In vitro assessment of needle and irrigant penetration when using different irrigation needle tips

Authors

  • Saleha Hussain Department of Odontology, University of Copenhagen, Copenhagen, Denmark
  • Lars Bjørndal Department of Odontology, University of Copenhagen, Copenhagen, Denmark
  • Merete Markvart Department of Odontology, University of Copenhagen, Copenhagen, Denmark

DOI:

https://doi.org/10.2340/biid.v12.42896

Keywords:

Needles, syringes, root canal irrigation

Abstract

Objective: The aim of this study was to compare the needle and irrigant penetration depth of a newly developed multi-vented polymer needle (30G), with three established needle designs – an open-ended metal needle (30G), a side-vented polymer needle (30G), and a notched metal needle (27G) used as a reference control. The effect of manual dynamic activation (MDA) was also measured. The null hypotheses were that the irrigant penetration would be the same regardless of needle tip, and the addition of MDA would make no difference in terms of irrigant penetration.

Materials and methods: A total of 120 mesial roots from mandibular molars were instrumented to a size 25/07, with reciprocating files. The maximum needle penetration depth was measured for each needle tip, using a rubber stop. Syringe irrigation was performed using a sodium diatrizoate solution, first with needle placement halfway down the root canal (working length subtracted from the canal length), and then 1 mm from the working length. MDA was performed. A digital radiograph was taken before the initial irrigation, after the initial irrigation, after the final irrigation, and after MDA. Digital subtraction was performed, and irrigant penetration was measured by a blinded operator. Non-parametric statistical tests were conducted using Mann–Whitney U-test and Wilcoxon signed-rank test.

Results: The multi-vented polymer needle had a significantly deeper needle penetration (mean value: 99%), compared to other test needles. The deepest irrigant penetration was achieved using the multi-vented polymer needle (mean value: 98%) and the open-ended metal needle (mean value: 99%). A significantly deeper irrigant penetration, was achieved by adding MDA, regardless of needle tip.

Conclusions: The multi-vented polymer needle and the open-ended metal needle showed superior performance in terms of irrigant penetration. However, the irrigant penetration only managed to reach the working length when MDA was added.

Downloads

Download data is not yet available.

References

El karim I, Kennedy J, Hussey D. The antimicrobial effects of root canal irrigation and medication. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2007;103(4):560–9. https://doi.org/10.1016/j.tripleo.2006.10.004 DOI: https://doi.org/10.1016/j.tripleo.2006.10.004

Nguy D, Sedgley C. The influence of canal curvature on the mechanical efficacy of root canal irrigation in vitro using real-time imaging of bioluminescent bacteria. J Endod. 2006;32(11):1077–80. https://doi.org/10.1016/j.joen.2006.04.011 DOI: https://doi.org/10.1016/j.joen.2006.04.011

Boutsioukis C, van der Sluis LWM. Syringe irrigation: blending endodontics and fluid dynamics. In: Basrani B, ed. Endodontic irrigation. 1st ed. Cham: Springer; 2015, p. 45–64. DOI: https://doi.org/10.1007/978-3-319-16456-4_3

Boutsioukis C, Gutierrez Nova P. Syringe irrigation in minimally shaped root canals using 3 endodontic needles: a computational fluid dynamics study. J Endod. 2021;47(9):1487–95. https://doi.org/10.1016/j.joen.2021.06.001 DOI: https://doi.org/10.1016/j.joen.2021.06.001

Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J. 2010;43(8):663–72. https://doi.org/10.1111/j.1365-2591.2010.01723.x DOI: https://doi.org/10.1111/j.1365-2591.2010.01723.x

Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, et al. The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod. 2010;36(10):1664–68. https://doi.org/10.1016/j.joen.2010.06.023 DOI: https://doi.org/10.1016/j.joen.2010.06.023

Gesi A, Mareschi P, Doldo T, Ferrari M. Apical dimension of root canal clinically assessed with and without periapical lesions. Int J Dent. 2014;2014:374971. https://doi.org/10.1155/2014/374971 DOI: https://doi.org/10.1155/2014/374971

Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J. 2022;55(S2):295–329. https://doi.org/10.1111/iej.13710 DOI: https://doi.org/10.1111/iej.13710

Caron G, Nham K, Bronnec F, Machtou P. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod. 2010;36(8):1361–66. https://doi.org/10.1016/j.joen.2010.03.037 DOI: https://doi.org/10.1016/j.joen.2010.03.037

