Abstract
This in vitro study aimed to evaluate apical pressure during irrigant delivery with syringe irrigation in immature teeth with an open apical foramen. Conventional syringe irrigation was performed in a 3D-printed immature incisor. A 5 mL syringe combined with 25 G and 30 G cannulas was used. Open-ended and side-vented needle tip designs were assessed. Cannulas were placed at tooth length (TL), TL −1 mm, TL −2 mm, and TL −4 mm. The syringe plunger was moved with a force of 10 N, 20 N, 40 N, and 80 N to simulate clinical conditions. A pressure sensor measured periapical pressures during irrigation. Each experiment was repeated 10 times. Data were analyzed descriptively (maximum, mean, standard deviation, 95% CI) with the critical threshold indicative of extrusion set at 7.64 mbar. 30 G cannulas with both needle tip designs never exceeded the threshold at any TL with a plunger force of 10–40 N. At 80 N, 30 G open-ended cannulas exceeded the threshold in 10%, 30 G side-vented in 20–60% of the measurements. At any TL, 25 G open-ended cannulas and 25 G side-vented cannulas never crossed the threshold with forces of 10–20 N and 10 N, respectively. Consequently, 30 G cannulas with both designs can be recommended for irrigant delivery in immature teeth. 25 G cannulas ought to be used with caution.
Highlights
Published: 15 May 2021Irrigation of the root canal system with chemical agents is an essential part of root canal treatment
With a plunger force of 80 N, 30 G open-ended cannulas and 30 G side-vented cannulas crossed the critical threshold in 10% and 20–60% of the measurements, respectively
Irrespective of the cannula insertion depth, no pressures indicative of irrigant extrusion were observed with 25 G open-ended cannulas and 25 G side-vented cannulas at plunger forces of 10–20 N and 10 N, respectively
Summary
Published: 15 May 2021Irrigation of the root canal system with chemical agents is an essential part of root canal treatment. Irrigation with sodium hypochlorite (NaOCl) supplements the removal of pulp tissue and microorganisms. Other irrigants, such as ethylenediaminetetraacetic acid, can remove the smear layer, which results from the mechanical preparation of root canal walls [1]. To deliver irrigants during root canal treatment, syringe irrigation is the most commonly used method [3,4]. NaOCl, the most widely used irrigant, can dissolve remnants of pulpal tissue and organic components of dentin [3,4,5,6]. NaOCl exerts cytotoxic effects in contact with healthy tissues. NaOCl accidents caused by apical irrigant extrusion are rare in clinical practice, but they can entail severe consequences for affected patients [7]
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