Evaluation of the penetration of CHX 2% on dentinal tubules using Conventional Irrigation, Sonic Irrigation (EDDY) and Passive Ultrasonic Irrigation (PUI) techniques: An in vitro study

Abstract

Background: Various procedures and techniques have been developed to increase the effectiveness and penetration of irrigants into the dentinal tubules and anatomical anfractuosities. Objective: The purpose of this in vitro study was to compare the effect of different irrigation techniques such as conventional irrigation with a syringe, sonic activation irrigation with EDDY and Passive Ultrasonic Irrigation. All these on dentinal tubule penetration using Chlorhexidine. Material and Methods: 45 lower premolar teeth extracted for orthodontic reasons were used. These teeth were de-coronated to a length of 18mm. This working length was achieved by inserting a size 15 K file into the root canal until it was observed in the apex. Then the length was reduced to 1 mm. The instrumentation was performed with the Wave One Gold system up to a file # 45. Irrigated with 2mL of CHX between instruments. A final irrigation was performed using 5 mL of 17% EDTA with an E1 - Irrisonic insert for 3 0 seconds. Then, the root canal was irrigated with 5 mL of distilled water and dried with paper tips. The final irrigation of the 2% CHX with Rhodamine B was carried out with the different techniques of irrigation. Syringe irrigation with 5 mL, sonic irrigation and passive ultrasonic activation activated for 30 seconds in two stages. Axial cuts were made at 200 microns, the observation was done with stereomicroscope and image analysis in Image J software. Results: Statistically significant differences were found only in the apical region, where the depth penetration in the PUI group was 76 μm, MI 48 um and SI 41 μm, while in the penetration area, the PUI group was 99 μm2, MI 77 um2 and finally SI 53 μm2. Conclusions: The CHX was able to penetrate the dentinal tubules of three-thirds of the roots, for which the technique that showed the greatest penetration capacity was the ultrasonic activation.