Examination of Irrigant Flow on a Tooth With Internal Root Resorption by Using a Computational Fluid Dynamics Model

Objective: This study investigated the flow of an endodontic irrigant in a single-rooted tooth with internal root resorption (IRR).
Methods: A simulation of a prepared central incisor with internal root resorption was created and irrigation with a 30-G needle was performed. The fluid pattern of the irrigant was evaluated using a Computational Fluid Dynamics model. In addition, the effects of the needle-insertion depth in the root canal and the size of root resorption on the fluid flow and the wall shear stress (WSS) values were assessed. The IRR was placed immediately below the canal orifice.
Results: Inadequate irrigant washout was observed inside the resorption cavity when the needle was positioned 1 mm from the working length while placing the needle slightly above the resorption cavity resulted in significant irrigant circulation inside the resorption cavity. Moreover, when the needle was placed slightly above the defect, the calculated WSS values in the resorption cavity walls were significantly higher (approximately 20 times higher in every case). In cases where the needle was placed 1 mm from the working length, the average and maximum WWS values were between 3 Pa and 51 Pa, while in cases where the needle was placed coronal to the IRR, the values were between 55 Pa and 528 Pa. The radius of the resorption cavity did not affect the irrigant flow patterns.
Conclusion: During the endodontic treatment of cases with internal root resorption, complementary irrigations with the needle tip placed slightly above the resorption cavity should be followed to better debride the root canal. (EEJ-2020-12-281)