{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:58:21Z","timestamp":1788267501988,"version":"build-2803163510"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Recep Tayyip Erdo\u011fan University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone\u2013beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven\u2019s criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Among the 56 teeth, 11 teeth were \u2018totally healed\u2019, and 39 teeth were \u2018reduced\u2019 on PA radiographs. No \u2018enlargement\u2019 was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%)\u2009&gt;\u2009PUI (85.4%)\u2009&gt;\u2009MDA (80.4%)\u2009&gt;\u2009control (74.5%), with no statistically significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-024-05758-4","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T03:02:42Z","timestamp":1718420562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial"],"prefix":"10.1007","volume":"28","author":[{"given":"Mehmet Umutcan","family":"Do\u011fan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Ar\u0131c\u0131o\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha Emre","family":"K\u00f6se","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahter \u015eanal","family":"\u00c7\u0131kman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve \u00c7oban","family":"\u00d6ks\u00fczer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"issue":"8","key":"5758_CR1","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.joen.2010.04.007","volume":"36","author":"D Ricucci","year":"2010","unstructured":"Ricucci D, Siqueira JF Jr. (2010) Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod 36(8):1277\u20131288","journal-title":"J Endod"},{"issue":"3","key":"5758_CR2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1046\/j.1365-2591.2001.00373.x","volume":"34","author":"OA Peters","year":"2001","unstructured":"Peters OA, Sch\u00f6nenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34(3):221\u2013230","journal-title":"Int Endod J"},{"issue":"1\u20132","key":"5758_CR3","first-page":"18","volume":"104","author":"B Basrani","year":"2011","unstructured":"Basrani B (2011) Irrigation in endodontic treatment. Alpha Omegan 104(1\u20132):18\u201325","journal-title":"Alpha Omegan"},{"issue":"7","key":"5758_CR4","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1016\/j.joen.2010.02.019","volume":"36","author":"C de Gregorio","year":"2010","unstructured":"de Gregorio C et al (2010) Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod 36(7):1216\u20131221","journal-title":"J Endod"},{"issue":"6","key":"5758_CR5","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.joen.2009.03.010","volume":"35","author":"L-s Gu","year":"2009","unstructured":"Gu L-s et al (2009) Review of Contemporary Irrigant Agitation techniques and devices. J Endod 35(6):791\u2013804","journal-title":"J Endod"},{"issue":"2","key":"5758_CR6","doi-asserted-by":"crossref","first-page":"155","DOI":"10.4103\/JCD.JCD_387_18","volume":"22","author":"CC Souza","year":"2019","unstructured":"Souza CC et al (2019) Efficacy of passive ultrasonic irrigation, continuous ultrasonic irrigation versus irrigation with reciprocating activation device in penetration into main and simulated lateral canals. J Conserv Dent 22(2):155\u2013159","journal-title":"J Conserv Dent"},{"issue":"1","key":"5758_CR7","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1365-2591.2008.01497.x","volume":"42","author":"A Al-Jadaa","year":"2009","unstructured":"Al-Jadaa A et al (2009) Necrotic pulp tissue dissolution by passive ultrasonic irrigation in simulated accessory canals: impact of canal location and angulation. Int Endod J 42(1):59\u201365","journal-title":"Int Endod J"},{"issue":"3","key":"5758_CR8","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.tripleo.2009.04.023","volume":"108","author":"S Goel","year":"2009","unstructured":"Goel S, Tewari S (2009) Smear layer removal with passive ultrasonic irrigation and the NaviTip FX: a scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108(3):465\u2013470","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"issue":"1","key":"5758_CR9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12903-021-01427-0","volume":"21","author":"M Mancini","year":"2021","unstructured":"Mancini M et al (2021) FESEM evaluation of smear layer removal from conservatively shaped canals: laser activated irrigation (PIPS and SWEEPS) compared to Sonic