Lecture 12: Irrigation of the Root Canal System : Operative Department | BDS Operative
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#irrigation
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IRRIGATION OF ROOT CANAL SYSTEM
INTRODUCTION
Root canal therapy is a chemo-mechanical process.
After shaping the canal with hand and rotary instruments, irrigants are used to clean the canal.
Therefore, irrigants are not only important for removal of debris and dentinal chips during cleaning and shaping, but are of critical importance in eradication of intra-radicular microbial infection.
IDEAL PROPERTIES OF IRRIGANTS
Antimicrobial activity
Mechanically flushes out the debris from the root canal
Nontoxic and biocompatible in nature
Dissolves necrotic and vital pulp tissues
Serves as a lubricant
Removes the smear layer
Low surface tension
Ease of storage
Remain active following storage
Adequate shelf-life
Inexpensive
CONTD
Currently, none of the available irrigating solutions have all the properties of an ideal irrigant
Combined use of separate irrigants is the clinical protocol recommended to ensure successful outcome of endodontic treatment
OBJECTIVES OF IRRIGATION
To remove debris created during instrumentation
To dissolve and/or flush out inorganic and organic remnants of the pulp
Lubrication of the canals for easy instrumentation
Removal of the smear layer
Anti-microbial action to reduce bacterial load in the canals
1-bacteria and bacteria by products that are not removed by mechanical instrumentation
3-With the introduction of obturation materials designed to bond with dentine,
TYPES OF IRRIGANTS
Sodium hypochlorite
EDTA
Chlorhexidine digluconate
Sodium hypochlorite (NaOCl), a reducing agent, is a clear, straw-colored solution containing about 5% of available chlorine.
It is the most widely used irrigating solution.
MECHANISM OF ACTION
NaOCl on ionization produces hypochlorous acid and hypochlorite ion. These are responsible for the antimicrobial ability of NaOCl.
Destruction of the bacteria takes place in two phases:
Penetration into the bacterial cell wall
Chemical combination with the protoplasm of the bacterial cell and disruption of DNA synthesis
PROPERTIES OF NaOCl
Concentration
Most effective concentration – 5.2%
For decreased toxicity – 0.5--- 2.5%
Tissue dissolving ability
Completely dissolves an entire pulp in 20 minutes to 2 hours
More effective in wide canals as compared to narrow canals
Efficacy increases with increase in temperature of the solution
Therefore, recommended to use low conc. solution with increased temperature to have same tissue dissolving ability as that of high conc. solution
DRAWBACKS
Cytotoxicity and caustic effects on healthy periradicular tissues on inadvertent extrusion during the irrigating procedure.
It does not remove the inorganic component of the endodontic smear layer.
It has an unpleasant taste.
The solution should be kept in a cool place, away from sunlight.
SODIUM HYPOCHLORITE ACCIDENT
Severe pain
Swelling
Profuse bleeding
Extension of edema to a large area of the face
Ecchymosis
IRRIGATION OF ROOT CANAL SYSTEM
INTRODUCTION
Root canal therapy is a chemo-mechanical process.
After shaping the canal with hand and rotary instruments, irrigants are used to clean the canal.
Therefore, irrigants are not only important for removal of debris and dentinal chips during cleaning and shaping, but are of critical importance in eradication of intra-radicular microbial infection.
IDEAL PROPERTIES OF IRRIGANTS
Antimicrobial activity
Mechanically flushes out the debris from the root canal
Nontoxic and biocompatible in nature
Dissolves necrotic and vital pulp tissues
Serves as a lubricant
Removes the smear layer
Low surface tension
Ease of storage
Remain active following storage
Adequate shelf-life
Inexpensive
CONTD
Currently, none of the available irrigating solutions have all the properties of an ideal irrigant
Combined use of separate irrigants is the clinical protocol recommended to ensure successful outcome of endodontic treatment
OBJECTIVES OF IRRIGATION
To remove debris created during instrumentation
To dissolve and/or flush out inorganic and organic remnants of the pulp
Lubrication of the canals for easy instrumentation
Removal of the smear layer
Anti-microbial action to reduce bacterial load in the canals
1-bacteria and bacteria by products that are not removed by mechanical instrumentation
3-With the introduction of obturation materials designed to bond with dentine,
TYPES OF IRRIGANTS
Sodium hypochlorite
EDTA
Chlorhexidine digluconate
Sodium hypochlorite (NaOCl), a reducing agent, is a clear, straw-colored solution containing about 5% of available chlorine.
It is the most widely used irrigating solution.
MECHANISM OF ACTION
NaOCl on ionization produces hypochlorous acid and hypochlorite ion. These are responsible for the antimicrobial ability of NaOCl.
Destruction of the bacteria takes place in two phases:
Penetration into the bacterial cell wall
Chemical combination with the protoplasm of the bacterial cell and disruption of DNA synthesis
PROPERTIES OF NaOCl
Concentration
Most effective concentration – 5.2%
For decreased toxicity – 0.5--- 2.5%
Tissue dissolving ability
Completely dissolves an entire pulp in 20 minutes to 2 hours
More effective in wide canals as compared to narrow canals
Efficacy increases with increase in temperature of the solution
Therefore, recommended to use low conc. solution with increased temperature to have same tissue dissolving ability as that of high conc. solution
DRAWBACKS
Cytotoxicity and caustic effects on healthy periradicular tissues on inadvertent extrusion during the irrigating procedure.
It does not remove the inorganic component of the endodontic smear layer.
It has an unpleasant taste.
The solution should be kept in a cool place, away from sunlight.
SODIUM HYPOCHLORITE ACCIDENT
Severe pain
Swelling
Profuse bleeding
Extension of edema to a large area of the face
Ecchymosis
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در تاریخ 1403/03/03 منتشر شده
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