Investigation of the Efficacy of Passive Ultrasonic Irrigation Versus Irrigation with Reciprocating Activation: An Environmental Scanning Electron Microscopic Study

• An innovative irrigation system with reciprocating activation (EasyClean) was evaluated.
• Environmental scanning electron microscopy allowed the same specimens to be used for the different irrigation techniques tested.
• EasyClean produced cleaner walls compared with PUI in the apical third of the root canal.

IntroductionThe objective of this ex vivo study was to compare the efficacy of passive ultrasonic irrigation (PUI) versus a new activation system using reciprocating motion (EasyClean [EC]; Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) to remove debris from the root canal walls at 6 predetermined apical levels using environmental scanning electron microscopy.MethodsMesiobuccal root canals of 10 mandibular molars were prepared with a 30/.05 final instrument. The specimens were embedded in flasks containing heavy body silicone, cleaved longitudinally, and 6 round indentations were made into the apical region of the buccal half at 1-mm intervals. The same specimens were used to prepare a blank control group (no debris), a negative control group (completely covered by debris), and 2 experimental groups: PUI and irrigation with reciprocating activation. Standardized images of the indentations were obtained under environmental scanning electron microscopy and assessed by 2 examiners. The amount of debris was then classified using a 4-category scoring system. The kappa test was applied to determine interexaminer agreement, whereas the Kruskal-Wallis, Dunn, and Friedman tests were used to compare scores.ResultsThe EC group had results statistically similar to those of the blank control group for all 6 root levels examined. The PUI group had results statistically similar to those of the negative control group for the 3 most apical levels and similar to those of the blank control group for the 3 most cervical levels.ConclusionsActivating the irrigant with a reciprocating system (EC) promoted more effective debris removal from the more apical regions of the root canal when compared with PUI.