Skip to main content
SpringerLink
Log in

Sonic and Ultrasonic Irrigation

  • Chapter
Endodontic Irrigation

Abstract

Cleaning and shaping of the root canal with the use of irrigants is a fundamental principle of endodontic therapy. However, current research has shown that needle-delivered irrigation, although effective, is unable to clean and disinfect the root canal system as well as an activated irrigant. This chapter reviews the use of ultrasonic, laser, and sonic-activated irrigation to improve the cleaning and disinfecting of the root canal system. A review of the concepts, systems, and mechanisms will be presented as well as review of the pertinent literature to justify the use of activated endodontic irrigants.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Abbott PV, Heijkoop PS, Cardaci SC, Hume WR, Heithersay GS. An SEM study of the effects of different irrigation sequences and ultrasonics. Int Endod J. 1991;24:308–16.

    PubMed  Google Scholar 

  2. Ahmad M, PittFord TR, Crum LA. Ultrasonic debridement of root canals: An insight into the mechanisms involved. J Endod. 1987;13:93–101.

    PubMed  Google Scholar 

  3. Ahmad M, PittFord TR, Crum LA. Ultrasonic debridement of root canals: acoustic streaming and its possible role. J Endod. 1987;13:490–9.

    PubMed  Google Scholar 

  4. Ahmad M, PittFord TR, Crum LA. Ultrasonic debridement of root canals: acoustic cavitation and its relevance. J Endod. 1988;14:486–93.

    PubMed  Google Scholar 

  5. Ahmad M, Roy RA, Kamarudin AG. Observations of acoustic streaming fields around an oscillating ultrasonic file. Endod Dent Traumatol. 1992;8:189–94.

    PubMed  Google Scholar 

  6. Ahmad M. Effect of ultrasonic instrumentation on Bacteroides intermedius. Endod Dent Traumatol. 1989;5:83–6.

    PubMed  Google Scholar 

  7. Alaçam T, Demirtola N, Misirligil A, Ayhan N, Gökay O. In vivo comparison of antimicrobial effectiveness of conventional and ultrasound activated irrigation techniques in root canal therapy. Bull Tokyo Dent Coll. 1987;28:19–22.

    PubMed  Google Scholar 

  8. Al-Jadaa A, Paqué F, Attin T, Zehnder M. Acoustic hypochlorite activation in simulated curved canals. J Endod. 2009;35:1408–11.

    PubMed  Google Scholar 

  9. Al-Jadaa A, Paqué F, Attin T, Zehnder M. Necrotic pulp tissue dissolution by passive ultrasonic irrigation in simulated accessory canals: impact of canal location and angulation. Int Endod J. 2009;42:59–65.

    PubMed  Google Scholar 

  10. Amato M, Vanoni-Heineken I, Hecker H, Weiger R. Curved versus straight root canals: the benefit of activated irrigation techniques on dentin debris removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:529–34.

    PubMed  Google Scholar 

  11. Andrabi SM, Kumar A, Zia A, Iftekhar H, Alam S, Siddiqui S. Effect of passive ultrasonic irrigation and manual dynamic irrigation on smear layer removal from root canals in a closed apex in vitro model. J Investig Clin Dent. 2014;5(3):188–93.

    PubMed  Google Scholar 

  12. Archer R, Reader A, Nist R, Beck M, Meyers WJ. An in vivo evaluation of the efficacy of ultrasound after step-back preparation in mandibular molars. J Endod. 1992;18:549–52.

    PubMed  Google Scholar 

  13. Arslan H, Capar ID, Saygili G, Gok T, Akcay M. Effect of photon-initiated photoacoustic streaming on removal of apically placed dentinal debris. Int Endod J. 2014;47(11):1072–77.

    PubMed  Google Scholar 

  14. Bago I, Plečko V, Gabrić Pandurić D, Schauperl Z, Baraba A, Anić I. Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment. Int Endod J. 2013;46:339–47.

    PubMed  Google Scholar 

  15. Baker NA, Eleazer PD, Averbach RE, Seltzer S. Scanning electron microscope study of the efficacy of various irrigating solutions. J Endod. 1975;1:127–35.

    PubMed  Google Scholar 

  16. Barnett F, Trope M, Khoja M, Tronstad L. Bacteriologic status of the root canal after sonic, ultrasonic, and hand instrumentation. Endod Dent Traumatol. 1985;1:228–31.

    PubMed  Google Scholar 

  17. Bhuva B, Patel S, Wilson R, Niazi S, Beighton D, Mannocci F. The effectiveness of passive ultrasonic irrigation on intraradicular Enterococcus faecalis biofilms in extracted single-rooted human teeth. Int Endod J. 2010;43:241–50.

    PubMed  Google Scholar 

  18. Blanken J, De Moor RJ, Meire M, Verdaasdonk R. Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study. Lasers Surg Med. 2009;41:514–9.

