Apical Extrusion of Debris and Irrigants Using Different Irrigation Needles.

Fernanda Geraldo Pappen,Renato de Toledo Leonardo,Renata Picanço Casarin,Angélica Mohnsam Krolow,Paula Barcellos Silva,Regina Karla Pontes Lima,Katerine Jahnecke Pilownic

doi:10.1590/0103-6440201600382

Fernanda Geraldo Pappen, Renato de Toledo Leonardo

Open Access

https://doi.org/10.1590/0103-6440201600382

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Abstract

This study evaluated the influence of irrigation tip, root canal curvature and final apical diameter on periapical debris and irrigant extrusion during root canal instrumentation. After being classified as mildly or moderately curved, the mesiobuccal root canals of 90 human molars were instrumented. The teeth were allocated into three groups according to the used needle type: a flat open-end needle (Group 1), a side-vented needle (Group 2) or a double side-vented needle (Group 3). The amount of extruded material after instrumentation was calculated for each group. The differences in irrigant and debris extrusion between the experimental groups were analyzed with the Mann-Whitney U test. Irrigation tips and final instrument diameter differences were analyzed with the Kruskal-Wallis test. Multiple groups were compared using the Mann-Whitney U-test with a Bonferroni correction at α=0.05. The amount of extruded material from the double side-vented needle was significantly less than the open-ended flat needle (p=0.008), but there was no difference compared to the side-vented needle (p=0.929). The results showed no effect of root curvature and final apical diameter on the amount of irrigant and debris extrusion (p>0.05). The double side-vented needles generated the least material extrusion to the periapical tissues. Irrigation needle type had the greatest influence on periapical irrigant and debris extrusion and the double side-vented needles may be safely used during endodontic therapy.

Highlights

Root canal irrigation is an important part of canal preparation for the removal of bacteria, debris and necrotic tissue, especially from root canal areas previously untouched by instrumentation [1]
The present study aimed to evaluate the influence of irrigation tip, root curvature and final apical diameter on periapical debris and irrigant extrusion
The amount of apically extruded debris and irrigant was significantly different among the three irrigation tips (p=0.034), as summarized in cavity coronally exposed

Summary

Introduction

Root canal irrigation is an important part of canal preparation for the removal of bacteria, debris and necrotic tissue, especially from root canal areas previously untouched by instrumentation [1]. Debris extrusion depends on several factors, including the apical anatomy, type and size of the irrigation needle, needle placement depth, apical preparation size and taper, and the instrumentation technique [4]. Several case reports have described complications in the periapical tissues caused by irrigation [6,7]. Extrusion of debris and irrigation solutions may be the main cause of inflammatory exacerbation [8], and could cause severe pain, burning sensation, oedema, periapical inflammation and delayed healing of apical periodontitis [6]

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