Chen JE, Nurbakhsh B, Layton G, Bussmann M, Kishen A. Irrigation dynamics associated with positive pressure, apical negative pressure and passive ultrasonic irrigations: a computational fluid dynamics analysis. Aust Endod J. 2014;40(2):54–60. https://doi.org/10.1111/aej.12027 DOI: https://doi.org/10.1111/aej.12027

Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, van der Sluis LWM. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady computational fluid dynamics model. Int Endod J. 2010;43(10):874–81. https://doi.org/10.1111/j.1365-2591.2010.01761.x DOI: https://doi.org/10.1111/j.1365-2591.2010.01761.x

Machtou P. Manual dynamic activation (MDA) technique. In: Basrani B, editor. Endodontic irrigation. 1st ed. Cham: Springer; 2015, p. 149–56. DOI: https://doi.org/10.1007/978-3-319-16456-4_8

AL-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health. 2023;23(1):1–38. https://doi.org/10.1186/s12903-023-03036-5 DOI: https://doi.org/10.1186/s12903-023-03036-5

Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271–5. https://doi.org/10.1016/0030-4220(71)90230-1 DOI: https://doi.org/10.1016/0030-4220(71)90230-1

Lambrechts P, Bergmans L. Root canal instrumentation. In: Bjørndal L, Kirkevang LL, Whitworth JM, editors. Textbook of endodontology. 3rd ed. John Wiley and Sons Ltd. Wiley-Blackwell, Hoboken, New Jersey, p. 205-230; 2018. DOI: https://doi.org/10.1002/9781394323081.ch13

Tay FR, Gu L, Schoeffel GJ, et al. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod. 2010;36(4):745–50. https://doi.org/10.1002/​9781394323081.ch13 DOI: https://doi.org/10.1016/j.joen.2009.11.022

Boutsioukis C, Arias-Moliz MT. Present status and future directions – irrigants and irrigation methods. Int Endod J. 2022;55(S3):588-612. https://doi.org/10.1111/iej.13739 DOI: https://doi.org/10.1111/iej.13739

Haapasalo M, Shen Y. Irrigation and disinfection. In: Bjørndal L, Kirkevang LL, Whitworth JM, eds. Textbook of Endodontology. 3rd ed. Wiley-Blackwell; 2018:231-245. DOI: https://doi.org/10.1002/9781394323081.ch14

Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LWM. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod. 2010;36(5):875-879. https://doi.org/10.1016/J.JOEN.2009.12.026 DOI: https://doi.org/10.1016/j.joen.2009.12.026

Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H, et al. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod. 2010;36(5):884–9. https://doi.org/10.1016/j. joen.2009.12.010 DOI: https://doi.org/10.1016/j.joen.2009.12.010

Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent. 2023;26(1):31. https://doi.org/10.4103/JCD.JCD_378_22 DOI: https://doi.org/10.4103/jcd.jcd_378_22

Boutsioukis C, Kastrinakis E, Lambrianidis T, Verhaagen B, Versluis M, van der Sluis LWM. Formation and removal of apical vapor lock during syringe irrigation: a combined experimental and computational fluid dynamics approach. Int Endod J. 2014;47(2):191–201. https://doi.org/10.1111/iej.12133 DOI: https://doi.org/10.1111/iej.12133

Duncan HF, Kirkevang LL, Peters OA, et al. Treatment of pulpal and apical disease: the European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J. 2023;56(S3):238–95. https://doi.org/10.1111/iej.13974 DOI: https://doi.org/10.1111/iej.13974

Ørstavik D. Essential endodontology: prevention and treatment of apical periodontitis. 3rd ed. Oxford: Blackwell Science; 2019. DOI: https://doi.org/10.1002/9781119272014

Azarpazhooh A, Sgro A, Cardoso E, et al. A scoping review of 4 decades of outcomes in nonsurgical root canal treatment, nonsurgical retreatment, and apexification studies-part 2: outcome measures. J Endod. 2022;48(1):29–39. https://doi.org/10.1016/j.joen.2021.09.019 DOI: https://doi.org/10.1016/j.joen.2021.09.019

Published

2025-02-18

How to Cite

Hussain, S., Bjørndal, L., & Markvart, M. (2025). In vitro assessment of needle and irrigant penetration when using different irrigation needle tips. Biomaterial Investigations in Dentistry, 12(1), 17–24. https://doi.org/10.2340/biid.v12.42896