and passive ultrasonic activation-an ex vivo study. BMC Oral Health 21(1):81","journal-title":"BMC Oral Health"},{"key":"5758_CR10","unstructured":"Lukac N, Jezersek MB, Lukac M (2017) M., Photoacoustic endodontics using the Novel SWEEPS Er: YAG Laser Modality. Journal of the Laser and Health Academy"},{"key":"5758_CR11","unstructured":"Heta S et al (2024) Cardiovascular diseases and apical periodontitis, connection of two pathologies in adult patients; a systematic review. J Endod Restor Dent"},{"issue":"8","key":"5758_CR12","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/j.1365-2591.2011.01989.x","volume":"45","author":"S Patel","year":"2012","unstructured":"Patel S et al (2012) The detection of periapical pathosis using periapical radiography and cone beam computed tomography - part 1: pre-operative status. Int Endod J 45(8):702\u2013710","journal-title":"Int Endod J"},{"issue":"10","key":"5758_CR13","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/j.joen.2013.07.001","volume":"39","author":"WG van der Borden","year":"2013","unstructured":"van der Borden WG et al (2013) Area and 3-dimensional volumetric changes of periapical lesions after root canal treatments. J Endod 39(10):1245\u20131249","journal-title":"J Endod"},{"issue":"1","key":"5758_CR14","first-page":"27","volume":"1","author":"FP Hatipo\u011flu","year":"2023","unstructured":"Hatipo\u011flu FP, \u00c7\u0131kman AB, K\u00f6se A\u015e (2023) Four Year follow-up of a Mandibular Second Premolar tooth with three canals and large Periapical Lesion after Retreatment: a Case Report. J Endod Restor Dent 1(1):27\u201330","journal-title":"J Endod Restor Dent"},{"issue":"7","key":"5758_CR15","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.joen.2017.02.007","volume":"43","author":"T Schloss","year":"2017","unstructured":"Schloss T et al (2017) A comparison of 2- and 3-dimensional Healing Assessment after endodontic surgery using cone-beam computed Tomographic volumes or periapical radiographs. J Endod 43(7):1072\u20131079","journal-title":"J Endod"},{"issue":"9","key":"5758_CR16","doi-asserted-by":"crossref","first-page":"2681","DOI":"10.1007\/s00784-017-2070-x","volume":"21","author":"K Urban","year":"2017","unstructured":"Urban K et al (2017) Canal cleanliness using different irrigation activation systems: a SEM evaluation. Clin Oral Investig 21(9):2681\u20132687","journal-title":"Clin Oral Investig"},{"issue":"9","key":"5758_CR17","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s10103-017-2297-4","volume":"32","author":"J Verstraeten","year":"2017","unstructured":"Verstraeten J et al (2017) Hard tissue debris removal from the mesial root canal system of mandibular molars with ultrasonically and laser-activated irrigation: a micro-computed tomography study. Lasers Med Sci 32(9):1965\u20131970","journal-title":"Lasers Med Sci"},{"issue":"1","key":"5758_CR18","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/aej.12342","volume":"46","author":"F Haupt","year":"2020","unstructured":"Haupt F et al (2020) Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: a SEM evaluation. Aust Endod J 46(1):40\u201346","journal-title":"Aust Endod J"},{"issue":"3","key":"5758_CR19","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/iej.12306","volume":"48","author":"H Arslan","year":"2015","unstructured":"Arslan H et al (2015) An in vitro comparison of irrigation using photon-initiated photoacoustic streaming, ultrasonic, sonic and needle techniques in removing calcium hydroxide. Int Endod J 48(3):246\u2013251","journal-title":"Int Endod J"},{"issue":"1","key":"5758_CR20","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jds.2021.05.015","volume":"17","author":"L Shi","year":"2022","unstructured":"Shi L et al (2022) Efficacy of five irrigation techniques in removing calcium hydroxide from simulated S-shaped root canals. J Dent Sci 17(1):128\u2013134","journal-title":"J Dent Sci"},{"issue":"3","key":"5758_CR21","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.joen.2013.10.019","volume":"40","author":"ID Capar","year":"2014","unstructured":"Capar ID et al (2014) Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod 40(3):451\u2013454","journal-title":"J Endod"},{"issue":"4","key":"5758_CR22","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.joen.2016.12.004","volume":"43","author":"L Generali","year":"2017","unstructured":"Generali L et al (2017) Effect of different Irrigation systems on Sealer Penetration into Dentinal Tubules. J Endod 43(4):652\u2013656","journal-title":"J Endod"},{"key":"5758_CR23","doi-asserted-by":"crossref","unstructured":"Dilara Koruk FB, Dilan K\u0131rm\u0131z\u0131 U, Aksoy The Impact of Laser-Activated and Conventional Irrigation Techniques on Sealer Penetration into Dentinal Tubules Photobiomodulation, Photomedicine, and Laser Surgery, 12 Aug 2022. 