Endodontic Irrigation Flashcards
(38 cards)
What are some obstacles to success with endodontics?
Complex pulpal anatomy
How much of the canal walls can remain untouched by instruments?
Up to 35%
What is the purpose of mechanical preparation of canals?
Creates space to allow irrigating solutions and medicaments to more effectively eliminate microorganisms from the root canal system
What are the 6 stages of mechanical root canal preparation?
- Access preparation
- Straight line access
- Initial scouting
- Coronal flare
- Glide path and working length determination
- Apical preparation
What are the ideal properties of an irrigant solution?
- Low cost
- Washing action
- Reduction of friction
- Improve cutting of dentine by the instruments
- Dissolution of organic and inorganic matter
- Good penetration within root canal system and surrounding dentinal tubules
- Kill planktonic microbes
- Kill biofilm microbes
- Detachment of biofilm
- Non toxic to PA tissues
- Bio compatible and non allergenic
- Compatible with restorative dental materials
- Does not alter properties of dentine unfavourable
What 3 things must an ideal irrigation protocol do?
- Disinfect the canal
- Remove smear layer
- Preserve dentine
What is sodium hypochlorite?
NaOCl
Which irrigant performs best?
Sodium hypochlorite
What are the properties of sodium hypochlorite?
- Potent antimicrobial action
- Removes organic debris within root canal
- Dissolves pulpal remnants and collagen
- Endodontic irrigant that dissolves vital and necrotic tissue
What is the only endodontic irritant that dissolves vital and necrotic tissue?
NaOCl
What are the modes of antibacterial action of sodium hypochlorite?
- Saponification
- Neutralisation
- Hypochlorous acid
- Chloramination
- Alkalinity
What does saponification mean?
Fat solvent (degrades fatty acids)
What does chloramination mean?
Hydrogen replaced with chlorine impeding cell metabolism
What are the complications of sodium hypochlorite?
- Discolouration of fabrics
- Chemical burns to ST
- Ophthalmic injuries
- Apical extrusions leading to tissue necrosis
- Allergic reactions
- Reduces flexural strength and elasticity of dentine
How does sodium hypochlorite affect dentine?
Reduces the flexural strength and elasticity
What percentage range of sodium hypochlorite can we use?
0.5 - 5.25%
What concentration of NaOCl do we use in ADI?
2-3%
What is the application of NaOCl?
Dynamic movements encourages penetration into accessory canals and dentinal tubules
Heat causes increased activity but reduces duration of effectiveness
How does heat affect NaOCl?
Increases activity but reduces duration of effectiveness therefore it is not advised
Why is dynamic irrigation so important?
Tissue dissolves 12x faster than with no agitation
What technique do we use for irrigation?
Manual dynamics irrigation
How long do we need the NaOCl to be in contact with the tooth for, at 2.5%?
At least 5 mins
How to do manual dynamic irrigation?
Use a GP point of a good fit, that is less tapered than the preparation
Move it up and down at a rate of 100 pulses per minute
Maximum 2mm movement
What is ultrasonic activation?
The use of ultrasonic energy to enhance the cleaning process during root canal treatment by agitating the irrigation solution, leading to improved removal of debris, pulp tissue remnants, bacteria, and the smear layer from the canal system, resulting in a cleaner and more effectively disinfected root canal