    PubMed  Google Scholar 

  19. Blanken JW, Verdaasdonk R. Cavitation as a working mechanism of the Er, Cr:YSGG laser in endodontics: a visualization study. J Oral Laser Appl. 2007;7:97–106.

    Google Scholar 

  20. Blank-Gonçalves LM, Nabeshima CK, Martins GH, Machado ME. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: conventional irrigation versus activation systems. J Endod. 2011;37:1268–71. http://www.ncbi.nlm.nih.gov/pubmed/?term=blank-goncalves.

    PubMed  Google Scholar 

  21. Hancock J. Ultrasonic cleaning. ASM Handbook® Vol 5: Surface Engineering. 1994;44–7. http://bluewaveinc.com/ultrasonic-cleaning-101/. Accessed 11 Mar 2014.

  22. Bolanos OR, Jensen JR. Scanning electron microscopy comparisons of the efficacy of various methods of root canal preparation. J Endod. 1980;6:815–22.

    PubMed  Google Scholar 

  23. Bolles JA, He J, Svoboda KK, Schneiderman E, Glickman GN. Comparison of Vibringe, EndoActivator, and needle irrigation on sealer penetration in extracted human teeth. J Endod. 2013;39:708–11.

    PubMed  Google Scholar 

  24. Boutsioukis C, Kastrinakis E, Lambrianidis T, Verhaagen B, Versluis M, van der Sluis LW. Formation and removal of apical vapor lock during syringe irrigation: a combined experimental and Computational Fluid Dynamics approach. Int Endod J. 2014;47:191–201.

    PubMed  Google Scholar 

  25. Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J. 2014;47:487–96.

    PubMed  Google Scholar 

  26. Boutsioukis C, Verhaagen B, Walmsley AD, Versluis M, van der Sluis LW. Measurement and visualization of file-to-wall contact during ultrasonically activated irrigation in simulated canals. Int Endod J. 2013;46:1046–55.

    PubMed  Google Scholar 

  27. Brito PR, Souza LC, Machado de Oliveira JC, Alves FR, De-Deus G, Lopes HP, Siqueira Jr JF. Comparison of the effectiveness of three irrigation techniques in reducing intracanal Enterococcus faecalis populations: an in vitro study. J Endod. 2009;35:1422–7.

    PubMed  Google Scholar 

  28. Burleson A, Nusstein J, Reader A, Beck M. The in vivo evaluation of hand/rotary/ultrasound instrumentation in necrotic, human mandibular molars. J Endod. 2007;33:782–7.

    PubMed  Google Scholar 

  29. Byström A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res. 1981;89:321–8.

    PubMed  Google Scholar 

  30. Byström A, Sundqvist G. Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy. Oral Surg Oral Med Oral Pathol. 1983;55:307–12.

    PubMed  Google Scholar 

  31. Byström A, Sundqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J. 1985;18:35–40.

    PubMed  Google Scholar 

  32. Cachovan G, Schiffner U, Altenhof S, Guentsch A, Pfister W, Eick S. Comparative antibacterial efficacies of hydrodynamic and ultrasonic irrigation systems in vitro. J Endod. 2013;39:1171–5.

    PubMed  Google Scholar 

  33. Cameron JA. The use of ultrasonics in the removal of the smear layer: a scanning electron microscope study. J Endod. 1983;9:289–92.

    PubMed  Google Scholar 

  34. Cameron JA. The synergistic relationship between ultrasound and sodium hypochlorite: a scanning electron microscope evaluation. J Endod. 1987;13:541–5.

    PubMed  Google Scholar 

  35. Cameron JA. The use of ultrasound for the removal of the smear layer. The effect of sodium hypochlorite concentration; an SEM study. Aust Dent J. 1988;33:193–200.

    PubMed  Google Scholar 

  36. Cameron JA. The choice of irrigant during hand instrumentation and ultrasonic irrigation of the root canal: a scanning electron microscope study. Aust Dent J. 1995;40:85–90.

    PubMed  Google Scholar 

  37. Capar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA. Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod. 2014;40:451–4.

    PubMed  Google Scholar 

  38. Card SJ, Sigurdsson A, Ørstavik D, Trope M. The effectiveness of increased apical enlargement in reducing intracanal bacteria. J Endod. 2002;28:779–83.

    PubMed  Google Scholar 

  39. Carver K, Nusstein J, Reader A, Beck M. In vivo antibacterial efficacy of ultrasound after hand and rotary instrumentation in human mandibular molars. J Endod. 2007;33:1038–43.

    PubMed  Google Scholar 

  40. Case PD, Bird PS, Kahler WA, George R, Walsh LJ. Treatment of root canal biofilms of Enterococcus faecalis with ozone gas and passive ultrasound activation. J Endod. 2012;38:523–6.

