Antibacterial effectiveness of different final irrigation activation techniques.


  • Bizhyan Mahdi Mustafa Department of conservative dentistry, College of Dentistry, University of Duhok , Duhok, Iraqi Kurdistan Region.
  • Bahar Jaafar Selivany )Department of conservative dentistry, College of Dentistry, University of Duhok , Duhok, Iraqi Kurdistan Region.
  • Abduloma Baraka Ali College of Dentistry, Almustafa University College, Baghdad, Iraq.



Utrasonic, Diode laser, XP endo finisher, irrigation activation techniques


Background and objective: To evaluate and compare the antibacterial effectiveness of ultrasonic, diode laser , XP endo finisher and finisher gentle file brush against Enterococcus faecalis in
root canal dentin.
Methods: Fifty-five single-rooted extracted mandibular premolars were decoronated to have a
length of 12 mm, instrumented biomechanically with protaper Next up to size X3. After sterilization, five roots were selected as negative controls and the remaining teeth were inoculated
with E. faecalis and incubated for 48 hr and at 37 ºC. The roots were then randomly divided into
five groups (n=10) , GI: Control group ,GII: 5.25% NaOCl irrigation was activated by the ultrasonic system , GIII: By 980-nm diode laser , GIV: By Xp-endo finisher and GV : Activated by Finisher
gentle file-brush. The antimicrobial efficacy was tested by collecting transfer fluid saline from
the canals and counting the colony forming units (CFUs) of viable E. faecalis on agar plates. The
statistical calculations were performed in JMP pro 14.3.0. using Analysis of Variance (ANOVA)
followed by a Tukey test to define the differences between the tested groups.
Result: The mean bacterial CFU were 10.6 X 10^7 for Finisher gentle file brush, 35.6×10^7 for
Diode laser, 39.6×10^7 for ultrasonic and 42.3×10^7 for XP Endo Finisher. Finisher gentle file
brush showed a significant reduction in the colony count compared to the other groups.
Conclusion: None of the irrigation activation techniques removed the bacteria completely from
the canal . The four tested irrigation activation techniques were shown to be effective in the
disinfection of the E. faecalis-contaminated root canals. Finisher gentle file brush was the most
effective against E. faecalis, while XP endo finisher was the least effective against E. faecalis.
treatment against E. faecalis in the root canal.


Jambagi, N., Kore, P., Dhaded, N. S., Patil, S. A., &

Shankar, M. (2021). Comparison of Antimicrobial Efficacy of Diode Laser, Ultrasonic Activated

and Conventional Irrigation with 2.5% NaOCl

during RCT: An Interventional Study. The Journal

of Contemporary Dental Practice, 22(6), 669-

Kamaci, A., Aydin, B., & Erdilek, N. (2018). The

effect of ultrasonically activated irrigation and

laser based root canal irrigation methods on

debris removal. The International Journal of

Artificial Organs, 41(2), 71-75.

Khaleefah, F. J., & Abdul-Ameer, Z. M. The Effect

of Different Endodontics Irrigant Activators on

Removal of Debris and Smear Layer from Root

Canal Dentin (An In Vitro Study). International

Medical Journal; 25( 04).

Grinkevičiūtė, P., Povilaitytė, G. & Siudikienė, J.

(2019). The Effect Of Laser Irradiation In Smear

Layer Removal –A Review Of The Literature.

European International Journal of Science and

Technology, 8(3), 72-84.72

Andreani, Y., Gad, B. T., Cocks, T. C., Harrison, J.,

Keresztes, M. E., Pomfret, J. K., ... & Rahimi, M.

(2021). Comparison of irrigant activation devices

and conventional needle irrigation on smear

layer and debris removal in curved canals.(Smear

layer removal from irrigant activation using

SEM). Australian Endodontic Journal, 47(2), 143-

Bitter, K., Vlassakidis, A., Niepel, M., Hoedke, D.,

Schulze, J., Neumann, K., ... & Noetzel, J. (2017).

Effects of diode laser, gaseous ozone, and medical dressings on Enterococcus faecalis biofilms in

the root canal ex vivo. BioMed research international, 2017.

Elnaghy, A. M., Mandorah, A., & Elsaka, S. E.

