Top

Published in:

01-03-2018 | Review

Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies

Authors: Venkateshbabu Nagendrababu, Jayakumar Jayaraman, Anand Suresh, Senthilnayagam Kalyanasundaram, Prasanna Neelakantan

Published in: Clinical Oral Investigations | Issue 2/2018

Abstract

Objectives

Reduction of microbial load from the root canal systems is a pre-requisite for healing of lesions of endodontic origin. Such microbial reduction is influenced by the method of irrigant delivery and activation. The aim of this systematic review was to compare the effect of ultrasonically activated irrigation (UAI) with other irrigation techniques on the reduction of microorganisms during root canal disinfection.

Materials and methods

The research question was created based on the PICO strategy. Two reviewers independently performed a comprehensive literature search in electronic databases. Following application of inclusion and exclusion criteria to the selected articles, a systematic data extraction sheet was constructed. The selected articles were assessed using methodological quality scoring protocol. The risk of bias in selected studies was critically assessed by two reviewers.

Results

A total of 15 articles were included for the systematic review. The included studies were heterogeneous in study design; hence, meta-analysis was not performed. The overall risk of bias for the selected studies was moderate. Overall, UAI showed superior reduction of microbial counts, resulting in better disinfection compared to other irrigation systems chosen for comparison in this review.

Conclusion

The use of UAI can bring about superior microbial reduction within the root canal system compared to other irrigant activation techniques.

Clinical relevance

Activation of irrigants with ultrasonic brings about significant bacterial reduction from the root canal systems compared to other methods of irrigant activation and conventional syringe irrigation. This might help in improving the outcome of root canal treatment.

Available only for authorised users

Friedman S, Mor C (2004) The success of endodontic therapy--healing and functionality. J Calif Dent Assoc 32(6):493–503PubMed

Moreira MS, Anuar ASN, Tedesco TK, Dos Santos M, Morimoto S (2017) Endodontic treatment in single and multiple visits: an overview of systematic reviews. J Endod 43(6):864–870. https://doi.org/10.1016/j.joen.2017.01.021 CrossRefPubMed

Estrela C, Holland R, Estrela CR, Alencar AH, Sousa-Neto MD, Pécora JD (2014) Characterization of successful root canal treatment. Braz Dent J 25(1):3–11. https://doi.org/10.1590/0103-6440201302356 CrossRefPubMed

Estrela C, Silva JA, Decurcio DA, Alencar AH, Estrela CR, Faitaroni LA, Batista AC (2014) Monitoring nonsurgical and surgical root canal treatment of teeth with primary and secondary infections. Braz Dent J 25(6):494–501. https://doi.org/10.1590/0103-6440201302437 CrossRefPubMed

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. https://doi.org/10.1016/j.joen.2010.04.007 CrossRefPubMed

Stewart PS, Costerton JW (2001) Antibiotic resistance of bacteria in biofilms. Lancet 358(9276):135–138. https://doi.org/10.1016/S0140-6736(01)05321-1 CrossRefPubMed

Nair PN, Henry S, Cano V, Vera J (2005) Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. J Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99(2):231–252. https://doi.org/10.1016/j.tripleo.2004.10.005 CrossRef

Vieira AR, Siqueira JF Jr, Ricucci D, Lopes WS (2012) Dentinal tubule infection as the cause of recurrent disease and late endodontic treatment failure: a case report. J Endod 38:250–254CrossRefPubMed

Siqueira JF Jr, Rôças IN (2008) Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 34:1249–1254CrossRefPubMed

10.

Paiva SS, Siqueira JF Jr, Rôças IN, Carmo FL, Leite DC, Ferreira DC, Rachid CT, Rosado AS (2013) Clinical antimicrobial efficacy of NiTi rotary instrumentation with NaOCl irrigation, final rinse with chlorhexidine and interappointment medication: a molecular study. Int Endod J 46(3):225–233. https://doi.org/10.1111/j.1365-2591.2012.02111.x CrossRefPubMed

11.

Shenoi PR, Morey ES, Makade CS, Gunwal MK, Khode RT, Wanmali SS (2016) In vitro evaluation of the antimicrobial efficacy of chitosan and other endodontic irrigants against Enterococcus faecalis. Gen Dent 64(5):60–63PubMed

12.

Zehnder M (2006) Root canal irrigants. J Endod 32(5):389–398. https://doi.org/10.1016/j.joen.2005.09.014 CrossRefPubMed

13.

