IMPACT OF CONTRACTED ACCESS ON IRRIGANT DELIVERY AND DEBRIS REMOVAL IN MANDIBULAR MOLARS: AN SEM EVALUATION.
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Keywords
Contracted endodontic access cavity, Debridement efficacy, Laser-activated irrigation, Ultrasonic-activated irrigation, Sonic-activated irrigation, Traditional endodontic access cavity, Mandibular molars
Abstract
Aim: To evaluate and compare the debridement efficacy of laser-activated (LA), ultrasonic-activated (UA), and sonic-activated (SA) irrigation in the distal canals of mandibular molars with either contracted (CEC) or traditional (TEC) endodontic cavity designs, using scanning electron microscopy (SEM).
Materials and methods: Sixty extracted mandibular first molars were randomly divided into TEC and CEC groups (n=30 each). Following CBCT assessment and instrumentation to #30/0.06 with NaOCl and EDTA irrigation, canals in each group were further randomized (n=10 per subgroup) for final irrigation with NaOCl/EDTA/NaOCl activated by LA, UA, or SA. Decoronated distal roots were split, and SEM assessed debris removal. Statistical analysis used an unpaired t-test.
Results: Overall, debris scores were comparable between TEC and CEC groups across all canal levels. Intergroup analysis revealed that LA irrigation resulted in significantly greater debris removal at the coronal, middle, and apical thirds compared to UA and SA, regardless of the cavity design.
Conclusion: Debridement efficacy in the distal roots of mandibular molars with CEC was similar to TEC, independent of the irrigation activation system used. However, LA consistently demonstrated superior debris removal in both cavity designs.
Clinical significance: While CEC preserves pericervical dentin, this study indicates that its reduced size does not compromise debridement efficacy compared to TEC. Furthermore, laser activation appears to be a more effective irrigation strategy in both cavity designs, informing clinical decisions regarding access cavity preparation and irrigation protocols for optimal canal cleaning.
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Dr. Somnath Chakraborty
Associate Professor, Department of Dentistry, Gouri Devi Institute of Medical Sciences and Hospital, Durgapur.