A Novel Educational Approach for Safe Endodontic Syringe Irrigation: A Randomized Controlled In Vitro Study

Area of Science:

• Endodontics
• Dental Education
• Biomedical Engineering

Background:

• Syringe irrigation with sodium hypochlorite (NaOCl) is crucial for root canal treatment.
• Preventing NaOCl extrusion into periapical tissues requires careful irrigant delivery.
• Quantifying plunger forces is essential for safe irrigation techniques.

Purpose of the Study:

• To quantify syringe plunger forces exerted by dental undergraduates during NaOCl irrigation.
• To assess the impact of an educational intervention on safe irrigant delivery parameters.
• To evaluate the effectiveness of repeated educational interventions on plunger force control.

Main Methods:

• A randomized controlled in vitro study involving 52 dental undergraduates.
• Syringe irrigation performed using 25G and 30G side-vented cannulas on 3D-printed teeth.
• Plunger forces measured using a force sensor; critical thresholds defined (10N for 25G, 40N for 30G).

Main Results:

• Mean maximum plunger forces were generally below critical thresholds (under 10N for 25G, under 20N for 30G).
• Exceeding critical forces occurred more with 25G than 30G cannulas.
• Repeated educational interventions at 12 weeks reduced average maximum plunger forces for both cannula types.

Conclusions:

• Integrating plunger force measurement with education effectively trains undergraduates in safe syringe irrigation.
• Undergraduates typically do not apply excessive forces risking apical extrusion.
• Repeated educational interventions demonstrably decrease plunger forces, promoting safer endodontic irrigation.