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Endodontic Irrigation: Cleansing of the Root Canal System

Learning Objectives:

After viewing this video, the viewer should:

  • Know how to properly use an antibacterial irrigant to clean a canal
  • Learn the characteristics of good antibacterial, antimicrobial irrigants

Instrumentation alone will not sufficiently clean all the internal surfaces of the root canal; antibacterial irrigants are needed to eradicate the remaining micro-organisms. Irrigants should be antimicrobial, have a low surface tension, not be mutagenic, carcinogenic or cytotoxic, possess tissue-dissolving properties, aid the removal of smear layer, have a long shelf life, and preferably be inexpensive

Sodium hypochlorite has been used as an irrigant in endodontics for many years. It is inexpensive, readily available, highly antimicrobial, and has tissue dissolving properties. While sodium hypochlorite is commonly available as a 5.2% solution, it is highly effective, and widely used, as an antibacterial agent when diluted to a 2.5% solution. By diluting the solution the potential irritating effect on periapical tissues is reduced.

Irrigants can be introduced into the root canal with the use of a syringe. It is critical that the syringe tip not be engaged in the canal. The clinician must be aware of the potential piston effect of an irrigating solution when it is delivered close to the periapical foramen. It is suggested that the solution be deposited at the mouth of the canal and then work down the canal system with instruments.

Related Reading:

  1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965;20:340-349.
  2. West JD, Roane JB. Cleaning and shaping the root canal system. In: Cohen S, Burns RC, eds. Pathways of the Pulp. 7th ed. St. Louis: CVMosby; 1998:203-257.
  3. Byström A, Sundqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 1985;18(1):35-40.
  4. Siqueira JF Jr, Rocas IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod 2000;26(6):331-334.
  5. Walton RE, Torabinejad M. Principles and Practice of Endodontics. 2nd ed. Philadelphia, PA: WB Saunders Company; 1996.
  6. Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root canal irrigation regimens. J Endod 1987;13(4):147-157.
  7. Moss HD, Allemang JD, Johnson JD. Philosophies and practices regarding the management of the endodontic smear layer: Results from two surveys. J Endod 2001;27(8):537-539.
  8. Villegas JC, Yoshioka T, Kobayashi C, Suda H. Obturation of accessory canals after four different final irrigation regimes. J Endod 2002;28(7):534-536.
  9. Foster KH, Kulild JC, Weller RN. Effect of smear layer removal on the diffusion of calcium hydroxide through radicular dentin. J Endod 1993;19(3):136-140.
  10. Barbakow F, Lutz F, Toth L. Materials and technics in root canal treatments in Switzerland—A determination of their status. Schweiz Monatsschr Zahnmed 1995;105(10):1265-1271.
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