Irrigation Flashcards
Purpose of irrigation
CLEAN out the canals following the preparation of canals via files
Ideal properties of irrigation solution
Organic tissue solvent Inorganic tissue solvent Antimicrobial Nontoxic Low surface tension Lubricant Non staining Remove smear layer
There is NO SINGLE irrigant solution that meets all of these needs. Will use a combination.
Definition of irrigation
Wash out body cavity or wound with water of medicated fluid
Commonly used irrigants (5)
Sodium hypochlorite (bleach) EDTA Chlorhexidine Sterile water Local anesthetic
Sodium hypochlorite
NUMBER 1 IRRIGANT
2.5% – 5.25%
Best proteolytic agent
* Breaks down proteins into amino acids via
free chlorine
Chelator
Removes debris and wets canal walls
Antimicrobial
Dissolves organic and inorganic debris
Opens dentinal tubules (removes smear layer)
Disinfects and cleans areas inaccessible to instrumentation
Leave in for 20 min to get complete dissolution of tissue
DO NOT USE on open apex
How much of the canal wall is left untouched by instruments?
40 - 60%
Important to use irrigants
EDTA
17%
Chelator
Effective smear layer remover when used for 1 min
H2O
Universal
Biocompatible
Sterile
FLUSHING action
Chelator
removes inorganic components of canal and leaves organic tissue intact
Chlohexidine
Broad antimicrobial activity
Effective against ENTEROCOCCUS FAECALI
Use with open apexes and stubborn bugs
Does NOT dissolve necrotic tissue
Doe NOT remove smear layer
Not toxic to tissues
FORMS PRECIPITATE WHEN COMBINED WITH SODIUM HYPOCHLORITE
Good to use with:
- chronic lesion
- open apex
Local anesthetic
Tissue compatible
Sterile
Some antimicrobial action
Good for open apex
Smear layer
Organic and inorganic substances as well as fragments of odontoblastic processes
Various species of bacteria and necrotic debris
When does the smear layer accumulate
During cleaning and shaping of the canal wall
Where does the smear layer accumulate
Accessory canals
Fins
Isthmuses
Canal walls
Why is the smear layer harmful?
Contaminated with bacteria and metabolic byproducts
Prevents sealer contact with canal wall – permitting leakage
Disintegrates then causes obturation leakage
How far into dentinal tubules can the smear layer pack?
1-5 microns
Why remove the smear layer? (3)
Filling material adapts better to the wall
Better adhesion of sealer to dentin
Better tubular penetration of sealer
What file and filing action reduces smear layer the most?
Hedstrom files
Rasping motion
Pulls debris out as you file and shaves off the wall
When do you irrigate?
Every 2-3 file changes
Agitate with small file #10 or #15
What type of needles should be used to irrigate
Small side vented needles
Keep chamber full of solution
NEVER instrument a dry canal with rotary
Alternate NaOCl with EDTA
TRUE
What is RC prep?
Lubricant
Good to use for bleeding cases
(irreversible pulpitis)
DO NOT place the irrigation needle to the apex
TRUE
Positive pressure irrigation
Push fluid into the chamber through the needle
Fluid will go 1 -3 mm
Negative pressure irrigation
Put fluid in the canal
Use canula to suck back up the solution
cleanest way of irrigating
Does not suck up a lot of debris
Side effects of NaOCL
swelling
bruising
Toxic outside of the canal – will see immediate reaction
What do you rinse with if the canal is bleeding?
Water
Local anesthetic
Follow by NaOCl
Use RC prep
When using a Gates Gladden bur rinse with
LOTS of water for flushing out the canal
GG bur leaves a lot of debris
