Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods .
There is insufficient evidence to cl aim general superiority of any one of these methods .
The aim of this study was to systematic ally review and critically analyse the published data on the treatment outcome ( primary outcome ) and on the  cleaning and disinfection of root canals  ( secondary outcomes ) achieved by negative pressure irrigation as compared to syringe irrigation .
In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars.
INTRODUCTION Many in vitro studies have debated over the ability of different irrigant delivery and /or agitation systems to reach the apical third of curved root canals ; however , little is known about irrigant penetration in vivo . Therefore , the purpose of this study was to compare the efficacy of the conventional endodontic irrigation needle , passive ultrasonic irrigation ( PUI ) , and a negative pressure system for irrigant delivery to working length ( WL ) of mesial canals of m and ibular molars . METHODS Thirty mesial canals of 30 vital m and ibular first or second molars were r and omly assigned into 3 groups ( n = 10 ) : ( 1 ) Monoject syringe with 27-gauge needle ; ( 2 ) PUI with IrriSafe tip ; and ( 3 ) EndoVac system . All canals were treated following the same preparation protocol to size 35/0.04 by using 5.25 % NaOCl as irrigant during preparation procedure . Before obturation , canals were irrigated with 1 mL of a radiopaque solution by using the assigned irrigation system , and a digital radiograph was taken by using a parallel technique . With the aid of image editing software the distance between WL and maximum irrigant penetration was measured . RESULTS Mean distances for Monoject , PUI , and EndoVac groups were 1.51 mm , 0.21 mm , and 0.42 mm , respectively . Analysis of variance test showed statistically significant differences between groups ( P < .001 ) . Tukey honestly significant difference test showed statistically significant differences between the Monoject group and the other 2 groups ( P < .001 ) but no significant differences between PUI and EndoVac groups ( P = .06 ) . CONCLUSIONS PUI and EndoVac are more effective than the conventional endodontic needle in delivering irrigant to WL of root canals
Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods .
There is insufficient evidence to cl aim general superiority of any one of these methods .
The aim of this study was to systematic ally review and critically analyse the published data on the treatment outcome ( primary outcome ) and on the  cleaning and disinfection of root canals  ( secondary outcomes ) achieved by negative pressure irrigation as compared to syringe irrigation .