(2017). Effectiveness of XP-endo Finisher, EndoActivator, and File agitation on debris and smear

layer removal in curved root canals: a comparative study. Odontology, 105(2), 178-183.

Neelakantan, P., Khan, K., Li, K. Y., Shetty, H., &

Xi, W. (2018). Effectiveness of supplementary

irrigant agitation with the Finisher GF Brush on

the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary

instruments. International endodontic journal,

(7), 800-807.

Al-Karadaghi, T. S., Franzen, R., Jawad, H. A., &

Gutknecht, N. (2015). Investigations of radicular

dentin permeability and ultrastructural changes

after irradiation with Er, Cr: YSGG laser and dual

wavelength (2780 and 940 nm) laser. Lasers in

medical science, 30(8), 2115-2121.

Liu, Y., Guo, L., Li, Y., Guo, X., Wang, B., &

Wu, L. (2015). In vitro comparison of antimicrobial effectiveness of QMix and other final irrigants in human root canals. Scientific reports, 5

(1), 1-6.

Zhang, R., Chen, M., Lu, Y., Guo, X., Qiao, F., &

Wu, L. (2015). Antibacterial and residual antimicrobial activities against Enterococcus faecalis

biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix. Scientific reports, 5(1), 1-5.

Tay, F. R., Gu, L. S., Schoeffel, G. J., Wimmer, C.,

Susin, L., Zhang, K., ... & Pashley, D. H. (2010).

Effect of vapor lock on root canal debridement

by using a side-vented needle for positivepressure irrigant delivery. Journal of endodontics, 36(4), 745-750.

Ruddle, C. J., Machtou, P., & West, J. D. (2013).

The shaping movement 5th generation technolo-Antibacterial effectiveness of different ……….

gy. Dent Today, 32(4), 94.

Al-baker, H. S., & Al-Huwaizi, H. F. (2021). Efficacy of Smear Layer Removal from Root Canal

Surface Using: Sonic, Ultrasonic, Different Lasers

as Activation Methods of Irrigant (SEM study).

Journal of Research in Medical and Dental Science, 9(5), 65-72.

Shehab, N. F., Zakaria, N. A., & Taha, M. Y.

(2018). Efficiency of Diode Laser as Root Canal

Disinfectant Against Enterococcus faecalis: An in

Vitro Study. Int J Sci Applied Res, 42(5), 15-23.

Al-Mafrachi, R. M., Awazli, L. G., & Al-Maliky,

M. A. (2018). The Effect of using 940 nm Diode

Laser in Comparison with Endoactivator on

Radicular Dentin Permeability and Smear Layer

Removal (An in Vitro Study). Iraqi Journal of Laser, 17(B), 9-15.

Sohrabi, K., Sooratgar, A., Zolfagharnasab, K.,

Kharazifard, M. J., & Afkhami, F. (2016). Antibacterial activity of diode laser and sodium hypochlorite in enterococcus faecalis-contaminated

root canals. Iranian Endodontic Journal, 11(1), 8.

Dumani, A., Guvenmez, H. K., Yilmaz, S., Yoldas,

O., & Kurklu, Z. G. B. (2016). Antibacterial efficacy of calcium hypochlorite with vibringe sonic

irrigation system on Enterococcus faecalis: an in

vitro study. BioMed research international,

Torabinejad M., Walton, R.E. (2009 ) Endodontics: Principles and Practice. 4th ed. St. Louis:


Elkhashab, R. A. M., Kataiab, M. A., Kamel, W.

H., & Shaaban, M. (2018). Comparison of antibacterial effect and smear layer removal of

herbal versus traditional irrigants–An in vitro

study. Future Dental Journal, 4(2), 165-169.

Eren, S. K., Uzunoğlu, E., Sezer, B., Yılmaz, Z., &

Boyacı, İ. H. (2018). Mineral content analysis of

root canal dentin using laser-induced breakdown spectroscopy. Restorative Dentistry &

Endodontics, 43(1).

Vertucci, F. J. (2005). Root canal morphology

and its relationship to endodontic procedures.

Endodontic topics, 10(1), 3-29.

Ercan, E., Özekinci, T., Atakul, F., & Gül, K.

