Evaluation of Debris Removal Efficacy of Conventional Syringe, Irrisafe, XP-endo Finisher File, and Photon-Induced Photoacoustic-Streaming Methods in Teeth with Artificial Internal Resorption Using Two Different Methodologies

Objective: This study sought to evaluate the effect of conventional syringe irrigation (CSI), irrigation with XP-endo Finisher file (XP-F), passive ultrasonic irrigation (PUI), and photon-induced photoacoustic-streaming (PIPS) methods on dentine debris removal from teeth with simulated internal root resorption (IRR) cavities by using scoring and image analyzing methods.Materials and methods: Chemomechanical preparation of 88 single-rooted sample teeth was completed, they were split longitudinally and IRR cavities were prepared. Simulated debris was placed into the cavities. Four teeth were separated to serve as the negative control group. According to the final irrigation technique, 4 experimental groups were created (n = 20): Group 1, CSI; Group 2, XP-F; Group 3, PUI; and Group 4, PIPS. The amount of remaining debris in the IRR cavities was examined under a stereomicroscope. Analysis was performed using two different methodologies: (1) scoring method and (2) image analyzing method. The data were statistically evaluated by one-way analysis of variance, Kruskal-Wallis, chi-square, and Dunn tests with a significance level set as 5%.Results: In both methodologies, PIPS was found to be significantly more effective than XP-F in terms of debris removal. There was no significant difference between XP-F and PUI (p > 0.05). According to the findings obtained from the image analyzing method, PIPS and PUI groups were not significantly different (p > 0.05).Conclusions: PIPS method can be selected as an irrigation activation methodology in teeth with IRR. Considering the similar results of both evaluation methods, image analyzing programs can be used as an alternative in studies on debris removal.