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Influence of apical foramen diameter, design and penetration depth of the needle and irrigating solution flow rate on cleaning and apical extrusion

Introduction:

The root canal irrigation aims to clean and disinfect the root canal system, without causing apical extrusion.

Objective:

To evaluate the influence of apical foramen diameter, needle penetration depth and needle design, and the irrigating solution flow rate on the cleaning and apical extrusion.

Material and method:

Roots of human mandibular incisors with single-canal were instrumented and after enlarged with two different root apical sizes (40 and 60 K-files), the root canals were filled with contrast solution thickened with propylene glycol and zinc oxide. Two types of irrigation needles (27-gauge) with different designs (apical or lateral opening) were used, two flow rates corresponding to 15 or 25 mL/min and needle penetration at two depths (3 and 6 mm from the apex). Before and after irrigation, the teeth were radiographed using a digital radiographic system. Pre-irrigation (canals filled with contrast) and post-irrigation (canals with remaining contrast) images were submitted to digital subtraction using the Adobe Photoshop CS4 software and the areas were measured using the Image Tool 3.0 software, obtaining the percentage of cleaning and extrusion. Data obtained were subjected to one-way ANOVA and Tukey's tests with the significance level of 5%.

Result:

There was no statistical difference between the apical foramen diameter, needle penetration depth and needle design, and the irrigating solution flow rate on the cleaning results (more than 97%) and the level of apical extrusion (less than 0.38 mm2), (p>0,05).

Conclusion:

All irrigation protocols evaluated provided cleaning of the root canal and low apical extrusion of irrigating solution.

Endodontics; root canal irrigants; radiology


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