Effectiveness of Combination Irrigant Technique for Debris Removal in Simulated Canal Irregularities: An in vitro Study

Aim: To evaluate the debridement efficacy of different irrigation systems in simulated canal irregularities. Study Design and Setting: About sixty maxillary central incisors were selected and after chemomechanical preparation were split longitudinally into two halves. Each groove and depression were filled with dentine debris mixed with 2.5 % NaOCl to simulate a situation where dentine debris accumulates in the un-instrumented extensions of the root canal. Materials and Methods: The specimens were randomly divided into 4 experimental groups as follows: Group I - Conventional Needle Irrigation, Group II - Apical Negative Pressure Irrigation (EndoVac), Group III - Passive Ultrasonic Irrigation and Group IV - Combination Irrigation (EV+PUI). 9 ml of 2.5 % NaOCl, 9 ml of 17 % EDTA and 9 ml of saline was used for the final irrigation protocol. Images were taken before and after irrigation using PRIMA DNT surgical microscope with digital camera. Statistical Analysis: The intergroup and individual comparison of percentage reduction of debris in groove and depressions were carried out by using Kruskal-Wallis and Mann-Whitney U tests respectively. The intergroup comparison for different scoring criteria was compared using Pearson’s chi-square tests. Differences were considered statistically significant at P value < 0.05. Results: The combination group, EV group and PUI group showed better removal of debris in Groove and Depressions than Conventional needle irrigation group. The Combination group had significant reduction of debris at 2 mm level when compared to all the other groups. Conclusion: The effectiveness of this combination irrigant delivery system for smear layer removal and antibacterial efficacy have to be evaluated further in future clinical studies