Evaluating the influence of different irrigation needles on the apical cleaning efficacy of endodontic irrigation - An in vitro study

Abstract

Context: Irrigation is an essential part of a successful root canal treatment.

Aim: This study evaluates and compares the influence of three different double-sided vented irrigation needle gauges (G) (27G, 30G, and 31G) on the apical cleaning effectiveness of endodontic irrigation using radiovisiography.

Settings and design: A thorough protocol describing the objectives and methodologies of the study was submitted to the Institutional Ethics Committee, Vivekanandha Dental College for Women. Ethical clearance no. VDCW/IEC/340/2023.

Subjects and methods: Forty-five human mandibular premolars were extracted, filled with a radiopaque medium, and subjected to irrigation with three varying sizes of double-sided vented irrigation needles. Preirrigation and postirrigation radiographic images were digitally subtracted to assess the cleaned areas.

Statistical analysis used: Statistical analysis was carried out with SPSS version 27. For the purpose of intergroup comparisons, one-way analysis of variance was implemented, followed by the execution of the Tukey honestly significant difference post hoc test. Throughout the comparisons, P < 0.05 was deemed statistically significant.

Results: Maximum cleaning was observed in 31G double-sided vented irrigation needles, followed by 30G and 27G double-sided vented irrigation needles.

Conclusions: The 31G double-sided vented irrigation needles exhibit a higher level of effectiveness in the cleansing of the apical third of the root canal system in comparison to the other two irrigation needle variants.

Keywords: Apical cleaning efficacy; digital subtraction; double-sided vented irrigation needles; radio opaque medium.

Figure 1

(a-c) Irrigation with 27G, 30G and 31 G double-sided vented irrigation needle gauges (d) Positioning assembly (e) Image before digital image processing (The image was captured while the sample was secured in the positioning assembly)

Figure 2

Bar graph for apical cleaning with different irrigation needles

Figure 3

GI-BL – (a) Group I-Pre irrigation image in buccolingual direction (sample filled with radio-opaque liquid) GI-BL – (b) Group I-Post irrigation image in buccolingual direction (contrast medium had been displaced or removed due to irrigation). GI-BL – (c) Group I-Digital subtracted image in buccolingual direction (post irrigation image subtracted from pre irrigation image). GI-BL – (d) Group I-Subtracted area in buccolingual direction. GI-MD – (a) Group I- Pre irrigation image in mesiodistal direction (sample filled with radio-opaque liquid). GI-MD – (b) Group I-Post irrigation image in mesiodistal direction (contrast medium had been displaced or removed due to irrigation). GI-MD – (c) Group I-Digital subtracted image in mesiodistal direction (post irrigation image subtracted from pre irrigation image). GI-MD – (d) Group I-Subtracted area in mesiodistal direction. GII-BL – (a) Group II- Pre irrigation image in buccolingual direction (sample filled with radio-opaque liquid). GII-BL – (b) Group II-Post irrigation image in buccolingual direction (contrast medium had been displaced or removed due to irrigation). GII-BL – (c) Group II-Digital subtracted image in buccolingual direction (post irrigation image subtracted from pre irrigation image). GII-BL – (d) Group II-Subtracted area in buccolingual direction

Figure 4

GII-MD – (a) Group II- Pre irrigation image in mesiodistal direction (sample filled with radio-opaque liquid). GII-MD – (b) Group II-Post irrigation image in mesiodistal direction (contrast medium had been displaced or removed due to irrigation). GII-MD – (c) Group II-Digital subtracted image in mesiodistal direction (post irrigation image subtracted from pre irrigation image). GII-MD – (d) Group II-Subtracted area in mesiodistal direction. GIII-BL – (a) Group III-Pre irrigation image in buccolingual direction (sample filled with radio opaque liquid). GIII-BL – (b) Group III-Post irrigation image in buccolingual direction (contrast medium had been displaced or removed due to irrigation). GIII-BL – (c) Group III-Digital subtracted image in buccolingual direction (post irrigation subtracted from pre irrigation image). GIII-BL – (d) Group III-Subtracted area in buccolingual direction. GIII-MD – (a) Group III- Pre irrigation image in mesiodistal direction (sample filled with radio-opaque liquid). GIII-MD – (b) Group III-Post irrigation image in mesiodistal direction (contrast medium had been displaced or removed due to irrigation). GIII-MD – (c) Group III-Digital subtracted image in mesiodistal direction (post irrigation image subtracted from pre irrigation image). GIII-MD – (d) Group III-Subtracted area in mesiodistal direction