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Endo Final > Canal Disinfection > Flashcards

Canal Disinfection Flashcards

1
Q

Key for successful endo bc the files can’t reach all the walls of the canal.

A

Thorough irrigation

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2
Q

Ideal irrigant has high or low surface tension?

A

LOW- so it can spread to all the surfaces of the canal.

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3
Q

Types of Irrigants

A

NaOCl
EDTA
CHX

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4
Q

NaOCl alkaline or acidic?

A

Alkaline

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5
Q

The gold standard irrigant that:

  • dissolves both vital and necrotic tissue,
  • removes the organic component of the smear layer,
  • kills bacteria,
  • eliminates biofilm
  • Lubricating action
  • Cytotoxic
A

NaOCl

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6
Q

NaOCl mechanism of action

A
  • Saponification
  • Amino acid neutralization
  • Chloramination
  • Alkaline pH (>11)
  • Hydrolysis
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7
Q

A fatty acid is heated with an alkali to make soap and alcohol.

A

Saponification

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8
Q

A chemical species that donates an electron pair to an electrophile to form a chemical bond; it’s electron rich.

A

Nucleophile

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9
Q

Nucleophiles work during this step of NaOCl’s MOA.

A

Saponification

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10
Q

An acid-base reaction, which yields a salt and water.

A

Amino acid neutralization

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11
Q

A rxn where chloramines are made from Chlorine and Ammonia

A

Chloramination

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12
Q

This pH (specifically, these IONS) alters the cell membrane by loss of phospholipids and fatty acids.

Disrupts cellular processes and enzymatic activity.

A

Alkaline ; OH- ions

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13
Q

Substance that dissolves tissue into soap and glycerol via saponification.

A

NaOCl

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14
Q

This product of NaOCl MOA interferes with cellular metabolism.

A

Chloramines

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15
Q

This disinfectant irreversibly inactivates essential bacterial enzymes via oxidation of sulfhydryl groups by Chlorine.

A

NaOCl

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16
Q

This is used as a chelating agent (underlined) in root canals to remove calcium, demineralize and soften dentin, and remove the smear layer.

A

EDTA

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17
Q

Used to negotiate calcified canals.

A

EDTA

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18
Q

Removing this increases Ca(OH)2 diffusion through the tubules, and increases tubule penetration by the sealer.

A

Smear layer

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19
Q

This irrigant is followed by a final rinse of NaOCl so the bleach can kill the bacteria in the tubules.

A

EDTA

20
Q

A bis-biguanide antiseptic used to prevent colonization of microbes and to kill microorganisms on surfaces;
known for its substantivity.

A

Chlorhexidine

21
Q

Definition: The binding of disinfectant to dentin and soft tissue with prolonged release.
Gives residual antimicrobial activity for a long time.

A

Substantivity

22
Q

This substance:

  • Kills bacteria
  • Does NOT dissolve pulp tissue.
  • Does NOT eliminate biofilm
  • Does NOT remove the smear layer
A

CHX

23
Q

Do not mix these two irrigants together.

A

NaOCl and CHX

24
Q

CHX MOA.

A

Positively charged CHX binds to Negatively charged phosphates in the bacterial cell wall, creating pores that disrupt the cell’s osmotic equilibrium, and the cell lyses.

25
Q

A gas bubble of NH3 and CO2 forms at the apical canal by hydrolysis of organic tissue, making it impossible to irrigate the most apical part of the canal.

A

Vapor lock

26
Q

Which canals get vapor lock?

A

Closed

27
Q

T/F: higher concentrations of NaOCl will dissolve tissue faster and increase antimicrobial effectiveness.

A

True

28
Q

When is the only time the canal should be dry?

A

When ready to place the sealer.

29
Q

T/F: increasing NaOCl temperature before irrigating will increase its effectiveness.

A

True

30
Q

What’s this process called: agitating the bleach into uninstrumentable portions of the canal.

A

Activation

31
Q

Cannot do this to the irrigant around root curvatures bc the metal tip will create procedural errors.

A

Activation

32
Q

Definition: Activation of fluid and hydrodynamic shear forces near a small vibrating object.

A

Acoustic streaming

33
Q

Definition: Use the alternating high frequency movement of an instrument tip to form submicroscopic voids. These voids implode and make shock waves that spread through the medium.

A

Cavitation.

34
Q

This SONIC device is used for activation of the irrigant.
Uses polymer tips, which are safe to use around curvatures.
Not as strong as ultrasonics.
Does NOT create cavitation.

A

EndoActivator

35
Q

Has low frequency (1500-6000 Hz) and high amplitude

A

Sonic

36
Q

Has High frequency ( >20,000) and low amplitude.

A

Ultrasonic

37
Q

Forms when you mix CHX and NaOCl.

A

PCA (para-chloroaniline)

38
Q

PCA is _____.

A

carcinogenic.

39
Q

This irrigant inhibits NaOCl by reducing the amount of free Chlorine.

A

EDTA

Reduces the amt of free Chlorine bc it’s a chelating agent.

40
Q

This doesn’t lose its chelating ability when mixed with NaOCl.

A

EDTA

41
Q

Mixing these two irrigants makes a salt, which is harmless.

A

CHX and EDTA

42
Q

Which intracanal medicament is this:

  • Alkaline pH
  • Bactericidal
  • Dissolves pulp tissue
  • Stimulates hard tissue formation
  • Resorbable
  • Eliminates biofilm?
A

Ca(OH)2

43
Q

Ca(OH)2 MOA:

A

1) Damages the cytoplasmic membrane
2) Protein denaturation
3) Damage to DNA

44
Q

How long does it take for Ca(OH)2 to get rid of most of the bacteria in the canal?

A

1 week; is NOT effective short-term.

45
Q

This material does reduce the bacterial load, but has not been shwon to increase outcomes.

A

Ca(OH)2

Endo Final (6 decks)

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