Investigation of an Improved Side-Vented Needle and Corresponding Irrigation Strategy for Root Canal Therapy with CFD Method

Lei Liu; Chenlu Shen; Weijia Ye; Hua Yao; Qiao Peng; Yongdong Cui; Boo Cheong Khoo

doi:10.1016/j.cmpb.2020.105547

Investigation of an Improved Side-Vented Needle and Corresponding Irrigation Strategy for Root Canal Therapy with CFD Method

Comput Methods Programs Biomed. 2020 Oct:195:105547. doi: 10.1016/j.cmpb.2020.105547. Epub 2020 May 23.

Authors

Lei Liu¹, Chenlu Shen², Weijia Ye², Hua Yao³, Qiao Peng⁴, Yongdong Cui⁵, Boo Cheong Khoo⁵

Affiliations

¹ School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, China; State Key Laboratory of Clean Energy Utilization, Zhejiang University, Hangzhou, China.
² The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
³ The First Affiliated Hospital, Zhejiang University, Hangzhou, China. Electronic address: yaohua@zju.edu.cn.
⁴ State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
⁵ Department of mechanical engineering, National University of Singapore, Singapore.

PMID: 32480193
DOI: 10.1016/j.cmpb.2020.105547

Abstract

Background and objective: This research aimed to present an improved side-vented needle and explore its availability as well as the corresponding irrigation strategy.

Methods: A CFD model was used to simulate the irrigant flow in a simplified prepared round root canal with an apical delta respectively with different needles for irrigation. The needle types include flat end-tip needle, original side-vented needle, and improved side-vented needle. Different insertion depths and inlet velocities were contrastively studied, as well as the gap size between the bulb at the end tip of the improved side-vented needle and the root canal. The study includes a total of 13 schemes. Velocity, pressure, and shear stress in the root canal were measured to contrast the internal flow-field details and irrigation efficiencies between different schemes.

Results: Poor irrigation replacement appeared in the schemes without enough needle insertion no matter which kind of needle has been used, though relatively lower pressure emerged at the apical foramen. On the contrary, deepening needle insertion not only brings better irrigant replacement but also higher apical foramen pressure. The original side-vented needle tends to make lower pressure at the apical foramen and simultaneously worse irrigant replacement as compared to the flat end-tip needle. The fluid entering the apical anatomy part deceases a lot as the original side-vented needle was replaced by the improved one. The scheme using the improved side-vented needle with gap size ratio and inlet velocity respectively equaling 5.0% and 5.50m/s can be considered the best one.

Conclusions: The improved side-vented needle can ensure acceptable irrigant replacement performance without leading to a high-pressure level at the apical foramen. The gap between the bulb and the wall of the root canal is very crucial for the pressure at the apical. The ideal irrigation strategy is ensuring the gap equals zero. However, it is a little hard to realize during the whole procedure of the root canal preparation except the final step. Consequently, another strategy that keeping the value of gap size ratio as small as possible such as less than 15% and simultaneously ensuring lower-velocity coming fluid, is necessary in the non-final irrigation.

Keywords: Computational fluid dynamics; Insertion depth; Irrigation; Needle; Root canal.

MeSH terms

Needles*
Root Canal Irrigants*
Root Canal Preparation
Root Canal Therapy
Therapeutic Irrigation

Substances

Root Canal Irrigants