40(8)","DOI":"10.1089\/photob.2022.0017"},{"key":"5758_CR24","doi-asserted-by":"crossref","first-page":"p8060489","DOI":"10.1155\/2020\/8060489","volume":"2020","author":"A Yilmaz","year":"2020","unstructured":"Yilmaz A, Yalcin TY, Helvacioglu-Yigit D (2020) Effectiveness of various final irrigation techniques on Sealer Penetration in Curved roots: a confocal laser scanning Microscopy Study. Biomed Res Int 2020:p8060489","journal-title":"Biomed Res Int"},{"issue":"3","key":"5758_CR25","first-page":"96","volume":"4","author":"A Susila","year":"2019","unstructured":"Susila A, Minu J (2019) Activated irrigation vs. conventional non-activated irrigation in Endodontics - A systematic review. Eur Endod J 4(3):96\u2013110","journal-title":"Eur Endod J"},{"issue":"9","key":"5758_CR26","doi-asserted-by":"crossref","first-page":"e821","DOI":"10.4317\/jced.56368","volume":"12","author":"A Verma","year":"2020","unstructured":"Verma A et al (2020) A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis. J Clin Exp Dent 12(9):e821\u2013e829","journal-title":"J Clin Exp Dent"},{"issue":"5","key":"5758_CR27","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.joen.2019.01.020","volume":"45","author":"AF Campello","year":"2019","unstructured":"Campello AF et al (2019) Determination of the initial apical canal diameter by the First file to bind or cone-beam computed tomographic measurements using micro-computed tomography as the Gold Standard: an Ex vivo study in human cadavers. J Endod 45(5):619\u2013622","journal-title":"J Endod"},{"key":"5758_CR28","first-page":"277","volume-title":"Endodontic therapy","author":"FS Weine","year":"1989","unstructured":"Weine FS (1989) Endodontic therapy. Mosby, St. Louis, pp 277\u2013369"},{"issue":"12","key":"5758_CR29","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/j.joen.2016.08.024","volume":"42","author":"KW Neuhaus","year":"2016","unstructured":"Neuhaus KW et al (2016) Antibacterial efficacy of a New Sonic Irrigation device for Root Canal Disinfection. J Endod 42(12):1799\u20131803","journal-title":"J Endod"},{"key":"5758_CR30","doi-asserted-by":"crossref","first-page":"750","DOI":"10.15311\/selcukdentj.805466","volume":"8","author":"B Ar\u0131c\u0131o\u011flu","year":"2021","unstructured":"Ar\u0131c\u0131o\u011flu B et al (2021) Enterococcus Faecalis Biyofilm Eliminasyonunun Er:Yag Modalitelerine (PIPS VE SWEEPS) G\u00f6re Kar\u015fila\u015ftirilmasi. Selcuk Dent J 8:750\u2013757","journal-title":"Selcuk Dent J"},{"issue":"7","key":"5758_CR31","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1089\/pho.2017.4293","volume":"35","author":"X Cheng","year":"2017","unstructured":"Cheng X et al (2017) Bactericidal Effect of Er:YAG Laser-activated Sodium Hypochlorite Irrigation against biofilms of Enterococcus faecalis isolate from Canal of Root-filled teeth with Periapical Lesions. Photomed Laser Surg 35(7):386\u2013392","journal-title":"Photomed Laser Surg"},{"issue":"6","key":"5758_CR32","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/iej.12016","volume":"46","author":"RG Miranda","year":"2013","unstructured":"Miranda RG et al (2013) Ex vivo antimicrobial efficacy of the EndoVac system plus photodynamic therapy associated with calcium hydroxide against intracanal Enterococcus faecalis. Int Endod J 46(6):499\u2013505","journal-title":"Int Endod J"},{"issue":"5","key":"5758_CR33","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.3390\/clinpract13050094","volume":"13","author":"A Iandolo","year":"2023","unstructured":"Iandolo A et al (2023) Traditional and recent Root Canal Irrigation methods and their effectiveness: a review. Clin Pract 13(5):1059\u20131072","journal-title":"Clin Pract"},{"issue":"05","key":"5758_CR34","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.19070\/2377-8075-21000514","volume":"8","author":"S Nivedhitha","year":"2021","unstructured":"Nivedhitha S (2021) Comparing the effectiveness of various Irrigant activation techniques with conventional needle Irrigation-A systematic review. Int J Dentistry Oral Sci 