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Root canal irrigation

Dr. Mohammad Najmul Alam.


Lecturer, Conservative Department.
Chattagram International Dental College.
Every root canal has 4 basic steps :
1. Access cavity
2. Bio mechanical preparation
3. Irrigation
4. Obturation.
Among these steps, the most significant step is Irrigation.
why??
 It is the secret behind the success of
root canal treatment.
Why??
 In the human, one of the most complex morphology is the pulp
morphology.
 Microorganisms are the main reasons for endodontic
failure.
How irrigation help us to overcome these obstacles??
1. Removal of debris and wetting the canal walls
2. Destruction of microorganisms
3. Disinfection and cleaning of areas inaccessible to endodontic instrument.
 Two basic questions :
1. How much time for irrigation?
2. How we apply the irrigation into the canal?
Time of irrigation

1. Naocl, 30 minutes including files and irrigation


2. EDTA, 1 minute
3. Chlorohexidine, use your clinical judgement.
Concentration range of irrigation

 Naocl (. 5% to 5.25%)
 Chlorohexidine (0.2% to 2%)
 EDTA (17%).
Method of Irrigation

1. The needle should placed loosely in the canal.


2. Deliver the irrigant drop by drop and not continuous flushing
3. Deliver less force
4. Don’t mix irrigants
Needle size

preferable size of needle :


1. 30 gauge
2. 27 gauge.

Types of needle :
 Beveled tip ( irrigation is apicaly)
 Monoject tip ( passing irrigant to the side)
 Safe endes tip ( passing irrigant to the side, best one).
 Now the question is single irrigation solution is better?
Or multiple irrigation solution?
 We will take our decision from below information.
Advantage of Naocl

 Mechanical flushing of debris from the canal.


 Dissolved vital and necrotic tissue.
 Antimicrobial action
 Lubricating action
 Cheap.
Advantage of Chx

 Mechanical flushing of debris from the canal.


 Can’t dissolve necrotic tissue.
 Broad spectrum antimicrobial action
 Can’t remove smear layer.
Advantage of EDTA

 Common chelating agent.


 Effective on removal of smear layer.
 No effect on organic tissue.
 Little or no antimicrobial activity.

So, multiple irrigation solution is better.


Sequence of Irrigation
1. Vital teeth.
 Naocl, then
 Naocl + K file activation, then
 EDTA.
Use distilled water in between every irrigation.
2. Non vital teeth

 As in Vital teeth, then


 Citric acid, then
 CHx.
use distilled water as the end irrigant.
Irrigation activation / agitation

 Root canal poses several irregularities that can’t be cleaned with regular
irrigation.
 30% of root canal system isn’t Irrigated with regular irrigation.
so, for these reasons activation of irrigation is necessary.
Various techniques of activation

 Manual agitation
 Sonic and Ultrasonic activation
 Safely irrigator
 Laser activation system.
Manual agitation

 Cheapest method
 Use mastercone gutta percha cut 2mm from its tip.
 Place it in the canal and use vertical up and down strokes.
 Recommended no of strokes is 100 strokes per minute.
Sonic activator

 Commercially known as Endoactivator.


 Use vibrating movement 1500 -6000 HZ/ Second.
 Less risk of perforation as compared with ultrasonic system.
Ultrasonic activation

 Vibration movement reach 20000 HZ/ Second and more.


 Activate irrigation by concept of acoustic streaming.
Sonic or Ultrasonic ?
Majority 0f the studies prefer ultrasonic.
Safety irrigator

 Similar in functionally to Endovac.

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