irrigation of endo

By : Osama Ahmad [email protected] | @Os_a_a ☚

NAO

CL"

sodiu

m h

ypoch

lorite

Norm

al Salin

e

ch

lorh

exid

ine

1 Organic tissue solvent 2 Inorganic tissue solvent 3 Antimicrobial action 4 Lubrication 5 Non toxic 6 Low surface tension

- Most common irrigant - house home bleach

イAdvantages :

1 mechanical flush 2 dissolve vital & necrotic tissue 3 Lubricant 4 Antimicrobial action 5 Inexpensive 6 Readily available

Disadvantage ひ

- Toxicity

Accidental error - Bad Taste -

Free chlorine in NaOCl dissolves necrotic tissue by breaking down proteins into amino acids.

Concentration ranging from 0.5% to 5.25 %

A common concentration is 2.5%

- Broad spectrum of Antimicrobial - Little Toxicity

イAdvantage

- sustained action

- Little Toxicity

ひ Disadvantage

Inability to dissolve necrotic tissue & inability remove smear layer

2 % chlorhexidine = antirnicrobial

action as 5.25% NaOCl

# more effective against " Enterococcus faecalis"

is a general phrase referring to a sterile solution of sodium chloride

イAdvantage:

Safe

ひ Disadvantage

No Antimicrobial effect No ability dissolve organic

properties of ideal irrigation

How to increase effect of solution ??

By Warming the solution , increase antimicrobial and tissue dissolving


Lubricant

- Facilitate file insertion during cleaning and shaping - Reduce torsional Force - Reduce potential fracture

Glycerin

- Mild alcohol - Aseptic - Inexpensive - Paste lubricants can incorporate chelators

イAdvantage of Glycerin:

Suspend dentinal debris

& prevent compaction

イDisadvantage of smear layer :

- prevent sealer contact with canal wall

- permit leakage

- Separate obturation material

イAdvantage of Removal smear layer :

- File adapt

- enhance sealer contact in the canal wall

- Reduce Leakage

Removal smear layer 1 by Irrigation with 17% EDTA for 1 minute followed by NaOcl .

2 or Use " MTAD "

Smear Layer


E D

T A

M T

A D

`

Decalcifying agent

# Ethylene Diamine Tetraccetic Acid #

イ - Chelating agent

Chelators remove the inorganic components and leave the organic tissue elements intact.

NaOCl is then necessary for removal of the remaining

organic components , and remove remaining EDTA

- Most effect in coronal and middle , reduce apically

Concentration : Removal smear layer by Irrigation with 17% EDTA

for 1 minute followed by NaOcl .

イDisadvantage: - Used over 10 min , cause excessive remove of peritubular and intratubular dentin

- Deactivation of NAOCL by reduce chlorine & potential toxicity

- additional Edta to lubricant is not effective

` # Mixture Tetracycline Acid Detergent # - Remove Smear Layer

- Completely remove Smear Layer

- NAOCL then MTAD - Superior antimicrobial than NAOCL

Concentration :

1.3 %

Advantages :

- Anti microbial action - Effect in kill Enterococcus faecalis . - Biocompatible - Not alter dentin - enhance bond strength


The G

roups

Phenol &

Ald

ehid

e

Calc

ium

Hydro

xid

e

Cort

icost

ero

ids

Chlo

rohexid

ine

1- phenolic ( Cresol , Thymol ) 2- Aldehide ( Form cresol ) 3- Halide ( NAOCL ) 4- Steroids 5- Calcium Hydroxide 6- Antibiotics

7- Combinations

Purpose :

1- Reduce pain

2- Reduce Bacteria

3- Canal be inert

` - Non specific action

Function : -Destroyed host tissue

-Aldehide are Fixation agent

- Control pain

Function :

- antimicrobial activity - inhibit microbial growth - Dissolve necrotic tissue - Radiopaque - induction of hard tissue " in root end closure " Apexification

- Alkaline Ph = 12.5 , 12.8 ph

Disadvantage ::

- No pain Reduction - Little benefit to vital pulp

Disadvantage :

- Toxicity - Not justified to use it

- placed as powder - or as mixed with liquid with L.A , water, saline

- By lentulo spiral or syringe - placed for 7 days to reduce bacteria

` - Anti inflammatory agent

Function : - Decrease pain - post operatively - Used in : 1 AAp Acute apical periodontitis 2 irreversible pulpitis

Disadvantage : - may ineffective in great pain

- 2 % gel - as gel or mixed with calcium hydroxide

Advantage : - Antimicrobial greater than calcium hydroxide - Fixative

Disadvantage : - Can't affect of smear Layer


Temporary Filling

1 to 4 week

# primary Function :

Disinfection

# Secondary Function :

1 pain control

2 Decrease Bacterial 3 Control exudation or Bleeding

4 Control inflammatory root resorption

irrigation of endo

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