Abstract
Objectives
The aim of this study was to introduce a methodology to map irrigant spreadability within the root canal space using micro-computed tomography (micro-CT).
Materials and methods
Mandibular molars presenting Vertucci’s types I and II canal configurations were selected, and four scans using isotropic resolution of 19.5 μm were accomplished per tooth: prior to treatment (S1), after glide path (S2) and after root canal preparation (S3 and S4). A contrast solution (CS) was used to irrigate the canals at stages S2 and S4. The touched and untouched surface areas of the canals, the volume of irrigant-free areas and the percentage volume occupied by the CS were calculated. Density, surface tension and the spread pattern of the CS and 2.5 % NaOCl were also evaluated.
Results
In the type I mesial root, there was an increase in the percentage volume of free-irrigated areas from S2 to S4 preparation steps, whilst in the distal roots and type II mesial root, a decrease of irrigant-free areas was observed. The use of CS allowed the quantification of the touched surface area and the volume of the root canal occupied by the irrigating solution. Density (g/mL) and surface tension (mN/m) of the CS and 2.5 % NaOCl were 1.39 and 47.5, and 1.03 and 56.2, respectively. Besides, a similar spread pattern of the CS and 2.5 % NaOCl in a simulated root canal environment was observed.
Conclusions
This study introduced a new methodology for mapping the irrigating solution in the different stages of the root canal preparation and proved useful for in situ volumetric quantification and qualitative evaluation of irrigation spreading and irrigant-free areas.
Clinical relevance
Micro-computed tomographic technology may provide a comprehensive knowledge of the flush effectiveness by different irrigants and delivery systems in order to predict the optimal cleaning and disinfection conditions of the root canal space.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schilder H (1974) Cleaning and shaping the root canal. Dent Clin N Am 18:269–296
Ribeiro MVM, Silva-Sousa YT, Versiani MA, Lamira A, Steier L, Pécora JD, Sousa Neto MD (2013) Comparison of the cleaning efficacy of self-adjusting file and rotary systems in the apical third of oval-shaped canals. J Endod 39:398–410. doi:10.1016/j.joen.2012.11.016
De-Deus G, Souza EM, Barino B, Maia J, Zamolyi RQ, Reis C, Kfir A (2011) The self-adjusting file optimizes debridement quality in oval-shaped root canals. J Endod 37:701–705. doi:10.1016/j.joen.2011.02.001
Peters OA, Laib A, Gohring TN, Barbakow F (2001) Changes in root canal geometry after preparation assessed by high-resolution computed tomography. J Endod 27:1–6
Versiani MA, Steier L, De-Deus G, Tassani S, Pécora JD, Sousa-Neto MD (2013) Micro-computed tomography study of oval-shaped canals prepared with the self-adjusting file, Reciproc, WaveOne, and Protaper Universal systems. J Endod 39:1060–1066. doi:10.1016/j.joen.2013.04.009
Versiani MA, Pécora JD, Sousa-Neto MD (2011) Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod 37:1002–1007. doi:10.1016/j.joen.2011.03.017
Siqueira JF Jr, Alves FRF, Versiani MA, Roças IN, Almeida BM, Neves MAS, Sousa Neto MD (2013) Correlative bacteriologic and micro–computed tomographic analysis of mandibular molar mesial canals prepared by self-adjusting file, Reciproc, and Twisted File systems. J Endod 39:1044–1050. doi:10.1016/j.joen.2013.04.034
Vera J, Siqueira JF Jr, Ricucci D, Loghin S, Fernandez N, Flores B, Cruz AG (2012) One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study. J Endod 38:1040–1052. doi:10.1016/j.joen.2012.04.010
Nair PN, Henry S, Cano V, Vera J (2005) Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:231–252
Brito PR, Souza LC, Machado de Oliveira JC, Alves FR, De-Deus G, Lopes HP, Siqueira JF Jr (2009) Comparison of the effectiveness of three irrigation techniques in reducing intracanal Enterococcus faecalis populations: an in vitro study. J Endod 35:1422–1427. doi:10.1016/j.joen.2009.07.001
Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR (2009) Review of contemporary irrigant agitation techniques and devices. J Endod 35:791–804. doi:10.1016/j.joen.2009.03.010
Gulabivala K, Patel B, Evans G, Ng YL (2005) Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics 10:103–122
Zehnder M (2006) Root canal irrigants. J Endod 32:389–398. doi:10.1016/j.joen.2005.09.014
Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW (2010) Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 36:875–879. doi:10.1016/j.joen.2009.12.026
Boutsioukis C, Lambrianidis T, Kastrinakis E (2009) Irrigant flow within a prepared root canal using various flow rates: a computational fluid dynamics study. Int Endod J 42:144–155. doi:10.1111/j.1365-2591.2008.01503.x
Vera J, Hernandez EM, Romero M, Arias A, van der Sluis LW (2012) Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study. J Endod 38:1340–1343. doi:10.1016/j.joen.2012.06.005
Nadalin MR, Perez DE, Vansan LP, Paschoala C, Sousa-Neto MD, Saquy PC (2009) Effectiveness of different final irrigation protocols in removing debris in flattened root canals. Braz Dent J 20:211–214. doi: S0103-64402009000300007
Gao Y, Haapasalo M, Shen Y, Wu H, Li B, Ruse ND, Zhou X (2009) Development and validation of a three-dimensional computational fluid dynamics model of root canal irrigation. J Endod 35:1282–1287. doi:10.1016/j.joen.2009.06.018
van der Sluis LW, Gambarini G, Wu MK, Wesselink PR (2006) The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J 39:472–476. doi:10.1111/j.1365-2591.2006.01108.x
Vera J, Arias A, Romero M (2012) Dynamic movement of intracanal gas bubbles during cleaning and shaping procedures: the effect of maintaining apical patency on their presence in the middle and cervical thirds of human root canals-an in vivo study. J Endod 38:200–203. doi:10.1016/j.joen.2011.10.026
Vera J, Arias A, Romero M (2011) Effect of maintaining apical patency on irrigant penetration into the apical third of root canals when using passive ultrasonic irrigation: an in vivo study. J Endod 37:1276–1278. doi:10.1016/j.joen.2011.05.042
Vertucci FJ (1984) Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 58:589–599
Paqué F, Laib A, Gautschi H, Zehnder M (2009) Hard-tissue debris accumulation analysis by high-resolution computed tomography scans. J Endod 35:1044–1047. doi:10.1016/j.joen.2009.04.026
Acknowledgments
The authors are grateful to Prof. Ana Paula Ramos from the Laboratório de Físico-Química de Superfícies e Colóides-DQ-FFCLRP, University of São Paulo, Ribeirão Preto, Brazil, for her essential technical assistance in the physical-chemical evaluation of the solutions. We also acknowledge the support of Dentsply for supplying materials for this study.
Conflict of interest
Authors deny any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Versiani, M.A., De-Deus, G., Vera, J. et al. 3D mapping of the irrigated areas of the root canal space using micro-computed tomography. Clin Oral Invest 19, 859–866 (2015). https://doi.org/10.1007/s00784-014-1311-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-014-1311-5