    PubMed  Google Scholar 

  41. Castelo-Baz P, Martín-Biedma B, Cantatore G, Ruíz-Piñón M, Bahillo J, Rivas-Mundiña B, Varela-Patiño P. In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod. 2012;38:688–91.

    PubMed  Google Scholar 

  42. Cheung GS, Stock CJ. In vitro cleaning ability of root canal irrigants with and without endosonics. Int Endod J. 1993;26:334–43.

    PubMed  Google Scholar 

  43. Chou K, George R, Walsh LJ. Effectiveness of different intracanal irrigation techniques in removing intracanal paste medicaments. Aust Endod J. 2014;40:21–5.

    PubMed  Google Scholar 

  44. Ciucchi B, Khettabi M, Holz J. The effectiveness of different endodontic irrigation procedures on the removal of the smear layer: a scanning electron microscopic study. Int Endod J. 1989;22:21–8.

    PubMed  Google Scholar 

  45. Magnetorestrictive versus piezoelectric transducers for power ultrasonic applications. Cleaning Technologies Group (CTM). http://www.ctgclean.com/blog/technology-library/articles/magnetostrictive-versus-piezoelectric-transducers-for-power-ultrasonic-applications. Accessed 25 Feb 2014.

  46. Coldero LG, McHugh S, MacKenzie D, Saunders WP. Reduction in intracanal bacteria during root canal preparation with and without apical enlargement. Int Endod J. 2002;35:437–46.

    PubMed  Google Scholar 

  47. Contardo L, De Luca M, Bevilacqua L, Breschi L, Di Lenarda R. Influence of calcium hydroxide debris on the quality of endodontic apical seal. Minerva Stomatol. 2007;56:509–17.

    PubMed  Google Scholar 

  48. Cunningham WT, Martin H. A scanning electron microscope evaluation of root canal debridement with the endosonic ultrasonic synergistic system. Oral Surg Oral Med Oral Pathol. 1982;53:527–31.

    PubMed  Google Scholar 

  49. Cunningham WT, Martin H, Forrest WR. Evaluation of root canal debridement by the endosonic ultrasonic synergistic system. Oral Surg Oral Med Oral Pathol. 1982;53:401–4.

    PubMed  Google Scholar 

  50. Cunningham WT, Martin H, Pelleu G, Stoops D. A comparison of antimicrobial effectiveness of endosonic and hand root canal therapy. Oral Surg Oral Med Oral Pathol. 1982;54:238–41.

    PubMed  Google Scholar 

  51. Curtis TO, Sedgley CM. Comparison of a continuous ultrasonic irrigation device and conventional needle irrigation in the removal of root canal debris. J Endod. 2012;38:1261–4.

    PubMed  Google Scholar 

  52. Cymerman J, Jerome L, Moodnik R. A scanning electron microscope study comparing the efficacy of hand instrumentation with ultrasonic instrumentation of the root canal. J Endod. 1983;9:327–31.

    PubMed  Google Scholar 

  53. Dalton BC, Ørstavik D, Phillips C, Pettiette M, Trope M. Bacterial reduction with nickel-titanium rotary instrumentation. J Endod. 1998;24:763–7.

    PubMed  Google Scholar 

  54. de Gregorio C, Estevez R, Cisneros R, Heilborn C, Cohenca N. Effect of EDTA, sonic, and ultrasonic activation on the penetration of sodium hypochlorite into simulated lateral canals: an in vitro study. J Endod. 2009;35:891–5.

    PubMed  Google Scholar 

  55. de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. 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. 2010;36:1216–21.

    PubMed  Google Scholar 

  56. de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J. 2009;42:1077–83.

    PubMed  Google Scholar 

  57. De Moor RJ, Blanken J, Meire M, Verdaasdonk R. Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: evaluation of the efficacy. Lasers Surg Med. 2009;41:520–3.

    PubMed  Google Scholar 

  58. De Moor RJ, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod. 2010;36:1580–3.

    PubMed  Google Scholar 

  59. Deleu E, Meire MA, De Moor RJ. Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci. 2015;30(2):831–5.

    PubMed  Google Scholar 

  60. DeNunzio MS, Hicks ML, Pelleu GB, Kingman A, Sauber JJ. A bacteriological comparison of ultrasonic and hand instrumentation of root canals in dogs. J Endod. 1989;14:290–3.

    Google Scholar 

  61. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009;35:545–9.

    PubMed  Google Scholar 

  62. DiVito E, Peters OA, Olivi G. Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation. Lasers Med Sci. 2012;27:273–80.

    PubMed  Google Scholar 

  63. Dovgyallo GI, Migun NP, Prokhorenko PP. The complete filling of dead-end conical capillaries with liquid. J Eng Phys. 1989;56:395–7.

    Google Scholar 

  64. Druttman AC, Stock CJ. An in vitro comparison of ultrasonic and conventional methods of irrigant replacement. Int Endod J. 1989;22:174–8.

