Comparison of the antibacterial efficacy of sonic- and two ultrasonic-activated irrigation techniques in reducing intracanal Enterococcus faecalis populations

Objective: This in-vitro study evaluated the antibacterial efficacy of sonic and ultrasonic irrigation with either intermittent or continuous flush in root canals infected with Enterococcus faecalis. Method and Materials: Seventy single-rooted, extracted teeth with straight root canals were prepared with FlexMaster NiTi-instruments, sterilized, inoculated with E faecalis and incubated for 72 hours. Sixty roots were randomly divided into four experimental groups as well as into infection and sterile controls (n = 10 each). The remaining teeth were used for SEM analysis of smear layer removal (n = 5) and infection with E faecalis (n = 5). Irrigation in the experimental groups was performed with 1% NaOCl and syringe irrigation, sonic activation of the irrigant with EndoActivator, ultrasonic activation with intermittent flush, or ultrasonic activation with continuous flush. Microbial sampling was performed by collecting dentin shavings from the root canal walls. Colony-forming units were counted and statistical analysis was performed using nonparametric rank-based ANOVA-type tests for longitudinal data (P .05). Results: A significant reduction of E faecalis of 3 log10 steps compared to the infection control was achieved by all irrigation techniques (P .0001). There were no significant differences in antibacterial efficacy between syringe irrigation, sonically, or ultrasonically activated irrigation (P > .45). Conclusion: Activation of 1% NaOCl with either sonic or ultrasonic devices did not increase the antimicrobial efficacy against E faecalis compared to conventional syringe irrigation in straight root canals. Keywords: Enterococcus faecalis, irrigation, root canal, sonic, ultrasonic