Haapasalo M, Shen Y, Qian W, Gao Y (2010) Irrigation in endodontics. Dent Clin N Am 54(2):291–312. https://doi.org/10.1016/j.cden.2009.12.001 CrossRefPubMed

14.

Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, Arun SN, Kim J, Looney SW, Pashley DH (2010) The effect of vapor lock on root canal debridement using a side-vented needle for positive- pressure irrigant delivery. J Endod 36(4):745–750. https://doi.org/10.1016/j.joen.2009.11.022 CrossRefPubMedPubMedCentral

15.

Nielsen BA, Baumgartner CJ (2007) Comparison of the EndoVac system to needle irrigation of root canals. J Endod 33(5):611–615. https://doi.org/10.1016/j.joen.2007.01.020 CrossRefPubMed

16.

Halford A, Ohl CD, Azarpazhooh A, Basrani B, Friedman S, Kishen A (2012) Synergistic effect of microbubble emulsion and sonic or ultrasonic agitation on endodontic biofilm in vitro. J Endod 38(11):1530–1534. https://doi.org/10.1016/j.joen.2012.07.007 CrossRefPubMed

17.

Bago I, Plecko V, Gabric Panduric D, Schauperl Z, Baraba A, Anic I (2013) Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment. Int Endod J 46(4):339–347. https://doi.org/10.1111/j.1365-2591.2012.02120.x CrossRefPubMed

18.

Guerreiro-Tanomaru JM, Chávez-Andrade GM, De Faria-Júnior NB, Watanabe E, Tanomaru-Filho M (2015) Effect of passive ultrasonic irrigation on Enterococcus faecalis from root canals: an ex vivo study. Braz Dent J 26(4):342–346. https://doi.org/10.1590/0103-6440201300022 CrossRefPubMed

19.

Bhardwaj A, Velmurugan N, Sumitha, Ballal S (2013) Efficacy of passive ultrasonic irrigation with natural irrigants (Morinda citrifolia juice, Aloe Vera and Propolis) in comparison with 1% sodium hypochlorite for removal of E. faecalis biofilm: an in vitro study. Indian J Dent Res 24:35–41CrossRefPubMed

20.

Neelakantan P, Cheng CQ, Mohanraj R, Sriraman P, Subbarao C, Sharma S (2015) Antibiofilm activity of three irrigation protocols activated by ultrasonic, diode laser or Er:YAG laser in vitro. Int Endod J 48(6):602–610. https://doi.org/10.1111/iej.12354 CrossRefPubMed

21.

Xhevdet A, Stubljar D, Kriznar I, Jukic T, Skvarc M, Veranic P, Ihan A (2014) The disinfecting efficacy of root canals with laser photodynamic therapy. J Lasers Med Sci 5:19–26PubMedPubMedCentral

22.

Tennert C, Drews AM, Walther V, Altenburger MJ, Karygianni L, Wrbas KT, Hellwig E, Al-Ahmad A (2015) Ultrasonic activation and chemical modification of photosensitizers enhances the effects of photodynamic therapy against Enterococcus faecalis root-canal isolates. Photodiagn Photodyn Ther 12(2):244–251. https://doi.org/10.1016/j.pdpdt.2015.02.002 CrossRef

23.

Neelakantan P, Cheng CQ, Ravichandran V, Mao T, Sriraman P, Sridharan S, Subbarao C, Sharma S, Kishen A (2015) Photoactivation of curcumin and sodium hypochlorite to enhance antibiofilm efficacy in root canal dentin. Photodiagn Photodyn Ther 12(1):108–114. https://doi.org/10.1016/j.pdpdt.2014.10.011 CrossRef

24.

Keir DM, Senia ES, Montgomery S (1990) Effectiveness of a brush in removing postinstrumentation canal debris. J Endod 16(7):323–327. https://doi.org/10.1016/S0099-2399(06)81942-4 CrossRefPubMed

25.

Roggendorf MJ, Kraus F, Lohbauer U, Frankenberger R, Petschelt A, Ebert J (2015) Apical debris removal of CanalBrushes with different tip modifications. Quintessence Int 46(10):853–860. https://doi.org/10.3290/j.qi.a33687 PubMed

26.

Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR (2009) Review of contemporary irrigant agitation techniques and devices. J Endod 35(6):791–804. https://doi.org/10.1016/j.joen.2009.03.010 CrossRefPubMed

27.