    PubMed  Google Scholar 

  65. Dutner J, Mines P, Anderson A. Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod. 2012;38:37–40.

    PubMed  Google Scholar 

  66. Goel S, Tewari S. Smear layer removal with passive ultrasonic irrigation and the NaviTip FX: a scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:465–70.

    PubMed  Google Scholar 

  67. Goldman M, White R, Moser C, Tenca J. A comparison of three methods of cleaning and shaping the root canal in vitro. J Endod. 1988;14:7–12.

    PubMed  Google Scholar 

  68. Goode N, Khan S, Eid AA, Niu LN, Gosier J, Susin LF, Pashley DH, Tay FR. Wall shear stress effects of different endodontic irrigation techniques and systems. J Dent. 2013;41:636–41.

    PubMed  Google Scholar 

  69. Goodman A, Reader A, Beck F, Melfi R, Meyers W. An in vitro comparison of the efficacy of the step-back technique versus a step-back ultrasonic technique in human mandibular molars. J Endod. 1985;11:249–56.

    PubMed  Google Scholar 

  70. Grischke J, Müller-Heine A, Hülsmann M. The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig. 2014;18(7):1845–51.

    PubMed  Google Scholar 

  71. Gründling GL, Zechin JG, Jardim WM, de Oliveira SD, de Figueiredo JA. Effect of ultrasonics on Enterococcus faecalis biofilm in a bovine tooth model. J Endod. 2011;37:1128–33.

    PubMed  Google Scholar 

  72. Guidotti R, Merigo E, Fornaini C, Rocca JP, Medioni E, Vescovi P. Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer. Lasers Med Sci. 2014;29:69–75.

    PubMed  Google Scholar 

  73. Gutarts R, Nusstein J, Reader A, Beck M. In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 2005;31:166–70.

    PubMed  Google Scholar 

  74. Haidet J, Reader A, Beck M, Meyers W. An in vivo comparison of the step-back technique versus a step- back/ultrasonic technique in human mandibular molars. J Endod. 1989;15:195–9.

    PubMed  Google Scholar 

  75. Heard F, Walton RE. Scanning electron microscope study comparing four root canal preparation techniques in small curved canals. Int Endod J. 1997;30:323–31.

    PubMed  Google Scholar 

  76. Hess W, et al. The anatomy of the root canals of the teeth of the permanent dentition. London: J. Bale, Sons and Danielsson, Ltd; 1925.

    Google Scholar 

  77. Hosoya N, Kurayama H, Iino F, Arai T. Effects of calcium hydroxide on physical and sealing properties of canal sealers. Int Endod J. 2004;37:178–84.

    PubMed  Google Scholar 

  78. Howard RK, Kirkpatrick TC, Rutledge RE, Yaccino JM. Comparison of debris removal with three different irrigation techniques. J Endod. 2011;37:1301–5.

    PubMed  Google Scholar 

  79. Huang TY, Gulabivala K, Ng YL. A bio-molecular film ex-vivo model to evaluate the influence of canal dimensions and irrigation variables on the efficacy of irrigation. Int Endod J. 2008;41:60–71.

    PubMed  Google Scholar 

  80. Huffaker SK, Safavi K, Spangberg LS, Kaufman B. Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod. 2010;36:1315–8.

    PubMed  Google Scholar 

  81. Huque J, Kota K, Yamaga M, Iwaku M, Hoshino E. Bacterial eradication from root dentine by ultrasonic irrigation with sodium hypochlorite. Int Endod J. 1998;31:242–50.

    PubMed  Google Scholar 

  82. Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod. 1999;25:735–8.

    PubMed  Google Scholar 

  83. Jiang LM, Verhaagen B, Versluis M, Langedijk J, Wesselink P, van der Sluis LW. The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. J Endod. 2011;37:688–92.

    PubMed  Google Scholar 

  84. Jiang LM, Verhaagen B, Versluis M, van der Sluis LW. Influence of the oscillation direction of an ultrasonic file on the cleaning efficacy of passive ultrasonic irrigation. J Endod. 2010;36:1372–6.

    PubMed  Google Scholar 

  85. Johnson M, Sidow SJ, Looney SW, Lindsey K, Niu LN, Tay FR. Canal and isthmus debridement efficacy using a sonic irrigation technique in a closed-canal system. J Endod. 2012;38:1265–8.

    PubMed  Google Scholar 

  86. Joyce E, Phull SS, Lorimer JP, Mason TJ. The development and evaluation of ultrasound for the treatment of bacterial suspensions. A study of frequency, power and sonication time on cultured Bacillus species. Ultrason Sonochem. 2003;10:315–8.

