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UBC Theses and Dissertations

Effectiveness of irrigation methods in removing materials of different size and density from the apical root canal of a mandibular molar – an in vitro study Kara, Aleem


Objectives: Small pieces of material, typically from dental restorations, may accidently fall into the apical root canal obstructing treatment. The aim of this study was i) to compare the efficacy of irrigation by different methods in removing materials from the apical root canal and ii) to determine if the efficacy is affected by canal orientation and irrigant flow rate. Methods: A transparent, 3D-printed, micro-CT scan-based resin mandibular molar tooth was selected. Four canals were confirmed for apical patency and their lengths measured. Apices were sealed with glue. Six materials of different density were passively placed into the apical part of the distal root canal: polyethylene, glass, titanium, stainless steel, gold alloy dust, and amalgam dust. Materials were removed using three irrigation methods at manufacturer recommended maximum irrigation times: GentleWave system (7 minutes), syringe needle irrigation with a 30 gauge open-ended and 30 gauge side-vented needle each at flow rates of 5 and 15 mL/min (2 minutes), and the ProUltra PiezoFlow ultrasonic irrigation system at flow rates of 0 and 15 mL/min (1 minute) resulting in seven experimental irrigation groups. For each material, each irrigation group was repeated 10 times, five in horizontal and five in vertical canal orientations using distilled water. Material removal was assessed using visual evaluation under a stereo microscope. The results were analyzed for the amount of different materials removed and for completely cleaned canals by each irrigation method using Fisher’s exact test. The percentage of materials removed was analyzed using one-way analysis of variance with Dunnett's test. Results: The GentleWave system was the most effective at completely cleaning canals at maximum and 1-minute irrigation times. Combining all materials tested, all other irrigation methods removed the materials significantly less well than GentleWave. Mean percentage removal by GentleWave was 98.6%, with overall values ranging from 67-100%. Canal orientation did not significantly affect the percentage of materials removed; however, higher flow rates did for open-ended needle and PiezoFlow. Conclusions: The GentleWave system was more effective in removing materials from the root canal than other irrigation methods. Removal of material was affected by flow rates, but not by canal orientation.

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