Lee SJ, Wu MK, Wesselink PR (2004) The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different-sized simulated plastic root canals. Int Endod J 37(9):607–612. https://doi.org/10.1111/j.1365-2591.2004.00857.x CrossRefPubMed

28.

Rodig T, Sedghi M, Konietschke F, Lange K, Ziebolz D, Hulsmann M (2010) Efficacy of syringe irrigation, RinsEndo and passive ultrasonic irrigation in removing debris from irregularities in root canals with different apical sizes. Int Endod J 43(7):581–589. https://doi.org/10.1111/j.1365-2591.2010.01721.x CrossRefPubMed

29.

Guo X, Miao H, Li L, Zhang S, Zhou D, Lu Y, Wu L (2014) Efficacy of four different irrigation techniques combined with 60 °C 3% sodium hypochlorite and 17% EDTA in smear layer removal. BMC Oral Health 14:114. https://doi.org/10.1186/1472-6831-14-114 CrossRefPubMedPubMedCentral

30.

Niazi SA, Clark D, Do T, Gilbert SC, Foschi F, Mannocci F, Beighton D (2014) The effectiveness of enzymic irrigation in removing a nutrient-stressed endodontic multispecies biofilm. Int Endod J 47(8):756–768. https://doi.org/10.1111/iej.12214 CrossRefPubMed

31.

Rico-Romano C, Zubizarreta-Macho Á, Baquero-Artigao MR, Mena-Álvarez J (2016) An analysis in vivo of intracanal bacterial load before and after chemo-mechanical preparation: a comparative analysis of two irrigants and two activation techniques. J Clin Exp Dent 8(1):e9–e13. https://doi.org/10.4317/jced.52585 PubMedPubMedCentral

32.

Seet AN, Zilm PS, Gully NJ, Cathro PR (2012) Qualitative comparison of sonic or laser energisation of 4% sodium hypochlorite on an Enterococcus faecalis biofilm grown in vitro. Aust Endod J 38(3):100–106. https://doi.org/10.1111/j.1747-4477.2012.00366.x CrossRefPubMed

33.

Weller RN, Brady JM, Bernier WE (1980) Efficacy of ultrasonic cleaning. J Endod 6(9):740–743. https://doi.org/10.1016/S0099-2399(80)80185-3 CrossRefPubMed

34.

Roy RA, Ahmad M, Crum LA (1994) Physical mechanisms, governing the hydrodynamic response of an oscillating ultrasonic file. Int Endod J 27:197–207CrossRefPubMed

35.

Ahmad M, Pitt Ford TR, Crum LA, Walton AJ (1988) Ultrasonic debridement of root canals: acoustic cavitation and its relevance. J Endod 14(10):486–493. https://doi.org/10.1016/S0099-2399(88)80105-5 CrossRefPubMed

36.

Van der Sluis LW, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40(6):415–426. https://doi.org/10.1111/j.1365-2591.2007.01243.x CrossRefPubMed

37.

Curtis TO, Sedgley CM (2012) Comparison of a continuous ultrasonic irrigation device and conventional needle irrigation in the removal of root canal debris. J Endod 38(9):1261–1264. https://doi.org/10.1016/j.joen.2012.05.012 CrossRefPubMed

38.

Macedo RG, Verhaagen B, Wesselink PR, Versluis M, van der Sluis LWM (2014) Influence of refreshment/activation cycles and temperature rise on the reaction rate of sodium hypochlorite with bovine dentine during ultrasonic activated irrigation. Int Endod J 47:147–154CrossRefPubMed

39.

Spoleti P, Siragusa M, Spoleti MJ (2003) Bacteriological evaluation of passive ultrasonic activation. J Endod 29(1):12–14. https://doi.org/10.1097/00004770-200301000-00004 CrossRefPubMed

40.

Blank-Gonçalves LM, Nabeshima CK, Martins GH, Machado ME (2011) Qualitative analysis of the removal of the smear layer in the apical third of curved roots: conventional irrigation versus activation systems. J Endod 37(9):1268–1271. https://doi.org/10.1016/j.joen.2011.06.009 CrossRefPubMed

41.

Lee SJ, Wu MK, Wesselink PR (2004) The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J 37(10):672–678. https://doi.org/10.1111/j.1365-2591.2004.00848.x CrossRefPubMed

42.

