title: Formation and removal of apical vapor lock during syringe irrigation: a combined experimental and Computational Fluid Dynamics approach.
abstract: OBJECTIVE
  (i) To evaluate the effect of needle type and insertion depth, root canal size and irrigant flow rate on the entrapment of air bubbles in the apical part of a root canal (apical vapor lock) during syringe irrigation using experiments and a Computational Fluid Dynamics (CFD) model, (ii) to investigate whether the irrigant contact angle affects bubble entrapment, (iii) to examine if an established vapor lock can be removed by syringe irrigation.
  
  
  METHODS
  Bubble entrapment during irrigation of straight artificial root canals of size 35 or 50 was evaluated by real-time visualizations. The irrigant was delivered by a closed-ended or an open-ended needle positioned at 1 or 3 mm short of working length (WL) and at a flow rate of 0.033-0.260 mL s(-1) . Results were analysed by nonparametric tests at 0.05 significance. Selected cases were also simulated by a two-phase CFD model.
  
  
  RESULTS
  A vapor lock was observed in 48% of the cases investigated experimentally. Increasing the apical size, using an open-ended needle, positioning the needle closer to WL and delivering the irrigant at higher flow rate resulted in significantly smaller vapor lock. An increased contact angle resulted in the entrapment of a larger bubble when a low flow rate was used. Both brief insertion of the needle to WL whilst irrigating at a flow rate of 0.083 mL s(-1) and delivering the irrigant at 0.260 mL s(-1) without changing the needle position were capable of removing an established vapor lock.
  
  
  CONCLUSIONS
  Apical vapor lock may occur under certain conditions, but appears to be easily prevented or removed by syringe irrigation.
authors.affiliation: Physics of Fluids Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands; MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Boutsioukis
authors.forename: E
authors.initials: E
authors.lastname: Kastrinakis
authors.forename: T
authors.initials: T
authors.lastname: Lambrianidis
authors.forename: B
authors.initials: B
authors.lastname: Verhaagen
authors.forename: M
authors.initials: M
authors.lastname: Versluis
authors.forename: L W M
authors.initials: LW
authors.lastname: van der Sluis
mesh_terms: D005740:Gases; D057446:Hydrodynamics; D008962:Models, Theoretical; D013594:Syringes; D007507:Therapeutic Irrigation
chemical_list: D005740:Gases
keywords: Apical vapor lock; Computational Fluid Dynamics; bubble; needle; root canal irrigation; syringe