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Successful root canal therapy depends on thorough debridement of pulpal tissue, dentin debris, and infective microorganisms. Currently, it is impossible to predictably eradicate intraradicular infection with mechanical instrumentation alone. Therefore, irrigants are required to be used as an important addition in the disinfection process. This chapter analyzes the main irrigating solutions used during the endodontic treatment and their actions and interactions among them. Explanation of their mechanism of action and effect on dentin structure and on biofi lm is also described. A clinical protocol is proposed at the end of the chapter.The goal of endodontic treatment is to prevent or cure apical periodontitis. Apical periodontitis is an infl ammatory process in the periradicular tissues caused by microorganisms in the infected root canal [ 84 ]. It is well known that shaping, cleaning, and obturating the root canal system provide the strategy for successful treatment. The principle to reach favorable outcomes in endodontic infection management requires the recognition of the problem and the removal of the etiological factors.In endodontic disinfection, there are two main challenges which are important to be recognized the anatomical challenge and the microbiological challenge [ 42 ].The anatomical challenge can be divided into complexity of the root canal system, dentin structure, and dentin constituents. Anatomical Complexities (also see Chap. 2 ):Root canal is an enclosed complex space with intricate confi gurations and apical constriction it is important to mention here that more than 35 % of the root canal surface is left untouched by conventional instrumentation [ 35 , 64 ] (Fig. 5.1 ). Also, common instrumentation techniques accumulate debris in isthmus areas. Paque et al. showed explained that when rotary fi les are used in canal with a round cross section, the dentine particles that are cut from the canal wall are car-

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Results of the efficacy and time efficiency of computer-assisted learning (CAL) in endodontics education are mixed in the literature. The objectives of this study were to compare the efficacy and time efficiency of CAL with traditional learning methods or no instruction. The search strategy included electronic and manual searches of randomized controlled trials (RCTs) completed in English up to June 2009. The intervention comprised any method of CAL, while the control group consisted of all traditional methods of instruction including no further instructions. Various outcome measures of CAL efficacy were considered and were categorized using Kirkpatrick's four-level model of evaluation: reaction, learning, behavior, results, with the addition of return on investment as a fifth level. The time efficiency of CAL was measured by the time spent on the learning material and the number of cases covered in a unit period. Seven RCTs met the inclusion criteria. Overall, students' attitudes were varied towards CAL. Results from the knowledge gain outcome were mixed. No conclusions can be made about students' performance on clinical procedures or cost-effectiveness of CAL. Better time efficiency was achieved using CAL compared to traditional methods. CAL is as efficacious as traditional methods in improving knowledge. There is some evidence to suggest that CAL is time efficient compared to traditional methods. Overall, the number of studies included in this review was small, thus warranting the need for more studies in this area and the exploration of various CAL techniques.Dr. Al-Jewair is an Orthodontic Resident,

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