Huque J, Kota K, Yamaga M, Iwaku M, Hoshino E (1998) Bacterial eradication from root dentine by ultrasonic irrigation with sodium hypochlorite. Int Endod J 31:242–250CrossRefPubMed

43.

Gulabivala K, Stock CJ, Lewsey JD, Ghori S, Ng YL, Spratt DA (2004) Effectiveness of electrochemically activated water as an irrigant in an infected tooth model. Int Endod J 37(9):624–631. https://doi.org/10.1111/j.1365-2591.2004.00867.x CrossRefPubMed

44.

Tardivo D, Pommel L, La Scola B, About I, Camps J (2010) Antibacterial efficiency of passive ultrasonic versus sonic irrigation. Ultrasonic root canal irrigation. Odontostomatol Trop 33(129):29–35PubMed

45.

Bhuva B, Patel S, Wilson R, Niazi S, Beighton D, Mannocci F (2010) The effectiveness of passive ultrasonic irrigation on intra radicular enterococcus faecalis biofilms in extracted single-rooted human teeth. Int Endod J 43(3):241–250. https://doi.org/10.1111/j.1365-2591.2009.01672.x CrossRefPubMed

46.

Siqueira JF Jr., Machado AG, Silveira RM, Lopes HP, De Uzeda M (1997) Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal: in vitro. Int Endod J 30:279–282, 4, https://doi.org/10.1111/j.1365-2591.1997.tb00708.x

47.

Joanna Briggs Institute. https://joannabriggs.org/assets/docs/critical-appraisal-tools/JBI_Critical_Appraisal-Checklist_for_Quasi_-_Experimental_Studies.pdf (Assessed 22 May 2017)

48.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174. https://doi.org/10.2307/2529310 CrossRefPubMed

49.

Ibi H, Hayashi M, Yoshino F, Tamura M, Yoshida A, Kobayashi Y, Shimizu K, Lee MC, Imai K, Ogiso B (2017) Bactericidal effect of hydroxyl radicals generated by the sonolysis and photolysis of hydrogen peroxide for endodontic applications. Microb Pathog 103:65–70. https://doi.org/10.1016/j.micpath.2016.12.010 CrossRefPubMed

50.

Kobayashi Y, Hayashi M, Yoshino F, Tamura M, Yoshida A, Ibi H, Lee MC, Ochiai K, Ogiso B (2014) Passive ultrasonic irrigation in the presence of a low concentration of hydrogen peroxide enhances hydroxyl radical generation and bactericidal effect against Enterococcus faecalis. J Oral Sci 56:35–39CrossRefPubMed

51.

Martin H (1976) Ultrasonic disinfection of the root canal. Oral Surg Oral Med Oral Pathol 42(1):92–99. https://doi.org/10.1016/0030-4220(76)90035-9 CrossRefPubMed

52.

Pladisai P, Ampornaramveth RS, Chivatxaranukul P (2016) Effectiveness of different disinfection protocols on the reduction of bacteria in Enterococcus faecalis biofilm in teeth with large root canals. J Endod 42(3):460–464. https://doi.org/10.1016/j.joen.2015.12.016 CrossRefPubMed

53.

Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A (2016) Antibacterial efficacy of a new sonic irrigation device for root canal disinfection. J Endod 42:1799–1803CrossRefPubMed

54.

Toljan I, Bago I, Jurič AI (2016) Eradication of intracanal Enterococcus faecalis biofilm by passive ultrasonic irrigation and RinsEndo system. Acta Stomatol Croat 50:14–22CrossRefPubMedPubMedCentral

55.

Hubbezoglu I, Zan R, Tunc T, Sumer Z (2014) Antibacterial efficacy of aqueous ozone in root canals infected by Enterococcus faecalis. Jundishapur J Microbiol 7:e11411CrossRefPubMedPubMedCentral

56.

Ghinzelli GC, Souza MA, Cecchin D, Farina AP, de Figueiredo JA (2014) Influence of ultrasonic activation on photodynamic therapy over root canal system infected with enterococcus faecalis : an in vitro study. Photodiagn Photodyn Ther 11(4):472–478. https://doi.org/10.1016/j.pdpdt.2014.07.004 CrossRef

57.

Cachovan G, Schiffner U, Altenhof S, Guentsch A, Pfister W, Eick S (2013) Comparative antibacterial efficacies of hydrodynamic and ultrasonic irrigation systems in vitro. J Endod 39(9):1171–1175. https://doi.org/10.1016/j.joen.2013.06.008 CrossRefPubMed

58.

