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Abstract
Effective irrigant delivery and agitation are prerequisites for successful endodontic
treatment.
This article presents an overview of the irrigant agitation methods currently available
and their debridement efficacy.
Technological advances during the last decade have brought to fruition new agitation
devices that rely on various mechanisms of irrigant transfer, soft tissue debridement,
and, depending on treatment philosophy, removal of smear layers. These devices might
be divided into the manual and machine-assisted agitation systems. Overall, they appear
to have resulted in improved canal cleanliness when compared with conventional syringe
needle irrigation. Despite the plethora of in vitro studies, no well-controlled study
is available. This raises imperative concerns on the need for studies that could more
effectively evaluate specific irrigation methods by using standardized debris or biofilm
models. In addition, no evidence-based study is available to date that attempts to
correlate the clinical efficacy of these devices with improved treatment outcomes.
Thus, the question of whether these devices are really necessary remains unresolved.
There also appears to be the need to refocus from a practice management perspective
on how these devices are perceived by clinicians in terms of their practicality and
ease of use.
Understanding these fundamental issues is crucial for clinical scientists to improve
the design and user-friendliness of future generations of irrigant agitation systems
and for manufacturers' contentions that these systems play a pivotal role in contemporary
endodontics.