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ABSTRACT:
Passive ultrasonic irrigation (PUI) is irrigant agitation technique without simultaneous instrumentation of root canal. In present article the available literature on PUI is reviewed from a MEDLINE database search. This article presents an overview of ultrasonic irrigation and their debridement efficacy. The use of PUI for irrigant activation results in improved canal cleanliness; better irrigant penetration and flow in the canal system; necrotic tissue debridement; and removal of smear layer and bacterial biofilms. Most of the studies conducted till date have only evaluated the effect of using PUI on irrigant penetration, debris removal and microbial reduction. Whether these parameters translate into better clinical outcome or not, remains to be seen.
Keywords: ultrasonic irrigation, irrigant agitation, PUI.
INTRODUCTION
Endodontic treatment (RCT) comprises of a combination of mechanical instrumentation of root canal system, its chemical debridement and filling with an inert material; intended to maintain or restore the health of the periradicular tissues (1). The primary aim of endodontic treatment is to obtain a clean root canal system free of microbiota and debris, which can then be sealed with a microbial-tight root canal filling. The chemomechanical preparation concept relates to the use of chemically active irrigating solutions in combination with mechanical cleansing. With the endodontic procedures at our disposal, it is impossible to shape & clean root canal completely. This is mainly due to the complex anatomy of the root canal system (2). Irregularities of the root canal walls in particular are a major concern, including oval extensions, isthmuses and apical deltas. Therefore irrigation is an essential part of a root canal treatment as it allows for cleaning in areas beyond the reach of root canal instruments.
Sodium hypochlorite (NaOCl) has been widely used in endodontic irrigation for its antimicrobial properties (3) and removal of organic tissue (4). In addition to NaOCl, the use of ethylene-diamine-tetra-acetic acid (EDTA) is a common practice in endodontic treatment to remove the inorganic component or smear layer left in the canal during root canal treatment (5). While substantial bacterial elimination from the root canal system can be achieved by chemo mechanical procedures using antimicrobial irrigants such as NaOCl, studies have demonstrated that 40-60% of root canals still have detectable levels of cultivable bacteria after chemo mechanical procedures using NaOCl...