Case PD, Bird PS, Kahler WA, George R, Walsh LJ (2012) Treatment of root canal biofilms of Enterococcus faecalis with ozone gas and passive ultrasound activation. J Endod 38(4):523–526. https://doi.org/10.1016/j.joen.2011.12.020 CrossRefPubMed

59.

Alves FR, Almeida BM, Neves MA, Moreno JO, Rôças IN, Siqueira JF Jr (2011) Disinfecting oval-shaped root canals: effectiveness of different supplementary approaches. J Endod 37(4):496–501. https://doi.org/10.1016/j.joen.2010.12.008 CrossRefPubMed

60.

Paqué F, Boessler C, Zehnder M (2011) Accumulated hard tissue debris levels in mesial roots of mandibular molars after sequential irrigation steps. Int Endod J 44:148–153CrossRefPubMed

61.

Shuping GB, Ørstavik D, Sigurdsson A, Trope M (2000) Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod 26(12):751–755. https://doi.org/10.1097/00004770-200012000-00022 CrossRefPubMed

62.

Young GR, Parashos P, Messer HH (2007) The principles of techniques for cleaning root canals. Aust Dent J 52(1 Suppl):S52–S63. https://doi.org/10.1111/j.1834-7819.2007.tb00526.x CrossRefPubMed

63.

Neelakantan P, Devaraj S, Jagannathan N (2016) Histologic assessment of debridement of the root canal isthmus of mandibular molars by irrigant activation techniques ex vivo. J Endod 42:1268–1272CrossRefPubMed

64.

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 34:221–230CrossRefPubMed

65.

Siqueira JF Jr, Pérez AR, Marceliano-Alves MF, Provenzano JC, Silva SG, Pires FR, Vieira GC, Rôças IN, Alves FR (2017) What happens to unprepared root canal walls: a correlative analysis using micro-computed tomography and histology/scanning electron microscopy. Int Endod J Feb 14. https://doi.org/10.1111/iej.12753

66.

Siqueira JF Jr, Rôças IN, Paiva SS, Magalhães KM, Guimarães-Pinto T 2007 Cultivable bacteria in infected root canals as identified by 16S rRNA gene sequencing. Oral Microbiol Immunol 22:266–271, 4, https://doi.org/10.1111/j.1399-302X.2007.00355.x

67.

Silva Almeida LH, Moraes RR, Morgental RD, Pappen FG (2017) Are premixed calcium silicate-based endodontic sealers comparable to conventional materials? A systematic review of in vitro studies. J Endod 43(4):527–535. https://doi.org/10.1016/j.joen.2016.11.019 CrossRefPubMed

68.

AlShwaimi E, Bogari D, Ajaj R, Al-Shahrani S, Almas K, Majeed A (2016) In vitro antimicrobial effectiveness of root canal sealers against Enterococcus faecalis: a systematic review. J Endod 42:1588–1597CrossRefPubMed

69.

Ahn SY, Kim HC, Kim E (2016) Kinematic effects of nickel-titanium instruments with reciprocating or continuous rotation motion: a systematic review of in vitro studies. J Endod 42(7):1009–1017. https://doi.org/10.1016/j.joen.2016.04.002 CrossRefPubMed

70.

Love RM (2001) Enterococcus faecalis--a mechanism for its role in endodontic failure. Int Endod J 34(5):399–405. https://doi.org/10.1046/j.1365-2591.2001.00437.x CrossRefPubMed

71.

Sedgley CM, Lennan SL, Appelbe OK (2005) Survival of Enterococcus faecalis in root canals ex vivo. Int Endod J 38(10):735–742. https://doi.org/10.1111/j.1365-2591.2005.01009.x CrossRefPubMed

72.

Svensäter G, Bergenholtz G (2004) Biofilms in endodontic infections. Endod Topics 9(1):27–36. https://doi.org/10.1111/j.1601-1546.2004.00112.x CrossRef

73.

Kakoli P, Nandakumar R, Romberg E, Arola D, Fouad AF (2009) The effect of age on bacterial penetration of radicular dentin. J Endod 35:78–81CrossRefPubMedPubMedCentral

74.

Ozdemir HO, Buzoglu HD, Calt S, Stabholz A, Steinberg D (2010) Effect of ethylenediaminetetraacetic acid and sodium hypochlorite irrigation on Enterococcus faecalis biofilm colonization in young and old human root canal dentin: in vitro study. J Endod 36(5):842–846. https://doi.org/10.1016/j.joen.2010.01.008 CrossRefPubMed

75.

