Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals

Background Infection control is important in root canal treatment. Effective cleaning and shaping are challenging due to complex anatomy, particularly in the isthmus—narrow connections between canals that can harbor bacteria. Conventional needle irrigation (CNI) is inadequate in this region, prompti...

Full description

Saved in:
Bibliographic Details
Main Authors: Chun-Hui Liu, Qiang Li, Xiao-Ying Zou, Lin Yue
Format: Article
Language:English
Published: PeerJ Inc. 2025-05-01
Series:PeerJ
Subjects:
Online Access:https://peerj.com/articles/19445.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849322110541889536
author Chun-Hui Liu
Qiang Li
Xiao-Ying Zou
Lin Yue
author_facet Chun-Hui Liu
Qiang Li
Xiao-Ying Zou
Lin Yue
author_sort Chun-Hui Liu
collection DOAJ
description Background Infection control is important in root canal treatment. Effective cleaning and shaping are challenging due to complex anatomy, particularly in the isthmus—narrow connections between canals that can harbor bacteria. Conventional needle irrigation (CNI) is inadequate in this region, prompting the use of passive ultrasonic irrigation (PUI) and high-frequency acoustic instruments like EDDY. This study evaluates the cleaning effects of four irrigation protocols using 3D-printed isthmus models. Methods Sixty digital root canal models with isthmuses in the coronal, middle, and apical thirds were designed using Ansys 19.0 and 3D printer (20 specimens per isthmus location). Specimens were prepared to 30#, 0.04 without irrigation. Debris accumulation in the isthmus was photographed and analyzed using Image J to calculate the initial debris area (S1). Specimens were then irrigated using CNI, low-frequency sonic irrigation (EndoActivator, EA; Dentsply, Charlotte, NC, USA), PUI, or high-frequency sonic irrigation (EDDY), followed by re-imaging to calculate remaining debris area (S2). Debris reduction percentage was determined using the formula: (S1–S2)/S1 × 100%. Results Debris reduction varied with isthmus position. In the coronal third, EDDY achieved the highest debris reduction (86.18 ± 2.25%), followed by PUI, EA, and CNI, with significant differences among groups (P < 0.05). The same trend was observed in the middle third, with EDDY showing the highest efficacy (73.96 ± 6.75%). In the apical third, debris reduction was lower overall, with no significant difference between EDDY and PUI, but both outperformed EA and CNI. Discussion Our results showed that EDDY demonstrated superior debris removal in the coronal and middle thirds, but all irrigation protocols showed limited efficacy in the apical third.
format Article
id doaj-art-206c7a2938f24595b7ee5dff9717512e
institution Kabale University
issn 2167-8359
language English
publishDate 2025-05-01
publisher PeerJ Inc.
record_format Article
series PeerJ
spelling doaj-art-206c7a2938f24595b7ee5dff9717512e2025-08-20T03:49:32ZengPeerJ Inc.PeerJ2167-83592025-05-0113e1944510.7717/peerj.19445Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canalsChun-Hui Liu0Qiang Li1Xiao-Ying Zou2Lin Yue3First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, ChinaDepartment of Oral Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, ChinaCenter of Stomatology, Peking University Hospital, Beijing, ChinaDepartment of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital, and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, ChinaBackground Infection control is important in root canal treatment. Effective cleaning and shaping are challenging due to complex anatomy, particularly in the isthmus—narrow connections between canals that can harbor bacteria. Conventional needle irrigation (CNI) is inadequate in this region, prompting the use of passive ultrasonic irrigation (PUI) and high-frequency acoustic instruments like EDDY. This study evaluates the cleaning effects of four irrigation protocols using 3D-printed isthmus models. Methods Sixty digital root canal models with isthmuses in the coronal, middle, and apical thirds were designed using Ansys 19.0 and 3D printer (20 specimens per isthmus location). Specimens were prepared to 30#, 0.04 without irrigation. Debris accumulation in the isthmus was photographed and analyzed using Image J to calculate the initial debris area (S1). Specimens were then irrigated using CNI, low-frequency sonic irrigation (EndoActivator, EA; Dentsply, Charlotte, NC, USA), PUI, or high-frequency sonic irrigation (EDDY), followed by re-imaging to calculate remaining debris area (S2). Debris reduction percentage was determined using the formula: (S1–S2)/S1 × 100%. Results Debris reduction varied with isthmus position. In the coronal third, EDDY achieved the highest debris reduction (86.18 ± 2.25%), followed by PUI, EA, and CNI, with significant differences among groups (P < 0.05). The same trend was observed in the middle third, with EDDY showing the highest efficacy (73.96 ± 6.75%). In the apical third, debris reduction was lower overall, with no significant difference between EDDY and PUI, but both outperformed EA and CNI. Discussion Our results showed that EDDY demonstrated superior debris removal in the coronal and middle thirds, but all irrigation protocols showed limited efficacy in the apical third.https://peerj.com/articles/19445.pdfIsthmus modelsSonic irrigationPassive ultrasonic irrigation
spellingShingle Chun-Hui Liu
Qiang Li
Xiao-Ying Zou
Lin Yue
Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
PeerJ
Isthmus models
Sonic irrigation
Passive ultrasonic irrigation
title Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
title_full Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
title_fullStr Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
title_full_unstemmed Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
title_short Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: an in vitro study based on simulated root canals
title_sort efficacy of high frequency sonic irrigation on removing debris from root canal isthmus an in vitro study based on simulated root canals
topic Isthmus models
Sonic irrigation
Passive ultrasonic irrigation
url https://peerj.com/articles/19445.pdf
work_keys_str_mv AT chunhuiliu efficacyofhighfrequencysonicirrigationonremovingdebrisfromrootcanalisthmusaninvitrostudybasedonsimulatedrootcanals
AT qiangli efficacyofhighfrequencysonicirrigationonremovingdebrisfromrootcanalisthmusaninvitrostudybasedonsimulatedrootcanals
AT xiaoyingzou efficacyofhighfrequencysonicirrigationonremovingdebrisfromrootcanalisthmusaninvitrostudybasedonsimulatedrootcanals
AT linyue efficacyofhighfrequencysonicirrigationonremovingdebrisfromrootcanalisthmusaninvitrostudybasedonsimulatedrootcanals