Investigations into in situ Enterococcus faecalis biofilm removal by passive and active sodium hypochlorite irrigation delivered into the lateral canal of a simulated root canal model

Abstract

Aim

To investigate in situ Enterococcus faecalis biofilm removal from the lateral canal of a simulated root canal system using passive or active irrigation protocols.

Methodology

Root canal models (n = 43) were manufactured from transparent resin materials using 3D-printing. Each canal was created with an 18 mm length, apical size 30, a .06 taper, and a lateral canal of 3 mm length, 0.3 mm diameter. Biofilms were grown on the lateral canal and apical 3 mm of the main canal for 10 days. Biofilm of three models was examined using SEM. The other forty models were divided to four groups (n = 10). The models were observed under a fluorescence microscope. Following 60 s of 9 mL of 2.5% NaOCl irrigation using syringe and needle, the irrigant was either left stagnant in the canal or activated using gutta-percha, sonic or ultrasonic methods for 30 s. Images were then captured every second using an external camera. The residual biofilm percentages were measured using image analysis software. The data were analyzed using generalized linear mixed models. A significance level of 0.05 was used throughout.

Results

The greatest level of biofilm removal was with ultrasonic agitation (66.76%) followed by sonic (45.49%), manual agitation (43.97%), and passive irrigation groups (38.67%) respectively. The differences were significant between the residual biofilm in the passive irrigation and both sonic & ultrasonic groups (P = 0.001).

Conclusion

Agitation resulted in better penetration of the 2.5% NaOCl into the lateral canal of an artificial root canal model. Ultrasonic agitation of NaOCl improved the removal of biofilm.

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