Ultrasonic cleaning of the root canal

A crucial step during a root canal treatment is the irrigation, where an antimicrobial fluid is injected into the root canal to eradicate all bacteria from the root canal system. Agitation of the fluid using a miniature file oscillating at 30 kHz has shown a significant improvement in the cleaning efficacy over conventional syringe irrigation. However, the exact cleaning mechanisms, being acoustic streaming, cavitation or an enhanced chemical effect, are not fully understood. Here we investigate ultrasonically activated irrigation through experiments and numerical simulations in order to understand the relative importance of each of the three cleaning mechanisms. We combine high-speed imaging and micro-Particle Imaging Velocimetry to visualize the flow pattern and cavitation in a root canal model (sub-millimeter dimensions), at timescales relevant to the cleaning processes (microseconds). Measurements of the acoustic streaming are coupled to the oscillation characteristics of the file as simulated numerically and measured with a laser vibrometer. Comparison between the streaming pattern inside the root canal and in the free field shows the importance of the confinement of the root canal on the acoustic streaming. The results give new insight into the role of acoustic streaming for the cleaning of root canals.