# Comparison of the effectiveness of different ırrigation activation methods on biofilm removal in lateral canals – an ın vitro study

## TL;DR

This study compares different methods to remove biofilm from lateral canals in teeth, finding that the SAF system is most effective.

## Contribution

The study introduces a novel in vitro comparison of irrigation techniques for biofilm removal in 3D-printed lateral canals.

## Key findings

- The SAF group showed the highest hydrogel removal scores compared to other groups.
- SA, PUI, and ICH groups had similar effectiveness in dissolving hydrogel.
- All activation methods outperformed the control group.

## Abstract

Activation of sodium hypochlorite (NaOCl) to remove biofilm from lateral canal is important for the success of endodontic treatment. This study aimed to compare the biofilm dissolving capacity of different irrigation techniques in resin blocks with two lateral canals manufactured with 3D printers.

Biofilm-mimicking hydrogel was placed in the upper and lower lateral canals of 75 resin blocks. Main canals of the blocks were irrigated with 5% NaOCl. Then, the blocks were randomly divided into five groups: sonic activation (SA), passive ultrasonic irrigation (PUI), intracanal heating (ICH), self-adjusting file (SAF) and control. The amount of hydrogel removed was measured by weighing the blocks before and after the treatment and further visually scored. Data were analyzed using Kruskall Wallis H, Wilcoxon, Tukey Post-hoc HSD (Honestly Significant Difference) and one-way ANOVA tests.

The SAF group showed the highest hydrogel scores compared to other groups (p < 0.05). The hydrogel dissolution capacity of the SA group was lower compared to SAF, PUI and ICH techniques (p < 0.05). Based on visual scoring, SAF group was superior to other activation methods (p < 0.05) which are similar to each other (p > 0.05) in both upper and lower lateral canals.

All activation methods were superior than the control group. The SAF system demonstrated superior hydrogel dissolving ability, while SA, PUI, and ICH groups showed similar effectiveness.