ArticleInternational endodontic journal2023
Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high-speed imaging.
Article in International endodontic journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- Effectiveness of irrigation systems for removing intracanal medication isthmuses in 3D-printed molars replicas.Odontology · 2026Article
- Dissolution versus dislodgment of dentin debris by pulsed erbium-doped yttrium aluminum garnet laser-activated endodontic irrigants.Lasers in medical science · 2026Article
- Impact of electrode distance, axial position, and energization time on cauterization of root canal isthmuses using high-frequency current.Clinical oral investigations · 2026Article
- Mesiobuccal root morphology influences biomechanical stability after endodontic microsurgery in maxillary first molars: a finite element analysis study.BMC oral health · 2026Article
- Impact of laser and sonic activated irrigation on obturation quality in conservatively prepared mandibular molars: a micro-CT analysis.Clinical oral investigations · 2025Article
- Apical Irrigant Extrusion Using Two Er: YAG Laser Irrigation Modes with Three Types of Laser Tips.Acta stomatologica Croatica · 2025Article
- Article
- Efficacy of high-frequency sonic irrigation on removing debris from root canal isthmus: anPeerJ · 2025Article
- Comparison of a Novel Modality of Erbium-Doped Yttrium Aluminum Garnet Laser-Activated Irrigation and Ultrasonic Irrigation against MatureBioengineering (Basel, Switzerland) · 2024Article
- Phase-locked µPIV analysis of flow dynamics in a simulated root canal with different laser-activated irrigations.Lasers in medical science · 2024Article
- Article
- Eradication of mature biofilm from the isthmus region using Er, Cr: YSGG Laser as an activator of 2% chlorhexidine gluconate.Journal of clinical and experimental dentistry · 2024Article
- Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review.Bioengineering (Basel, Switzerland) · 2023Review
- Investigating the effect of Er,Cr:YSGG laser agitation of sodium hypochlorite on the removal of mature biofilm in the complex root canal systems using atomic force microscopy.Journal of dental research, dental clinics, dental prospects · 2023Article
- Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high-speed imaging.International endodontic journal · 2023Article
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
aimLittle is known about the influence of isthmus morphology on the debridement efficacy of activated irrigation. The aim of this study was to investigate the influence of isthmus morphology on the debridement efficacy of laser-activated irrigation (LAI), EDDY and needle irrigation (NI), and to explain the methods of isthmus cleaning by LAI and EDDY. METHODOLOGY: Four root canal models (apical diameter: 0.30 mm, taper: 0.06, curvature: 23°, length: 20 mm) were produced by CAD-CAM with different isthmus morphologies: long-wide (4 mm; 0.4 mm), long-narrow (4 mm; 0.15 mm), short-wide (2 mm; 0.4 mm) and short-narrow (2 mm; 0.15 mm). The isthmuses were filled with a hydrogel containing dentine debris. The canals were filled with irrigant and models were assigned to the following irrigation protocols (n = 240): needle irrigation (NI) with a 30G needle, Eddy, and LAI (2940 nm Er:YAG-laser, 15 Hz, 40 mJ, SWEEPS, tip at the canal entrance). Standardized images of the isthmuses were taken before and after irrigation, and the amount of removed hydrogel was determined using image analysis software and compared across groups using Kruskal-Wallis test followed by Dunn's multiple comparison. Visualization of the isthmus during activation was achieved using a high-speed camera. The pattern and speed of the flow in the isthmus as well as transient and stable cavitation were analysed using imaging software.
resultsLaser-activated irrigation, EDDY and NI removed more hydrogel in short-wide isthmuses than in narrow isthmuses (p < .001). LAI and EDDY removed more hydrogel than NI in every isthmus configuration (p < .001). EDDY showed eddies and stable cavitation, and LAI showed transient cavitation at each pulse, and pulsed horizontal flow with the highest particle speed in closed short isthmuses.
conclusionsIsthmus morphology influences debridement in all irrigation groups. Short-wide isthmuses were the easiest to clean while narrow isthmuses were the most challenging to clean. Width seems to be a more critical anatomical parameter than length. LAI and EDDY resulted in the greatest biofilm removal and performed better than NI. EDDY produced eddies and stable cavitation in the isthmus, and LAI showed transient cavitation and pulsed horizontal flow.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.