# A Comparison Between Multisonic and Ultrasonic Irrigant Activation Techniques for Multispecies Biofilm Removal During Root Canal Disinfection: A Systematic Review

## TL;DR

This systematic review compares multisonic and ultrasonic techniques for removing biofilms during root canal disinfection.

## Contribution

The study provides a comparative analysis of multisonic and ultrasonic methods for multispecies biofilm removal in root canals.

## Key findings

- Three studies were included, evaluating biofilm removal in extracted teeth models.
- The GentleWave® multisonic System outperformed ultrasonic activation in most studies.
- Both techniques showed similar efficacy in reducing intraradicular biofilm.

## Abstract

This systematic review aims to compare multisonic and ultrasonic irrigant activation techniques in polymicrobial biofilm removal. We conducted a literature search involving SCOPUS, PubMed, Cochrane, EBSCO host, and LILACS databases from inception to December 2024, in addition to a manual search using Google Scholar. The risk of bias assessment was done using the guidelines described for in vitro studies and the criteria for evaluation was based on JBI criteria and CRIS guidelines for quality assessment of in vitro studies. Three articles were included in the final analysis. The included studies evaluated biofilm removal in extracted teeth models incubated with biofilm; while two studies used quantitative polymerase chain reaction (qPCR) methodology, one used colony forming unit (CFU). Except in the study by Llerena et al., the GentleWave® multisonic System (GWS) outperformed ultrasonic irrigant activation (UI) in terms of biofilm removal. Despite the limitations of this systematic review, multisonic irrigant activation demonstrated similar efficacy in reducing intraradicular biofilm when compared to ultrasonic irrigant activation.