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Objectives The aim of this study was to evaluate the apical pressure generated by 2 endodontic irrigation needles and the GentleWave system in mandibular molars. Materials and methods The mesial and distal root canals of 12 mandibular molars were irrigated with a 30-gauge close-end needle or with a 30-gauge open-end needle. Procedures were performed in the mesial and distal canals. The GentleWave procedure and irrigation at 1 mm from the apex in the distal roots using an open-end needle were used, respectively, as negative and positive controls. The apical pressure was measured using a data acquisition pressure setup. Apical pressure exerted by the different needles in the 2 different canal types was statistically compared using 2-way analysis of variance. Results Significant differences were found in the apical pressure for both needles and the canal type. The lowest values were obtained with close-end needles and in mesial canals. Negative apical pressure values were obtained using GentleWave. Conclusions The needle and the canal type influenced the apical pressure. The GentleWave procedure produced negative apical pressure.

As many other infections in the oral cavity, endodontic disease has a bacterial component that involves the presence of a mixed infection including facultative and anaerobic bacteria. These bacterial aggregations are able to attach to the root canal dentinal walls perpetuating an inflammatory condition known as apical periodontitis. Classically, hand and rotary instruments in conjunction with antimicrobial agents have been used to manage the infection at the apical root third. Whereas the removal of tooth structure is necessary to achieve biological goals, the uncontrolled dentin removal can present some side effects including the weakening of the tooth structure. One of the goals of minimally invasive endodontic procedures is to minimally modify the tooth architecture in order to avoid structural failures that may end in a tooth extraction; in this context, the main challenge is to improve the delivery of antimicrobials to the apical third modifying the technical endodontic triad process that has guided the contemporary practice of root canal treatment. Most specifically, decreasing the size of the access and the size of the preparation.