Elsevier

Dental Abstracts

Volume 59, Issue 5, September–October 2014, Pages 274-276
Dental Abstracts

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Irrigation

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Background

Irrigation provides important mechanical, chemical, and microbiological functions in root canal treatment. It allows cleansing of root canal areas and the removal of tissue remnants and biofilms that cannot be accomplished with mechanical instrumentation. A report on the current state of knowledge about irrigation and recommendations regarding specific solutions, concentrations, irrigant sequencing, and methods of delivery was prepared.

Irrigation Principles

Irrigation is especially valuable for eradicating root canal microbes. The solutions used for irrigation during and after instrumentation facilitate the killing and removal of microorganisms, necrotic and inflamed tissue, and debris. Irrigating solutions also reduce the friction between instruments and dentin, improve cutting effectiveness, dissolve tissues, and cool the file and the tooth, especially when ultrasonic tools are used. It may also prevent packing hard and soft tissue into apical

Solutions and Sequences

Sodium hypochlorite (NaOCl) is the only solution that can dissolve organic matter in the canal and permits removal of necrotic tissue remnants as well as biofilm. NaOCl ionizes in water and establishes equilibrium with hypochlorous acid (HOCl). Most chlorine exists at acidic or neutral pH levels, but at a pH of 9 or greater, hypochlorite ion (OCl) is the most abundant form. OCl is less effective against bacteria than hypochlorous acid, which directly affects the vital functions of microbial

Equipment

Classic equipment consists of a syringe and needle. Needle irrigation applied with care is both effective and sufficient when done using small 27-gauge or preferably 30-gauge needles to access the apical canal. Irrigant exchange beyond the needle tip reaches 1 to 3 mm, depending on needle type and irrigant flow. Side-vented needles may be safer than open-ended needles with positive-pressure irrigation. Solutions tend to be more effective if the irrigant is agitated and constantly refreshed. A

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Haapasalo M, Shen Y, Wang Z, et al: Irrigation in endodontics. Br Dent J 216:299-303, 2014

Reprints available from M Haapasalo, Div of Endodontics, Dept of Oral Biological and Medical Sciences, UBC Faculty of Dentistry, The Univ of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada, V6T 1Z3; e-mail: [email protected]

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