Efficacy of different irrigation needles used in endodontics: an in silico and an in vitro investigation
DOI:
https://doi.org/10.2340/biid.v12.45148Keywords:
Endodontics, root canal preparation, root canal therapy, fluid dynamics, 3D printing, dental irrigation needleAbstract
Objective: Irrigation is a clinical procedure in which needles of various designs, attached to syringes, are delivered by positive pressure to cleanse the root canals of infection-promoting agents. Despite being available in multiple designs and different materials, the irrigant does not necessarily reach every portion of the canal. This study compared four different needle designs in terms of depth of penetration of the needle (DOP), wear of the needle and fluid dynamics of the irrigant (FD).
Methods: Stereolithography was used to manufacture four 3D-printed single-rooted mandibular premolars with double curvature. The four needle designs used were Group I (NiTi open-ended, notched needle tip), Group II (Stainless steel, single-sided vented needle tip), Group III (Stainless steel, double-ended needle tip), and Group IV (Soft propylene, multi-vented needle tip) (n = 10 in each group). After assigning each tooth to a group, a stereomicroscope was used to measure the DOP. Pre- and post-irrigation scanning electron microscopy images of three randomly chosen needles from each group helped qualitatively determine the wear. Later, particle image velocimetry (PIV) experiments for each of the four needle designs were subsequently compared with those obtained from computational fluid dynamics (CFD).
Results: The open-ended syringe had the significantly lowest mean DOP as determined by one-way ANOVA and Tukey’s post hoc test. Wear was significantly lowest in the non-metallic syringes. The PIV and CFD analyses were in close agreement with each other. The non-metallic needle exhibited the highest pressure and axial velocity near the apex.
Conclusion: The validated CFD models showed a greater canal coverage and irrigant flow from the non-metallic syringe in the double curvature root canal simulations; though with the highest risk of apical extrusion.
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References
Berman L, Hargreaves K. Cohen’s pathways of the pulp [Internet]. Elsevier; 2015. Available from: https://shop.elsevier.com/books/cohens-pathways-of-the-pulp-expert-consult/berman/978-0-323-09635-5 [cited 2025 Sep 25]
Konstantinidi E, Psimma Z, Chávez De Paz LE, Boutsioukis C. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system. Int Endod J. 2017 Nov;50(11):1034–54. https://doi.org/10.1111/iej.12725 DOI: https://doi.org/10.1111/iej.12725
Poggio C, Ceci M, Beltrami R, Colombo M, Dagna A. Viscosity of endodontic irrigants: influence of temperature. Dent Res J. 2015;12(5):425. https://doi.org/10.4103/1735-3327.166189 DOI: https://doi.org/10.4103/1735-3327.166189
Hu S, Duan L, Wan Q, Wang J. Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model. Biomed Eng Online. 2019 Dec;18(1):52. https://doi.org/10.1186/s12938-019-0679-5 DOI: https://doi.org/10.1186/s12938-019-0679-5
Yu M, Li Y, Zhao M, Huang Z, Zhou N, Jin H. Computational fluid dynamics investigation on the irrigation of a real root canal with a side-vented needle. BMC Oral Health. 2024 Mar 9;24(1):321. https://doi.org/10.1186/s12903-024-03966-8 DOI: https://doi.org/10.1186/s12903-024-03966-8
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 May;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
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 May;36(5):875–9. https://doi.org/10.1016/j.joen.2009.12.026 DOI: https://doi.org/10.1016/j.joen.2009.12.026
Boutsioukis C, Gutierrez Nova P. Syringe irrigation in minimally shaped root canals using 3 endodontic needles: a computational fluid dynamics study. J Endod. 2021 Sept;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
Bulgu S, Yildizeli A, Çadirci S, Yildirim S. Investigation of the effects of needle designs on the root canal irrigation using computational fluid dynamics. Deu Muhendislik Fak Fen Ve Muhendislik. 2023 Sept 27;25(75):769–80. https://doi.org/10.21205/deufmd.2023257520 DOI: https://doi.org/10.21205/deufmd.2023257520
Çiftçioğlu E, Yücel Ö, Işık V, Keleş A, Kayahan MB. Irrigant flow characteristics in the root canal with internal root resorption: a computational fluid dynamics evaluation. Odontology. 2022 Oct;110(4):769–76. https://doi.org/10.1007/s10266-022-00698-5 DOI: https://doi.org/10.1007/s10266-022-00698-5
Liu L, Shen C, Ye W, Yao H, Peng Q, Cui Y, et al. Investigation of an improved side-vented needle and corresponding irrigation strategy for root canal therapy with CFD method. Comput Methods Programs Biomed. 2020 Oct;195:105547. https://doi.org/10.1016/j.cmpb.2020.105547 DOI: https://doi.org/10.1016/j.cmpb.2020.105547
Loroño G, Zaldivar JR, Arias A, Cisneros R, Dorado S, Jimenez‐Octavio JR. Positive and negative pressure irrigation in oval root canals with apical ramifications: a computational fluid dynamics evaluation in micro‐CT scanned real teeth. Int Endod J. 2020 May;53(5):671–9. https://doi.org/10.1111/iej.13260 DOI: https://doi.org/10.1111/iej.13260
Savitha S, Kumar N, Chalamalla VK, Sharma S, Kumar V, Chawla A, et al. Flow characteristics of positive and negative pressure irrigation in an immature tooth – a computational fluid dynamics study. J Conserv Dent Endod. 2023;26:544–9.
