373.X
  • 2. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J. 2010;43(8):663-672. doi:10.1111/J.1365-2591.2010.01723.X
  • 3. Malentacca A, Uccioli U, Mannocci F, et al. The comparative effectiveness and safety of three activated irrigation techniques in the isthmus area using a transparent tooth model. Int Endod J. 2018;51 Suppl 1:e35-e41. doi:10.1111/IEJ.12748
  • 4. Caron G, Nham K, Bronnec F, MacHtou P. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod. 2010;36(8):1361-1366. doi:10.1016/J.JOEN.2010.03.037
  • 5. Rodríguez-Figueroa C, McClanahan SB, Bowles WR. Spectrophotometric determination of irrigant extrusion using passive ultrasonic irrigation, EndoActivator, or syringe irrigation. J Endod. 2014;40(10):1622-1626. doi:10.1016/J.JOEN.2014.03.017
  • 6. Van Der Sluis LWM, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007;40(6):415-426. doi:10.1111/J.1365-2591.2007.01243.X
  • 7. Garcia A, Fernandez R, Arias A, de Gregorio C. Efficacy of Different Irrigation Protocols for Removing Gutta-Percha and Sealer Remnants in Artificial Un-instrumented Areas. Eur Endod J. 2017;2(1). doi:10.5152/EEJ.2017.16033
  • 8. Neelakantan P, Devaraj S, Jagannathan N. Histologic Assessment of Debridement of the Root Canal Isthmus of Mandibular Molars by Irrigant Activation Techniques Ex Vivo. J Endod. 2016;42(8):1268-1272. doi:10.1016/J.JOEN.2016.05.005
  • 9. McGill S, Gulabivala K, Mordan N, Ng YL. The efficacy of dynamic irrigation using a commercially available system (RinsEndo) determined by removal of a collagen “bio-molecular film” from an ex vivo model. Int Endod J. 2008;41(7):602-608. doi:10.1111/J.1365-2591.2008.01408.X
  • 10. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009;35(4):545-549.
  • 11. Farmakis ETR, Palamidakis FD, Skondra FG, Nikoloudaki G, Pantazis N. Emergency care provided in a Greek dental school and analysis of the patients’ demographic characteristics: a prospective study. Int Dent J. 2016;66(5):280-286. doi:10.1111/IDJ.12245
  • 12. Haupt F, Meinel M, Gunawardana A, Hülsmann M. Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: a SEM evaluation. Aust Endod J. 2020;46(1):40-46. doi:10.1111/AEJ.12342
  • 13. Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A. Antibacterial Efficacy of a New Sonic Irrigation Device for Root Canal Disinfection. J Endod. 2016;42(12):1799-1803. doi:10.1016/J.JOEN.2016.08.024
  • 14. Mitchell RP, Baumgartner JC, Sedgley CM. Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod. 2011;37(12):1677-1681. doi:10.1016/J.JOEN.2011.09.004
  • 15. Kusxtarci A, Er K. Efficacy of Laser Activated Irrigation on Apically Extruded Debris with Different Preparation Systems. Photomed Laser Surg. 2015;33(7):384-389. doi:10.1089/PHO.2015.3900
  • 16. Nagendrababu V, Murray PE, Ordinola-Zapata R, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: A consensus-based development. Int Endod J. 2021;54(9):1482-1490. doi:10.1111/IEJ.13542
  • 17. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-275. doi:10.1016/0030-4220(71)90230-1
  • 18. Karatas E, Ozsu D, Arslan H, Erdogan AS. Comparison of the effect of nonactivated self-adjusting file system, Vibringe, EndoVac, ultrasonic and needle irrigation on apical extrusion of debris. Int Endod J. 2015;48(4):317-322. doi:10.1111/IEJ.12317
  • 19. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275-279. doi:10.1016/S0099-2399(06)81866-2
  • 20. Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent. 2023;26(1):31-35. doi:10.4103/JCD.JCD_378_22