    PubMed  Google Scholar 

  87. Kanter V, Weldon E, Nair U, Varella C, Kanter K, Anusavice K, Pileggi R. A quantitative and qualitative analysis of ultrasonic versus sonic endodontic systems on canal cleanliness and obturation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:809–13.

    PubMed  Google Scholar 

  88. Kaptan F, Karapinar-Kazandag M, Kayahan MB, Bora T, Bayirli G. Potential of an Er:YAG laser in the removal of calcium hydroxide from root canals. Photomed Laser Surg. 2012;30:250–4.

    PubMed  Google Scholar 

  89. Khaleel HY, Al-Ashaw AJ, Yang Y, Pang AH, Ma JZ. Quantitative comparison of calcium hydroxide removal by EndoActivator, ultrasonic and ProTaper file agitation techniques: an in vitro study. J Huazhong Univ Sci Technolog Med Sci. 2013;33:142–5.

    PubMed  Google Scholar 

  90. Kuah HG, Lui JN, Tseng PS, Chen NN. The effect of EDTA with and without ultrasonics on removal of the smear layer. J Endod. 2009;35:393–6.

    PubMed  Google Scholar 

  91. Langeland K, Liao K, Pascon E. Work saving devices in endodontics: efficacy of sonic and ultrasonic technique. J Endod. 1985;11:499–510.

    PubMed  Google Scholar 

  92. Lee SJ, Wu MK, Wesselink PR. The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J. 2004;37:672–8.

    PubMed  Google Scholar 

  93. Lee SJ, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different-sized simulated plastic root canals. Int Endod J. 2004;37:607–12.

    PubMed  Google Scholar 

  94. Lev R, Reader A, Beck M, Meyers W. An in vitro comparison of the step-back technique versus a step- back/ultrasound technique for one and three minutes. J Endod. 1987;13:523–30.

    PubMed  Google Scholar 

  95. Liang YH, Jiang LM, Jiang L, Chen XB, Liu YY, Tian FC, Bao XD, Gao XJ, Versluis M, Wu MK, van der Sluis L. Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: a randomized controlled trial. J Endod. 2013;39:1218–25.

    PubMed  Google Scholar 

  96. Lumley PJ, Walmsley AD, Walton RE, Rippin JW. Effect of precurving endosonic files on the amount of debris and smear layer remaining in curved root canals. J Endod. 1992;18:616–9.

    PubMed  Google Scholar 

  97. Macedo RG, Verhaagen B, Fernandez Rivas D, Gardeniers JG, van der Sluis LW, Wesselink PR, Versluis M. Sonochemical and high-speed optical characterization of cavitation generated by an ultrasonically oscillating dental file in root canal models. Ultrason Sonochem. 2014;21:324–35.

    PubMed  Google Scholar 

  98. Macedo RG, Verhaagen B, Wesselink PR, Versluis M, van der Sluis LW. 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. 2014;47:147–54.

    PubMed  Google Scholar 

  99. Malentacca A, Uccioli U, Zangari D, Lajolo C, Fabiani C. Efficacy and safety of various active irrigation devices when used with either positive or negative pressure: an in vitro study. J Endod. 2012;38:1622–6.

    PubMed  Google Scholar 

  100. Malki M, Verhaagen B, Jiang LM, Nehme W, Naaman A, Versluis M, Wesselink P, van der Sluis L. Irrigant flow beyond the insertion depth of an ultrasonically oscillating file in straight and curved root canals: visualization and cleaning efficacy. J Endod. 2012;38:657–61.

    PubMed  Google Scholar 

  101. Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L. Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. J Endod. 2013;39:1456–60.

    PubMed  Google Scholar 

  102. Margelos J, Eliades G, Verdelis C, Palaghias G. Interaction of calcium hydroxide with zinc oxide-eugenol type sealers: a potential clinical problem. J Endod. 1997;23:43–8.

    PubMed  Google Scholar 

  103. Martin H. Ultrasonic disinfection of the root canal. Oral Surg Oral Med Oral Pathol. 1976;42:92–9.

    PubMed  Google Scholar 

  104. Martin H, Cunningham WT. The effect of endosonic and hand manipulation on the amount of root canal material extruded. Oral Surg Oral Med Oral Pathol. 1982;53:611–3.

    PubMed  Google Scholar 

  105. Martin H, Cunningham WT. An evaluation of postoperative pain incidence following endosonic and conventional root canal therapy. Oral Surg Oral Med Oral Pathol. 1982;54:74–6.

    PubMed  Google Scholar 

  106. Martin H, Cunningham WT. Endosonic endodontics: the ultrasonic synergistic system. Int Dent J. 1984;34:198–203.

    PubMed  Google Scholar 

  107. Martin H, Cunningham WT. Endosonics – the ultrasonic synergistic system of endodontics. Endod Dent Traumatol. 1985;1:201–6.

