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

IntroductionThe purpose of this in vitro study was to compare the debris removal efficacy of the EndoActivatorTM system, the F fileTM, ultrasonic irrigation, or 6% NaOCl irrigation alone in human mandibular molars after hand-rotary instrumentation.MethodsA custom brass cube (K-Kube) was used to create a sealed canal system, allowing each tooth to serve as its own control. Forty extracted mandibular molars were randomly divided into 4 equal experimental groups. Each tooth was mounted, sectioned at 1, 3, and 5 mm from the working length, and then reassembled into the K-Kube, and the mesial roots were similarly prepared by using hand-rotary instrumentation. For final debridement, group 1 used F file for 30 seconds, group 2 used EndoActivator system for 30 seconds, group 3 used ultrasonic irrigation for 30 seconds, and group 4 used irrigation with 6% NaOCl within 1 mm of working length. All groups received a final irrigation with 6% NaOCl in each canal. Specimens were evaluated at 1, 3, and 5 mm from the working length for cleanliness by capturing a digital image with a stereomicroscope. All specimens had the percent cleanliness for each canal and isthmus calculated both before and after final debridement. Statistical analysis was completed by using a repeated-measures analysis of variance with Tukey post hoc tests.Results and ConclusionsThe results showed no statistically significant difference in canal or isthmus cleanliness among the 4 groups, but there was a statistically significant difference (P < .001) in canal cleanliness between the 1-mm level versus the 3-mm and 5-mm levels for all of the groups.