Irrigation

Irrigation is an important part of endodontic treatment because it removes dentin shavings from root canal treated canals. As a result, they do not become compacted near the root apex. Due to the lack of lubrication in the dry canals, endodontic instruments are unable to work properly.

Purpose of Endodontic Irrigation #

Goal of endodontic treatment is to remove all vital and necrotic tissue, microorganisms and microbial byproducts from root canal system.

Properties Of Ideal Irrigant #

• Broad spectrum antimicrobial properties

• Aid in debridement of root canal system

• Ability to dissolve necrotic tissue or debris

• Low toxicity level

• Good lubricant

• Ability to sterilize the canal

• Dissolve the smear layer

• Inactivate endotoxin

Factors Modifying The Irrigants Activity #

• Concentration of irrigant solution

• Contact with the substrate

• Presence of organic tissue

• Quantity of irrigant

• Temperature of irrigating solutions

Types of Irrigating Solutions #

• Sodium hypochlorite

• chlorhexidine gluconate

• EDTA

Sodium Hypochlorite #

• Strong base with PH more than 11

• Broad antibactrial spectrum

• Sporicidal

• Viricidal

• Greater tissue dissolving activity for necrotic than vital tissues

Chlorhexidine gluconate #

• Cationic bisbiguanide antiseptic

• At low concentrations it is bacteriostatic

• At high concentrations it is bactericidal to both gram ‘-’ and gram ‘+’ bacteria

• It attacks multiple sites at cellular level, making resistance less likely.

EDTA #

• Also known as ethylenediamine tetraacetic acid

• Non corrosive to instruments

• Not bactericidal nor bacteriostatic in nature

• It emulsifies soft tissues and remove the smear layer with no deleterious effects

• At concentrations of 15-17% it removes calcium from dentin leaving a softened matrix of dentin.

Sequence Of Irrigation #

The process of endodontic irrigation in a normal root canal treatment takes place the following sequence

• Use of Hypo -> Saline irrigation -> Hypo -> Hypoactivation -> Saline irrigation -> Evacuate -> EDTA/ Smearclear -> Saline irrigation -> Evacuate -> 2% Chlorhexidine -> Dry the canals with paper point -> Obturate the canals with Gutta percha points.