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Flashcards in Irrigation Deck (29)
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1

Purpose of irrigation

CLEAN out the canals following the preparation of canals via files

2

Ideal properties of irrigation solution

Organic tissue solvent
Inorganic tissue solvent
Antimicrobial
Nontoxic
Low surface tension
Lubricant
Non staining
Remove smear layer

There is NO SINGLE irrigant solution that meets all of these needs. Will use a combination.

3

Definition of irrigation

Wash out body cavity or wound with water of medicated fluid

4

Commonly used irrigants (5)

Sodium hypochlorite (bleach)
EDTA
Chlorhexidine
Sterile water
Local anesthetic

5

Sodium hypochlorite

NUMBER 1 IRRIGANT

2.5% -- 5.25%
Best proteolytic agent
* Breaks down proteins into amino acids via
free chlorine
Chelator
Removes debris and wets canal walls
Antimicrobial
Dissolves organic and inorganic debris
Opens dentinal tubules (removes smear layer)
Disinfects and cleans areas inaccessible to instrumentation

Leave in for 20 min to get complete dissolution of tissue

DO NOT USE on open apex

6

How much of the canal wall is left untouched by instruments?

40 - 60%

Important to use irrigants

7

EDTA

17%
Chelator
Effective smear layer remover when used for 1 min

8

H2O

Universal
Biocompatible
Sterile
FLUSHING action

9

Chelator

removes inorganic components of canal and leaves organic tissue intact

10

Chlohexidine

Broad antimicrobial activity
Effective against ENTEROCOCCUS FAECALI

Use with open apexes and stubborn bugs

Does NOT dissolve necrotic tissue
Doe NOT remove smear layer
Not toxic to tissues

FORMS PRECIPITATE WHEN COMBINED WITH SODIUM HYPOCHLORITE

Good to use with:
* chronic lesion
* open apex

11

Local anesthetic

Tissue compatible
Sterile
Some antimicrobial action
Good for open apex

12

Smear layer

Organic and inorganic substances as well as fragments of odontoblastic processes

Various species of bacteria and necrotic debris

13

When does the smear layer accumulate

During cleaning and shaping of the canal wall

14

Where does the smear layer accumulate

Accessory canals
Fins
Isthmuses
Canal walls

15

Why is the smear layer harmful?

Contaminated with bacteria and metabolic byproducts

Prevents sealer contact with canal wall -- permitting leakage

Disintegrates then causes obturation leakage

16

How far into dentinal tubules can the smear layer pack?

1-5 microns

17

Why remove the smear layer? (3)

Filling material adapts better to the wall
Better adhesion of sealer to dentin
Better tubular penetration of sealer

18

What file and filing action reduces smear layer the most?

Hedstrom files

Rasping motion

Pulls debris out as you file and shaves off the wall

19

When do you irrigate?

Every 2-3 file changes
Agitate with small file #10 or #15

20

What type of needles should be used to irrigate

Small side vented needles

21

Keep chamber full of solution

NEVER instrument a dry canal with rotary

22

Alternate NaOCl with EDTA

TRUE

23

What is RC prep?

Lubricant
Good to use for bleeding cases
(irreversible pulpitis)

24

DO NOT place the irrigation needle to the apex

TRUE

25

Positive pressure irrigation

Push fluid into the chamber through the needle
Fluid will go 1 -3 mm

26

Negative pressure irrigation

Put fluid in the canal
Use canula to suck back up the solution

cleanest way of irrigating
Does not suck up a lot of debris

27

Side effects of NaOCL

swelling
bruising

Toxic outside of the canal -- will see immediate reaction

28

What do you rinse with if the canal is bleeding?

Water
Local anesthetic
Follow by NaOCl

Use RC prep

29

When using a Gates Gladden bur rinse with

LOTS of water for flushing out the canal

GG bur leaves a lot of debris