Efficacy of needle irrigation, EndoActivator, and photon-initiated photoacoustic streaming technique on removal of double and triple antibiotic pastes

J Endod. 2014 Sep;40(9):1439-42. doi: 10.1016/j.joen.2014.02.013. Epub 2014 Apr 13.

Abstract

Introduction: Photon-induced photoacoustic streaming (PIPS) is a novel technique used for the removal of material on root canal walls, such as bacteria and the smear layer. This study evaluated the efficacy of needle irrigation, the EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK), and PIPS on the removal of antibiotic pastes from an artificial groove created in a root canal.

Methods: Root canal preparation was performed up to size #40 on 84 extracted single-rooted teeth using ProTaper rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland). The specimens were then split longitudinally, and 2 standardized grooves were prepared in the coronal and apical part of each segment. Double (DAP) and triple antibiotic pastes (TAP) were placed in the grooves for 4 weeks, and the root halves were reassembled. Needle irrigation, the EndoActivator System, and PIPS were used for the removal of DAP and TAP. The root segments were disassembled, and the amount of remaining antibiotic pastes was evaluated under a stereomicroscope at 20× magnification using a 4-grade scoring system. The data were evaluated statistically using Mann-Whitney U tests with a 95% confidence level (P = .05).

Results: PIPS removed significantly more antibiotic pastes than the EndoActivator and needle irrigation (P < .001). The EndoActivator was superior to needle irrigation in removing antibiotic pastes (P < .001). There were no statistically significant differences between DAP and TAP and between coronal and apical thirds in their removing from artificially created grooves (P > .05).

Conclusions: PIPS was more effective in removing both DAP and TAP from artificial grooves in root canals than the EndoActivator System and needle irrigation. The EndoActivator was also more effective than needle irrigation. It is difficult to completely remove antibiotic pastes from root canals.

Keywords: Double antibiotic paste; EndoActivator; endodontics; photon-induced photoacoustic streaming; regenerative; triple antibiotic paste.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / chemistry*
  • Ciprofloxacin / chemistry
  • Dental Pulp Cavity / anatomy & histology*
  • Humans
  • Lasers, Solid-State
  • Low-Level Light Therapy / instrumentation
  • Materials Testing
  • Metronidazole / chemistry
  • Minocycline / chemistry
  • Needles*
  • Photoacoustic Techniques / instrumentation*
  • Photoacoustic Techniques / methods
  • Photography / methods
  • Random Allocation
  • Root Canal Irrigants / chemistry*
  • Root Canal Preparation / instrumentation*
  • Root Canal Preparation / methods
  • Surface Properties
  • Therapeutic Irrigation / instrumentation*
  • Therapeutic Irrigation / methods
  • Tooth Apex / anatomy & histology

Substances

  • Anti-Bacterial Agents
  • Root Canal Irrigants
  • Metronidazole
  • Ciprofloxacin
  • Minocycline