• It’s still controversial how much time irrigant should be left in canal, but
30 minutes seems reasonable.
Dilution of Sodium Hypochlorite
• EDTA
• MTAD ( commercially known as BioPure ® and TetraClean ®
• QMix
EDTA
Clinical studies:
• As chelating agent proved equally effective as EDTA.
• As antimicrobial agent is less than optimal.
• As compared to 5.25% NaOCl, the latter proved superior antimicrobial action.
QMix
• The needle should placed loosely in the canal and not bent.
• Deliver the irrigant drop-by-drop and not continuous flushing, especially
NaOCl.
• Use index finger to press the needle head, instead of thumb, as less force will be
delivered
• The irrigant technically will not go more than 1 mm away from the needle tip.
• Do not mix irrigants.
How much time for each irrigant?
• NaOCl, still controversial, 30 minutes seems reasonable. Plus use files and
irrigation synergistically
• EDTA, 1 minute is enough.
• Chlorhexidine, not reported. Use your own clinical judgment.
Does Temperature Affect Irrigant Efficiency?
• Manual agitation
• Sonic and Ultrasonic activation
• Negative apical pressure
• Safety irrigator
• Laser activation system
Manual agitation
• Cheapest method.
• Use master cone gutta percha, cut 2
mm from its tip.
• Place it in the canal and use vertical
up and down strokes
• Recommended No. of strokes, 100
stroke per minute.
Sonic activation
Similar in functionality
to EndoVac ® system
• In virto study to test the difference between activation techniques,
the results were:
Final
• See the next slide
irrigant
Final Irrgant to Use?
• Cohen Pathways of Pulp, Chapter 6, Cleaning and Shaping of Root Canal System.
• Endodotnics: Principle and Practice. 5th edition, Chapter 16, Cleaning and Shaping.
• Matthias Zehnder, JOE, Volume 32, Number 5, 2006. Root Canal Irrigants
• JOE, Irrigation Trends among American Association of Endodontists Members: A Web-
based Survey