Effect of root canal dimensions, injection rate, and needle design on the apical extrusion of an irrigant: an in vitro study

J Investig Clin Dent. 2015 Aug;6(3):221-7. doi: 10.1111/jicd.12092. Epub 2014 Jul 22.

Abstract

Aim: The purpose of this study was to determine the effect of root canal dimensions, type of needle, and injection rate on the apical extrusion of an irrigant in a simulated root canal.

Methods: Ten students used two types of 28-gauge needles, to deliver 3 mL irrigant solution into artificial canals prepared in acrylic blocks to a standard size of ISO 25, 30, or 40 (0.06 taper; n = 10). Each block was preweighed to the nearest microgram before and after irrigation once the canal was dried with paper points. This was repeated with a syringe pump at a flow rate of 50, 100, 200 or 300 μL/s with the needle inserted to a standard depth.

Results: Significant differences were observed between the side-vented and notched-end needles when the rate of irrigation was higher than 100 μL/s, and when the apical size was below ISO 40 (P < 0.001). The amount of extrusion was more variable and significantly higher when irrigation was performed manually, compared with the syringe pump groups.

Conclusions: Injection rates above 100 μL/s increased the risk of extrusion, whereas increasing the apical canal size to ISO 40 reduced the amount of extrusion in all groups. The use of a side-vented needle negates the injection-rate effects.

Keywords: apical extrusion; injection rate; irrigant; need design; root canal injection.

Publication types

  • Comparative Study

MeSH terms

  • Dental Pulp Cavity / anatomy & histology*
  • Equipment Design
  • Extravasation of Diagnostic and Therapeutic Materials / etiology*
  • Humans
  • In Vitro Techniques
  • Injections / instrumentation
  • Models, Anatomic
  • Needles*
  • Pressure
  • Rheology
  • Root Canal Irrigants / administration & dosage*
  • Syringes
  • Therapeutic Irrigation / instrumentation*
  • Tooth Apex / anatomy & histology*

Substances

  • Root Canal Irrigants