Research Article
BibTex RIS Cite

Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study

Year 2022, Volume: 39 Issue: 3, 58 - 63, 07.09.2022
https://doi.org/10.17214/gaziaot.945129

Abstract

Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method:
Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.

Supporting Institution

None declared.

References

  • Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J 2014;216:299-303.
  • Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern Endodontic Principles Part 4: Irrigation. Dent Update 2016;43:20-2, 25-6, 28-30 passim.
  • Vidas J, Snjaric D, Braut A, Carija Z, Persic Bukmir R, De Moor RJG, et al. Comparison of apical irrigant solution extrusion among conventional and laser-activated endodontic irrigation. Lasers Med Sci 2020;35:205-11.
  • Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2018;51:605-21.
  • Hülsmann M, Rödig T, Nordmeyer S. Complications during root canal irrigation. Endod Topics 2009;16:27-63.
  • Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J 2014;47:211-21.
  • Boutsioukis C, Psimma Z, van der Sluis LW. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 2013;46:599-618.
  • Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. Sodium Hypochlorite Accident: A Systematic Review. J Endod 2017;43:16-24.
  • Tenore G, Palaia G, Ciolfi C, Mohsen M, Battisti A, Romeo U. Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite. Ann Stomatol (Roma) 2018;8:117-22.
  • Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:e31-5.
  • Psimma Z, Boutsioukis C, Kastrinakis E, Vasiliadis L. Effect of needle insertion depth and root canal curvature on irrigant extrusion ex vivo. J Endod 2013;39:521-4.
  • Psimma Z, Boutsioukis C, Vasiliadis L, Kastrinakis E. A new method for real-time quantification of irrigant extrusion during root canal irrigation ex vivo. Int Endod J 2013;46:619-31.
  • Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J 2014;47:487-96.
  • Jezeršek M, Jereb T, Lukač N, Tenyi A, Lukač M, Fidler A. Evaluation of Apical Extrusion During Novel Er:YAG Laser-Activated Irrigation Modality. Photobiomodul Photomed Laser Surg 2019 Sep;37:544-50.
  • Silva PB, Krolow AM, Pilownic KJ, Casarin RP, Lima RK, Leonardo Rde T, et al. Apical Extrusion of Debris and Irrigants Using Different Irrigation Needles. Braz Dent J 2016;27:192-5.
  • 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 2017;43:e2.
  • Romualdo PC, de Oliveira KMH, Nemezio MA, Küchler EC, Silva RAB, Nelson-Filho P, et al. Does apical negative pressure prevent the apical extrusion of debris and irrigant compared with conventional irrigation? A systematic review and meta-analysis. Aust Endod J 2017;43:129-37.
  • Tinaz AC, Alacam T, Uzun O, Maden M, Kayaoglu G. The effect of disruption of apical constriction on periapical extrusion. J Endod 2005;31:533-5.
  • Gulabivala K, Ng YL, Gilbertson M, Eames I. The fluid mechanics of root canal irrigation. Physiol Meas 2010;31:R49-84.
  • 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;36:884-9.
  • 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;36:1664-8.
  • Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010;36:875-9.
  • Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, Van der Sluis LW. The effect of root canal taper on the irrigant flow: evaluation using an unsteady Computational Fluid Dynamics model. Int Endod J 2010;43:909-16.
  • Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971;32:271-5.
  • Alaçam T. Kök kanallarının irrigasyonu. In: Alaçam T, editor. Endodonti. Ankara: Özyurt Matbaacılık; 2012. p. 529-88.
  • Borges ÁH, Pereira TM, Porto AN, de Araújo Estrela CR, Miranda Pedro FL, Aranha AM, et al. The Influence of Cervical Preflaring on the Amount of Apically Extruded Debris after Root Canal Preparation Using Different Instrumentation Systems. J Endod 2016;42:465-9.
  • Topçuoğlu HS, Üstün Y, Akpek F, Aktı A, Topçuoğlu G. Effect of coronal flaring on apical extrusion of debris during root canal instrumentation using single-file systems. Int Endod J 2016;49:884-9.
  • Uzunoglu E, Görduysus M, Görduysus Ö. A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 2015;7:e218-23.
  • Genc Sen O, Kaya M. Comparative Safety of Needle, EndoActivator, and Laser-Activated Irrigation in Overinstrumented Root Canals. Photomed Laser Surg 2018;36:198-202.
  • Yücel O, Sarıçam E, Altunkaynak B, Kayaoğlu G. Comparison of two techniques for measuring apical irrigant extrusion: a methodological laboratory study. (abstract no: R159, p. 89), Int Endod J 2016;49:37-116. https://doi.org/10.1111/iej.12496

Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma

Year 2022, Volume: 39 Issue: 3, 58 - 63, 07.09.2022
https://doi.org/10.17214/gaziaot.945129

Abstract

Amaç: Bu çalışmanın amacı farklı koniklik açıları ve iğne tiplerini test ederek, kök kanal geometrisinin apikalden taşan irrigan miktarına etkisini değerlendirmektir.
Gereç ve Yöntem: Kırk üç adet çekilmiş tek köklü insan mandibular küçük azı dişi kullanıldı. Deney grupları, birbirini takip eden her grupta artan koniklik üretecek şekilde enstrümante edildi: Grup 1 (#25/.02), Grup 2 (#25/.04), Grup 3 (#25/.06) ve Grup 4 (# 25/.08) (n=43, her grupta). İrrigasyon, sırasıyla, 30-G açık-düz uçlu iğne, 30-G kapalı uçlu yandan perfore iğne ve 27-G açık-bevel uçlu iğne kullanılarak yapıldı. Açık-düz uçlu ve kapalı uçlu yandan perfore iğneler apeksten 3 mm kısa olacak şekilde yerleştirilirken, açık-bevel uçlu iğne kanal içerisinde sıkışmadan ilerleyebileceği son noktaya kadar yerleştirildi. Taşan irrigan önceden tartılmış sünger küplerde toplandı. İstatistiksel anlamlılık değeri p<0.05 olarak belirlendi.
Bulgular:
Kanal konikliğindeki artış, açık-düz uçlu iğne (p<0.05, Grup 1 ve 2 ile Grup 3 ve 4 arasında) ve kapalı uçlu yandan perfore iğne (p<0.05, Grup 1 ve 2 ile Grup 4 arasında) için taşan irrigan miktarında azalmaya neden oldu. Buna karşın, açık-bevel uçlu iğne için anlamlı bir etki görülmedi. Taşan irrigan miktarı, tüm koniklik açılarında, açık-düz uçlu iğne kullanıldığında kapalı uçlu yandan perfore iğneye göre ve çoğu koniklik açısında açık-bevel uçlu iğneye göre daha fazlaydı (p<0.05). Kapalı uçlu yandan perfore iğne genellikle en az irrigan taşmasıyla ilişkiliydi.
Sonuç: İğne yerleştirme derinliği sabit olduğunda, apikalden taşan irrigan miktarı, kanal konikliği arttıkça azaldı. En fazla ve en az taşma genellikle, sırasıyla, açık-düz uçlu ve kapalı uçlu yandan perfore iğnede gözlendi.

