root canal irrigants & chemical aids in endodontics

7/25/2019 Root Canal Irrigants & Chemical Aids in Endodontics

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ROOT CANAL IRRIGANTS &CHEMICAL AIDS IN ENDODONTICS


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Local Measures for controllingLocal Measures for controlling

Endodontic infectionsEndodontic infections

This includes chemo-mechanical debridemenThis includes chemo-mechanical debridemeno! he canal"o! he canal"

Mechanical #Roo canal $re$araionMechanical #Roo canal $re$araion

usin% !iles & reamers"usin% !iles & reamers" Chemical aids'Chemical aids'

-Root canal irrigants.-Root canal irrigants.

- Chelating agents- Chelating agents

- Solvents- Solvents

-Intracanal medicaments-Intracanal medicaments


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A-Irrigating Solutions:

!uncions'

(- aids in he removalof tissue debrisand microorganisms.

)- Ipreventshe !ormaion o! dentin mud"

*- I cleanshe canal +all !rom he smear layer"

,- I increasesthe cuttingefficiency of root canal

instruments,and decreasehe chance !or insrumen

breaa%e"

.- I mae negotiationand enlar%emen o! he canal !ar

easier by lubricatingthe canal walls.

/- Man0 irri%ans are mildbleaches"


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Requirements for ideal effective

irrigating solutions:(- should be a $o+er!ulgermicide"

)- mus $ossess a dissolvingactionon $ul$alremnans and debris"

*- should be !ree !rom any harmful effect on

denin and$eria$ical issue"

,- mus ac asableachingagent"


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Commonly used irrigants solutions:

Sodium hypochloriteHydrogen peroxidesalineLocal anestheticSterile water

ChlorhexideneBiopure MTA !mixture o" tetracycline#

ctric acid $ detergent%


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&-Sodium hypochlorite:&-Sodium h

ypochlorite:

-- It is theIt is the most popularlymost popularlyused irrigating solution in endodontics.used irrigating solution in endodontics.

- Sodium hypochlorite in a concentration of- Sodium hypochlorite in a concentration of 1 to 6%1 to 6%solutions is asolutions is a

powerful germicide .powerful germicide .

- stronglystrongly alkalinealkalineand ecellent necroticand ecellent necrotic tissue sol!ents.tissue sol!ents.

- "a!e a- "a!e a mildmild#leaching#leachingaction.action.

- Sodium h0$ochlorie is usuall0 used as- Sodium h0$ochlorie is usuall0 used as rooroo

canalcanal irri%aion inirri%aion in concenraionconcenraion ran%ed !romran%ed !rom

(".-)".1 "(".-)".1 "


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'-Hydrogen peroxide:

- effervescence or bubbling action mechanical

debridemen"

-i is seldomused as he soleirri%ain% soluion2because i has '

- limited%ermicidal$ro$eries and- noability to dissolvenecrotic tissue

-irri%aion alernael0+ih h0dro%en $ero3ideandsodium h0$ochlorie"

- The release o!CL)increases %ermicidalaci4i0 +hilehee!!er4escencee!!ec !romhe ra$id releaseo! boh

%ases increases mechanical aci4i0"

- Sodium h0$ochlorieshould be he lasirri%an

soluion used $rior o sealin% he canal"


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B-Chelating agents:

- Chelain% a%ens are chemicals usuall0

used !or he $re$araion o! se4erel0

consricedor calci!iedcanals"

- reacs +ih he inor%anic $orion o! he

denin +alls"

- 50 subsiuin% sodium ions #!rom he

chelain% a%en !or calcium ions #!rom

denin"


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(-(-E!"E!"I is heI is he #$%#&' $"(! %) E!*+(EE-#"'#E !E!R"#$%#&' $"(! %) E!*+(EE-#"'#E !E!R"

"CE!#C "C#."CE!#C "C#.

- A- A (6 o (. $ercen(6 o (. $ercenbu!!ered soluions arebu!!ered soluions are nono irriain%irriain%andand non-o3ic "non-o3ic "

- The aci4i0 o!- The aci4i0 o! E!"E!" isis limiedlimied oo he !irs se4eralhe !irs se4eralminuesminuesin he canal"in he canal"

- he chamber is !looded +ih- he chamber is !looded +ih E!"E!"and +ored ino heand +ored ino hecanal +ih acanal +ih a small si7esmall si7e!ile"!ile"

- A!er minues he- A!er minues he soluionsoluion should beshould be as$iraedas$iraed andandre$lacedre$laced+ih a+ih a !resh!reshsoluion"soluion"

- he canal should be- he canal should be irri%aedirri%aed +ih a+ih a .1 sodium.1 sodium

h0$ochlorieh0$ochloriesoluion osoluion o arresarreshe aci4i0 o!he aci4i0 o! E!"E!"..


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)-E!"C

- Is a / 5899ERED SOL8TION O9 E!" $lus "0&"!E"R+ "''%#&' C%'1%&2CE!"3(%orCE!R"'#E4"

- This subsance e3ersall he $ro$eries !ound in E!"as +ell as increased anise$ic aci4i0 o! cetavlon orcetramide.

- The aci4i0 o! E!"C is - lie - ha o! E!" can beabored b0 !loodin% he canal +ih .1 sodiumh0$ochlorie soluion"


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*-*-R.C.1RE1R.C.1RE1

IS THEIS THE COM5INATION O9COM5INATION O9 #$%#&' $"(! %)#$%#&' $"(! %)

E!*+(EE #"'#E !E!R" "CE!#C "C#E!*+(EE #"'#E !E!R" "CE!#C "C#""&RE"&RE"1ER%5#E1ER%5#E##""1%(+E!*+(EE 6(CER%( B"$E.1%(+E!*+(EE 6(CER%( B"$E.

Ad4ana%es'Ad4ana%es'

(-(-IsIs chelain%chelain%$ro$eries$ro$eriesenhance he ne%oiaion o! consriced orenhance he ne%oiaion o! consriced or

oblieraed canals"oblieraed canals"

)-)-TheThe polyethylene glycerolpolyethylene glycerolbasebaseis included mainl0 ois included mainl0 o $roec$roecheheE!"E!" !rom!rom o3idaiono3idaion b0 heb0 he urea pero7ideurea pero7ide22 alsoalso ser4esser4es as aas alubricanlubrican!or endodonic insrumenaion"!or endodonic insrumenaion"

*-*-TheThe ureaurea $ero3ide$ero3ide slo+l0slo+l0 dissociaesdissociaes ino ureaino urea andand h0dro%enh0dro%en$ero3ide &$ero3ide & $ro4ides$ro4idesanise$icanise$icandand e!!er4escene!!er4escen$ro$eries"$ro$eries"

,- A,- A $lasic$lasic s0rin%e is used o $lace he maerial in he $ul$s0rin%e is used o $lace he maerial in he $ul$chamber sincechamber since E!"E!"+ill+ill reac +ih he %lassreac +ih he%lass""


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C-$olvents

-5ylol:- Is an e3cellen sol4en o%ua $ercha androo canalsealers"

- I is hi%hl0 irriain%and e3reme cauion mus be

e3ercised o con!inehe soluion ohe roo canal

s$ace"

8-Chloroform:

-I is an e3cellen sol4en o%ua $ercha androocanal sealer"

-I is o3ic and hi%hl0 irriain%o 4iable issue and i

mus be used +ih almos cauion"


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- Mehod o! a$$licaion '

-b0 !loodin% he $ul$chamber+ih he sol4enand a

small!ileis hen inroduced inohe canal "

-9re:uen as$iraiono! he sol4en and re$lacemen+ih

a !reshsoluion"

-con!inehe soluion o he roo canal s$ace"

-Once he !illin% maerial has been remo4edhe sol4enmus be eliminaedb0 liberal bu%enle irri%aion +ih

alcohol!ollo+ed b0 horou%hirri%aion +ihsodium

hypochlorite"


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Ade:uaedebridemen2 correcsha$in%

andenlar%in%o! he canal2 irri%aiono!he roo canal and ishermeicseal2 as

+ell as hebod0 de!ensesare he

$rimar0means o comba in!ecion"

Canal medication with antibacterial

activities plays onlya secondaryrolein

successful endodontic therapy.


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Roo canal disin!ecion ma0 be

accom$lished b0'

- Chemical means.

8- 1hysical means.

9- Combination of both.


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-Chemical means %r Root canal

medicaments:

I is he serili7aion o! he roo canal b0 cerainI is he serili7aion o! he roo canal b0 cerain%rou$s o! medicamens"%rou$s o! medicamens"

Requirements for ideal root canal medicament:

(-Should be %ermicideand !un%icide"

)-Should be non-irriain%o he so! issues

and $eria$ical issues"

*-Should remain sable in soluion",-Should ha4e $rolon%ed anibaceriale!!ec"

.-Should be e!!eci4ein he $resence o!

blood2 serum2 and issue$roein deri4ai4es"


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6-Should #e capa#le of penetratingthe tissue

deeply.

$-Should #e easily introducedinto the root canal.

-Should #e capa#le of #eing inacti!atedor

neutrali&edin culture media.

'-Shouldn(t interferewith periapical tissue repair.

1)-Shouldn(t staintooth structure.


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#. 1henolic compounds:

(" Cam$horaed $arachloro$henol #CM;C'(" Cam$horaed $arachloro$henol #CM;C'

It is an oily liquidprepared by triturating30 parts

parachlorophenol crystalsin 70 partsgum

camphor.

I $ro4ides mared %ermicidalaci4i0 a%ainsall 0$eso! baceriaas +ell as !un%i"

*-+resatin,It is an antiseptic analgesic and fungicidalcompound.

Its anti#acterialeffect is enhanced#ecause of its low

surface tension.

Its effect is prolonged#y its low !olatility.

It is not causticand will not precipitate al#umin..


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##."ldehydes:Like formocresol and glutraldehyde

(-9ormocresol'(-9ormocresol'

It is a combination of formaldehydeand cresol.

It is irritatingto tissues and producesmaredinflammation follo!ed by necrosis.


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)" Halides')" Halides'

IodineIodineandand chlorinechlorineantiseptics !ere foundantiseptics !ere foundto have an action ofto have an action of short durationshort durationin thein the

root canal.root canal.

"queous solutions of"queous solutions of chlorinechlorinetend totend todecomposedecomposeas it interact rapidly !ithas it interact rapidly !ith

organicorganicmaterials# therefore# root canalmaterials# therefore# root canal

dressing have to bedressing have to be rene!edrene!edtoo often fortoo often forpractical purposes.practical purposes.


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III" Chlorhe3idine'III" Chlorhe3idine' It is an effecti!eIt is an effecti!e antimicro#ialantimicro#ialagent inagent in weakweaksolutions.solutions.

It is used as root canalIt is used as root canal

irrigantirrigant

solutionsolution

and orand or

as aas a

root canalroot canal medicamentmedicament#etween endodontic !isits for#etween endodontic !isits for

its disinfectant properties.its disinfectant properties.


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;ol0anibioic $ase';ol0anibioic $ase'

/he polyanti#iotic paste is considered as one of themost commonand effecti!ecom#inationof theantimicro#ial drug against a wide range ofmicroorganisms commonly isolatedfrom infectedrootcanals.

)-Coricoseroid-Anibioic combinaion')-Coricoseroid-Anibioic combinaion'&$E$:&$E$:

0educes0educes pain and inflammationpain and inflammation#y ha!ing anti-inflammatory#y ha!ing anti-inflammatory

effect oneffect on periapical tissues of o!er instrumented teethperiapical tissues of o!er instrumented teeth. It gi!es. It gi!es

thethe greatestgreatestimpact in theimpact in the first *2 hrsfirst *2 hrs..3ost operati!e.43ost operati!e.4

C%!R"##C"!#%:C%!R"##C"!#%:

Incase ofIncase of infectioninfectionto a!oid its spread.to a!oid its spread.

##C"!#%:##C"!#%:

In case of pain ofIn case of pain of inflammation and in5uryinflammation and in5ury7/7/for painfor painassociated withassociated with infection and Swellinginfection and Swelling


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Calcium H0dro3ide'CalciumH0dro3ide'

(S)S:

1-0educe #acterial colonies1-0educe #acterial coloniesand theirand their #yproducts#yproducts

#est results#est resultsachie!ed whenachie!ed when leftleftin the canalin the canal forfor

at leastat leastaa weekweek4.4.

*-"a!e the possi#ility to*-"a!e the possi#ility to reduce postoperati!e painreduce postoperati!e pain

#y ha!ing a#ility of#y ha!ing a#ility of killingkilling8acteria and8acteria and

neutrali&eneutrali&etheir #y products4.their #y products4.

*ote:the anti +acterial action o" calcium hydroxideis related to its high ,H# It minimie the occurrence

o" "lare ups as it ha.e the a+ility o" /illing

Anaero+ic +acteria#


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##C"!#%$:

(- Necroic$ul$

)- O4er-insrumenaion

*- Ha4in% sron% $ossibili0 o! !lare u$$resen"

DISAD


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8-1hysical 'eans:8-1hysical 'eans:

The mos suiable $h0sicalmean is b0Laser"

The animicrobial e!!ec o! laser de$ends

on se4eral !acorssuch as'0$e o! laser2

$o+er and ener%02 irradiaion e3$osure

ime2 as +ell as he 0$e o! baceria$resens in he roo canal"


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9-Combination of both Chemical

and 1hysical means :

8lrasonic disin!ecion8lrasonic disin!ecioncan be $er!ormed +hencan be $er!ormed +henusin%usin% sodium h0$ochlorie soluionsodium h0$ochlorie soluion+ih an+ih anulrasonic $re$araion !iles or i$sulrasonic $re$araion !iles or i$s""

he ulrasoniche ulrasonic +a4es+a4es+ill+ill sli%hl0 risesli%hl0 risehehesodium h0$ochlorie soluionsodium h0$ochlorie soluion em$eraureem$eraureincreaseincreasein hein he animicrobialanimicrobiale!!ec o! hee!!ec o! he

soluion"soluion"

Also heAlso he ulrasoniculrasonic+a4es+a4es !orce!orcehehesoluion ino hesoluion ino he inaccessibleinaccessiblearea o! hearea o! he rooroocanal s0sem"canal s0sem"


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ReferencesReferences

;ah+a0s o! he $ul$ 2=;ah+a0s o! he $ul$ 2=hh

" Ed" Cohen S" e"al)66/" Ed" Cohen S" e"al)66/

;rinci$les and ;racice;rinci$les and ;racice ofof $%&'&'%(ICS$%&'&'%(ICS THIRDTHIRD

EDITIONRICHARD E" >ALTON2 DMD2EDITIONRICHARD E" >ALTON2 DMD2##MAHMO8D TORA5INE?ADMAHMO8D TORA5INE?AD

EndodonicsEndodonicsColleagues for E7cellenceColleagues for E7cellence ;ublished !or he Denal;ublished !or he Denal;ro!essional Communi0 b0 he;ro!essional Communi0 b0 he"merican "ssociation of"merican "ssociation of

Endodontists,Endodontists, >iner )6((2>iner )6((2Root Canal #rrigants and isinfectantsRoot Canal #rrigants and isinfectants

Endodonics /Endodonics /hh" Ed" In%le & 5aland& 5aum%arner" Ed" In%le & 5aland& 5aum%arner

Color alas & e3 o! endodonics2)Color alas & e3 o! endodonics2)ndnd" Ed" Soc e"al" Ed" Soc e"al


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root canal irrigants & chemical aids in endodontics

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