• apical extrusion;
  • cleansing efficacy;
  • cleansing techniques;
  • dentinal tubules;
  • dye penetration;
  • hydrodynamic irrigation


Aim  To investigate the efficiency of a hydrodynamic irrigation system compared with conventional cleansing techniques in root canals.

Methodology  Forty-five freshly extracted single-rooted teeth were de-coronated and their root canals were enlarged to size 30 at the apex. The teeth were randomly divided into three groups (n = 15) for the final rinsing sequence using 2% NaOCl plus acid fuchsin: group I: static application of irrigant, 3 min; group II: flushing with a syringe; 5-mL NaOCl, 1 min; group III: RinsEndo®-system; 5-mL NaOCl, 50 s. Apical extrusion was documented photographically. The roots were sectioned at 2, 4, 6 and 8 mm from their apices and the penetration depths of dye into dentine measured, using a stereomicroscope. Wilcoxon's test and Pearson's chi-squared test were employed to prove statistic relevance.

Results  Greater dye penetration depth into the dentinal tubules was achieved when employing hydrodynamic rinsing procedures. Using this technique, 23% of the specimens were penetrated for more than 50% of their dentine thickness, whereas the results for flushing with a syringe were 12% (static application, 7%). No penetration of dentine occurred in 63% of specimens with static application, 39% flushing with a syringe and 15% using the hydrodynamic system (P < 0.05 Pearson's chi-squared test). Apical extrusion occurred more frequently after hydrodynamic rinsing (extruded specimens: RinsEndo® = 80%; static application/flushing with a syringe = 13%; P < 0.05 Pearson's chi-squared test).

Conclusions  Hydrodynamic rinsing demonstrated an improvement over conventional methods in terms of dentine penetration of a dye marker. A higher risk of apical extrusion with the RinsEndo®-system was evident.