{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:14:12Z","timestamp":1777360452338,"version":"3.51.4"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>This study aims to compare the effectiveness of ultrasonically and sonically activated irrigation in terms of extrusion risk, root canal debridement, and biofilm removal, considering distinct apical preparation sizes, through an ex vivo study in human teeth. Instrumented teeth, to an apical size of 35\/.06 or 50\/.06, were assigned to three different irrigation procedures: ultrasonically activated irrigation, sonically activated irrigation, and conventional manual irrigation. Apical extrusion risk was evaluated by quantifying irrigant and debris extrusion (n = 10\/group). Debris evaluation and smear layer removal from the root canal wall were conducted by scanning electron microscopy (SEM) (n = 5\/group), and the elimination of a mature biofilm of Enterococcus faecalis was assessed through resazurin assay and SEM (n = 10\/group). For statistical analyses, Student\u2019s paired t-test and the ANOVA with post-hoc Tukey were used. Activated irrigations exhibited a higher risk of extrusion for the larger apical size, while the risk for manual irrigation remained independent of the apical size. Substantially fewer residual debris and smear layers were observed after the activation of the irrigant, and there was a notable enhancement in biofilm elimination compared to manual irrigation (p &lt; 0.05). Notably, the effectiveness of both activated irrigations was more pronounced in root canals prepared to a size 50\/.06, with ultrasonic activation showing enhanced improvements. The findings of this study underscore the substantial impact of both ultrasonically and sonically activated irrigation on the effectiveness of root canal disinfection and debridement. This impact is especially prominent with larger apical size, albeit accompanied by an increased risk of extrusion.<\/jats:p>","DOI":"10.3390\/app14093904","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T03:43:46Z","timestamp":1714707826000},"page":"3904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparative Evaluation of Ultrasonic and Sonic Irrigant Activation Systems: Assessing Extrusion Risk, Debridement, and Biofilm Removal in Distinct Apical Preparation Sizes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3899-4365","authenticated-orcid":false,"given":"Sara","family":"Paix\u00e3o","sequence":"first","affiliation":[{"name":"BoneLab\u2014Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-2123","authenticated-orcid":false,"given":"Pedro Sousa","family":"Gomes","sequence":"additional","affiliation":[{"name":"BoneLab\u2014Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"Associated Laboratory for Green Chemistry-Network of Chemistry and Technology (LAQV-REQUIMTE), University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9391-9574","authenticated-orcid":false,"given":"Maria Helena","family":"Fernandes","sequence":"additional","affiliation":[{"name":"BoneLab\u2014Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"Associated Laboratory for Green Chemistry-Network of Chemistry and Technology (LAQV-REQUIMTE), University of Porto, 4200-393 Porto, Portugal"}]},{"given":"Cl\u00e1udia","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"BoneLab\u2014Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"}]},{"given":"Liliana","family":"Grenho","sequence":"additional","affiliation":[{"name":"BoneLab\u2014Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"Associated Laboratory for Green Chemistry-Network of Chemistry and Technology (LAQV-REQUIMTE), University of Porto, 4200-393 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/etp.12028","article-title":"Irrigation of the apical root canal","volume":"27","author":"Park","year":"2012","journal-title":"Endod. 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