Efficacy of Different Irrigation Needles and Ultrasonic Activation on Calcium Hydroxide Removal: A Micro-CT Study Using 3D-Printed Endodontic Models

J Endod. 2024 Oct;50(10):1478-1483. doi: 10.1016/j.joen.2024.07.008. Epub 2024 Jul 20.

Abstract

Introduction: The aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)2 from an endodontic model that duplicated a root canal configuration of a human natural tooth.

Methods: An extracted human maxillary premolar was subjected to root canal preparation and scanned with microcomputed tomography. A 3-dimensional reconstruction model of the natural tooth was printed to endodontic models using a polyjet printer. The root canals of the models were filled with Ca(OH)2 paste and divided into 2 groups based on the irrigation protocol: conventional syringe-needle irrigation (conventional group) and passive ultrasonic irrigation (PUI) group. Each group was subdivided into 3 groups (n = 10) according to the type of needle: half-cut, side-vented, and TruNatomy irrigation needle. Microcomputed tomographyimaging was used to assess the percentage of reduction of Ca(OH)2. Data were analyzed using two-way analysis of variance test (α = .05).

Results: The side-vented and TruNatomy irrigation needles showed significantly higher percentage reductions than the half-cut needle (P < .05) in the conventional irrigation group. The PUI group showed significantly higher percentage reductions of Ca(OH)2 than the conventional group regardless of the type of needle (P < .05). However, no significant difference was found among the needles in the PUI group.

Conclusions: The type of irrigation needle and the use of PUI influenced the removal efficacy of Ca(OH)2. PUI enhanced the removal of Ca(OH)2 regardless of the type of irrigation needle.

Keywords: 3D Printed canal; 3D superimposition; calcium hydroxide; passive ultrasonic irrigation; syringe-needle irrigation.

MeSH terms

  • Calcium Hydroxide*
  • Dental Pulp Cavity / diagnostic imaging
  • Humans
  • Models, Dental
  • Needles*
  • Printing, Three-Dimensional*
  • Root Canal Irrigants* / administration & dosage
  • Root Canal Preparation* / instrumentation
  • Root Canal Preparation* / methods
  • Therapeutic Irrigation* / instrumentation
  • Therapeutic Irrigation* / methods
  • Ultrasonics
  • X-Ray Microtomography*

Substances

  • Calcium Hydroxide
  • Root Canal Irrigants