Root Canal Irrigants
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ROOT CANAL IRRIGANTS:
Removal of all pathogenic microflora from the root canal system is highly essential to ensure success of endodontic therapy. Mechanical debridement of the root canal is augmented using root canal irrigants. They facilitate flushing out debris, dissolving the tissues and disinfection of the root canal system. Instrumentation, although carried out diligently cannot completely debride the root canal of the causative pathogens, especially in curved canals. Endodontic irrigants are used along with irrigation to enhance the whole process and increasing the overall prognosis of treatment.
Objectives of root canal irrigation:
The objectives of irrigating the root canal system may be grouped under two heads:
Chemo-mechanical objectives:
- Flushing action of the irrigants facilitates the removal of debris.
- Lubrication aids in instrumentation of canals which are difficult to negotiate.
- Dissolution of the tissues to enhance removal.
- Removal of the smear layer is highly significant as it ensures easier and more efficient canal instrumentation.
Biological objectives:
Antimicrobial action against disease causing pathogens to eliminate the etiological factors of the disease.
Ideal requirements of root canal irrigants:
- Completely remove the smear layer
- Easy handling and application
- Prolonged and sustained antibacterial effect
- Germicidal and fungicidal action
- Must not irritate the periapical tissues
- Disinfect dentinal tubules
- Inexpensive
- Does not stain tooth structure
- Does not hinder the sealing ability of filling materials
- Does not induce an immune response
Factors influencing the efficacy of root canal irrigants:
- Depth of irrigating needle that is engaged in the root canal
- Size of the root canal
- Diameter of irrigating needle
- Viscosity of irrigating solution
- Velocity of irrigation at the needle tips
- Orientation of needle bevel
- Temperature of irrigating solution
ANTIBACTERIAL & TISSUE DISSOLVERS:
Chlorhexidine digluconate, MTAD and sodium hypochlorite are root canal irrigants known for their antibacterial and tissue dissolving properties.
Sodium Hypochlorite:
NaOCl is a clear pale yellow-green liquid. It has a strong odour of chlorine. It is one of the most extensively used endodontic irrigants worldwide. The use of NaOCl is attributed to its excellent antibacterial properties. It kills most bacterial on direct contact, almost instantly. Sodium hypochlorite also effectively dissolves the necrotic and vital pulpal tissue.
Properties of sodium hypochlorite:
- Potent antimicrobial
- Tissue solvent
- Acts as a lubricant
- Flushes debris
Mechanism of action of sodium hypochlorite:
NaOCl undergoes ionization in water to sodium and hypochlorite ions. This establishes an equilibrium with hypochlorous acid (HOCl). This acid is responsible for the antibacterial properties of NaOCl. It disrupts vital functions of the bacterial cell, which results in death of the microbes.
Sodium hypochlorite undergoes three reaction with the organic tissues namely Saponification, Amino acid neutralization and Chloramination.
The efficacy of this irrigant can be enhanced by altering the pH and temperature of the solution and by ultrasonic agitation.
Prevention of Hypochlorite accidents:
Sodium hypochlorite is one of the most commonly advocated root canal irrigants. However, the toxic effects of the irrigant can result in a number of serious complications. Hence it is always essential to practice caution while using NaOCl. The following points can serve as guidelines to prevent hypochlorite accidents.
- Proper straight line access with adequate coronal preparation
- Assessment of root canal anatomy
- Usage of specialized needles
- Accurate determination of working length
- Do not wedge the tip of the needle in the canal
- Avoid excessive digital pressure
- Constant in and out movements of the needle
- Flow back of the irrigating solution should be observed
Chlorhexidine digluconate:
CHX is a synthetic cationic bis-guanide. It is an extensively used root canal irrigant having broad spectrum antibacterial action. It is relatively non-toxic.
Mechanism of action:
CHX is a positively charged lipophilic molecule that interacts with the cell membrane of the bacterial cell (phospholipids and lipopolysaccharides). The chlorhexidine molecules enter the bacterial cell via active or passive transport. This causes disruption of the bacterial cell wall. As a result, leakage of the intracellular constituents occurs. Consequently, the cytoplasm of the bacterial cell becomes congealed and a reduction in leakage is observed.
CHELATING AGENTS/ EDTA:
Ethylenediamine tetra acetic acid is a widely used endodntic irrigant best known for its excellent properties of smear layer removal. Another chelating agent with similar properties is citric acid. In addition to their cleaning ability chelating agents have also shown to remove the biofilms that adhere to the root canal walls. Coating endodontic files with EDTA prior to insertion into the canals can be highly efficacious when dealing with calcified canals.
Mechanism of action:
The calcium ions in the root dentin react with EDTA to form soluble calcium chelates. Studies have shown that EDTA decalcified root dentin to a depth off 20 to 30 microns. This facilliates easier removal of the debris present in the root canal and also enhances ease of instrumentation.
OVERVIEW OF COMMONLY USED IRRIGANTS
Compound
Recommended concentration
Type
Antimicrobial action
Tissue dissolving capacity
Inactivation of endotoxins
Smear layer action
Caustic potential
Allergic Potential
Hydorgen peroxide
3-30%
Peroxygen
Reported
Negligible
Negligible
Negligible
Depends on concentration
Negligible
Sodium Hypochlorite
1 -5.25%
Halogen release
Present
Strong
Reported
Present (organic compunds)
Depends on concentration
Reported
Chlorhexidine
0.2 – 2%
Bisguanide
Present
Negligible
Reported
Negligible
Depends on concentration
Present
Ethylene diamine tetra acetic acid
10 – 17%
Polyprotic acid
Reported
Negligible
Negligible
Present (Inorganic compounds)
Negligible
Negligible
Citric Acid
10 – 50%
Organic acid
Negligible
Negligible
Negligible
Strong (Inorganic compounds)
Negligible
Negligible
What are the brands selling root canal irrigants online?
Dentsply, Prime Dental, Ultradent, Dental Avenue, Anabond, D-Tech, GDP, Deor, Septdont, Pulpdent, Ramen Insta, Medicept, Ammdent and MAARC are a few of the many brands that sell root canal irrigants online at PinkBlue.in
Why buy root canal irrigants online at PinkBlue.in?
At PinkBlue.in we understand the need for quality materials and instruments to efficiently run your clinical practice. To ensure the delivery of genuine, high quality products we ensure that all the items sold on the website are procured from trusted manufacturers and vendors. PinkBlue offers the best prices for dental supplies in the country. With various payment options and a wide range of products, PinkBlue.in is the one stop shop for all your dental supply needs.