Activated fluids promote deep cleaning and disinfection throughout the root canal.
When the irrigation fluids in the root canal are disrupted through cavitation and acoustic streaming, debridement occurs and the smear layer is disrupted. This, in turn, promotes deep cleaning and disinfection into the lateral canals, fins, webs, and anastomoses. The EndoActivator, recently introduced by DENTSPLY Tulsa Dental Specialties and designed by Drs. Clifford Ruddle, Robert Sharp, and Pierre Machtou, uses noncutting polymer tips to agitate irrigation solutions during endodontic therapy.
Nine dentists participated in the evaluation of the EndoActivator. They were asked to rate the product on such things as ease of use, handpiece ergonomics, and snap on/off tip design.
Ease of Use
The manufacturer describes the EndoActivator as easy to use. It is designed to energize irrigants for less than $2.00 per case, according to DENTSPLY Tulsa. The manufacturer also says that in some cases it may reduce overall irrigation time.
When the evaluators were asked to rate the EndoActivator on ease of use, 2 rated it as excellent, 6 rated it as very good, and 1 rated it as poor. One evaluator said that his assistant “had trouble getting the plastic sleeve onto the handle.” Another evaluator said, “The EndoActivator is simple to use.”
According to the manufacturer, the EndoActivator handpiece is built for user comfort with a contraangled design for easy access to posterior teeth. The handpiece is cordless and battery operated. The evaluators were asked to rate the EndoActivator on handpiece ergonomics. Five rated it as excellent, 3 rated it as very good, and 1 rated it as fair. One evaluator said he had some difficulty accessing posterior teeth. Another evaluator described the handpiece as “very light and comfortable to work with.” A third evaluator said he “liked the design of the handpiece.”
Snap On/Off Tip Design
The single-use, 22 mm Activator tips are made of flexible medical-grade polymer. They are color-coded by size and have depth gauge rings at 18 mm, 19 mm, and 20 mm. To aid in ease of use, DENTSPLY Tulsa designed the tips to be easily snapped on and off. By supporting the head of the handpiece with the thumb and grasping the flange portion of the tip, the user pulls the tip straight off. When the evaluators were asked to rate this feature, 5 rated it as excellent, 3 rated it as very good, and 1 rated it as fair. One evaluator described this feature as “very easy.” Another evaluator said, “The tips are easy to snap on and off.”
Debridement and Smear Layer Disruption
As opposed to soaking a canal to clean and disinfect it, the EndoActivator agitates irrigation solutions to improve debridement and disrupt the smear layer. The evaluators were asked to rate the EndoActivator on its ability to debride the canal and its effectiveness on the smear layer. With regard to debridement, 4 evaluators rated the EndoActivator as excellent, 3 rated it as very good, 1 rated it as good, and 1 rated it as fair. In response to the question about disrupting the smear layer, 2 rated the product as excellent, 4 rated it as very good, 1 rated it as good, and 1 rated it as fair. One evaluator did not answer this question, saying that he wasn’t sure how to evaluate it. Another evaluator said that it “appears to do a very good job, but difficult to evaluate at the clinical level.” A third evaluator said, “I cannot visually determine this, but the agitation of the solution inside the canals by the EndoActivator should lead to better cleaning of the canals when compared to simple irrigation.”
When asked if they would recommend the EndoActivator to their colleagues, 7 evaluators said definitely or probably. Six evaluators said they would definitely or probably purchase the device in the future.
When the evaluators were asked to give their overall satisfaction rating for the EndoActivator, 6 rated it as excellent to very good, 1 rated it as good, 1 rated it as fair and 1 rated it as poor. One evaluator said, “Overall, the EndoActivator was easy to use and ergonomically well designed.”