Frequency and performance analysis of polymer, steel, and titanium ultrasonic inserts in intracanal medication removal

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Guilherme Nilson Alves Dos Santos¹, Alice Corrêa Silva-Sousa¹, Angelo José Sócrates Torres-Carrillo¹, Guilherme de Araujo Braz², Thais Oliveira Alves¹, Fabiane Carneiro Lopes-Olhê¹, Yara Teresinha Corrêa Silva-Sousa³, Jardel Francisco Mazzi-Chaves¹, Ricardo Gariba Silva¹, Manoel Damião Sousa-Neto⁴

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作者单位

¹ Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.

² Technology Center of the Supera Park of Innovation and Technology of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.

³ Faculty of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil.

⁴ Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil. Electronic address: sousanet@forp.usp.br.

DOI: 10.1016/j.joen.2025.06.003 PMID: 40516753

Introduction: Ultrasonic inserts can be manufactured in various shapes, angles, and materials, this study evaluated the frequencies generated by steel, titanium, and polymer ultrasonic inserts using acoustic wave analysis and assessed the effectiveness of the iVac system and passive ultrasonic irrigation (PUI) compared to conventional irrigation for removing calcium hydroxide-based intracanal medication using micro-computed tomography (microCT).

Methods: Steel and titanium inserts from the Ultra X system (blue, silver, gold) and the polymer insert from the iVac system were analyzed using vibroacoustography in Ultra X (45 kHz) and Woodpecker (40 kHz) ultrasonic devices. Inserts were positioned in a water tank for standardized placement. The excitation signal was generated using MATLAB software, and power measurements were conducted in duplicate. After root canal preparation in 30 teeth, calcium hydroxide-based medication was applied and scanned using microCT. After seven days, initial removal was performed with a K-file (#45.02), followed by three protocols: conventional irrigation, PUI, or iVac. A second microCT scan was performed. ANOVA and Tukey's tests compared ultrasonic power and residual medication volume.

Results: The steel, titanium, and polymer inserts exhibited frequencies from 37 to 45 kHz. The iVac group (99.8 ± 0.3%) achieved greater medication removal than the PUI group (97.3 ± 2.9%), both significantly superior to conventional irrigation (73.0 ± 9.4%) (p<0.05).

Conclusion: The ultrasonic power of the inserts operated within the expected frequency range. The iVac system demonstrated superior effectiveness in removing intracanal medication.

Keywords: intracanal medication; irrigation; power; ultrasound.