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3rd yr- CSB labs- Endodontics > Week 2: Endodontic irrigation > Flashcards

Week 2: Endodontic irrigation Flashcards

1
Q

What are the primary goals of irrigation

A
  1. Dissolution of organic tissue and pulpal remnants
  2. Dissolution of select inorganic components
  3. Killing of micro organisms and neutralisation of Endo toxins
  4. Lubricate canals
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2
Q

Why is irrigation important

A

to clean to canals properly

Because instruments do not reach all of the anatomy of the complex root canal

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3
Q

Name the different irrigation options we have?

A
  1. Sodium hypochlorite
  2. Chlorohexidine
  3. EDTA
  4. Iodine potassium iodide
  5. Hydrogen peroxide
  6. Saline/ water/ local anaesthetic
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4
Q

Name the gold standard irrigant

A

Sodium Hypochlorite

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5
Q

What are the benefits of Sodium Hypochlorite?

A
  1. It works on the flora
  2. Causes tissue dissolution
  3. Causes endotoxin deactivation
  4. Cheap
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6
Q

What are the disadvantages of Sodium Hypochlorite ?

A
  1. Doesn’t remove the smear layer

2. Isn’t substantive

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7
Q

How does Sodium Hypochlorite work?

A

Halogen ions

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8
Q

How does Chlorhexidine work?

A

Bisguanide

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9
Q

What are the benefits of Chlorhexidine

A
  1. Works on the flora
  2. Causes endotoxin deactivation
  3. Is substantive
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10
Q

What are the disadvantages of Chlorhexidine

A
  1. Dont dissolve tissues
  2. Cant remove the smell Layer
  3. Bit more expensive
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11
Q

How does EDTA work?

A

Chelating agents

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12
Q

What are the benefits of EDTA

A

Very effective at removing the inorganic smear layer

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13
Q

What are the disadvantages of EDTA

A
  1. Not that good at working on the flora
  2. Doesn’t dissolve tissues
  3. Doesn’t deactivate endotoxins
  4. Isn’t substantive
  5. Bit more expensive
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14
Q

How does Iodine Potassium Iodide work

A

Halogen ions

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15
Q

What are benefits of Iodine Potassium Iodide

A

Works on the flora

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16
Q

What are the disadvantages of Iodine Potassium Iodide

A
  1. Doesn’t dissolve tissue
  2. Doesn’t deactivate endotoxins
  3. Doesn’t remove inorganic smear layer
  4. Isn’t substantive
  5. Is a bit more expensive
17
Q

How does hydrogen peroxide work?

A

Peroxide

18
Q

What are the benefits of hydrogen peroxide

A

Cheap

19
Q

WWhat are the disadvantages of hydrogen peroxide

A
  1. Doesn’t dissolve tissue
  2. Doesn’t deactivate endotoxins
  3. Doesn’t remove inorganic smear layer
  4. Isn’t substantive
  5. Doesn’t effectively work on flora
20
Q

When do we irrigate

A

As much as possible and between every file change

21
Q

How do we irrigate

A

Ideally we should be passing the tip of our irrigation needle to at least 3mm from our apical preparation

22
Q

How far does irrigation reach from the needle tip?

A

2mm

23
Q

Area further than 2mm from the needle tip is classed as….

Why

A

The dead zone as it remains unirrigated

24
Q

What do we need to remember when irrigating

A
  1. Light pressure with forefinger and NOT your thumb whilst keeping the needle moving within the canal
  2. Do not allow needle to lock with the canal
25
Q

What flow rate should we aim to achieve?

A

1ml over 15 seconds

26
Q

What happens if we increase the irrigation rate over 4ml per min

A

It can increase the risk of extrusion

27
Q

What are the DOs of irrigation

A
  1. Ensure you irrigate after each instrument change

2. Ensure you have flipped the rubber dam over the wings and sealed with oraseal

28
Q

What are the DON’Ts off irrigation

A
  1. Down allow your needle to lock in the canal or use excessive pressure
  2. don’t irrigate and take a radiograph
  3. Don’t allow Chlorhexidine to mix with hypochlorite
29
Q

What happens take a radiograph Chlorhexidine mix

A

Can form a precipitate the is carcinogenic and will impair disinfection

30
Q

What can small amounts of hypochlorite ingestion result in?

A

Not harmful but will cause mucosal irritation and a bad taste

31
Q

Give some signs and symptoms of extrusion

A
  1. Sudden pain irrespective of the presence of LA
  2. Profuse bleeding from within the canal
  3. Extensive oedema
32
Q

How do we manage a hypochlorite incidence

A
  1. STAY CALM
  2. Irrigate canal with saline
  3. Give additional LA for pain relief
  4. Dress canal with non setting calcium hydroxide
  5. Reassure patient
  6. Advise of analgesia – Paracetomol and Ibuprofen
  7. Arrange a further appointment to review the patient

3rd yr- CSB labs- Endodontics (6 decks)

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