    PubMed  Google Scholar 

  108. Martin H, Cunningham WT, Norris JP, Cotton WR. Ultrasonic versus hand filing of dentin: a quantitative study. Oral Surg Oral Med Oral Pathol. 1980;49:79–81.

    PubMed  Google Scholar 

  109. Martin H, Cunningham WT, Norris JP. A quantitative comparison of the ability of diamond and K-type files to remove dentin. Oral Surg Oral Med Oral Pathol. 1980;50:566–8.

    PubMed  Google Scholar 

  110. Matsumoto H, Yoshimine Y, Akamine A. Visualization of irrigant flow and cavitation induced by Er:YAG laser within a root canal model. J Endod. 2011;37:839–43.

    PubMed  Google Scholar 

  111. Merino A, Estevez R, de Gregorio C, Cohenca N. The effect of different taper preparations on the ability of sonic and passive ultrasonic irrigation to reach the working length in curved canals. Int Endod J. 2013;46:427–33.

    PubMed  Google Scholar 

  112. Metzler RS, Montgomery S. The effectiveness of ultrasonics and calcium hydroxide for the debridement of human mandibular molars. J Endod. 1989;15:373–8.

    PubMed  Google Scholar 

  113. Mitchell RP, Baumgartner JC, Sedgley CM. Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod. 2011;37:1677–81.

    PubMed  Google Scholar 

  114. Moon YM, Kim HC, Bae KS, Baek SH, Shon WJ, Lee W. Effect of laser-activated irrigation of 1320-nanometer Nd:YAG laser on sealer penetration in curved root canals. J Endod. 2012;38:531–5.

    PubMed  Google Scholar 

  115. Moorer WR, Wesselink PR. Factors promoting the tissue dissolving capability of sodium hypochlorite. Int Endod J. 1982;15(4):187–96.

    Google Scholar 

  116. Munoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod. 2012;38(4):445–8.

    Google Scholar 

  117. Ordinola-Zapata R, Bramante CM, Aprecio RM, Handysides R, Jaramillo DE. Biofilm removal by 6 % sodium hypochlorite activated by different irrigation techniques. Int Endod J. 2014;47(7):659–66.

    PubMed  Google Scholar 

  118. Pafford J. In vivo evaluation of intraoperative and postoperative pain of hand/rotary/ultrasound technique in the root canals of vital and necrotic teeth. Master’s thesis, The Ohio State University; 2007.

    Google Scholar 

  119. Paragliola R, Franco V, Fabiani C, Mazzoni A, Nato F, Tay FR, Breschi L, Grandini S. Final rinse optimization: influence of different agitation protocols. J Endod. 2010;36:282–5.

    PubMed  Google Scholar 

  120. Pasqualini D, Cuffini AM, Scotti N, Mandras N, Scalas D, Pera F, Berutti E. Comparative evaluation of the antimicrobial efficacy of a 5 % sodium hypochlorite subsonic-activated solution. J Endod. 2010;36:1358–60.

    PubMed  Google Scholar 

  121. Passarinho-Neto JG, Marchesan MA, Ferreira RB, Silva RG, Silva-Sousa YT, Sousa-Neto MD. In vitro evaluation of endodontic debris removal as obtained by rotary instrumentation coupled with ultrasonic irrigation. Aust Endod J. 2006;32:123–8.

    PubMed  Google Scholar 

  122. Pataky L, Ivanyi I, Grigar A, Fazekas A. Antimicrobial efficacy of various root canal preparation techniques: an in vitro comparative study. J Endod. 2002;28:603–5.

    PubMed  Google Scholar 

  123. Peeters HH, Mooduto L. Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er, Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig. 2013;17:2105–12.

    PubMed  Google Scholar 

  124. Peeters HH, Suardita K. Efficacy of smear layer removal at the root tip by using ethylenediaminetetraacetic acid and erbium, chromium: yttrium, scandium, gallium garnet laser. J Endod. 2011;37:1585–9.

    PubMed  Google Scholar 

  125. Peters LB, van Winkelhoff AJ, Buijs JF, Wesselink PR. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J. 2002;35:13–21.

    PubMed  Google Scholar 

  126. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30:559–67.

    PubMed  Google Scholar 

  127. Peters OA, Bardsley S, Fong J, Pandher G, Divito E. Disinfection of root canals with photon-initiated photoacoustic streaming. J Endod. 2011;37:1008–12.

    PubMed  Google Scholar 

  128. Richman MJ. The use of ultrasonics in root canal therapy and root resection. J Dent Med. 1957;12:12–8.

    Google Scholar 

  129. Rödig T, Bozkurt M, Konietschke F, Hülsmann M. Comparison of the Vibringe system with syringe and passive ultrasonic irrigation in removing debris from simulated root canal irregularities. J Endod. 2010;36:1410–3.

