Comparative evaluation of radiographic healing after nonsurgical endodontic treatment with and without irrigant activation: A randomized controlled trial

Aim: To compare the evaluation of radiographic healing after nonsurgical endodontic treatment with and without irrigant activation. Materials and Methods: Permanent anterior mandibular and maxillary teeth with associated periapical lesion were assessed for eligibility. Forty-eight patients were randomly split into three groups ( n = 16) using allocation concealment method, and irrigation was performed in accordance with the allocated groups. The groups allocated were (a) sodium hypochlorite (NaOCl) irrigation with conventional syringe and needle, (b) NaOCl irrigation with sonic activation, and (c) NaOCl irrigation with ultrasonic activation. Root canals were medicated with calcium hydroxide for 14 days. In the second visit, after washing away the medicament and irrigation protocols, obturation was done with a bioceramic sealer with gutta-percha. The radiographic evaluation was done at 6 and 12 months of the treatment by taking intraoral periapical radiographs and periapical index (PAI). Results: The results revealed that both sonic and ultrasonic activation of 5.25% NaOCl showed a significant less PAI score when compared with conventional syringe and needle technique (Group I) and thus superior periapical healing in both sonic (Group II) and ultrasonic (Group III) groups. Conclusion: This study concluded that sonic and ultrasonic activation of 5.25% NaOCl led to maximum disinfection of canal systems and thus resulted in better healing of periradicular lesions than conventional syringe and needle irrigation technique.