(TC64) Optimizing Endodontic Irrigation: A Gastrografin-Based Cadaveric Model for Precision Evaluation of Apical Extrusion

Abstract: The majority of research investigating the extrusion of irrigants in endodontic procedures relies heavily on ex vivo techniques employing extracted teeth. While these studies have provided valuable insights into the dynamics of irrigant extrusion, there is a notable limitation in their ability to accurately reflect the clinical scenario. The ex vivo approach, by its nature, excludes the impact of periradicular tissues on the occurrence of extrusion. We propose a novel model for evaluating irrigation outcomes in endodontics by utilizing a human cadaveric model as a surrogate for clinical evaluation. With an increasing emphasis on advanced irrigation techniques in endodontics, the need for a precise and clinically relevant assessment tool is crucial. The methodology involves the injection of a radiopaque dye, Gastrografin, into the root canal system, followed by activation with various irrigation techniques (e.g., laser, sonic, and ultrasonic). Gastrografin's radiopacity enables visualization of irrigant flow and extrusion via cone-beam computed tomography (CBCT) imaging. This proposed method holds promise as it addresses the limitations of existing evaluation techniques and provides a direct, visual means of assessing apical irrigant extrusion during endodontic procedures. The use of Gastrografin offers a practical and efficient approach to evaluate irrigation outcomes, potentially contributing valuable insights into refining and optimizing endodontic irrigation strategies. This model has the potential to enhance the safety and efficacy of endodontic procedures by offering a reliable method for assessing irrigant dynamics in a clinically relevant context.