Comparative Evaluation of Penetrability of Root Canal Irrigants with Different Activation Techniques Using CBCT And Periapical Digital Radiography – An In Vitro Study.

Abstract

Background: Effective irrigation is crucial for disinfecting spaces beyond of instruments reach within the complex root canal anatomy. Traditional needle irrigation is limited in flushing irrigants to the apical region, whereas advanced activation methods like sonic and laser techniques may improve penetration.

Aim: The intend of the investigation is to comparatively assess the penetrability of irrigants using various endodontic irrigant activation methods, assessed through CBCT and RVG.

Materials and Methods: Using Protaper Gold files up to the F2 size, single-rooted thirty mandibular premolars were chosen, Tooth sectioned at the CEJ and biomechanically prepared. Sodium hypochlorite (5.25%) and EDTA(17%) was utilized to irrigate root canals, then a final rinse was carried out using sodium hypochlorite. After that, the samples were allocated to three groups (n = 10): Group I – Irrigation done using a side-vented needle, Group II- sonic irrigant activation using EndoActivator, Group III - laser activation with a diode laser980 nm. 2 mm above the full canal length, the activation process was finished. To assess Irrigant diffusion, CBCT scans and periapical radiographs were acquired after irrigation. The collected data was statistically analyzed using Tukey's post hoc test and one-way ANOVA at a significance level of p < 0.05.

Results: The average dye penetration that was highest was recorded in Group III (Diode Laser) at 3.50 ± 0.58, indicating superior irrigant activation. Group II (EndoActivator) showed moderate penetration at 0.40 ± 0.05, while the lowest penetration was recorded in Group I (Side-vented needle) at 0.02 ± 0.04. Significant differences between groups were found by statistical analysis (Kruskal-Wallis test, p value = 0.000). The advantage related to activation strategies over traditional irrigation was confirmed by post hoc tests, which showed that Group II performed better than Group I (p < 0.05) and Group III was much more effective than Groups II and I (p = 0.000).

Conclusion: Considering the study's limitations, it may be determined that irrigant penetration is superior with Laser group followed by Endoactivator and Side vented needle.