![]() ![]() However, the literature has a considerable variation on this point. For the irrigant to be effective, it requires reaching and disrupting the biofilm attached to the canal walls. Irrigation sequence: Which sequence of irrigants should I use?Ĭontact time of the irrigants and medications with the contaminated dentin is essential.Disinfection of apical third of the canal: How can the irrigant reach the apical portion?.Concentration of irrigating solutions: Which concentration of NaOCl should I use?.Duration of irrigation: How much time do I need to disinfect the canal?.Some of the dilemmas in selecting the best irrigating protocol during endodontic treatment are as the following: ![]() (1).ĭespite all the advances made in the last 80 years, many published articles worldwide have demonstrated some controversial results, which may confuse clinicians in their selection of the best irrigation regimen. ![]() They range from very caustic single irrigants (such as NaOCl) to herbal formulations (like chamomile or green tea). Nowadays, there is a whole variety of irrigating solutions tested for root canal disinfection. Later in 1957, Nygaard-Ostby introduced the ethylenediaminetetraacetic acid (EDTA) solution for root canal irrigation. In 1943, Grossman recommended the use of NaOCl and hydrogen peroxide. Sodium hypochlorite (NaOCl), back in 1936, was recommended by Walker to irrigate the root canals. Many irrigating solutions and delivery systems were proposed to overcome some of these limitations. It is well documented that mechanical instrumentation and strong antibacterial irrigation followed by well-sealed obturation of the root canal system can significantly reduce the bacterial load and create an environment conducive to healing.ĭuring endodontic disinfection, the clinician faces many limiting factors: such as complex root canal anatomy, untouched dentin walls left during mechanical instrumentation, and bacterial load in forms of biofilm attached to dentin walls and in the isthmus. Root canal treatment aims to prevent or cure apical periodontitis, and this aim is achieved by eliminating microorganisms capable of causing an intraradicular or extraradicular infection. and Gevik Malkhassian, D.D.S., M.SC., FRCD(C) ![]()
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