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Journal ArticleDOI

Irrigation in Endodontics

01 Apr 2010-Dental Clinics of North America (Elsevier)-Vol. 54, Iss: 2, pp 291-312
TL;DR: The chemistry, biology, and procedures for safe and efficient irrigation are summarized and cutting-edge information on the most recent developments are provided.
About: This article is published in Dental Clinics of North America.The article was published on 2010-04-01. It has received 495 citations till now.
Citations
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Journal ArticleDOI
TL;DR: Different means of delivery are used for root canal irrigation, from traditional syringe-needle delivery to various machine-driven systems, including automatic pumps and sonic or ultrasonic energy.
Abstract: Irrigation is a key part of successful root canal treatment. It has several important functions, which may vary according to the irrigant used: it reduces friction between the instrument and dentine, improves the cutting effectiveness of the files, dissolves tissue, cools the file and tooth, and furthermore, it has a washing effect and an antimicrobial/antibiofilm effect. Irrigation is also the only way to impact those areas of the root canal wall not touched by mechanical instrumentation. Sodium hypochlorite is the main irrigating solution used to dissolve organic matter and kill microbes effectively. High concentration sodium hypochlorite (NaOCl) has a better effect than 1 and 2% solutions. Ethylenediaminetetraacetic acid (EDTA) is needed as a final rinse to remove the smear layer. Sterile water or saline may be used between these two main irrigants, however, they must not be the only solutions used. The apical root canal imposes a special challenge to irrigation as the balance between safety and effectiveness is particularly important in this area. Different means of delivery are used for root canal irrigation, from traditional syringe-needle delivery to various machine-driven systems, including automatic pumps and sonic or ultrasonic energy.

395 citations

Journal ArticleDOI
TL;DR: AgNPs as a medicament and not as an irrigant showed potential to eliminate residual bacterial biofilms during root canal disinfection, suggesting that the antibiofilm efficacy of AgNPs depends on the mode of application.

267 citations

Journal ArticleDOI
TL;DR: Although the outcome of revascularization procedures remains somewhat unpredictable and the clinical management of these teeth is challenging, when successful, they are an improvement to treatment protocols that leave the roots short and the walls of the root canal thin and prone to fracture.

220 citations

Journal ArticleDOI
TL;DR: QMiX and NaOCl were superior to CHX and MTAD under laboratory conditions in killing E. faecalis and plaque bacteria in planktonic and biofilm culture and ability to remove smear layer was comparable to EDTA.
Abstract: Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant, QMiX. International Endodontic Journal, 45, 363–371, 2012. Abstract Aim To assess in a laboratory experimental model the efficacy of a novel root canal irrigant, QMiX, against Enterococcus faecalis and mixed plaque bacteria in planktonic phase and biofilms. In addition, its ability to remove smear layer was examined. Methodology Enterococcus faecalis and mixed plaque bacteria were exposed to QMiX, 2% chlorhexidine (CHX), MTAD and 1% sodium hypochlorite (NaOCl) for 5 s, 30 s and 3 min. Following exposure, samples were taken, serially diluted and grown aerobically and anaerobically on tryptic soy agar (TSA) plates or on blood agar plates for 24 and 72 h, respectively, to measure killing of bacteria. E. faecalis and plaque biofilms were grown for 3 weeks on collagen-coated hydroxyapatite or dentine discs and exposed for 1 and 3 min to QMiX, 2% CHX, MTAD, 1% and 2% NaOCl. The amount of killed bacteria in biofilms was analysed by confocal laser scanning microscopy using viability staining. Dentine blocks were exposed to QMiX and 17% EDTA for 5 min. The effectiveness of smear layer removal by the solution was evaluated using scanning electron microscopy. For statistical analysis, one-way analysis of variance and comparison of two proportions were used. Results QMiX and 1% NaOCl killed all planktonic E. faecalis and plaque bacteria in 5 s, while 2% CHX and MTAD were unable to kill all plaque bacteria in 30 s, and some E. faecalis cells survived even 3 min of exposure. QMiX and 2% NaOCl killed up to 12 times more biofilm bacteria than 1% NaOCl (P < 0.01), 2% CHX (P < 0.05; P < 0.001) and MTAD (P < 0.05; P < 0.001). QMiX removed smear layer equally well as EDTA (P = 0.18 × 10−5). Conclusion QMiX and NaOCl were superior to CHX and MTAD under laboratory conditions in killing E. faecalis and plaque bacteria in planktonic and biofilm culture. Ability to remove smear layer by QMiX was comparable to EDTA.