8(05):2626\u20132631","journal-title":"Int J Dentistry Oral Sci"},{"issue":"3","key":"5758_CR35","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/s12565-023-00727-5","volume":"98","author":"FP Hatipo\u011flu","year":"2023","unstructured":"Hatipo\u011flu FP et al (2023) Prediction of root canal lengths and pulp volume of the maxillary permanent first molar based on stature, crown diameters, and facial morphometry. Anat Sci Int 98(3):454\u2013462","journal-title":"Anat Sci Int"},{"issue":"1","key":"5758_CR36","first-page":"12","volume":"2","author":"F Pertek Hatipo\u011flu","year":"2024","unstructured":"Pertek Hatipo\u011flu F, Ma\u011fat G (2024) Assessment of the Root Canal configuration of Mandibular Anterior Teeth in Turkish Population; a systematic review and Meta-analysis. J Endod Restor Dent 2(1):12\u201318","journal-title":"J Endod Restor Dent"},{"issue":"1","key":"5758_CR37","first-page":"8","volume":"1","author":"G Ma\u011fat","year":"2023","unstructured":"Ma\u011fat G, Buchanan US (2023) Evaluation of Maxillary First Molar Teeth\u2019s Mesiobuccal Root and Root Canal morphology using two classification systems amongst a Turkish population: a cone-beam computed Tomography study. J Endod Restor Dent 1(1):8\u201314","journal-title":"J Endod Restor Dent"},{"issue":"1","key":"5758_CR38","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.joen.2011.09.032","volume":"38","author":"S Kaya","year":"2012","unstructured":"Kaya S et al (2012) Measuring bone density in healing periapical lesions by using cone beam computed tomography: a clinical investigation. J Endod 38(1):28\u201331","journal-title":"J Endod"},{"issue":"2","key":"5758_CR39","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1259\/dmfr\/28403350","volume":"33","author":"D Schulze","year":"2014","unstructured":"Schulze D et al (2014) Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofacial Radiol 33(2):83\u201386","journal-title":"Dentomaxillofacial Radiol"},{"issue":"2","key":"5758_CR40","first-page":"64","volume":"7","author":"M Kumar","year":"2015","unstructured":"Kumar M et al (2015) Cone beam computed tomography - know its secrets. J Int Oral Health 7(2):64\u201368","journal-title":"J Int Oral Health"},{"issue":"1","key":"5758_CR41","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/iej.12270","volume":"48","author":"S Patel","year":"2015","unstructured":"Patel S et al (2015) Cone beam computed tomography in Endodontics - a review. Int Endod J 48(1):3\u201315","journal-title":"Int Endod J"},{"issue":"5","key":"5758_CR42","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/iej.12650","volume":"50","author":"S Kanagasingam","year":"2017","unstructured":"Kanagasingam S et al (2017) Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard. Int Endod J 50(5):417\u2013426","journal-title":"Int Endod J"},{"issue":"7","key":"5758_CR43","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.joen.2009.04.006","volume":"35","author":"FW de Paula-Silva","year":"2009","unstructured":"de Paula-Silva FW et al (2009) Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 35(7):1009\u20131012","journal-title":"J Endod"},{"issue":"9","key":"5758_CR44","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.joen.2006.03.008","volume":"32","author":"JH Simon","year":"2006","unstructured":"Simon JH et al (2006) Differential diagnosis of large periapical lesions using cone-beam computed tomography measurements and biopsy. J Endod 32(9):833\u2013837","journal-title":"J Endod"},{"issue":"3","key":"5758_CR45","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1365-2591.1996.tb01361.x","volume":"29","author":"D Orstavik","year":"1996","unstructured":"Orstavik D (1996) Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29(3):150\u2013155","journal-title":"Int Endod J"},{"issue":"12","key":"5758_CR46","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1097\/01.don.0000164856.27920.85","volume":"31","author":"T Waltimo","year":"2005","unstructured":"Waltimo T et al (2005) Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing. J Endod 31(12):863\u2013866","journal-title":"J Endod"},{"issue":"6","key":"5758_CR47","doi-asserted-by":"crossref","first-page":"484","DOI":"10.4103\/0972-0707.120933","volume":"16","author":"G Dorasani","year":"2013","unstructured":"Dorasani G, Madhusudhana K, Chinni SK (2013) Clinical and radiographic evaluation of single-visit and multi-visit endodontic treatment of teeth with periapical pathology: an in vivo study. J Conserv Dent 16(6):484\u2013488","journal-title":"J Conserv Dent"},{"key":"5758_CR48","doi-asserted-by":"crossref","unstructured":"\u00c7al\u0131\u015fkan MJIej (2004) Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. 