The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 24 , ISSUE 7 ( July, 2023 ) > List of Articles


Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study

Priyanka Reddy Chinta, Nagalakshmi Kalla, Padma Chaitanya Dhavala, Damarla Poorna Samudra Satyavathi, Sanjay Adarsh Rolla, Pragnya Uppalapati

Keywords : Agitation, Debris, EndoVac, Irrigation, Mandibular molars, Plastic finishing file, Smear layer, XP-endo Finisher

Citation Information : Chinta PR, Kalla N, Dhavala PC, Satyavathi DP, Rolla SA, Uppalapati P. Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study. J Contemp Dent Pract 2023; 24 (7):449-453.

DOI: 10.5005/jp-journals-10024-3533

License: CC BY-NC 4.0

Published Online: 19-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. Methods and materials: Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I—XP-endo Finisher; group II—EndoVac; group III—plastic finishing file; and group IV— standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. Results: Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). Conclusion: The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. Clinical significance: The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.

  1. Duque JA, Duarte MA, Canali LC, et al. Comparative effectiveness of new mechanical irrigant agitating devices for debris removal from the canal and isthmus of mesial roots of mandibular molars. J Endod 2017; 43(2):326–331. DOI: 10.1016/j.joen.2016.10.009.
  2. Jayakumaar A, Ganesh A, Kalaiselvam R, et al. Evaluation of debris and smear layer removal with XP-endo Finisher: A scanning electron microscopic study. Indian J Dent Res 2019; 30(3):420–423. DOI: 10.4103/ijdr.IJDR_655_17.
  3. Carvalho MC, Zuolo ML, Arruda–Vasconcelos R, et al. Effectiveness of XP-endo Finisher in the reduction of bacterial load in oval-shaped root canals. Braz Oral Res 2019;33(21):e021. DOI: 10.1590/1807-3107bor-2019.vol33.0021.
  4. Kungwani ML, Prasad KP, Khiyani TS. Comparison of the cleaning efficacy of EndoVac with conventional irrigation needles in debris removal from root canal. An in-vivo study. J Conserv Dent 2014; 17:374–378. DOI: 10.4103/0972-0707.136514.
  5. Versiani MA, Alves FR, Andrade–Junior CV, et al. Micro-CT evaluation of the efficacy of hard–tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J 2016; 49(11):1079–1087. DOI: 10.1111/iej.12559.
  6. Thomas AR, Velmurugan N, Smita S, et al. Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems. J Endod 2014;40(10):1676–1680. DOI: 10.1016/j.joen.2014.05.014.
  7. Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: A comparative SEM investigation. J Endod 1997;23(5):301–306. DOI: 10.1016/S0099-2399(97)80410-4.
  8. Peters OA, Barbakow F. Effects of irrigation on debris and smear layer on canal walls prepared by two rotary techniques: A scanning electron microscopic study. J Endod 2000;26(1):6–10. DOI: 10.1097/00004770-200001000-00002.
  9. Howard RK, Kirkpatrick TC, Rutledge RE, et al. Comparison of debris removal with three different irrigation techniques. J Endod 2011;37(9):1301–1305. DOI: 10.1016/j.joen.2011.05.008.
  10. Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivatorTM System, the F FileTM, ultrasonic irrigation, and NaOCl irrigation alone after hand–rotary instrumentation in human Mandibular molars. J Endod 2010; 36(8):1367–1371. DOI: 10.1016/j.joen.2010.03.022.
  11. Bramante CM, Berbert A, Borges RP. A methodology for evaluation of root canal instrumentation. J Endod 1987;13(5):243–245. DOI: 10.1016/S0099-2399(87)80099-7.
  12. Singh N, Chandra A, Tikku AP, et al. A comparative evaluation of different irrigation activation systems on smear layer removal from root canal: An in-vitro scanning electron microscope study. J Conserv Dent 2014;17(2):159–163. DOI: 10.4103/0972-0707.128060.
  13. Leoni GB, Versiani MA, Silva–Sousa YT, et al. Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root canal system of mandibular first molars. Int Endod J 2017;50(4):398–406. DOI: 10.1111/iej.12630.
  14. Bao P, Shen Y, Lin J, et al. In vitro efficacy of XP-endo Finisher with 2 different protocols on biofilm removal from apical root canals. J Endod 2017;43(2):321–325. DOI: 10.1016/j.joen.2016.09.021.
  15. Chatterjee S, Desai PD, Mukherjee S, et al. Evaluation of debris and smear layer formation using three different NI-TI rotary instrument systems: An in vitro scanning electron microscope study. J Conserv Dent 2021;24(6):568–575. DOI: 10.4103/JCD.JCD_510_20.
  16. Baumeier NC, Duarte MA, Vivan RR, et al. Passive ultrasonic irrigation, EndoActivator system and XP-endo Finisher R as additional cleaning techniques to remove residual filling materials from flattened root canals. J Conserv Dent 2022;25(4):385–391. DOI: 10.4103/jcd.jcd_117_22.
  17. Karunakar P, Solomon RV, Kumar BS, et al. Evaluation of smear layer removal of radicular Dentin in comparison with different irrigation devices: An in vitro study. J Conserv Dent 2021;24(3):236–240. DOI: 10.4103/JCD.JCD_208_19.
  18. Saini M, Kumari M, Taneja S. Comparative evaluation of the efficacy of three different irrigation devices in removal of debris from root canal at two different levels: An in vitro study. J Conserv Dent 2013;16(6):509–513. DOI: 10.4103/0972-0707.120959.
  19. Parente JM, Loushine RJ, Susin L, et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J 2010;43(11):1001–1012. DOI: 10.1111/j.1365-2591.2010.01755.x.
  20. Abarajithan M, Dham S, Velmurugan N, et al. Comparison of EndoVac irrigation system with conventional irrigation for removal of intracanal smear layer: An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(3):407–411. DOI: 10.1016/j.tripleo.2011.02.024.
  21. Mancini M, Cerroni L, Iorio L, et al. 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(11):1456–1460. DOI: 10.1016/j.joen.2013.07.028.
  22. 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):445–448. DOI: 10.1016/j.joen.2011.12.007.
  23. Gade VJ, Sedani SK, Lokade JS, et al. Comparative evaluation of debris removal from root canal wall by using EndoVac and conventional needle irrigation: An in vitro study. Contemp Clin Dent 2013;4(4): 432–436. DOI: 10.4103/0976-237X.123019.
  24. Heilborn C, Reynolds K, Johnson JD, et al. Cleaning efficacy of an apical negative-pressure irrigation system at different exposure times. Quintessence Int 2010;41(9):759–767. PMID: 20806100.
  25. Freire LG, Iglecias EF, Cunha RS, et al. Micro–computed tomographic evaluation of hard tissue debris removal after different irrigation methods and its influence on the filling of curved canals. J Endod 2015;41(10):1660–1666. DOI: 10.1016/j.joen.2015.05.001.
  26. Gu LS, Kim JR, Ling J, et al. Review of contemporary irrigant agitation techniques and devices. J Endod 2009;35(6):791–804. DOI: 10.1016/j.joen.2009.03.010.
  27. Haapasalo M, Shen Y, Wang Z, et al. Irrigation in endodontics. Br Dent J 2014;216(6):299–303. DOI: 10.1038/sj.bdj.2014.204.
  28. Susin L, Liu Y, Yoon JC, et al. Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system. Int Endod J 2010;43:1077–1090.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.