Localized transient whitening of the gastric mucosa after water-jet flushing through the auxiliary water channel is rarely described. We report a 49-year-old man who underwent endoscopic submucosal dissection for a 5-mm gastric-type neoplasm on the greater curvature of the lower gastric body. During washing of adjacent non-lesional mucosa, strong auxiliary water-channel flushing for approximately 2-5 s was followed by a focal whitish linear change confined to the flushed area, which became evident approximately 10 s after flushing was stopped and persisted for approximately 30 s before resolving spontaneously, without symptoms or adverse events. Similar changes were observed on the following day and 84 days after resection, but not under the recorded conditions of weaker auxiliary water-channel flushing or manual instrument-channel spraying. When a localized whitish change is observed after strong auxiliary water-channel flushing, brief observation for spontaneous resolution may help distinguish this transient finding from a fixed mucosal lesion. Trial Registration: N/A.

Root canal treatment is crucial for preventing oral diseases, and its success hinges on the effective removal of biofilm and debris from the canal wall by the irrigant. However, the intricate and narrow anatomy of root canals limits the efficacy of irrigant jet in the critical apical region, hindering fluid mixing and the removal of wall-adherent material. To address this, a passive self-exciting jet technique using a novel slot jet needle is proposed. This design aims to reorganize the flow and induce secondary jet self-excitation within the narrow cavity, thereby enhancing root canal irrigation effect. The influence of the slot angle and aperture diameter is first investigated, and the results show that the efficacy of jet coupling depends not only on the slot jet direction but also on the relative strength of the jets. The irrigation performance is optimal when the slot angle is 90 deg and the aperture diameter is 0.1 mm. Furthermore, the influence of the tapering angle is investigated using the principle of a tapering nozzle. Compared to the clinically common prototype 30 G needle, the optimized design increases the effective cleaning area by up to 20.82% and the extending depth by up to 50.79%, while reducing the mean apical pressure by up to 23.39%. These improvements demonstrate that the cleaning performance, mass exchange capability, and safety are improved simultaneously.

This case report reviews the effect of combining a 250-cc bottle of standard antimicrobial, buffered sodium hypochlorite with a surgical method, low-pressure jet lavage irrigation in the outpatient setting to control difficult wound contamination. A 73-year-old man had been in treatment for over 8 years, undergoing at least 18 surgical wound debridement procedures for an extensive undermined pelvic pressure injury involving the sacrum, ischium, and greater trochanter. Cultures and polymerase chain reaction diagnostics revealed a multibacterial presence. Autofluorescent imaging (AFI) was used in 21 examinations performed after a 72-hour delay over a long weekend. The AFI contamination exceeded log 4 colony-forming units/g of tissue in all pretreatment examinations and was reduced to less than log 2 colony-forming units in 6 of 21 examinations, with the remaining 15 showing an estimated 80% or higher removal of the bacterial porphyrin "red" appearance. A total of 54 AFI examinations were performed using the combination treatment, and no adverse reactions were encountered. Treatment paradigms can be improved with a multifactorial approach.

The present study aims to assess the efficacy of different irrigation agitation systems in removing calcium silicate-based sealers from artificial standardised apical grooves. After the root canal instrumentation of 96 teeth, artificial apical grooves were created in half of each root. The samples were divided into two main groups according to the sealer type (AH Plus Jet [APJ] and Sure-Seal Root™ [SSR]) (n = 48). The root halves were then reassembled and divided into four experimental groups based on the final irrigation technique used: Conventional Syringe Irrigation (CSI), Ultrasonic Irrigant Agitation (UIA), Sonic Agitation (SA) and Manual Dynamic Agitation (MDA). The roots were then dissembled to assess the amount of root canal sealer. UIA significantly removed more of SSR sealer than CSI, MDA and SA while there was no statistical difference between CSI, MDA, SA and UIA groups in the APJ group. None of the irrigation agitation systems used had completely removed the APJ and SSR sealers. However, UIA was more effective in removing SSR sealer from the standardised apical groove than were CSI, MDA and SA.