37(6):408\u2013416","DOI":"10.1111\/j.1365-2591.2004.00809.x"},{"issue":"8","key":"5758_CR49","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/01.DON.0000129039.59003.9D","volume":"30","author":"OA Peters","year":"2004","unstructured":"Peters OA (2004) Current challenges and concepts in the preparation of root canal systems: a review. J Endod 30(8):559\u2013567","journal-title":"J Endod"},{"issue":"2","key":"5758_CR50","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00004770-200302000-00009","volume":"29","author":"R Holland","year":"2003","unstructured":"Holland R et al (2003) A comparison of one versus two appointment endodontic therapy in dogs\u2019 teeth with apical periodontitis. J Endod 29(2):121\u2013124","journal-title":"J Endod"},{"key":"5758_CR51","doi-asserted-by":"crossref","unstructured":"Cabanillas-Balsera D et al (2020) Smoking and Radiolucent Periapical Lesions in Root filled Teeth: systematic review and Meta-analysis. J Clin Med, 9(11)","DOI":"10.3390\/jcm9113506"},{"issue":"4","key":"5758_CR52","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/iej.13253","volume":"53","author":"V Nagendrababu","year":"2020","unstructured":"Nagendrababu V et al (2020) Association between diabetes and the outcome of root canal treatment in adults: an umbrella review. Int Endod J 53(4):455\u2013466","journal-title":"Int Endod J"},{"issue":"6","key":"5758_CR53","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00784-016-1805-4","volume":"20","author":"JJ Segura-Egea","year":"2016","unstructured":"Segura-Egea JJ et al (2016) Association between diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig 20(6):1133\u20131141","journal-title":"Clin Oral Investig"},{"issue":"2","key":"5758_CR54","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.joen.2013.10.036","volume":"40","author":"IJ M\u00e1rton","year":"2014","unstructured":"M\u00e1rton IJ, Kiss C (2014) Overlapping protective and destructive regulatory pathways in apical periodontitis. J Endod 40(2):155\u2013163","journal-title":"J Endod"},{"issue":"10","key":"5758_CR55","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.joen.2008.07.010","volume":"34","author":"MF Leite","year":"2008","unstructured":"Leite MF et al (2008) Diabetes induces metabolic alterations in dental pulp. J Endod 34(10):1211\u20131214","journal-title":"J Endod"},{"issue":"3","key":"5758_CR56","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/s41415-019-0532-z","volume":"227","author":"E Silva","year":"2019","unstructured":"Silva E et al (2019) Effectiveness of passive ultrasonic irrigation on periapical healing and root canal disinfection: a systematic review. Br Dent J 227(3):228\u2013234","journal-title":"Br Dent J"},{"issue":"10","key":"5758_CR57","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/j.joen.2013.06.024","volume":"39","author":"YH Liang","year":"2013","unstructured":"Liang YH et al (2013) Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: a randomized controlled trial. J Endod 39(10):1218\u20131225","journal-title":"J Endod"},{"issue":"Suppl 1","key":"5758_CR58","first-page":"S311","volume":"26","author":"Z Tang","year":"2015","unstructured":"Tang Z, Wang H, Jiang S (2015) Clinical study of single-visit root canal treatment with a nickel-titanium (Ni-Ti) rotary instrument combined with different ultrasonic irrigation solutions for elderly patients with chronic apical periodontitis. Biomed Mater Eng 26(Suppl 1):S311\u2013S318","journal-title":"Biomed Mater Eng"},{"issue":"2","key":"5758_CR59","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s10103-013-1442-y","volume":"30","author":"E Deleu","year":"2015","unstructured":"Deleu E, Meire MA, De Moor RJG (2015) Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci 30(2):831\u2013835","journal-title":"Lasers Med Sci"},{"issue":"8","key":"5758_CR60","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1089\/pho.2013.3515","volume":"31","author":"X Zhu","year":"2013","unstructured":"Zhu X et al (2013) Comparison of the antibacterial effect and smear layer removal using photon-initiated photoacoustic streaming aided irrigation versus a conventional irrigation in single-rooted canals: an in vitro