Effectiveness of the iVac System Compared to Conventional Irrigation and Ultrasonic Activation in Reducing Microbial Biofilm, Lipopolysaccharides and Apical Extrusion.

This in vitro study evaluated the effectiveness of irrigation techniques (IT)-conventional irrigation (CI), ultrasonic activation (UA), and iVac system (IA)- using 2.5% NaOCl and saline in reducing Enterococcus faecalis, Escherichia coli and Candida albicans in root canals and intratubular dentine. It also assessed the reduction of lipopolysaccharides (LPS) and apical extrusion. Lower premolar roots were contaminated and divided based on IT and irrigants, with saline as control. Microbiological and LPS samples were collected before and after IT. The apical extrusion volume was determined. Results showed that when NaOCl was used, there was no statistical difference between the ITs regarding CFU reduction and between UA and IA regarding LPS reduction. When saline was used, IA was the most effective technique in reducing CFU and LPS. Regarding apical extrusion, IA caused the lowest irrigant extrusion. In conclusion, IA reduced the levels of LPS, microorganisms and apical extrusion.