, Volume 106, Issue 4, pp 454–459 | Cite as

Sodium hypochlorite penetration into dentinal tubules after manual dynamic agitation and ultrasonic activation: a histochemical evaluation

  • Luigi Generali
  • Erica Campolongo
  • Ugo Consolo
  • Carlo Bertoldi
  • Luciano Giardino
  • Francesco Cavani
Original Article


The aim of this study was to compare the effects of Manual Dynamic Agitation and Passive Ultrasonic Irrigation on sodium hypochlorite (NaOCl) penetration into dentinal tubules using its bleaching ability. Thirty-four single-rooted teeth with round-shaped root canals were distributed in two homogeneous groups and one control group, characterized by different NaOCl activation systems: Manual Dynamic Agitation and Passive Ultrasonic Irrigation. After instrumentation, all root canals were stained with 10% copper sulphate solution followed by 1% rubeanic acid alcohol solution under vacuum. Final irrigation was performed with 5 mL of 5.25% NaOCl solution for 1 min and activated with Manual Dynamic Agitation or Passive Ultrasonic Irrigation for another 1 min depending on the treatment group. The teeth were transversely sectioned at the middle portion of the apical, middle, and coronal thirds and observed under light microscope. NaOCl solution penetration was evaluated by measuring the percentage of bleached circumference of the root canal relative to the stained circumference, bleached areas, mean, and maximum penetration depth. No differences in the evaluated parameters were observed between groups (p > 0.05). Within groups, an increase of values was recorded from apical to coronal direction as for percentage of staining, percentage of bleaching and bleached area. NaOCl penetration into dentinal tubules did not significantly vary among the three levels. No significant differences in penetration of sodium hypochlorite into dentinal tubules when activated by means of Manual Dynamic Agitation or Passive Ultrasonic Irrigation were observed in the apical, middle, and coronal thirds of teeth with single straight round root canals.


Dentinal tubules Manual dynamic agitation Penetration Sodium hypochlorite Ultrasonic activation 