Boutsioukis C, Verhaagen B, Walmsley AD, Versluis M, van der Sluis LW (2013) Measurement and visualization of file-to-wall contact during ultrasonically activated irrigation in simulated canals. Int Endod J 46:1046–1055CrossRefPubMed

76.

Amato M, Vanoni-Heineken I, Hecker H, Weiger R (2011) Curved versus straight root canals: the benefit of activated irrigation techniques on dentin debris removal. Oral Surg Oral Med Oral Path Oral Radiol Endod 111(4):529–534. https://doi.org/10.1016/j.tripleo.2010.11.002 CrossRef

77.

Aminoshariae A, Kulild JC (2015) Master apical file size – smaller or larger: a systematic review of healing outcomes. Int Endod J 48(7):639–647. https://doi.org/10.1111/iej.12370 CrossRefPubMed

78.

Hauser V, Braun A, Frentzen M (2007) Penetration depth of dye marker into dentine using novel hydrodynamic system (RinsEndo). Int Endod J 40:644–652CrossRefPubMed

79.

Chau NP, Chung NH, Jeon JG (2015) Relationships between the antibacterial activity of sodium hypochlorite and treatment time and biofilm age in early Enterococcus faecalis biofilms. Int Endod J 48(8):782–789. https://doi.org/10.1111/iej.12376 CrossRefPubMed

80.

Shen Y, Stojicic S, Haapasalo M (2011) Antimicrobial efficacy of chlorhexidine against bacteria in biofilms at different stages of development. J Endod 37:657–661CrossRefPubMed

81.

82.

Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S (2017) Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J. https://doi.org/10.1111/iej.12877

83.

Shahriari S, Kasraei S, Roshanaei G, Karkeabadi H, Davanloo H (2017) Efficacy of sodium hypochlorite activated with laser in intracanal smear layer removal: an SEM study. J Lasers Med Sci 8:36–41CrossRefPubMedPubMedCentral

84.

Mancini M, Cerroni L, Iorio L, Dall'Asta L, Cianconi L (2017) FESEM evaluation of smear layer removal using different irrigant activation methods (EndoActivator, EndoVac, PUI and LAI) An in vitro study. Clin Oral Investig. https://doi.org/10.1007/s00784-017-2179-y

85.

Kishen A, Haapasalo M (2010) Biofilm models and methods of biofilm assessment. Endod Topics 22(1):58–78. https://doi.org/10.1111/j.1601-1546.2012.00285.x CrossRef

86.

Ma J, Wang Z, Shen Y, Haapasalo M (2011) A new noninvasive model to study the effectiveness of dentin disinfection by using confocal laser scanning microscopy. J Endod 37(10):1380–1385. https://doi.org/10.1016/j.joen.2011.06.018 CrossRefPubMed

87.

Kim SY, Shin Y, Lee CY, Jung IY (2013) In vivo quantitative evaluation of live and dead bacteria in root canal infection by using propidium monoazide with real-time PCR. J Endod 39(11):1359–1363. https://doi.org/10.1016/j.joen.2013.05.004 CrossRefPubMed

88.

Krithikadatta J, Indira R, Dorothykalyani AL (2007) Disinfection of dentinal tubules with 2% chlorhexidine, 2% metronidazole, bioactive glass when compared with calcium hydroxide as intracanal medicaments. J Endod 33:1473–1476CrossRefPubMed

Title: Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies
Authors: Venkateshbabu Nagendrababu
Jayakumar Jayaraman
Anand Suresh
Senthilnayagam Kalyanasundaram
Prasanna Neelakantan
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 2/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2345-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 2/2018

Influence of subcrestal implant placement compared with equicrestal position on the peri-implant hard and soft tissues around platform-switched implants: a systematic review and meta-analysis

Trigemino-gustatory interactions: a randomized controlled clinical trial assessing the effects of selective anesthesia of dental afferents on taste thresholds

Impact of manual control point selection accuracy on automated surface matching of digital dental models

Does a face-bow lead to better occlusion in complete dentures? A randomized controlled trial: part I

Chemical composition and morphology study of bovine enamel submitted to different sterilization methods

Effectiveness for dentin hypersensitivity treatment of non-carious cervical lesions: a meta-analysis