Mechano-chemical coupling of irrigation enhances endodontic biofilm debridement.

The complexity of the root canal system results in areas where mechanical instrumentation is impossible during endodontic treatment. To disinfect these areas, the effect of irrigation on biofilm debridement is of great significance but has not yet been well explored. Using an in vitro Enterococcus faecalis biofilm model and a biofilm reactor, the present study provides a better understanding of the relative contributions of mechanical and chemical effects of irrigation on biofilm removal, as well as the factors influencing their coupling efficiency. The results clearly demonstrate that, the mechanical effect of irrigation alone does not significantly influence the stability of biofilms. However, the mechanical effect promotes biofilm eradication by coupling with the chemical effect. In addition, both the irrigant concentration and the irrigant-biofilm contact time are among the key factors affecting the mechano-chemical coupling. This knowledge may serve to better direct endodontists in designing irrigation regimes during root canal therapy.