Effectiveness of Three Different Irrigation Methods During a Root Canal Treatment

July 25, 2026 updated by: Haroon Hafeez, Pakistan Institute of Medical Sciences

Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal

This study aims to compare the effectiveness of three root canal irrigation techniques-Conventional Needle Irrigation (CNI), Side-Vented Needle (SVN), and Ultrasonic Irrigation (UI)-in achieving irrigant penetration into the apical third of the root canal. Since conventional irrigation often fails to adequately clean complex root canal anatomy, the study evaluates whether activation methods improve irrigant penetration. A randomized controlled trial will compare these three techniques using extracted single-rooted mandibular premolars. A radiopaque dye mixed with sodium hypochlorite will be used to measure irrigant penetration on digital radiographs, and the results will be statistically analyzed to determine the most effective irrigation method.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study focuses on evaluating the effectiveness of three different root canal irrigation techniques in achieving irrigant penetration into the apical third of the root canal. Successful root canal treatment depends not only on mechanical instrumentation but also on adequate irrigation to eliminate bacteria, dissolve organic tissue, and remove debris from areas that instruments cannot reach. Due to the complex anatomy of the root canal system, studies have shown that nearly 35% of the canal walls remain untouched after instrumentation. Therefore, irrigation plays a vital role in ensuring complete disinfection of the canal system. Furthermore, bacteria are capable of penetrating 300-500 micrometers into the dentinal tubules, making it essential for the irrigant to reach as deep as possible within the canal.

Conventionally, sodium hypochlorite is delivered into the canal using a syringe and needle. Although it is considered the gold standard irrigant because of its tissue-dissolving ability and broad-spectrum antimicrobial action, conventional needle irrigation has limitations. The irrigant generally does not travel beyond the tip of the needle, leaving the apical third and other complex areas inadequately cleaned. To overcome these shortcomings, newer irrigation activation methods such as side-vented needles and ultrasonic irrigation have been introduced to improve irrigant flow and penetration throughout the root canal system.

The purpose of this study is to compare three irrigation techniques-Conventional Needle Irrigation (CNI), Side-Vented Needle Irrigation (SVN), and Ultrasonic Irrigation (UI)-to determine which technique provides the deepest penetration of the irrigant into the apical third of the root canal. The hypothesis of the study is that ultrasonic irrigation, being an active irrigation technique, will result in significantly greater irrigant penetration than conventional needle irrigation and side-vented needle irrigation.

According to the synopsis, this study is designed as a randomized controlled trial and will be conducted in the Department of Operative Dentistry over a period of one year after approval. A total sample size of 105 teeth will be included, with 35 samples allocated to each of the three study groups. The study will include extracted single-rooted mandibular first and second premolars with straight canals and closed apices, while teeth with open apices, curved canals, or calcified canals will be excluded.

Initially, all selected teeth will be examined radiographically to exclude unsuitable samples. Standard access cavity preparation will then be carried out, followed by determination of the working length. The canals will be instrumented using the ProTaper rotary system up to file F3, while sodium hypochlorite will be used as the irrigating solution during instrumentation. After completion of canal preparation, the samples will be randomly assigned to one of the three irrigation groups: Conventional Needle Irrigation, Side-Vented Needle Irrigation, or Ultrasonic Irrigation.

To assess irrigant penetration, a radiopaque iohexol dye will be mixed with sodium hypochlorite. After irrigation using the assigned technique, digital radiographs will be obtained. The distance from the apical foramen to the deepest point reached by the radiopaque irrigant will be measured for each sample. This measurement will represent the depth of irrigant penetration achieved by each irrigation technique.

The collected data will be entered into Microsoft Excel and analyzed using SPSS version 23. Descriptive statistics, including the mean and standard deviation, will be calculated to compare the irrigant penetration among the three groups. Based on the study hypothesis, ultrasonic irrigation is expected to demonstrate the greatest penetration into the apical third of the root canal, suggesting that it may provide superior canal disinfection compared with conventional and side-vented needle irrigation. This expectation reflects the hypothesis stated in the synopsis rather than study results, as the research has not yet been conducted.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
105

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

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Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Straight Canals
  • Single Rooted 1st and 2nd mandibular premolars with closed apices

Exclusion Criteria:

  • Mandibular premolars with open apices
  • Mandibular premolars with curved or calcified canals

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Conventional Needle Irrigation
Participants in this group will receive root canal irrigation using a conventional 27-gauge syringe needle. The irrigant, consisting of a radiopaque iohexol dye mixed with 5.25% sodium hypochlorite, will be delivered into the prepared root canal using the conventional needle irrigation technique. Irrigant penetration into the apical third will be assessed using digital radiographs.
Procedure: Conventional Needle
Conventional syringe irrigation will be performed using a 27-gauge needle to deliver the radiopaque sodium hypochlorite solution into the prepared root canal. No additional activation technique will be used during irrigation
Active Comparator: Side Vented Needle Irrigation
Participants in this group will receive root canal irrigation using a side-vented irrigation needle. The radiopaque irrigant solution, prepared by mixing iohexol dye with 5.25% sodium hypochlorite, will be delivered into the canal using the side-vented needle technique. Irrigant penetration into the apical third will be measured on digital radiographs.
Procedure: Side Vented Needle
Irrigation will be carried out using a side-vented needle to introduce the radiopaque sodium hypochlorite solution into the prepared canal. The side-vented design is intended to improve irrigant distribution within the canal while minimizing direct apical flow
Experimental: Ultrasonic Irrigation
Participants in this group will receive ultrasonic irrigation following completion of canal preparation. A radiopaque irrigant solution consisting of iohexol dye mixed with 5.25% sodium hypochlorite will be ultrasonically activated within the root canal. Digital radiographs will be used to measure the depth of irrigant penetration into the apical third and compare it with the other irrigation techniques
Procedure: Ultrasonic Irrigation
Following canal preparation, the radiopaque sodium hypochlorite solution will be activated using an ultrasonic device to enhance irrigant movement throughout the root canal system before radiographic evaluation of penetration depth.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Depth of irrigant penetration into the apical third of the root canal (measured in millimeters).
Time Frame: 5 months
The primary outcome is the depth of penetration of a radiopaque irrigant solution into the apical third of the root canal following irrigation with Conventional Needle Irrigation (CNI), Side-Vented Needle Irrigation (SVN), or Ultrasonic Irrigation (UI). Penetration depth will be measured on digital radiographs as the distance from the apical foramen to the deepest point reached by the irrigant.
5 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Pakistan Institute of Medical Sciences

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Haroon H Panezai, BDS, School Of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 12, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 10, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 26, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 22, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 25, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 28, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 28, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 25, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • SOD/ERB/2025/89

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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