The authors would like to thank Dr. Shaniko Kaleci for assistance in statistical analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Ando N, Hoshino E. Predominant obligate anaerobes invading the deep layers of root canal dentin. Int Endod J. 1990;23:20–7.CrossRefGoogle Scholar
  2. 2.
    Love R. Regional variation in root dentinal tubule infection by Streptococcus gordonii. J Endod. 1996;22:290–3.CrossRefGoogle Scholar
  3. 3.
    Haapasalo M, Ørstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987;66:1375–9.CrossRefGoogle Scholar
  4. 4.
    Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment. J Endod. 2006;32:93–8.CrossRefGoogle Scholar
  5. 5.
    Zou L, Shen Y, Li W, Haapasalo M. Penetration of sodium hypochlorite into dentin. J Endod. 2010;36:793–6.CrossRefGoogle Scholar
  6. 6.
    Mohammadi Z, Mombeinipour A, Giardino L, Shahriari S. Residual antibacterial activity of a new modified sodium hypochlorite-based endodontic irrigation solution. Med Oral Patol Oral Cir Bucal. 2011;16:588–92.CrossRefGoogle Scholar
  7. 7.
    Ardizzoni A, Generali L, Righi E, Baschieri MC, Cavani F, Manca L, Lugli E, Migliarese L, Blasi E, Neglia RG. Differential efficacy of endodontic obturation procedures: an ex vivo study. Odontology. 2014;102:223–31.CrossRefGoogle Scholar
  8. 8.
    Ricucci D, Siqueira JF. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod. 2010;8:1277–88.CrossRefGoogle Scholar
  9. 9.
    Peters LB, Wesselink PR, Moorer WR. The fate and the role of bacteria left in root dentinal tubules. Int Endod J. 1995;28:95–9.CrossRefGoogle Scholar
  10. 10.
    Generali L, Cavani F, Serena V, Pettenati C, Righi E, Bertoldi C. Effect of different irrigation systems on sealer penetration into dentinal tubules. J Endod. 2017;43:652–6.CrossRefGoogle Scholar
  11. 11.
    Agarwal A, Deore RB, Rudagi K, Nanda Z, Baig MO, Fareez MA. Evaluation of apical vapor lock formation and comparative evaluation of its elimination using three different techniques: an in vitro study. J Contemp Dent Pract. 2017;18:790–4.CrossRefGoogle Scholar
  12. 12.
    Gulabivala K, Ng YL, Gilbertson M, Eames I. The fluid mechanics of root canal irrigation. Physiol Meas. 2010;31:49–84.CrossRefGoogle Scholar
  13. 13.
    Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35:791–804.CrossRefGoogle Scholar
  14. 14.
    Giardino L, Cavani F, Generali L. Sodium hypochlorite solution penetration into human dentine: a histochemical evaluation. Int Endod J. 2016;50:492–8.CrossRefGoogle Scholar
  15. 15.
    Spångberg LSW, Acierno TC, Yongbum CB. Influence of entrapped air on the accuracy of leakage studies using dye penetration methods. J Endod. 1989;15:548–51.CrossRefGoogle Scholar
  16. 16.
    Oliver CM, Abbott PV. Entrapped air and its effects on dye penetration of voids. Endod Dent Traumatol. 1991;7:135–8.CrossRefGoogle Scholar
  17. 17.
    Wu M-K, De Gee AJ, Wesselink PR. Fluid transport and dye penetration along root canal fillings. Int Endod J. 1994;27:233–8.CrossRefGoogle Scholar
  18. 18.
    De Deus G, Barino B, Marins J, Magalhães K, Thuanne E, Kfir A. Self-adjusting file cleaning-shaping-irrigation system optimizes the filling of oval-shaped canals with thermoplasticized gutta-percha. J Endod. 2012;38:846–9.CrossRefGoogle Scholar
  19. 19.
    Vhadana S, Latha J, Velmurugan N. Evaluation of penetration depth of 2% chlorhexidine digluconate into root dentinal tubules using confocal laser scanning microscope. Restor Dent Endod. 2015;40:149–54.CrossRefGoogle Scholar
  20. 20.
    Ghorbanzadesh A, Aminsobhani M, Sohrabi K, Chiniforush N, Ghafari S, Shamshiri AR, Noroozi N. Penetration depth of sodium hypochlorite in dentinal tubules after conventional irrigation, passive ultrasonic agitation and Nd:YAG laser activated irrigation. J Lasers Med Sci. 2016;7:105–11.CrossRefGoogle Scholar
  21. 21.
    van der Sluis LWM, Wu M-K, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from human root canals prepared using instruments of varying taper. Int Endod J. 2005;38:764–8.CrossRefGoogle Scholar
  22. 22.
    Llena C, Forner L, Cambralla R, Lozano A. Effect of three irrigation solutions applied by passive ultrasonic irrigation. Restor Dent Endod. 2015;40:143–8.CrossRefGoogle Scholar
  23. 23.
    Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY. Effect of different agitation techniques on the penetration of irrigant and sealer into dentinal tubules. Photomed Laser Surg. 2017;35:71–7.CrossRefGoogle Scholar
  24. 24.
    Vasiliadis L, Darling AI, Levers BG. The amount and distribution of sclerotic human root dentine. Arch Oral Biol. 1983;28:645–9.CrossRefGoogle Scholar
  25. 25.
    Mjör IA, Smith MR, Ferrari M, Mannocci F. The structure of dentine in the apical region of human teeth. Int Endod J. 2001;34:346–53.CrossRefGoogle Scholar
  26. 26.
    Generali L, Prati C, Pirani C, Cavani F, Gatto MR, Gandolfi MG. Double dye technique and fluid filtration test to evaluate early sealing ability of an endodontic sealer. Clin Oral Investig. 2017;21:1267–76.CrossRefGoogle Scholar
  27. 27.
    Russel AA, Chandler NP, Haumann C, Siddiqui AY, Tompkins GR. The butterfly effect: an investigation of sectioned roots. J Endod. 2013;39:208–10.CrossRefGoogle Scholar
  28. 28.
    Russel AA, Friedlander LT, Chandler NP. Sealer penetration and adaptation in root canals with the butterfly effect. Aust Endod J. 2017. (Epub ahead of print).CrossRefGoogle Scholar
  29. 29.
    Giardino L, Mohammadi Z, Beltrami R, Poggio C, Estrela C, Generali L. Influence of temperature on the antibacterial activity of sodium hypochlorite. Braz Dent J. 2016;1:32–6.CrossRefGoogle Scholar
  30. 30.
    Mohmmed SA, Vianna ME, Penny MR, Hilton ST, Mordan NJ, Knowles JC. Investigations into in situ Enterococcus faecalis biofilm removal by passive and active sodium hypochlorite irrigation delivered into the lateral canal of a simulated root canal model. Int Endo J. 2017. (Epub ahead of print).CrossRefGoogle Scholar
  31. 31.
    Neelakantan P, Devaraj S, Jagannathan N. Histologic assessment of debridement of the root canal isthmus of mandibular molars by irrigant activation techniques ex vivo. J Endod. 2016;42:1268–72.CrossRefGoogle Scholar

Copyright information

© The Society of The Nippon Dental University 2018

Authors and Affiliations

  1. 1.Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO)University of Modena and Reggio EmiliaModenaItaly
  2. 2.School of DentistryUniversity of Catanzaro Magna GraeciaCatanzaroItaly
  3. 3.Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly

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