Evaluation of different activated irrigation protocols on debridement quality in various access cavity designs

Aims: This study aimed to evaluate the debridement quality of various activated irrigation (AI) protocols in the mesial root canal system of mandibular molars prepared with three different access cavity designs. Materials and Methods: Fifty-four freshly extracted mandibular molars were selected as per the inclusion criteria using preoperative cone-beam computer tomography. The teeth were randomly divided into three groups for three different access designs – Traditional Access Cavity (TradAC), Conservative Access Cavity, and Truss Access Cavity. Each group was further divided into three subgroups for three different irrigation protocols – Side Vent needle irrigation (SNI), sonic AI, and laser-AI. Each subgroup contained six samples. They were subjected to biomechanical preparation with different irrigation protocols using the standardized technique. Then samples were processed for histological evaluation after sectioning for measurement of remaining pulp tissues (RPT). Results: There was a statistically significant reduction in RPT using AI protocols ( P < 0.05) in the pulp chamber, and all areas of the mesial root canal system in minimally invasive access cavity designs (MIAD) as compared to SNI protocol. However, in the TradAC design, a statistically significant reduction in RPT was found only in the isthmus area using AI protocols ( P < 0.05). Conclusion: AI protocols efficiently removed RPT from the pulp chamber and the root canal system of MIAD.