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Syringe irrigation in confluent canals: A sequential computational fluid dynamics assessment.

Mário Rito Pereira1,2, Goncalo Silva3, Viriato Semiao4

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Optimizing root canal irrigation in confluent canals requires specific needle design and placement. An open-ended needle with a 30/.07v preparation size best achieves irrigant renewal and penetration.

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Area of Science:

  • Endodontics
  • Dental Materials Science
  • Biomedical Engineering

Background:

  • Effective irrigation is crucial for root canal disinfection.
  • Confluent canals present unique challenges for irrigant delivery and renewal.
  • Syringe irrigation is a common method, but its efficacy in complex anatomy is debated.

Purpose of the Study:

  • To evaluate the impact of root canal preparation, irrigation needle design, and placement depth on irrigant flow in confluent canals.
  • To determine optimal parameters for efficient irrigant delivery and renewal in mesial roots of mandibular molars.

Main Methods:

  • Micro-computed tomography (micro-CT) was used to scan prepared root canal models.
  • Computational fluid dynamics (CFD) simulations assessed irrigation flow dynamics.
  • Tested variables included ProTaper Next preparation sizes (X2, X3, X4), needle designs (side-vented, open-ended), and placement depths (5, 3, 2 mm from working length).

Main Results:

  • Irrespective of needle type or depth, irrigant predominantly exited through the canal without the needle.
  • Apical irrigant penetration and renewal were most effective with a 30G open-ended needle.
  • The 30/.07v (ProTaper Next X3) preparation size demonstrated superior irrigant delivery with the optimal needle configuration.

Conclusions:

  • Needle design and canal preparation significantly influence irrigant flow in confluent canals.
  • An open-ended needle placed optimally, combined with a 30/.07v preparation, enhances apical irrigant exchange.
  • These findings can inform improved endodontic irrigation protocols for complex root canal systems.