Irrigation of the apical root canal

Abstract

Effective apical irrigation is one of the most important root canal procedures that has stood as a long‐standing challenge for the clinician. Despite the myriad of technological advances seen in the last few decades such as nickel–titanium rotary files of various designs and new irrigation delivery systems, very few seem to reliably impact upon a clinician's ability to deliver and replenish irrigant in the most apical part of a root canal. Replenishing irrigant in the apical third is complicated by the multitude of factors that affect the efficacy of this procedure. The current research provides detailed insight on how the principles of fluid mechanics work to explain the physical impediments to thorough irrigation, and how the biological impediments, in the form of biofilm, prevent disinfection despite adequate irrigation. The recent introduction of new irrigation and agitation modalities, coupled with a new understanding of the old problem through novel research techniques, provides a vision to the future and will establish a new standard of irrigation in this field.

Revascularization of an immature tooth with apical periodontitis using a single visit protocol: a case report

“…).It is likely that the ultrasonic file tip will generate a lateral flow towards the root canal walls rather than an apical flow (Park et al . ).…”

“…The perceived importance of irrigation in root canal treatment has grown considerably in recent years (Zehnder 2006, Park et al 2012. Sodium hypochlorite is considered the primary irrigant of choice for all root canal treatments (Zehnder 2006).…”

Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system

“…, Park et al . ) to identify titles not retrieved by the previous methods. No language restriction was applied to any of the searches.…”

Evaluation of Root Canal Debridement of Human Molars Using the GentleWave System

“…In most of these cases, the remaining tissue and bacteria were detected in intricate anatomic features (eg, apical region of the canal, isthmi, and lateral canals) (3)(4)(5)(6)(7)(8)(9)(10). This is primarily because of the fact that files only contact 30%-65% of the root canal surface and irrigants are unable to reach and clean some areas of the root canal system (4,5).…”