References

  • Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J 2014;216:299-303.
  • Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern Endodontic Principles Part 4: Irrigation. Dent Update 2016;43:20-2, 25-6, 28-30 passim.
  • Vidas J, Snjaric D, Braut A, Carija Z, Persic Bukmir R, De Moor RJG, et al. Comparison of apical irrigant solution extrusion among conventional and laser-activated endodontic irrigation. Lasers Med Sci 2020;35:205-11.
  • Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2018;51:605-21.
  • Hülsmann M, Rödig T, Nordmeyer S. Complications during root canal irrigation. Endod Topics 2009;16:27-63.
  • Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J 2014;47:211-21.
  • Boutsioukis C, Psimma Z, van der Sluis LW. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 2013;46:599-618.
  • Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. Sodium Hypochlorite Accident: A Systematic Review. J Endod 2017;43:16-24.
  • Tenore G, Palaia G, Ciolfi C, Mohsen M, Battisti A, Romeo U. Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite. Ann Stomatol (Roma) 2018;8:117-22.
  • Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:e31-5.
  • Psimma Z, Boutsioukis C, Kastrinakis E, Vasiliadis L. Effect of needle insertion depth and root canal curvature on irrigant extrusion ex vivo. J Endod 2013;39:521-4.
  • Psimma Z, Boutsioukis C, Vasiliadis L, Kastrinakis E. A new method for real-time quantification of irrigant extrusion during root canal irrigation ex vivo. Int Endod J 2013;46:619-31.
  • Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J 2014;47:487-96.
  • Jezeršek M, Jereb T, Lukač N, Tenyi A, Lukač M, Fidler A. Evaluation of Apical Extrusion During Novel Er:YAG Laser-Activated Irrigation Modality. Photobiomodul Photomed Laser Surg 2019 Sep;37:544-50.
  • Silva PB, Krolow AM, Pilownic KJ, Casarin RP, Lima RK, Leonardo Rde T, et al. Apical Extrusion of Debris and Irrigants Using Different Irrigation Needles. Braz Dent J 2016;27:192-5.
  • 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 2017;43:e2.
  • Romualdo PC, de Oliveira KMH, Nemezio MA, Küchler EC, Silva RAB, Nelson-Filho P, et al. Does apical negative pressure prevent the apical extrusion of debris and irrigant compared with conventional irrigation? A systematic review and meta-analysis. Aust Endod J 2017;43:129-37.
  • Tinaz AC, Alacam T, Uzun O, Maden M, Kayaoglu G. The effect of disruption of apical constriction on periapical extrusion. J Endod 2005;31:533-5.
  • Gulabivala K, Ng YL, Gilbertson M, Eames I. The fluid mechanics of root canal irrigation. Physiol Meas 2010;31:R49-84.
  • 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;36:884-9.
  • 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;36:1664-8.
  • Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010;36:875-9.
  • Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, Van der Sluis LW. The effect of root canal taper on the irrigant flow: evaluation using an unsteady Computational Fluid Dynamics model. Int Endod J 2010;43:909-16.
  • Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971;32:271-5.
  • Alaçam T. Kök kanallarının irrigasyonu. In: Alaçam T, editor. Endodonti. Ankara: Özyurt Matbaacılık; 2012. p. 529-88.
  • Borges ÁH, Pereira TM, Porto AN, de Araújo Estrela CR, Miranda Pedro FL, Aranha AM, et al. The Influence of Cervical Preflaring on the Amount of Apically Extruded Debris after Root Canal Preparation Using Different Instrumentation Systems. J Endod 2016;42:465-9.
  • Topçuoğlu HS, Üstün Y, Akpek F, Aktı A, Topçuoğlu G. Effect of coronal flaring on apical extrusion of debris during root canal instrumentation using single-file systems. Int Endod J 2016;49:884-9.
  • Uzunoglu E, Görduysus M, Görduysus Ö. A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 2015;7:e218-23.
  • Genc Sen O, Kaya M. Comparative Safety of Needle, EndoActivator, and Laser-Activated Irrigation in Overinstrumented Root Canals. Photomed Laser Surg 2018;36:198-202.
  • Yücel O, Sarıçam E, Altunkaynak B, Kayaoğlu G. Comparison of two techniques for measuring apical irrigant extrusion: a methodological laboratory study. (abstract no: R159, p. 89), Int Endod J 2016;49:37-116. https://doi.org/10.1111/iej.12496
There are 30 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Original Research Article
Authors

Büşra Serçe Fikirli

Bülent Altunkaynak

Güven Kayaoğlu 0000-0002-6562-6034

Publication Date September 7, 2022
Published in Issue Year 2022 Volume: 39 Issue: 3

Cite

APA Serçe Fikirli, B., Altunkaynak, B., & Kayaoğlu, G. (2022). Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. Acta Odontologica Turcica, 39(3), 58-63. https://doi.org/10.17214/gaziaot.945129
AMA Serçe Fikirli B, Altunkaynak B, Kayaoğlu G. Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. Acta Odontol Turc. September 2022;39(3):58-63. doi:10.17214/gaziaot.945129
Chicago Serçe Fikirli, Büşra, Bülent Altunkaynak, and Güven Kayaoğlu. “Effect of Root Canal Geometry and Needle Type on Apical Extrusion of Irrigant: An Ex Vivo Study”. Acta Odontologica Turcica 39, no. 3 (September 2022): 58-63. https://doi.org/10.17214/gaziaot.945129.
EndNote Serçe Fikirli B, Altunkaynak B, Kayaoğlu G (September 1, 2022) Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. Acta Odontologica Turcica 39 3 58–63.
IEEE B. Serçe Fikirli, B. Altunkaynak, and G. Kayaoğlu, “Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study”, Acta Odontol Turc, vol. 39, no. 3, pp. 58–63, 2022, doi: 10.17214/gaziaot.945129.
ISNAD Serçe Fikirli, Büşra et al. “Effect of Root Canal Geometry and Needle Type on Apical Extrusion of Irrigant: An Ex Vivo Study”. Acta Odontologica Turcica 39/3 (September 2022), 58-63. https://doi.org/10.17214/gaziaot.945129.
JAMA Serçe Fikirli B, Altunkaynak B, Kayaoğlu G. Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. Acta Odontol Turc. 2022;39:58–63.
MLA Serçe Fikirli, Büşra et al. “Effect of Root Canal Geometry and Needle Type on Apical Extrusion of Irrigant: An Ex Vivo Study”. Acta Odontologica Turcica, vol. 39, no. 3, 2022, pp. 58-63, doi:10.17214/gaziaot.945129.
Vancouver Serçe Fikirli B, Altunkaynak B, Kayaoğlu G. Effect of root canal geometry and needle type on apical extrusion of irrigant: an ex vivo study. Acta Odontol Turc. 2022;39(3):58-63.