Šnjarić D, Čarija Z, Braut A, Halaji A, Kovačević M, Kuiš D. Irrigation of human prepared root canal – ex vivo based computational fluid dynamics analysis. Croat Med J. 2012 Oct;53(5):470–9. https://doi.org/10.3325/cmj.2012.53.470 DOI: https://doi.org/10.3325/cmj.2012.53.470
Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Van Der Sluis LWM. Irrigant flow in the root canal: experimental validation of an unsteady Computational Fluid Dynamics model using high‐speed imaging. Int Endod J. 2010 May;43(5):393–403. https://doi.org/10.1111/j.1365-2591.2010.01692.x DOI: https://doi.org/10.1111/j.1365-2591.2010.01692.x
Chaniotis A, Ordinola‐Zapata R. Present status and future directions: management of curved and calcified root canals. Int Endod J. 2022 May;55(S3):656–84. https://doi.org/10.1111/iej.13685 DOI: https://doi.org/10.1111/iej.13685
Machado R, Chaniottis A, Vera J, Saucedo C, Vansan LP, Silva EJNL. S-shaped canals: a series of cases performed by four specialists around the world. Case Rep Dent. 2014;2014:1–6. https://doi.org/10.1155/2014/359438 DOI: https://doi.org/10.1155/2014/359438
Seirawan M. A simple predictable triple protocol for the management of double-curved canals (Case report of three cases). J Conserv Dent. 2022;25(5):573. https://doi.org/10.4103/jcd.jcd_289_22 DOI: https://doi.org/10.4103/jcd.jcd_289_22
Jang YE, Kim Y, Kim SY, Kim BS. Predicting early endodontic treatment failure following primary root canal treatment. BMC Oral Health. 2024 Mar 12;24(1):327. https://doi.org/10.1186/s12903-024-03974-8 DOI: https://doi.org/10.1186/s12903-024-03974-8
Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971 Aug;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
Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. Int Endod J. 2009 Feb;42(2):144–55. https://doi.org/10.1111/j.1365-2591.2008.01503.x DOI: https://doi.org/10.1111/j.1365-2591.2008.01503.x
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 Oct;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
Boutsioukis C, Lambrianidis T, Kastrinakis E, Bekiaroglou P. Measurement of pressure and flow rates during irrigation of a root canal ex vivo with three endodontic needles. Int Endod J. 2007 July;40(7):504–13. https://doi.org/10.1111/j.1365-2591.2007.01244.x DOI: https://doi.org/10.1111/j.1365-2591.2007.01244.x
Guerisoli D, Silva R, Pecora J. Evaluation of some physico-chemical properties of different concentrations of sodium hypochlorite solutions. Braz Endod J. 1998;3:21–3.
Uzunoglu-Özyürek E, Karaaslan H, Türker SA, Özçelik B. Influence of size and insertion depth of irrigation needle on debris extrusion and sealer penetration. Restor Dent Endod. 2018;43(1):e2. https://doi.org/10.5395/rde.2018.43.e2 DOI: https://doi.org/10.5395/rde.2018.43.e2
Provoost C, Rocca GT, Thibault A, Machtou P, Bouilllaguet S. Influence of needle design and irrigant flow rate on the removal of Enterococcus faecalis biofilms in vitro. Dent J. 2022 Apr 2;10(4):59. https://doi.org/10.3390/dj10040059 DOI: https://doi.org/10.3390/dj10040059
Sosnovskiy LA. Tribo-Fatigue [Internet]. Berlin, Heidelberg: Springer; 2005 [cited 2024 Dec 26]. (Babitsky VI, Wittenburg J, editors. Foundations of Engineering Mechanics). Available from: http://link.springer.com/10.1007/978-3-540-27027-0 DOI: https://doi.org/10.1007/978-3-540-27027-0
Wang R, Shen Y, Ma J, Huang D, Zhou X, Gao Y, et al. Evaluation of the effect of needle position on irrigant flow in the C-shaped root canal using a computational fluid dynamics model. J Endod. 2015 June;41(6):931–6. https://doi.org/10.1016/j.joen.2015.02.002 DOI: https://doi.org/10.1016/j.joen.2015.02.002
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 Nov;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
Rito Pereira M, Silva G, Semiao V, Silverio V, Martins JNR, Pascoal-Faria P, et al. Experimental validation of a computational fluid dynamics model using micro-particle image velocimetry of the irrigation flow in confluent canals. Int Endod J. 2022 Dec;55(12):1394–403. https://doi.org/10.1111/iej.13827 DOI: https://doi.org/10.1111/iej.13827
Gao Y, Haapasalo M, Shen Y, Wu H, Li B, Ruse ND, et al. Development and validation of a three-dimensional computational fluid dynamics model of root canal irrigation. J Endod. 2009 Sept;35(9):1282–7. https://doi.org/10.1016/j.joen.2009.06.018 DOI: https://doi.org/10.1016/j.joen.2009.06.018
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