Computational fluid dynamic analysis on the induced apical pressures in simulated oval and irregular round canals: an ex-vivo study
https://doi.org/10.32067/GIE.2022.36.02.12
Accepted: 5 October 2022
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Aim: Fluid dynamics can be understood in-vitro by observing the fluid flow patterns in the simulated canal models. The current study aimed at assessing the apical pressures in simulated oval and irregular round canals using computational fluid dynamic analysis (CFD) as a tool.
Methodology: Following the ethical approval, a total of 58 freshly extracted mandibular second premolars were collected for the present study. Cone-beam computed tomography (CBCT) scanning was done to confirm the root canal morphology. Based on the specified inclusion and exclusion criteria, the specimens were divided into two groups: group I: irregular round canals (n=29), and group II: completely oval canals (n=29). Following this, the instrumentation of the specimens was carried out using the XP-Endo Shaper (XPS) file system. A post-instrumentation CBCT was then taken to obtain a computer-aided design (CAD) model. Once the CAD model was obtained the CFD simulations were then carried out at different needle placements.
Results: Group I showed significantly higher (P<0.05) apical pressures at all the needle positions analyzed.
Conclusion: Oval-shaped canals showed the least apical pressures at all needle positions as compared to irregular round canals.
Teja KV, Ramesh S, Battineni G, Vasundhara KA, Jose J, Janani K. The effect of various in-vitro and ex-vivo parameters on irrigant flow and apical pressure using manual syringe needle irrigation: Systematic review. Saudi Dent J. 2022 Feb;34(2):87–99.
Goode N, Khan S, Eid AA, Niu LN, Gosier J, Susin LF, Pashley DH, Tay FR. Wall shear stress effects of different endodontic irrigation techniques and systems. J Dent. 2013 Jul;41(7):636-41. doi: 10.1016/j.jdent.2013.04.007. Epub 2013 Apr 19. PMID: 23603086.
Layton G, Wu WI, Selvaganapathy PR, Friedman S, Kishen A. Fluid Dynamics and Biofilm Removal Generated by Syringe-delivered and 2 Ultrasonic-assisted Irrigation Methods: A Novel Experimental Approach. J Endod. 2015 Jun;41(6):884-9. doi: 10.1016/j.joen.2015.01.027. Epub 2015 Mar 6. PMID: 25749254.
Chen JE, Nurbakhsh B, Layton G, Bussmann M, Kishen A. Irrigation dynamics associated with positive pressure, apical negative pressure and passive ultrasonic irrigations: a computational fluid dynamics analysis. Aust Endod J J Aust Soc Endodontology Inc. 2014 Aug;40(2):54–60.
Gulabivala K, Ng YL, Gilbertson M, Eames I. The fluid mechanics of root canal irrigation. Physiol Meas. 2010 Nov 12;31(12):R49.
Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. Int Endod J. 2009 Feb;42(2):144-55. doi: 10.1111/j.1365-2591.2008.01503.x. PMID: 19134043.
Park E, Shen Y, Khakpour M, Haapasalo M. Apical pressure and extent of irrigant flow beyond the needle tip during positive-pressure irrigation in an in vitro root canal model. J Endod. 2013 Apr;39(4):511–5.
Loroño G, Zaldivar JR, Arias A, Cisneros R, Dorado S, Jimenez-Octavio JR. Positive and negative pressure irrigation in oval root canals with apical ramifications: a computational fluid dynamics evaluation in micro-CT scanned real teeth. Int Endod J. 2020 May 1;53(5):671–9.
Huang Q, Barnes JB, Schoeffel GJ, Fan B, Tay C, Bergeron BE, et al. Effect of Canal Anastomosis on Periapical Fluid Pressure Build-up during Needle Irrigation in Single Roots with Double Canals using a Polycarbonate Model. Sci Rep. 2017 08;7(1):1582.
Boutsioukis C, Lambrianidis T, Kastrinakis E, Bekiaroglou P. Measurement of pressure and flow rates during irrigation of a root canal ex vivo with three endodontic needles. Int Endod J. 2007 Jul;40(7):504–13.
Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H, et al. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod. 2010 May;36(5):884–9.
Snjaric D, Carija Z, Braut A, Halaji A, Kovacevic M, Kuis D. Irrigation of human prepared root canal--ex vivo based computational fluid dynamics analysis. Croat Med J. 2012 Oct;53(5):470–9.
Li P, Zhang D, Xie Y, Lan J. Numerical investigation of root canal irrigation adopting innovative needles with dimple and protrusion. Acta Bioeng Biomech. 2013;15(1):43–50.