202 citations


Cites background from "Irrigation in Endodontics"

  • ...In addition, it should not be toxic for the surrounding tissue and not weaken the tooth structure (Haapasalo et al. 2010)....

    [...]

Journal ArticleDOI
TL;DR: Most of the respondents are using full-strength sodium hypochlorite and are routinely removing the smear layer during endodontic treatment and almost half are using an adjunct, such as ultrasonic activation, to aid in their irrigation technique.

197 citations


Cites methods from "Irrigation in Endodontics"

  • ...For a thorough analysis, readers are referred to the review by Haapasalo et al (21) of endodontic irrigation....

    [...]

References
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Journal ArticleDOI
TL;DR: Known mechanisms of microbial resistance (both intrinsic and acquired) to biocides are reviewed, with emphasis on the clinical implications of these reports.
Abstract: Antiseptics and disinfectants are extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications A wide variety of active chemical agents (biocides) are found in these products, many of which have been used for hundreds of years, including alcohols, phenols, iodine, and chlorine Most of these active agents demonstrate broad-spectrum antimicrobial activity; however, little is known about the mode of action of these agents in comparison to antibiotics This review considers what is known about the mode of action and spectrum of activity of antiseptics and disinfectants The widespread use of these products has prompted some speculation on the development of microbial resistance, in particular whether antibiotic resistance is induced by antiseptics or disinfectants Known mechanisms of microbial resistance (both intrinsic and acquired) to biocides are reviewed, with emphasis on the clinical implications of these reports

4,243 citations

Book
19 Dec 1975
TL;DR: In this paper, the authors present a method to find the optimal set of words for a given sentence in a sentence using the Bibliogr. Index Reference Record created on 2004-09-07, modified on 2016-08-08
Abstract: Note: Bibliogr. : p. 413-424. Index Reference Record created on 2004-09-07, modified on 2016-08-08

3,758 citations

Book
01 Jan 1983
TL;DR: Infection, sterilization, and preservation, Disinfection, Sterility, and Preservation, کتابخانه دیجیتال جندی اهواز.
Abstract: Disinfection, sterilization, and preservation , Disinfection, sterilization, and preservation , کتابخانه دیجیتال جندی شاپور اهواز

1,743 citations

Journal ArticleDOI
TL;DR: Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed and some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.

1,599 citations

Journal ArticleDOI
TL;DR: Endodontic medicaments were applied to infected specimen for comparison of antibacterial potency, and camphorated p-monochlorophenol was generally more efficient than Calasept, and of the irrigants tested, iodine potassium iodide appeared more potent than sodium hypochlorite or chlorhexidine.
Abstract: The effect of endodontic irrigants and dressings was tested on bacteria in bovine dentin specimens experimentally infected with Enterococcus faecalis, Streptococcus sanguis, Escherichia coli, or Pseudomonas aeruginosa. Standardized, cylindrical dentin test pieces were prepared and cleaned by ultrasonic treatment with EDTA and sodium hypochlorite. The specimens were infected with the test organism for periods up to 14 days, and the degree of infection into the tubules was monitored using Brown & Brenn stain, scanning electron microscopy, and culturing of dentin dust from sequential bur samples starting from the pulpal side. E. faecalis rapidly infected the whole length of the tubules; S. sanguis required up to 2 weeks for complete infection; E. coli only penetrated to some 600 μm, even after prolonged incubation periods. P. aeruginosa infected dentin quickly, but apparently in very low numbers. E. faecalis persisted for at least 10 d after withdrawal of nutrient support, whereas the other 3 organisms died within 4 to 48 h. Endodontic medicaments were applied to infected specimen for comparison of antibacterial potency. Camphorated p-monochlorophenol was generally more efficient than Calasept, and of the irrigants tested, iodine potassium iodide appeared more potent than sodium hypochlorite or chlorhexidine. The presence of a smear layer delayed, but did not eliminate, the effect of the medicaments.

744 citations