  • 21. Siqueira JF, Rôças IN, Santos SRLD, Lima KC, Magalhães FAC, De Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002;28(3):181-184. doi:10.1097/00004770-200203000-00009
  • 22. İnce Yusufoglu S, Keskin NB, Saricam E, Bozkurt DA. Comparison of apical debris extrusion using EDDY, passive ultrasonic activation and photon-initiated photoacoustic streaming irrigation activation devices. Aust Endod J. 2020;46(3):400-404. doi:10.1111/AEJ.12429
  • 23. Al-Jadaa A, Saidi Z, Mahmoud M, Al-Taweel R, Zehnder M. Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems. J Endod. 2023;49(4):438-444.e6. doi:10.1016/J.JOEN.2023.01.002
  • 24. Pedullà E, Iacono F, Pitrolo M, Barbagallo G, La Rosa GRM, Pirani C. Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment. Aust Endod J. Published online September 5, 2023. doi:10.1111/AEJ.12795
  • 25. Gu L sha, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35(6):791-804. doi:10.1016/J.JOEN.2009.03.010
  • 26. Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J. 2014;47(5):487-496. doi:10.1111/IEJ.12176
  • 27. Shetty V, Naik B, Pachlag A, Yeli M. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: An in vitro study. J Conserv Dent. 2017;20(6):411-414. doi:10.4103/JCD.JCD_200_17
  • 28. İnce-Yusufoğlu S, Keskin NB, Uslu G, Helvacioglu-Yigit D. Effect of EDDY and manual dynamic activation techniques on postoperative pain in non-surgical retreatment: a randomized controlled trial. BMC Oral Health. 2023;23(1). doi:10.1186/S12903-022-02702-4
  • 29. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J. 2014;47(3):211-221. doi:10.1111/IEJ.12137
  • 30. Al Omari T, El-Farraj H, Arıcan B, Atav Ateş A. Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. Aust Endod J. 2022;48(2):245-250. doi:10.1111/AEJ.12540
  • 31. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275-279. doi:10.1016/S0099-2399(06)81866-2
  • 32. Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4). doi:10.1016/J.TRIPLEO.2011.03.044
  • 33. Karataslioglu E, Arslan H, Er G, Avci E. Influence of canal curvature on the amount of apically extruded debris determined by using three-dimensional determination method. Aust Endod J. 2019;45(2):216-224. doi:10.1111/AEJ.12311
  • 34. Peeters HH, Suardita K, Mooduto L, Gutknecht N. Extrusion of Irrigant in Open Apex Teeth with Periapical Lesions Following Laser-Activated Irrigation and Passive Ultrasonic Irrigation. Iran Endod J. 2018;13(2):169-175. doi:10.22037/IEJ.V13I2.17150
  • 35. Bürklein S, Hinschitza K, Dammaschke T, Schäfer E. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J. 2012;45(5):449-461. doi:10.1111/J.1365-2591.2011.01996.X
There are 35 citations in total.

Details

Primary Language English
Subjects Endodontics
Journal Section Research Articles
Authors

Meltem Sümbüllü 0000-0002-2647-7988

Mine Büker 0000-0003-4833-4547

Oğuzhan Ünal 0000-0001-6709-7837

Mirze Muhammet Özen 0009-0008-5675-7287

Project Number none
Publication Date January 20, 2025
Submission Date February 15, 2024
Acceptance Date April 17, 2024
Published in Issue Year 2025 Volume: 35 Issue: 1

Cite

AMA Sümbüllü M, Büker M, Ünal O, Özen MM. Comparison of Apical Debris Extrusion Using EDDY, EndoActivator, Ultrasonic Irrigation and Manual Dynamic Agitation. Curr Res Dent Sci. January 2025;35(1):36-40. doi:10.17567/currresdentsci.1437596

Current Research in Dental Sciences is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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