Biofilm removal from a simulated isthmus and lateral canal during syringe irrigation at various flow rates: a combined experimental and Computational Fluid Dynamics approach

T.C. Pereira, C. Boutsioukis, R.J.B. Dijkstra, X. Petridis, M. Versluis, F.B. de Andrade, W.J. van de Meer, P.K. Sharma, L.W.M. van der Sluis, M.V.R. So

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Abstract

© 2020 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic SocietyAim: (i) To quantify biofilm removal from a simulated isthmus and a lateral canal in an artificial root canal system during syringe irrigation with NaOCl at different concentrations and delivered at various flow rates (ii) to examine whether biofilm removal is further improved by a final high-flow-rate rinse with an inert irrigant following irrigation with NaOCl. (iii) to simulate the irrigant flow in these areas using a computer model (iv) to examine whether the irrigant velocity calculated by the computer model is correlated to biofilm removal. Methodology: Ninety-six artificial root canals with either a simulated isthmus or lateral canal were used. A dual-species in vitro biofilm was formed in these areas using a Constant Depth Film Fermenter. NaOCl at various concentrations (2, 5 and 10%) or adhesion buffer (control) was delivered for 30 s by a syringe and an open-ended needle at 0.033, 0.083, or 0.166 mL s−1 or passively deposited in the main root canal (phase 1). All specimens were subsequently rinsed for 30 s with adhesion buffer at 0.166 mL s−1 (phase 2). The biofilm was scanned by Optical Coherence Tomography to determine the percentage of the remaining biofilm. Results were analysed by two 3-way mixed-design ANOVAs (α = 0.05). A Computational Fluid Dynamics model was used to simulate the irrigant flow inside the artificial root canal system. Results: The flow rate during phase 1 and additional irrigation during phase 2 had a significant effect on the percentage of the remaining biofilm in the isthmus (P = 0.004 and P < 0.001). Additional irrigation during phase 2 also affected the remaining biofilm in the lateral canal significantly (P ≤ 0.007) but only when preceded by irrigation at medium or high flow rate during phase 1. The effect of NaOCl concentration was not significant (P > 0.05). Irrigant velocity in the isthmus and lateral canal increased with increasing flow rate and it was substantially correlated to biofilm removal from those areas. Conclusions: The irrigant flow rate affected biofilm removal in vitro more than NaOCl concentration. Irrigant velocity predicted by the computer model corresponded with the pattern of biofilm removal from the simulated isthmus and lateral canal.
Original languageEnglish
Pages (from-to)427-438
JournalInternational Endodontic Journal
Volume54
Issue number3
DOIs
Publication statusPublished - 1 Mar 2021

Funding

This study has been partly funded by the annual research grant of the European Society of Endodontology. Financial assistance from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior ‐ CAPES and the Abel Tasman Talent Program (ATTP) of the Graduate School of Medical Sciences of the University of Groningen, which enabled Thais Cristina Pereira to hold a Visiting Research Fellow at the Dental School UMCG, Groningen, the Netherlands are graciously acknowledged. Prof. Dr. So was financially supported by a CNPq scholarship. Dr. Thais Pereira reports grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior ‐ CAPES and Abel Tasman Talent Program. Dr van der Sluis report a grant from the European Society of Endodontology. Dr Marcus So reported a grant from CNPq. The other authors have stated explicitly that there are no conflicts of interest in connection with this article. This study has been partly funded by the annual research grant of the European Society of Endodontology. Financial assistance from Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES and the Abel Tasman Talent Program (ATTP) of the Graduate School of Medical Sciences of the University of Groningen, which enabled Thais Cristina Pereira to hold a Visiting Research Fellow at the Dental School UMCG, Groningen, the Netherlands are graciously acknowledged. Prof. Dr. So was financially supported by a CNPq scholarship.

FundersFunder number
European Society of Endodontology
European Society of Endocrinology
Rijksuniversiteit Groningen
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Conselho Nacional de Desenvolvimento Científico e Tecnológico

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