An in-vitro SEM study comparing the debridement efficacy of the EndoVac® system versus the Canal CleanMax® following hand-rotary istrumentation

Abstract

This in-vitro, prospective, randomized study microscopically compared the debridement efficacy of negative pressure irrigation with the EndoVac (Discus Dental, Culver City, CA) versus the Canal CleanMax (Maximum Dental, Inc., Secaucus, NJ). Sixty extracted human canines were instrumented using a combination of hand-instrumentation with Lexicon K-type files and rotary instrumentation with ProTaper files. All canals were irrigated with 6.0-percent sodium hypochlorite and 17- percent ethylenediaminetetraacetic acid (EDTA). However, the irrigation/aspiration techniques differed among three groups of 20 randomly selected teeth. Group one (control) was irrigated with only a 12-ml Monoject syringe via 30-gauge side-vented, closed-end needle. Group two was irrigated with the EndoVac system. Group three was irrigated similar to group one, but with the adjunct of the Canal CleanMax system. All teeth were sectioned longitudinally, and the more intact sections were divided into coronal, middle, and apical thirds. Each portion of the canal was photographed with a scanning electron microscope (SEM). The photographs were scored by two independent examiners according to relative amount of debris and/or smear layer present, as well as relative number of patent dentinal tubules. These scores were statistically analyzed using a Krustal-Wallis test and Wilcoxon Rank Sum tests to determine differences between groups. The coronal aspect of root canal walls irrigated with the EndoVac system exhibited significantly less debris and/or smear layer present when compared to the coronal aspect of root canals irrigated with only a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle (control). There were no other significant differences in scores between any groups at any location. For all locations combined, the EndoVac system produced significantly cleaner root canal walls as compared to the control. No significant differences were seen between the Canal CleanMax and Control or Canal CleanMax and EndoVac. This study suggested negative pressure irrigation delivery with the EndoVac system during and after hand-rotary instrumentation is more effective in removal of debris and smear layer from the coronal third and combined thirds of root canal walls compared to irrigation with a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle.