Update of Endodontic Irrigating Solutions

Abstract

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-

Management of an internal root resorption on a permanent tooth. A case report.

“…Upon dissociation CH produces high pH (12.5-12.8) preventing the dissolution of mineral components of dentin, in addition to activating alkaline phosphatase, which plays an important role in the formation of hard tissue [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] .…”

“…The use of CHX is an alternative to Sodium Hypochlorite and has proven effective in removing biofilm [16][17] .…”

“…The most significant property of CHX is substantivity, which provides adhesion to dentin, allowing antimicrobial action even after completion of irrigation 17 . The Max-i-probe cannula was used for irrigation.…”

Evaluation of antimicrobial efficacy of cetrimide and <i>Glycyrrhiza glabra L.</i> extract against <i>Enterococcus faecalis</i> biofilm grown on dentin discs in comparison with NaOCl

“…Enterococcus faecalis is the most commonly recovered species from the teeth of failed root canal treatments and persistent root canal infections, with a prevalence of more than 70% 2) . Sodium hypochlorite (NaOCl) has excellent tissue dissolution properties and antimicrobial activity, however its cytotoxicity and allergic potential have compelled researchers to develop new irrigation materials and protocols 3) . Cetrimide is a cationic surface-active agent (surfactant), and in endodontics, it is typically used in combination with other irrigants, as it increases the effectiveness of endodontic irrigants by reducing the surface tension 4,5) .…”

“…When used as a single agent, 0.1% cetrimide showed antibacterial activity that was comparable to that of 2% NaOCl and 2% chlorhexidine 8) . Natural products, especially herbal extracts, have been used in medicine and shown to be good alternatives to synthetic chemicals 3) . Antimicrobial activity of G. glabra L. extract is associated with its content Glycyrrhizin 9,10) .…”