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BDS3.5 Endodontics > Principles of Endodontic irrigation > Flashcards

Principles of Endodontic irrigation Flashcards

1
Q

What are some obstacles to success with endodontics?

A

Complex pulpal anatomy

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2
Q

How much of the canal walls can remain untouched by instruments?

A

Up to 35%

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3
Q

What is the purpose of mechanical preparation of canals?

A

Creates space to allow irrigating solutions and medicaments to more effectively eliminate microorganisms from the root canal system

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4
Q

What are the 6 stages of mechanical root canal preparation?

A
  1. Access preparation
  2. Straight line access
  3. Initial scouting
  4. Coronal flare
  5. Glide path and working length determination
  6. Apical preparation
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5
Q

What are the ideal properties of an irrigant solution?

A
  1. Low cost
  2. Washing action
  3. Reduction of friction
  4. Improve cutting of dentine by the instruments
  5. Dissolution of organic and inorganic matter
  6. Good penetration within root canal system and surrounding dentinal tubules
  7. Kill planktonic microbes
  8. Kill biofilm microbes
  9. Detachment of biofilm
  10. Non toxic to PA tissues
  11. Bio compatible and non allergenic
  12. Compatible with restorative dental materials
  13. Does not alter properties of dentine unfavourable
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6
Q

What 3 things must an ideal irrigation protocol do?

A
  1. Disinfect the canal
  2. Remove smear layer
  3. Preserve dentine
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7
Q

What is sodium hypochlorite?

A

NaOCl

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8
Q

Which irrigant performs best?

A

Sodium hypochlorite

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9
Q

What are the properties of sodium hypochlorite?

A
  1. Potent antimicrobial action
  2. Removes organic debris within root canal
  3. Dissolves pulpal remnants and collagen
  4. Endodontic irrigant that dissolves vital and necrotic tissue
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10
Q

What are the modes of antibacterial action of sodium hypochlorite?

A
  1. Saponification
  2. Neutralisation
  3. Hypochlorous acid
  4. Chloramination
  5. Alkalinity
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11
Q

What are the complications of sodium hypochlorite?

A
  1. Discolouration of fabrics
  2. Chemical burns to soft tissues
  3. Ophthalmic injuries
  4. Apical extrusions leading to tissue necrosis
  5. Allergic reactions
  6. Reduces flexural strength and elasticity of dentine
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12
Q

What concentration of NaOCl do we use in ADI?

A

2-3%

In real life can get 0.5-5.25%

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13
Q

What is the application of NaOCl?

A

Dynamic movements encourage penetration into accessory canals and dentinal tubules. Heat causes increased activity but reduces duration of effectiveness. Don’t use too much - keep within the tooth.

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14
Q

How long do we need the NaOCl to be in contact with the tooth for, at 2.5%?

A

At least 5 mins

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15
Q

How to do manual dynamic irrigation?

A

Use a GP point of a good fit, that is less tapered than the preparation. Move it up and down at a rate of 100 pulses per minute. Maximum 2mm movement.

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16
Q

What is ultrasonic activation?

A

The use of ultrasonic energy to enhance the cleaning process during root canal treatment by agitating the irrigation solution, leading to improved removal of debris, pulp tissue remnants, bacteria, and the smear layer from the canal system, resulting in a cleaner and more effectively disinfected root canal.

17
Q

Why is chlorhexidine gluconate not used as an irrigant?

A

Not a satisfactory alternative to NaOCl. Can cause allergic reactions. Does not dissolve tissues like NaOCl. Not as effective as NaOCl.

18
Q

What can isopropyl alcohol be used for?

A

70% can be used as a final rinse. Dries root canal. Reduces surface tension of canal wall. Aids removal of temporary filling materials.

19
Q

What is the smear layer?

A

Layer of organic pulpal material and inorganic debris that becomes caked onto canal walls during mechanical preparation of root canals. Prevents sealer penetration.

20
Q

What is EDTA?

A

Ethylenediaminetetraacetic acid. It is a chelating agent of calcium.

21
Q

What do chelating agents do?

A

Dissolution and removal of inorganic debris. Dissolution of intra canal medicaments.

22
Q

What are some common chelating agents and when are they used?

A
  1. 17% EDTA
  2. 17% EGTA
  3. Citric acid

Used as the penultimate rinse.

23
Q

How much contact time does EDTA need?

24
Q

What are the effects of combined use of NaOCl and EDTA?

A

Tissue dissolving ability of NaOCl reduces when in contact with EDTA. Erosion of tooth structure. Damage to NiTi instruments -> increased likelihood of fatigue.

25
Q

What is a classic irrigation protocol?

A

NaOCl during and after shaping. EDTA after shaping. NaOCl final rinse.

26
Q

Why is gentle finger pressure so important?

A

Minimises the risk of extrusion.

27
Q

When to use EDTA?

A

Penultimate rinse

28
Q

What type of syringe to use for irrigation?

A

Side venting syringe

BDS3.5 Endodontics (13 decks)

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