    PubMed  Google Scholar 

  130. Rödig T, Döllmann S, Konietschke F, Drebenstedt S, Hülsmann M. Effectiveness of different irrigant agitation techniques on debris and smear layer removal in curved root canals: a scanning electron microscopy study. J Endod. 2010;36:1983–7.

    PubMed  Google Scholar 

  131. Rödig T, Hirschleb M, Zapf A, Hülsmann M. Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals. Int Endod J. 2011;44:1155–61.

    PubMed  Google Scholar 

  132. Rollison S, Barnett F, Stevens RH. Efficacy of bacterial removal from instrumented root canals in vitro related to instrumentation technique and size. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:366–71.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  134. Saber S-D, Hashem AA. Efficacy of different final irrigation activation techniques on smear layer removal. J Endod. 2011;37:1272–5.

    Google Scholar 

  135. Sabins RA, Johnson JD, Hellstein JW. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod. 2003;29:674–8.

    PubMed  Google Scholar 

  136. Sahar-Helft S, Stabholtz A, Moshonov J, Gutkin V, Redenski I, Steinberg D. Effect of Er:YAG laser-activated irrigation solution on Enterococcus faecalis biofilm in an ex-vivo root canal model. Photomed Laser Surg. 2013;31:334–41.

    PubMed  Google Scholar 

  137. Salzgeber RM, Brilliant JD. An in vivo evaluation of the penetration of an irrigating solution in root canals. J Endod. 1977;3:394–8.

    PubMed  Google Scholar 

  138. Schuping GB, Ørstavik D, Sigurdsson A, Trope M. Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod. 2000;26:751–5.

    Google Scholar 

  139. Seet AN, Zilm PS, Gully NJ, Cathro PR. Qualitative comparison of sonic or laser energisation of 4 % sodium hypochlorite on an Enterococcus faecalis biofilm grown in vitro. Aust Endod J. 2012;38:100–6.

    PubMed  Google Scholar 

  140. Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H, Haapasalo M. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod. 2010;36:884–9.

    PubMed  Google Scholar 

  141. Shen Y, Stojicic S, Qian W, Olsen I, Haapasalo M. The synergistic antimicrobial effect by mechanical agitation and two chlorhexidine preparations on biofilm bacteria. J Endod. 2010;36:100–4.

    PubMed  Google Scholar 

  142. Siqueira JF, Lima KC, Magalhaes FA, Lopes HP, de Uzeda M. Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques. J Endod. 1999;25:232–5.

    Google Scholar 

  143. Siqueira JF, Machado AG, Silveira RM, Lopes HP, de Uzeda M. 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. 1997;30:279–82.

    PubMed  Google Scholar 

  144. Siqueira JF, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1 %, 2.5 %, and 5.25 % sodium hypochlorite. J Endod. 2000;26:331–4.

    PubMed  Google Scholar 

  145. Siqueira JF, Rôças IN, Santos SRLD, Lima KC, Magalhaes FAC, de Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002;28:181–4.

    PubMed  Google Scholar 

  146. Sjögren U, Sundqvist G. Bacteriologic evaluation of ultrasonic root canal instrumentation. Oral Surg Oral Med Oral Pathol. 1987;63:366–70.

    PubMed  Google Scholar 

  147. Spoleti P, Siragusa M, Spoleti MJ. Bacteriological evaluation of passive ultrasonic activation. J Endod. 2003;29:12–4.

    PubMed  Google Scholar 

  148. Spoorthy E, Velmurugan N, Ballal S, Nandini S. Comparison of irrigant penetration up to working length and into simulated lateral canals using various irrigating techniques. Int Endod J. 2013;46:815–22.

    PubMed  Google Scholar 

  149. Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod. 2010;36:1558–62.

    PubMed  Google Scholar 

  150. Tambe VH, Nagmode PS, Vishwas JR, P SK, Angadi P, Ali FM. Evaluation of the Amount of Debris extruded apically by using Conv-entional Syringe, Endovac and Ultrasonic Irrigation Technique: An In Vitro Study. J Int Oral Health. 2013;5(3):63–6.

    Google Scholar 

  151. Tan BT, Messer HH. The quality of apical canal preparation using hand and rotary instruments with specific criteria for enlargement based on initial apical file size. J Endod. 2002;28:658–64.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  153. Tasdemir T, Er K, Celik D, Yildirim T. Effect of passive ultrasonic irrigation on apical extrusion of irrigating solution. Eur J Dent. 2008;2:198–203.

    PubMed Central  PubMed  Google Scholar 

  154. Tauber R, Morse D, Sinai I, Furst M. A magnifying lens comparative evaluation of conventional and ultrasonically energized filing. J Endod. 1983;9:269–74.

    PubMed  Google Scholar 

  155. Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, Arun SN, Kim J, Looney SW, Pashley DH. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010;36:745–50.