study. Photomed Laser Surg 31(8):371\u2013377","journal-title":"Photomed Laser Surg"},{"issue":"12","key":"5758_CR61","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1089\/pho.2016.4234","volume":"35","author":"E Turkel","year":"2017","unstructured":"Turkel E, Onay EO, Ungor M (2017) Comparison of Three final irrigation activation techniques: effects on Canal Cleanness, Smear Layer removal, and Dentinal Tubule Penetration of two Root Canal Sealers. Photomed Laser Surg 35(12):672\u2013681","journal-title":"Photomed Laser Surg"},{"issue":"1","key":"5758_CR62","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.joen.2018.09.010","volume":"45","author":"PE C\u0103put\u0103","year":"2019","unstructured":"C\u0103put\u0103 PE et al (2019) Ultrasonic Irrigant activation during Root Canal treatment: a systematic review. J Endod 45(1):31\u201344e13","journal-title":"J Endod"},{"issue":"6","key":"5758_CR63","doi-asserted-by":"crossref","first-page":"2787","DOI":"10.1007\/s00784-023-04862-1","volume":"27","author":"T R\u00f6dig","year":"2023","unstructured":"R\u00f6dig T et al (2023) Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology. Clin Oral Investig 27(6):2787\u20132796","journal-title":"Clin Oral Investig"},{"key":"5758_CR64","doi-asserted-by":"crossref","first-page":"102707","DOI":"10.1016\/j.pdpdt.2021.102707","volume":"37","author":"M Vatanpour","year":"2022","unstructured":"Vatanpour M, Toursavadkouhi S, Sajjad S (2022) Comparison of three irrigation methods: SWEEPS, ultrasonic, and traditional irrigation, in smear layer and debris removal abilities in the root canal, beyond the fractured instrument. Photodiagnosis Photodyn Ther 37:102707","journal-title":"Photodiagnosis Photodyn Ther"},{"issue":"1","key":"5758_CR65","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s41547-021-00113-2","volume":"5","author":"B Ar\u0131c\u0131o\u011flu","year":"2021","unstructured":"Ar\u0131c\u0131o\u011flu B, \u00c7\u0131kman A\u015e, Babacan M (2021) The comparison of cleaning efficacy and apical extrusion of advanced irrigation activation methods with a novel Er:YAG laser modality: sweeps. Lasers Dent Sci 5(1):43\u201352","journal-title":"Lasers Dent Sci"},{"issue":"9","key":"5758_CR66","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.joen.2011.06.007","volume":"37","author":"SE-D Saber","year":"2011","unstructured":"Saber SE-D, Hashem AAR (2011) Efficacy of different final irrigation activation techniques on Smear Layer removal. J Endod 37(9):1272\u20131275","journal-title":"J Endod"},{"issue":"2","key":"5758_CR67","doi-asserted-by":"crossref","first-page":"66925194","DOI":"10.1259\/dmfr\/66925194","volume":"42","author":"PC Chang","year":"2013","unstructured":"Chang PC et al (2013) A comparison of the thresholding strategies of micro-CT for periodontal bone loss: a pilot study. Dentomaxillofac Radiol 42(2):66925194","journal-title":"Dentomaxillofac Radiol"},{"issue":"2","key":"5758_CR68","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1259\/dmfr\/85088069","volume":"39","author":"K Kamburo\u011flu","year":"2010","unstructured":"Kamburo\u011flu K et al (2010) Accuracy of chemically created periapical lesion measurements using limited cone beam computed tomography. Dentomaxillofac Radiol 39(2):95\u201399","journal-title":"Dentomaxillofac Radiol"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-024-05758-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-024-05758-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-024-05758-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T06:19:42Z","timestamp":1723011582000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-024-05758-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,15]]},"references-count":68,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["5758"],"URL":"https:\/\/doi.org\/10.1007\/s00784-024-05758-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4014149\/v1","asserted-by":"object"}]},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,15]]},"assertion":[{"value":"4 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Local ethics committee approval was obtained from the Ethical Review Committee of the Research Foundation at the Medical Faculty of Recep Tayyip Erdogan University (No: 2023\/35). Patients were informed about the procedure, and written informed consent was obtained before the commencement of treatment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"376"}}