Comparison of the Effect of Two Endodontic Irrigation Protocols on the Elimination of Bacteria from Root Canal

By Beus C, Safavi K, Stratton J, Kaufman B

Date: 01/2012
Journal: JOE


To compare the results of two different irrigation protocols in removing bacteria from the root canals, and to observe the bacterial elimination following second visit instrumentation and intra-appointment Ca(OH)2. N= 50 pts with a posterior tooth with apical periodontitis requiring non-surgical root canal therapy (NSRCT); 5 control teeth positive to cold and no signs of apical periodontitis


  • Standard NSRCT performed in a two-visit approach with Ca(OH)2 as intra-appointment medicament with one of the following irrigation protocols:
    • (n= 25) 1 % NaOCl non-activated single irrigation protocol (NAI)
    • (n= 25) 1 % NaOCl, 17 % EDTA, and 2 % chlorhexidine with passive ultrasonic multi-irrigation protocol (PUI)
    • (n= 5) control teeth. 3 in PUI group, 2 in NAI group
  • 4 samples taken: Before Instrumentation, After Irrigation Protocol, after Ca(OH)2 medication, and after final prep


  • 4 patients lost to follow-up
  • All control teeth showed no signs of bacterial contamination and all negative throughout treatment; experimental teeth all tested positive for cultured bacteria
  • The following results are not statistically significant: Canals [NAI (80 %) and PUI (84 %)] bacteria free at the end of the first visit. After Ca(OH)2 medication the total sample (NAI + PUI) had increased to 87 % bacteria free, and the second-visit instrumentation resulted in a total of 91 % bacteria free.

Clinical Significance:

No differences were found between the irrigation protocols presented.