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      Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model

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          Abstract

          Background

          Irrigation is considered to be a critical part of root canal treatment. However, little is known about the effect of needle movement on the irrigation process. Therefore, this study aimed to investigate the influence of the syringe and needle movement on root canal irrigation using a three-dimensional computational fluid dynamics (CFD) numerical model.

          Methods

          The CFD codes Flow-3D was adopted to simulate the root canal irrigation process with the syringe and needle moving up and down in motions at different amplitudes and frequencies. One stationary needle was adopted to allow comparison with the needles in up-and-down motions. Six cases where the needles were moving up and down with different amplitudes and frequencies were used to investigate the relationships between the motion of needle and irrigation efficacy.

          Results

          The stationary needle gained relatively higher flow velocity and apical pressure all through the irrigation process, while the needles in constant up-and-down motions exhibited lower mean flow velocity and apical pressure. The larger the amplitude, the less mean flow velocity and apical pressure were developed. In addition, the needles moving with different frequencies were similar in the terms of irrigant replacement and apical pressure.

          Conclusions

          To avoid periapical extrusion accidents while obtaining adequate irrigant replacement, the needle should be moving up and down with a moderate amplitude during manual root canal irrigation; and the motion frequency was not highly relevant in terms of the irrigation efficiency.

          Electronic supplementary material

          The online version of this article (10.1186/s12938-019-0679-5) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          Irrigation in endodontics.

          The success of endodontic treatment depends on the eradication of microbes from the root-canal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root-canal space. Irrigants have traditionally been delivered into the root-canal space using syringes and metal needles of different size and tip design. Clinical experience and research have shown, however, that this classic approach typically results in ineffective irrigation. Many of the compounds used for irrigation have been chemically modified and several mechanical devices have been developed to improve the penetration and effectiveness of irrigation. This article summarizes the chemistry, biology, and procedures for safe and efficient irrigation and provides cutting-edge information on the most recent developments. Copyright 2010 Elsevier Inc. All rights reserved.
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            Irrigation trends among American Association of Endodontists members: a web-based survey.

            The purpose of this study was to determine current trends in irrigation selection among endodontists. An invitation to participate in a web-based survey (QuestionPro) was e-mailed to 3844 members of the American Association of Endodontists. Survey participants were asked between 10 and 14 questions based on their individual responses. Among other questions, participants were asked about their irrigant selection, irrigant concentration, smear layer removal, and use of adjuncts to irrigation. A total of 3707 survey invitations were successfully delivered by e-mail after accounting for several undeliverable e-mail invitations. There were 1102 participants, with an overall completion rate of 28.5% (n = 1054). Our data indicate that >90% of respondents primarily use sodium hypochlorite, with 57% of them using it at a concentration >5.0%. Seventy-seven percent of respondents aim to remove the smear layer during endodontic treatment. At least 45% of respondents reported using an adjunct to irrigation. Most of the respondents are using full-strength sodium hypochlorite and are routinely removing the smear layer during endodontic treatment. In addition, almost half of the respondents are using an adjunct, such as ultrasonic activation, to aid in their irrigation technique. Published by Elsevier Inc.
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              Comparative safety of various intracanal irrigation systems.

              The objective of this project was to evaluate the safety of various intracanal irrigation systems by measuring the apical extrusion of irrigant. Twenty-two single canal, extracted mature teeth were instrumented and secured through the lid of a scintillation vial to collect apically extruded irrigant. A precision syringe pump delivered controlled amounts of irrigant at a constant flow. The irrigation systems used were EndoVac Micro and Macro Cannula, EndoActivator, manual irrigation with Max-I-Probe needle, Ultrasonic Needle Irrigation, and Rinsendo. Results were analyzed by using one-way analysis of variance with Scheffé test (P < .05). The EndoVac Micro and Macro cannulae groups did not extrude irrigant, and there was no statistically significant difference between these 2 groups and the EndoActivator group. Within the groups that produced extrusion, EndoActivator extruded statistically significantly less irrigant than Manual, Ultrasonic, and Reinsendo groups. There was no statistically significant difference among Manual, Ultrasonic, and Rinsendo groups. This study showed that the EndoVac did not extrude irrigant after deep intracanal delivery and suctioning the irrigant from the chamber to full working length. EndoActivator had a minimal, although statistically insignificant, amount of irrigant extruded out of the apex when delivering irrigant into the pulp chamber and placing the tip into the canal and initiating the sonic energy of the EndoActivator. Manual, Ultrasonic, and Rinsendo groups had significantly greater amount of extrusion compared with EndoVac and EndoActivator.
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                Author and article information

                Contributors
                coralhss@yeah.net
                lunliangduan@163.com
                champion@scu.edu.cn
                +86-136-6628-7060 , ferowang@hotmail.com
                Journal
                Biomed Eng Online
                Biomed Eng Online
                BioMedical Engineering OnLine
                BioMed Central (London )
                1475-925X
                6 May 2019
                6 May 2019
                2019
                : 18
                : 52
                Affiliations
                [1 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, , Sichuan University, ; Chengdu, China
                [2 ]ISNI 0000 0004 1791 7667, GRID grid.263901.f, Department of Bridge Engineering, , Southwest Jiaotong University, ; Chengdu, 610031 China
                [3 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Department of Prosthodontics, West China Hospital of Stomatology, , Sichuan University, ; Chengdu, 610041 China
                Author information
                http://orcid.org/0000-0002-5137-0330
                Article
                679
                10.1186/s12938-019-0679-5
                6501388
                31060550
                6a9b796f-b344-4113-8821-027ccdc9332c
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 February 2019
                : 30 April 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81771122
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004829, Department of Science and Technology of Sichuan Province;
                Award ID: 2018SZ0037
                Award ID: 19YYJC2625
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Biomedical engineering
                computational fluid dynamics,root canal treatment,irrigation,needle movement,periapical extrusion

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