Root Canal Debridement Efficacy of Heated Sodium Hypochlorite in Conjunction with Passive Ultrasonic Agitation: An Ex Vivo Study

Abstract

Objective: The study aims to investigate the endodontic debridement efficacy of the different sodium hypochlorite (NaOCl) irrigation regimens with and without ultrasonic agitation followed by ethylenediaminetetraacetic acid (EDTA) via scanning electron microscope (SEM) after the rotary instrumentation system. Methods: Single-rooted teeth (n=50) were randomly divided into 5 experimental groups (n=10) and root canals were prepared with ProTaper Universal rotary system up to F3. The root canal system was treated with intracanal heated (100°C) NaOCl or preheated (55°C) NaOCl followed by ultrasonic agitation and EDTA treatment. Samples irrigated with conventional needle irrigation using normal saline were used as controls. Debridement efficacy was analyzed by scanning electron microscope (SEM). A five-point scale was used to estimate the presence/absence of debris for each canal segment (coronal, middle, and apical). Data were analyzed using One-Way ANOVA and post-hoc Tukey tests (P<0.05). Results: All experimental groups had less debris than the control (P<0.05). The amount of debris decreased significantly for the group with NaOCl intracanal heating compared to extraoral heating. The ultrasonic agitation further enhanced the root canal debridement efficacy of NaOCl. Conclusion: In summary, with and without ultrasonic agitation of the intracanal heated NaOCl followed by EDTA appears to be very promising in eliminating debris from the root canal system.

Keywords: Intracanal heating, Irrigation, Root canal irrigant, Sodium hypochlorite, Ultrasonic agitation