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Extrusão apical do irrigante usando diferentes tipos de agulha de irrigação
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Abstract(s)
Introdução: O tratamento endodôntico (TE) pode definir-se como um procedimento comum, usado pelos profissionais da Medicina Dentária, com o objetivo de tratar infeções da polpa radicular do dente. O sucesso deste tipo de tratamento está diretamente relacionado com o controlo da infeção e, para isso, realizam-se os processos de limpeza e de desinfeção do canal radicular (CR), com o auxílio de instrumentos e soluções irrigadoras. A irrigação representa um passo crucial na endodontia para a desinfeção de bactérias e remoção da camada de detritos com o máximo de segurança, evitando a extrusão apical. Várias estratégias de irrigação foram propostas, embora os seus efeitos na extrusão apical do irrigante sejam controversos. Este estudo teve como objetivo avaliar a eficácia de agulhas de irrigação endodôntica na extrusão apical do irrigante, fazendo uma comparação entre três sistemas de irrigação diferentes. Materiais e Métodos: Foram usados trinta dentes em 3D de molares mandibulares, em resina (e=10/grupo), formulados com hidrogel para simulação de tecido e biofilme artificial e inseridos num cubo do mesmo material, onde conseguimos visualizar a extrusão apical do irrigante. Eles, foram divididos em três tipos distintos de agulhas: (A), (B) e (C). Seguidamente, as imagens pré e pós-irrigação geradas através da CBCT, foram comparadas e avaliadas quantitativamente através do volume e da área nos planos coronal, sagital e axial, que representava a presença ou ausência de extrusão apical. Resultados/Discussão: Os resultados foram diferentes de grupo para grupo, consoante as características de cada agulha. Este estudo indica que o tipo de agulha afeta significativamente a extrusão apical do irrigante, na irrigação endodôntica. Conclusão: A associação de dois sistemas de irrigação – sistema pressurizado (convencional ou positivo), de agulha de ponta fechada IrriFlex, de polietileno flexível, com dupla ventilação lateral e sistema de irrigação de pressão negativa EndoVac – mostrou ser o mais eficaz na segurança da extrusão apical do irrigante.
Introduction: Endodontic treatment (ET) can be defined as a common procedure used by dental professionals with the aim of treating infections of the tooth’s root pulp. The success of this type of treatment is directly related to infection control, which involves cleaning and disinfecting the root canal (RC) using instruments and irrigating solutions. Irrigation represents a crucial step in endodontics for disinfecting bacteria and removing the smear layer with maximum safety, while avoiding apical extrusion. Several irrigation strategies have been proposed, although their effects on apical extrusion of the irrigant remain controversial. The goal of this study is to evaluate the effectiveness of endodontic irrigation needles in the apical extrusion of the irrigant by comparing three different irrigation systems. Materials and Methods: Thirty 3D-printed mandibular molar teeth made of resin (n=10 per group) were used, formulated with hydrogel to simulate tissue and artificial biofilm and embedded in a cube made of the same material, allowing for visualization of irrigant apical extrusion. The samples were divided into three distinct needle types: (A), (B), and (C). Pre and post irrigation images obtained via CBCT were compared and quantitatively evaluated based on volume and area in the coronal, sagittal, and axial planes, which indicated the presence or absence of apical extrusion. Results/Discussion: The results varied between groups depending on the characteristics of each needle. This study indicates that the type of needle significantly affects the apical extrusion of the irrigant during endodontic irrigation. Conclusion: The combination of two irrigation systems – a pressurized system (conventional or positive), using the closed-end IrriFlex needle made of flexible polyethylene with dual lateral vents, and the negative pressure irrigation system EndoVac – proved to be the most effective in ensuring the safety of apical irrigant extrusion.
Introduction: Endodontic treatment (ET) can be defined as a common procedure used by dental professionals with the aim of treating infections of the tooth’s root pulp. The success of this type of treatment is directly related to infection control, which involves cleaning and disinfecting the root canal (RC) using instruments and irrigating solutions. Irrigation represents a crucial step in endodontics for disinfecting bacteria and removing the smear layer with maximum safety, while avoiding apical extrusion. Several irrigation strategies have been proposed, although their effects on apical extrusion of the irrigant remain controversial. The goal of this study is to evaluate the effectiveness of endodontic irrigation needles in the apical extrusion of the irrigant by comparing three different irrigation systems. Materials and Methods: Thirty 3D-printed mandibular molar teeth made of resin (n=10 per group) were used, formulated with hydrogel to simulate tissue and artificial biofilm and embedded in a cube made of the same material, allowing for visualization of irrigant apical extrusion. The samples were divided into three distinct needle types: (A), (B), and (C). Pre and post irrigation images obtained via CBCT were compared and quantitatively evaluated based on volume and area in the coronal, sagittal, and axial planes, which indicated the presence or absence of apical extrusion. Results/Discussion: The results varied between groups depending on the characteristics of each needle. This study indicates that the type of needle significantly affects the apical extrusion of the irrigant during endodontic irrigation. Conclusion: The combination of two irrigation systems – a pressurized system (conventional or positive), using the closed-end IrriFlex needle made of flexible polyethylene with dual lateral vents, and the negative pressure irrigation system EndoVac – proved to be the most effective in ensuring the safety of apical irrigant extrusion.
Description
Keywords
Endodontia Agulhas Extrusão apical Irrigante CBCT Endodontics Needles Apical extrusion Irrigant
Pedagogical Context
Citation
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CC License
Without CC licence