Removal of plaque biofilm by a 3D-printed precision pericoronal irrigator for impacted wisdom teeth: an in vitro study

Objective‍ ‍To prepare an advanced irrigation device equipped with a specialized nozzle designed to access the pericoronal blind sac of impacted wisdom teeth, and evaluate its efficacy in plaque removal. Methods‍ 3D-printer was utilized to develop pericoronal models simulating mandibular wisdom teeth with high vertical impaction and varying soft tissue coverage (0%, 25%, 50%, and 75%, respectively) and personalized pericoronal irrigator. The obtained pericoronal models were randomly divided into 3 groups, treated with personalized precision pericoronal flushing, routine flushing and brushing, respectively, and, under a pressures of 45 psi or 75 psi （1 psi=6 894.76 Pa）, were performed to clean the test surfaces of plaque-biofilm-obstructed wisdom teeth, respectively. Images of the tooth surfaces were analyzed before and after cleaning, and the cleaning rate was calculated using Python software. Results‍ ‍For wisdom teeth with 50% and 75% pericoronal soft tissue coverage, at a pressure of 45 psi, the precision pericoronal flushing group demonstrated significantly higher cleaning rate when compared to the brushing and routine flushing groups (P<0.05). At 0% and 25% pericoronal soft tissue coverage, the precision pericoronal flushing and brushing groups exhibited significantly higher cleaning rates than the routine flushing group (P<0.05). Furthermore, at 75 psi, the precision pericoronal flushing group achieved a significantly higher cleaning rate across all 4 levels of pericoronal soft tissue coverage than both the routine flushing and brushing groups (P<0.05). Notably, the precision pericoronal flushing group at 75 psi obtained significantly higher cleaning rate than at 45 psi across 0%, 25%, and 50% pericoronal soft tissue coverage (P<0.05). Conclusion‍ ‍The precision pericoronal irrigation device demonstrates significantly superior cleaning efficacy for vertically impacted mandibular third molars compared to conventional irrigation devices and manual tooth brushing. It is an effective device for preventing and treating pericoronitis.