(2004). Antibacterial activity of 2% chlorhexidine

gluconate and 5.25% sodium hypochlorite in

infected root canal: in vivo study. Journal of endodontics, 30(2), 84-87.

Thomas, S., Asokan, S., John, B., Priya, G., &

Kumar, S. (2017). Comparison of antimicrobial

efficacy of diode laser, triphala, and sodium hypochlorite in primary root canals: A randomized

controlled trial. International journal of clinical

pediatric dentistry, 10(1), 14.

Van der Sluis, L. W. M., Gambarini, G., Wu, M.

K., & Wesselink, P. R. (2006). The influence of

volume, type of irrigant and flushing method

on removing artificially placed dentine debris

from the apical root canal during passive ultrasonic irrigation. International endodontic

journal, 39(6), 472-476.

Trope, M., & Debelian, G. (2015). XP-3D Finisher file—the next step in restorative endodontics. Endod Pract US, 8(5), 14-6.

Tilakchand, M., Singh, N. N., Yeli, M. M., &

Naik, B. D. (2018). “Evaluation of the antibacterial efficacy of EZLASE diode LASER on the

infected root canal system:” An in vivo study.

Journal of Conservative Dentistry, 21(3), 306.

Neelakantan, P., Cheng, C. Q., Mohanraj, R.,

Sriraman, P., Subbarao, C., & Sharma, S.

(2015). Antibiofilm activity of three irrigation

protocols activated by ultrasonic, diode laser

or Er: YAG laser in vitro. International endodontic journal, 48(6), 602-610.

Rahimi, S., Shahi, S., Gholizadeh, S., Shakouie,

S., Rikhtegaran, S., Soroush Barhaghi, M. H.,

... & Abdolrahimi, M. (2012). Bactericidal

effects of Nd: YAG laser irradiation and sodium hypochlorite solution on Enterococcus

faecalis biofilm. Photomedicine and laser surgery, 30(11), 637-641.

Aveiro, E., Chiarelli‐Neto, V. M., de‐Jesus‐

Soares, A., Zaia, A. A., Ferraz, C. C. R., Almeida, J. F. A., ... & Gomes, B. P. F. A. (2020).

Efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite in the reduction of microbial content and virulence factors in teeth with primary endodontic infection. International endodontic journal, 53(5),


Abu Hasna A, Pereira Da Silva,L, Pelegrini FC,

Ferreira CLR, de Oliveira LD, Carvalho CAT

(2020). Effect of sodium hypochlorite solution

and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli

and their endotoxins. F1000Research, 9.


PMC7573735/, accessed 6 December 2020).

Kesim B, Ülger S, topçuoğlu H, Aslan G,

Kurnaz N, Sağsen B (2020). Evaluation of the

Efficacy of 2% Chlorhexidine in Combination

with Passive Ultrasonic Irrigation on Enterococcus faecalis Biofilm. Meandros Med. Dent;


de Oliveira, H. F., da Silva Júnior, I. F., Teixeira, L. C. G., Camilo, N. G., de Almeida Decurcio,

D., Guedes, O. A., & de Araújo Estrela, C. R.

(2022). Influence of different agitation techniques on bacterial reduction in curved root

canals. Australian Endodontic Journal.

Herce-Ros, N., Álvarez-Sagües, A., Álvarez-Losa,

L., Nistal-Villan, E., Amador, U., Presa, J., & Azabal, M. (2021). Antibacterial ability of sodium

hypochlorite activated with PUI vs. XPF File

against Bacteria growth on Enterococcus faecalis

mature biofilm. Dentistry Journal, 9(6), 67.

Carvalho, M. C., Zuolo, M. L., ArrudaVasconcelos, R., Marinho, A. C. S., Louzada, L.

M., Francisco, P. A., ... & Gomes, B. P. F. D. A.

(2019). Effectiveness of XP-Endo Finisher in the

reduction of bacterial load in oval-shaped root

canals. Brazilian oral research, 33.




How to Cite

Mustafa BM, Selivany BJ, Ali AB. Antibacterial effectiveness of different final irrigation activation techniques. EDJ [Internet]. 2023 Dec. 22 [cited 2024 Mar. 5];6(2):132-41. Available from:



Original Articles