    PubMed Central  PubMed  Google Scholar 

  156. Tinaz AC, Karadag LS, Alaçam T, Mihçioglu T. Evaluation of the smear layer removal effectiveness of EDTA using two techniques: an SEM study. J Contemp Dent Pract. 2006;7:9–16.

    PubMed  Google Scholar 

  157. The ultrasonic cleaning process: How does an ultrasonic cleaner clean?. TM Associates. http://www.tmasc.com/qa%20process.htm. Accessed 11 Mar 2014.

  158. Townsend C, Maki J. An in vitro comparison of new irrigation and agitation techniques to ultrasonic agitation in removing bacteria from a simulated root canal. J Endod. 2009;35:1040–3.

    PubMed  Google Scholar 

  159. Türkün M, Cengiz T. The effects of sodium hypochlorite and calcium hydroxide on tissue dissolution and root canal cleanliness. Int Endod J. 1997;30:335–42.

    PubMed  Google Scholar 

  160. Uroz-Torres D, González-Rodríguez MP, Ferrer-Luque CM. Effectiveness of the EndoActivator System in removing the smear layer after root canal instrumentation. J Endod. 2010;36:308–11.

    PubMed  Google Scholar 

  161. van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR. Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod. 2010;36:737–40.

    PubMed  Google Scholar 

  162. van der Sluis LW, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from human root canals prepared using instruments of varying taper. Int Endod J. 2005;38:764–8.

    PubMed  Google Scholar 

  163. van der Sluis LW, Wu MK, Wesselink PR. A comparison between a smooth wire and a K-file in removing artificially placed dentine debris from root canals in resin blocks during ultrasonic irrigation. Int Endod J. 2005;38:593–6.

    PubMed  Google Scholar 

  164. Vera J, Arias A, Romero M. Effect of maintaining apical patency on irrigant penetration into the apical third of root canals when using passive ultrasonic irrigation: an in vivo study. J Endod. 2011;37:1276–8.

    PubMed  Google Scholar 

  165. Vera J, Hernández EM, Romero M, Arias A, van der Sluis LW. Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study. J Endod. 2012;38:1340–3.

    PubMed  Google Scholar 

  166. Walmsley AD. Ultrasound and root canal treatment: the need for scientific evaluation. Int Endod J. 1987;20:105–11.

    PubMed  Google Scholar 

  167. Walmsley AD, Williams AR. Effects of constraint on the oscillatory pattern of endosonic files. J Endod. 1989;15:189–94.

    PubMed  Google Scholar 

  168. Weller RN, Brady JM, Bernier WE. Efficacy of ultrasonic cleaning. J Endod. 1980;6:740–3.

    PubMed  Google Scholar 

  169. Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD. Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod. 2011;37:235–8.

    PubMed  Google Scholar 

  170. Yang SF, Rivera EM, Walton RE, Baumgardner KR. Canal debridement: effectiveness of sodium hypochlorite and calcium hydroxide as medicaments. J Endod. 1996;22:521–5.

    PubMed  Google Scholar 

  171. Yavari HR, Rahimi S, Shahi S, Lotfi M, Barhaghi MH, Fatemi A, Abdolrahimi M. Effect of Er, Cr: YSGG laser irradiation on Enterococcus faecalis in infected root canals. Photomed Laser Surg. 2010;28 Suppl 1:S91–6.

    PubMed  Google Scholar 

  172. Yoo YJ, Lee W, Kim HC, Shon WJ, Baek SH. Multivariate analysis of the cleaning efficacy of different final irrigation techniques in the canal and isthmus of mandibular posterior teeth. Restor Dent Endod. 2013;38:154–9.

    PubMed Central  PubMed  Google Scholar 

  173. Yücel AÇ, Gürel M, Güler E, Karabucak B. Comparison of final irrigation techniques in removal of calcium hydroxide. Aust Endod J. 2013;39:116–21.

    PubMed  Google Scholar 

  174. Zhu X, Yin X, Chang JW, Wang Y, Cheung GS, Zhang C. Comparison of the antibacterial effect and smear layer removal using photon-initiated photoacoustic streaming aided irrigation versus a conventional irrigation in single-rooted canals: an in vitro study. Photomed Laser Surg. 2013;31:371–7.

    PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Endodontics, The Ohio State University College of Dentistry, Postle Hall, Room 3058, 305 W. 12th Ave., Columbus, OH, 43210, USA

    John M. Nusstein DDS, MS

Authors
  1. John M. Nusstein DDS, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John M. Nusstein DDS, MS .

Editor information

Editors and Affiliations

  1. Department of Dentistry, University of Toronto, Toronto, Canada

    Bettina Basrani

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Nusstein, J.M. (2015). Sonic and Ultrasonic Irrigation. In: Basrani, B. (eds) Endodontic Irrigation. Springer, Cham. https://doi.org/10.1007/978-3-319-16456-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-16456-4_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16455-7

  • Online ISBN: 978-3-319-16456-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation