The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

Current clinical practice of endodontic irrigation

파일이 닿지 않는 곳. 어떻게 세척할 것인가!

  • Seo, Minseock (Department of Conservative Dentistry, School of Dentistry, Wonkwang University, Wonkwang University Daejeon Dental Hospital)
  • 서민석 (원광대학교 치과대학 대전치과병원 치과보존과)
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Whether you use a hand file or an engine-driven file, you cannot remove bacteria completely from the root canal by mechanical work alone. If the root canal is well cleaned, endodontic irrigants will well penetrate into these areas that will not be mechanically accessible. It will decompose and remove the biofilm and also remove the smear layer to reach the dentinal tubule. Clinicians who are not yet using NaOCl as their primary irrigant, should be aware that there are no other irrigants that offer all the benefits of NaOCl and are inexpensive. Clinicians may be reluctant to use it because of concern about NaOCl accident, but this possibility is extremely low if used with caution.

Keywords

References

  1. Fedorowicz Z, Nasser M, Sequeira-Byron P et al. Irrigants for non-surgical root canal treatment in mature permanent teeth. Cochrane Database Syst Rev [Internet] 2012; (9). Available from: onlinelibrary.wiley.com/doi/10.1002/14651858.CD008948.pub2/abstract
  2. Zehnder M. Root canal irrigants. J Endod 2006; 32(5): 389-398. https://doi.org/10.1016/j.joen.2005.09.014
  3. Dutner J, Mines P, Anderson A. Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod 2012; 38: 37-40. https://doi.org/10.1016/j.joen.2011.08.013
  4. Rutala WA, Weber DJ. Uses of inorganic hypochlorite (bleach) in health-care facilities. Clin Microbiol Rev 1997; 10(4): 597-610. https://doi.org/10.1128/CMR.10.4.597
  5. Haapasalo M. Current advances in irrigation. Endod Topics 2012; 27(1): 1-2. https://doi.org/10.1111/etp.12033
  6. Emilson C. Susceptibility of various microorganisms to chlorhexidine. Eur J Oral Sci 1977; 85(4): 255-265. https://doi.org/10.1111/j.1600-0722.1977.tb00561.x
  7. Ng Y, Gulabivala K, Mann V. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 1 perapical health. Int Endod J 2011; 44: 583-609. https://doi.org/10.1111/j.1365-2591.2011.01872.x
  8. Haapasalo M, Qian W, Shen Y. Irrigation: beyond the smear layer. Endod Topics 2012; 27(1): 35-53. https://doi.org/10.1111/etp.12030
  9. Moller A. Microbiological examination of root canals and periapical tissues of human teeth. Methodological studies. Odontol Tidskr 1966; 74(5)(Suppl): 1-380.
  10. Haapasalo M, Endal U, Zandi H et al. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Topics 2005; 10(1): 77-102. https://doi.org/10.1111/j.1601-1546.2005.00135.x
  11. Singla MG, Garg A, Gupta S. MTAD in endodontics: an update review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112(3):e70-e76. https://doi.org/10.1016/j.tripleo.2011.02.015
  12. Malkhassian G, Manzur AJ, Legner M et al. Antibacterial efficacy of MTAD final rinse and two percent chlorhexidine gel medication in teeth with apical periodontitis: a randomized doubleblinded clinical trial. J Endod 2009; 35(11): 1483-1490. https://doi.org/10.1016/j.joen.2009.08.003
  13. Basrani B, Haapasalo M. Update on endodontic irrigating solutions. Endod Topics 2012; 27(1): 74-102. https://doi.org/10.1111/etp.12031
  14. Siqueira Jr JF, Rocas IN, Favieri A et al. 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. https://doi.org/10.1097/00004770-200006000-00006
  15. Bystrom A, Sunvqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 1985; 18(1): 35-40. https://doi.org/10.1111/j.1365-2591.1985.tb00416.x
  16. Boutsioukis C, Psimma Z, Sluis L. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 2013;46(7): 599-618. https://doi.org/10.1111/iej.12038
  17. Cunningham WT, Balekjian AY. Effect of temperature on collagen-dissolving ability of sodium hypochlorite endodontic irrigant. Oral Surg Oral Med Oral Pathol 1980; 49(2): 175-177. https://doi.org/10.1016/0030-4220(80)90313-8
  18. Ram Z. Effectiveness of root canal irrigation. Oral Surg Oral Med Oral Pathol 1977; 44(2): 306-312. https://doi.org/10.1016/0030-4220(77)90285-7
  19. Moorer W, Wesselink P. Factors promoting the tissue dissolving capability of sodium hypochlorite. Int Endod J 1982; 15(4):187-196. https://doi.org/10.1111/j.1365-2591.1982.tb01277.x
  20. Park E, Shen Y, Khakpour M et al. Apical pressure and extent of irrigant flow beyond the needle tip during positivepressure irrigation in an in vitro root canal model. J Endod 2013; 39(4):511-515. https://doi.org/10.1016/j.joen.2012.12.004
  21. Gao Y, Haapasalo M, Shen Y et al. Development and validation of a three-dimensional computational fluid dynamics model of root canal irrigation. J Endod 2009; 35(9): 1282-1287. https://doi.org/10.1016/j.joen.2009.06.018
  22. Chow T. Mechanical effectiveness of root canal irrigation. J Endod 1983; 9(11):475-479. https://doi.org/10.1016/S0099-2399(83)80162-9
  23. Hsieh Y, Gau C, Kung Wu S et al. Dynamic recording of irrigating fluid distribution in root canals using thermal image analysis. Int Endod J 2007; 40(1): 11-17. https://doi.org/10.1111/j.1365-2591.2006.01168.x
  24. Jawad S, Roudsari RV, Hunter M. Modern Endodontic Principles Part 4: Irrigation. Dent Update 2016; 43: 20-33. https://doi.org/10.12968/denu.2016.43.1.20
  25. ay FR, Gu L-S, Schoeffel GJ et al. Effect of vapor lock on root canal debridement by using a sidevented needle for positivepressure irrigant delivery. J Endod 2010; 36(4): 745-750. https://doi.org/10.1016/j.joen.2009.11.022
  26. Parente J, Loushine R, Susin L et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J 2010; 43(11):1001-1012. https://doi.org/10.1111/j.1365-2591.2010.01755.x
  27. Nielsen BA, Craig Baumgartner J. Comparison of the EndoVac system to needle irrigation of root canals. J Endod 2007; 33(5): 611-615. https://doi.org/10.1016/j.joen.2007.01.020
  28. hmad M, Pitt Ford TR, Crum LA. Ultrasonic debridement of root canals: acoustic streaming and its possible role. J Endod 1987; 13(10): 490-499. https://doi.org/10.1016/S0099-2399(87)80016-X
  29. De Moor RJ, Meire M, Goharkhay K et al. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod 2010; 36(9): 1580-1583. https://doi.org/10.1016/j.joen.2010.06.007
  30. Kahn FH, Rosenberg PA, Gliksberg J. An in vitro evaluation of the irrigating characteristics of ultrasonic and subsonic handpieces and irrigating needles and probes. J Endod 1995; 21(5): 277-280. https://doi.org/10.1016/S0099-2399(06)80998-2
  31. Jensen SA, Walker TL, Hutter JW et al. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod 1999; 25(11): 735-738. https://doi.org/10.1016/S0099-2399(99)80120-4
  32. Haapasalo M, Wang Z, Shen Y et al. Tissue dissolution by a novel multisonic ultracleaning system and sodium hypochlorite. J Endod 2014;40:1178-1181. https://doi.org/10.1016/j.joen.2013.12.029
  33. Arevalo-Silva C, Eliashar R, Wohlgelernter J et al. Ingestion of caustic substances: a 15-year experience. The Laryngoscope 2006; 116(8):1422-1426. https://doi.org/10.1097/01.mlg.0000225376.83670.4d
  34. Mehdipour O, Kleier DDJ, Averbach DRE et al. Anatomy of sodium hypochlorite accidents. Choice 2007; 5(8): 9.
  35. Hulsmann M, Rodig T, Nordmeyer S. Complications during root canal irrigation. Endod Topics 2007; 16(1): 27-63. https://doi.org/10.1111/j.1601-1546.2009.00237.x