Ordinola-Zapata R, Crepps JT, Arias A, Lin F. In vitro apical pressure created by 2 irrigation needles and a multisonic system in mandibular molars. Restor Dent Endod. 2021 Feb 8;46(1):e14. doi: 10.5395/rde.2021.46.e14. PMID: 33680903; PMCID: PMC7906849.
Silva PB, Krolow AM, Pilownic KJ, Casarin RP, Lima RKP, Leonardo R de T, et al. Apical Extrusion of Debris and Irrigants Using Different Irrigation Needles. Braz Dent J. 2016 Apr;27:192–5.
Khan S, Niu L na, Eid AA, Looney SW, Didato A, Roberts S, et al. Periapical pressures developed by nonbinding irrigation needles at various irrigation delivery rates. J Endod. 2013 Apr;39(4):529–33.
Teja KV, Ramesh S, Vasundhara KA, Janani KC, Jose J, Battineni G. A new innovative automated root canal device for syringe needle irrigation. J Taibah Univ Med Sci. 2022 Feb;17(1):155–8.
Zhou N, Huang Z, Yu M, Deng S, Fu B, Jin H. Influence of needle working length and root canal curvature on irrigation: a computational fluid dynamics analysis based on a real tooth. BMC Oral Health. 2022 Dec;22(1):1–10.
Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LWM. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod. 2010 May;36(5):875–9.
Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, Van der Sluis LWM. The effect of root canal taper on the irrigant flow: evaluation using an unsteady Computational Fluid Dynamics model. Int Endod J. 2010 Oct;43(10):909–16.
Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, Van der Sluis LWM. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computational Fluid Dynamics model. Int Endod J. 2010 Oct;43(10):874–81.
Boutsioukis C, Psimma Z, Sluis LWM van der. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J. 2013 Jul 1;46(7):599–618.
Teja KV, Ramesh S, Choudhari S, Janani K, Jose J, Vasundhara KA. A questionnaire-based cross-sectional survey of Indian postgraduates and endodontists on awareness, attitude, and practice of using conventional syringe needle irrigation during root canal treatment. Saudi Endod J. 2022 Sep 1;12(3):302.
Wang R, Shen Y, Ma J, Huang D, Zhou X, Gao Y, et al. Evaluation of the Effect of Needle Position on Irrigant Flow in the C-shaped Root Canal Using a Computational Fluid Dynamics Model. J Endod. 2015 Jun;41(6):931–6.
Boreak NM, Inamdar MNK, Khan S, Merdad KA, Jabali A, Albar N, et al. Evaluation of the root canal cross-sectional morphology in maxillary and mandibular premolars in Saudi subpopulation. Saudi Endod J. 2022 Jan 1;12(1):17.
Nagendrababu V, Murray PE, Ordinola-Zapata R, Peters OA, Rôças IN, Siqueira JF, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: explanation and elaboration. Int Endod J. 2021 Sep 1;54(9):1491–515.
Sujith IL, Teja KV, Ramesh S. Assessment of irrigant flow and apical pressure in simulated canals of single-rooted teeth with different root canal tapers and apical preparation sizes: An ex vivo study. J Conserv Dent. 2021 Jul 1;24(4):314.
Jose J, Khandelwal A, Siddique R. Qualitative Assessment of the Surface Topographic Changes of XP-endo Shaper and TruNatomy files after exposure to Sodium Hypochlorite and Ethylenediaminetetraacetic Acid. Eur Endod J. 2021;6(2):197–204.
Boutsioukis C, Lambrianidis T, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, et al. The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod. 2010 Oct;36(10):1664–8.
Gopikrishna V, Sibi S, Archana D, Pradeep Kumar AR, Narayanan L. An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate. J Conserv Dent JCD. 2016 Apr;19(2):189–93.
Gopikrishna V, Pare S, Kumar AP, Narayanan LL. Irrigation protocol among endodontic faculty and post-graduate students in dental colleges of India: A survey. J Conserv Dent. 2013 Sep 1;16(5):394.
Simdar N, Bashardoust N, Jahangir M. Comparison of the cleaning efficacy of XP-endo shaper and Mtwo rotary files in oval-shaped canals. Dent Res J.2021 Dec 10;18:107. PMID: 35265290; PMCID: PMC8804547.
Amaral RR, Oliveira AGG, Braga T, Reher P, Farias L de M, Magalhães PP, et al. Quantitative Assessment of the Efficacy of Two Different Single-file Systems in Reducing the Bacterial load in Oval-Shaped Canals: A Clinical Study. J Endod. 2020 Sep 1;46(9):1228–34.
Hu S, Duan L, Wan Q, Wang J. Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model. Biomed Eng Online. 2019 May 6;18(1):52.
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NilCopyright (c) 2022 Sahil Choudhari, Kavalipurapu Venkata Teja, Sindhu Ramesh, Raja Kumar, Alessandra Valletta, Marzia Maglitto
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