Evaluation of Effect of Irrigants with or without Surfactant on Root Canal Transportation by Cone Beam Computed Tomography-An In vitro Study.

Introduction: Maintenance of original canal anatomy with proper disinfection is our primary goal to achieve during root canal instrumentation. Surfactants are added to irrigating solution to promote deeper penetration into dentinal tubules.

Aim: The aim of this study was to evaluate the influence of addition of surfactants to Sodium Hypochlorite (NaOCl) and Ethylenediaminetetraacetic Acid (EDTA) on transportation of root canal.

Materials and Methods: Fifty human mandibular molars with mesial root curvatures of 10° - 40° were selected and embedded in silicone impression material to simulate mandibular arch form to facilitate imaging process and maintain reproducibility of images. Before instrumentation, root canals were scanned by using Cone Beam Computed Tomography (CBCT) imaging (Carestream, India). The canals were then prepared with the ProTaper Next (PTN) system (Dentsply Maillefer, Ballaigues, Switzerland), using one of the following irrigation regimens during the instrumentation and were divided into five groups based on irrigation regimens followed: G1 (n=10)-irrigation with saline solution(control); G2 (n=10)-irrigation with 2.5% NaOCl; G3 (n=10)-irrigation with 2.5% NaOCl added with surfactant; G4 (n=10)-irrigation with 17% EDTA; G5 (n=10)-irrigation with 17% EDTA added with surfactant. Post-instrumentation scans were obtained with similar parameters and position as pre-instrumentation scans by CBCT imaging. Transportation of the root canals were then analysed at three cross-sectional planes of pre-instrumentation and post-instrumentation images at 2 mm, 5 mm, 8 mm from the apical end of the root. The data was statistically analyzed using Analysis of Variance (ANOVA) and Tukey post hoc test (p<0.05).

Results: The mean transportation values were higher in G5. Transportation in G3 and G5 was not significantly different compared to G2 and G4 respectively (p<0.05).

Conclusion: Instrumentation using irrigating solutions added with surfactant like 1% cetrimide maintained the canal curvature well.