What is the endodontic lubricant that we use in the VCU Undergraduate Endodontics Clinic?
RC Prep in our clinic
Inadequate shaping of the root canal space leads to all of the following EXCEPT:
a.
Inadequate cleaning of the root canal space
b.
Inadequate sealing of the root canal space
c.
Inadequate removal of dentin
d.
Treatment failure
inad removal of dentin
Which of the following is a DISADVANTAGE of using water as an irrigating solution?
a.
Water is non toxic. b. Water does not remove the smear layer. c. Water does not stain dentin. d. Water does not flush debris from the canal.
water does not remove the smear layer
What is the most popular irrigating solution used in endodontiics?
NaOCl
-alternative is Chlorhexidine
What is the concentration of NaOCl used in the Undergraduate Endodontics Clinic at VCU?
2.6%
What is the advantage of using a safety tip needle when irrigating a root canal?
It helps prevent extrusion of the solution from the apex of the canal.
Which component of the smear layer is removed by EDTA?
inorganic
How long is EDTA left in the tooth in order to remove smear layer?
one minute
Which of the following are disadvantages of chlorhexidine?
Chlorhexidine is expensive.
Chlorhexidine does not disolve tissue.
Statement 1: RC Prep is used with hand files.
Statement 2: RC Prep is used with rotary files.
first statement=true
second statement=false
Objectives of Shaping
• Provide better access for the cleaning and
irrigating the canal space.
• Create a tapered preparation to facilitate obturation (sealing of the canal system).
Failure to achieve shaping objectives
• Leads to:
– Inadequate cleaning of the root canal space
– Inadequate obturation (sealing of the root canal space.
– Treatment failure
• A canal cannot be instrumented dry because it would:
- Create dust and chunks of dentin that would clog the canal space.
- Create frictional heat.
Working in a Wet Environment
- Flushes and Floats debris from the canal space
* Cools instruments working in the canal space
Ideal Properties of an Irrigating Solution
- dissolve vital and necrotic pulp tissue
- antimicrobial
- lubricates
- low surface tension
- removes biofilm
- removes smear layer
- readily available
- inexpensive
- adequate shelf life
- non-staining
safest irrigating agent
water or saline
-cheap, non-toxic, non-staining
• Is not antimicrobial, does not dissolve tissue, has no effect on smear layer
Most Popular Agent for irrigation
• Sodium Hypochlorite (NaOCl,Commercial Bleach)
what are the effective concentrations of NaOCl used, and what does VCU use?
-6 or 5.25% (full strength commercial bleach)
-3 or 2.6% (half strength)
VCU uses 2.6%
what are the advantages and disadvantages of NaOCl for irrigation?
– Advantages
• antimicrobial
• dissolves vital and necrotic pulp tissue • inexpensive and readily available
• removes organic portion of smear layer
– Disadvantages
• toxic to vital tissue
• dangerous if extruded from canal space
alternative agent for NaOCl:
- 2% Chlorhexidine (Peridex is 0.12%)
- Effective antimicrobial
- Sometimes mixed with surfactant to reduce surface tension
- Low to moderate toxicity
- Does not dissolve tissue
- Expensive
the smear layer has organic and inorganic portions, what is the most effect for removing the organic and inorganic portions respectively?
NaOCl (organic)
-17% EDTA for non-organic
Clinic Protocol: Irrigation
- Half Strength NaOCl as Primary Irrigant
- 17% EDTA as final irrigant for 1 minute prior to obturation
- Flush with saline
- Final irrigation with 2% Chlorhexidine for 1 minute
what irrigants should NOT BE MIXED?
- NaOCl with 2% Chlorhexidine – forms brown precipitate (parachloroaniline) which is potentially carcinogenic
- EDTA with 2% Chlorhexidine- forms white precipitate (salt) which is harmless
what are the ways that irrigation can be inhanced?
- Heating NaOCl (controversial)
- Sonic Activation (controversial)
- Ultrasonic Activation (proven)
- Negative Pressure (new)(endo-vac)
