When compared to conventional needle irrigation, the use of EndoVac system was associated with a better reduction in microbial count and incidence of postoperative pain in patients with asymptomatic necrotic pulp and apical periodontitis.

In single-rooted teeth with necrotic teeth and apical periodontitis following single visit treatment, a randomized controlled clinical trial aimed to examine the efficacy of employing the EndoVac irrigation equipment (negative pressure irrigation) on microbial decrease and postsurgical pain.

A total of 36 single-rooted teeth from individuals whose age ranged from 20 to 50 years were used. Patients were divided randomly and evenly into the conventional irrigation group and EndoVac irrigation group, each with 18 teeth, in accordance with the irrigation protocols. Both groups used a 2.5% sodium hypochlorite irrigation solution. Each patient received care in only one visit. After preparing the access cavity, a microbiological sample was collected. 

Chemomechanical root canal preparation was performed using ProTaper rotary devices up to #F4. The second microbiological sample was taken following irrigation activation. Colony forming units were measured and recorded after samples were cultivated on nutrient agar plates and incubated at 37°C for one day. The major endpoint measured the microbial decline in both groups. At 6, 12, 24, and 72 hours, the secondary endpoint was assessed utilizing a numeric rating scale (NRS).

In comparison to the conventional irrigation group, the EndoVac group's mean percentage reduction in the microbial count was substantially greater. In comparison to the EndoVac group, the conventional group had significantly greater pain scores, as illustrated in Table 1:

In necrotic teeth with apical periodontitis, the EndoVac irrigation device might be used as an effective adjuvant to conventional root canal irrigation.