RC irrigants & Root repair
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RC IRRIGANTS & ROOT REPAIR:
The important phases of root canal therapy include removal of the etiological agents of pulpitis, proper instrumentation, irrigation and completely sealing the root canal with suitable biocompatible substitutes. Irrigation may be considered as the most important phase of endodontic therapy because, if properly done, it eliminates the causes of pulpal inflammation such as bacteria and other irritants present in the root canal system and determines the healing of the periapical tissues. Inadequate irrigation and debridement of the canal, may in the long run, become a reason for failure of endodontic therapy.
Root canal instrumentation is done with utmost care by dentists, since it is very significant to avoid any damage to the root structure. But in certain cases, untoward events such as root perforations do happen. Root perforations are iatrogenic or pathologic communications between the root canal and the surrounding periodontium. In these circumstances root repair agents are highly useful in correcting root perforations, thereby protecting the periodontal attachments.
ROOT CANAL IRRIGANTS:
Irrigation goes hand in hand with instrumentation during endodontic therapy. Irrigating solutions when used with proper biomechanical preparation help to loosen debris, microbes and pulpal tissue and facilitate their removal from the canal. Root canal irrigation has mechanical, chemical and biological objectives such as removal of the smear layer, flushing, lubrication and dissolving actions and most importantly antimicrobial action.
Ideal Requirements of Root Canal Irrigants:
- Germicidal and fungicidal action
- Must not irritate the periapical tissues
- Prolonged and sustained antibacterial effect
- Completely remove the smear layer
- Does not stain tooth structure
- Does not induce an immune response
- Does not hinder the sealing ability of filling materials
- Disinfect dentinal tubules
- Easy handling and application
What are the commonly used root canal irrigants?
Root canal irrigating solutions may be classified as antimicrobial, tissue dissolving and chelating agents. Certain materials such as MTAD have combinations of these properties. The most commonly used root canal irrigating solutions are sodium hypochlorite (NaOCl), Chlorhexidine gluconate (CHX), ethylenediaminetetraacetic acid (EDTA), 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) or Etidronate, a mixture of doxycycline, citric acid and detergent known as MTAD and normal saline.
ANTIBACTERIAL & TISSUE DISSOLVERS:
Irrigants such as chlorhexidine, sodium hypochlorite and MTAD have antibacterial properties. Of these, CHX and MTAD have bacteriostatic properties while NaOCl is bacteriocidal.
Sodium hypochlorite in addition to being bacteriocidal, acts as a tissue dissolving agent. It is used in concentrations between 0.5% to 7%. Although higher concentrations of NaOCl have better antibacterial and tissue dissolving properties, it has been shown to effectively kill target microbes even at low concentrations of 0.1%, when the confounding factors are eliminated. However, irrigation with NaOCl should be carried out with caution as it exhibits toxic effects such as hemolysis, epithelial ulceration and necrosis on vital tissues.
Chlorhexidine gluconate is a widely used root canal irrigant which is an excellent antibacterial and antifungal agent. The antibacterial effect of CHX has been estimated to last upto 12 weeks in dentin. CHX, containing positively charged molecules reacts with the negatively charged phosphate groups on the microbial cell wall, ultimately causing lysis of the cell. It is usually used in concentrations between 0.12% and 2%. Care should be taken while using CHX along with NaOCl as the reaction between the two results in the formation a precipitate, parachloroaniline (PCA). PCA has adverse effects on treatment as it occludes the dentinal tubules, thereby compromising the seal of the obturated root canal.
MTAD, a mixture of doxycycline (tetracycline), citric acid and detergent is a recently developed root canal irrigant which satisfies most of the ideal requisites. It has excellent antimicrobial properties, in addition to being able to effectively remove the smear layer and act as a chelating agent. Studies have shown that MTAD is highly effective in killing the Enterococcus faecalis bacteria even in 200x dilutions. In comparison NaOCl proved to be efficacious up to 32x dilutions.
Chelation is derived from the Greek word “chele” meaning “crab claw”. Chelating agents are used in endodontic therapy to chemically soften the dentin in the root canal, remove the smear layer and increase dentin permeability. The most commonly used chelating agent in endodontics is Ethylenediaminetetraacetic acid (EDTA). Commercially it is marketed as RC Help, SurePrep, Endogel, PrepRite and various other names by manufacturers.
It is recommended to use EDTA along with rotary endodontic files to facilitate root canal preparation. Also final irrigation of the canal with 15-17% EDTA is recommended by many authors for removal of smear layer.
Advantages and Disadvantages of Commonly Used RC Irrigants
Ability to remove smear layer
Dentin conditioning properties
Shelf life stability
Positive effect on root canal seal
Negative effect on dentin structure
Upregulation of regional immune response
Iatrogenic perforations of the root canal occur sometimes during instrumentation of while preparing the canal for a post. As a result, the periradicular tissues are inflamed, which reduces the prognosis. Moreover, coronal microleakge further complicates the situation as the microbes re-infect the canal. Therefore, as a remedial measure repair of root canal perforations, irrespective of cause, are indicated to increase the rate of success of therapy. Materials such as glass ionomer cement (GIC), mineral trioxide aggregate (MTA), Biodentine and platelet rich fibrin (PRF) are used in repair of perforations in the root canal. MTA has been a biocompatible material that has numerous applications in dentistry. It has been shown to induce regeneration of cementum, a property not exhibited by other root repair materials.
What are the brands selling RC Irrigants and Root Repair materials online in india ?
Cresophene, Canal Plus, Largal Ultra and Parcan by Septodont, BioSol, Exawash and Hypo 3 by Xenon, Prep Rite, EDTA 17% and File Rite by Pulpdent, Hyposol, Chlor X and Dolo Endogel by Prevest Denpro, Glyde File Prep by Dentsply are a few of the various materials sold online at PinkBlue.in by leading manufacturers of dental products worldwide.
Why buy RC Irrigants and Root Repair materials at PinkBlue.in?
PinkBlue.in has the widest range of dental materials online in India. Root canal irrigants and root repair materials are sold by over 20 manufacturers and vendors at PinkBlue.in. All products sold by PinkBlue.in are genuine as they are procured from the manufacturers themselves and from trusted dealers of dental products worldwide. With various modes of payment suited to every dentist, PinkBlue ensures prompt delivery of quality products.