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Endod. 2008;34:1374-7. 95 Gutarts R, Nusstein J, Reader A, Beck M. In vivo debridement efficacy of ultrasonic irrigation following handrotary instrumentation in human mandibular molars. J Endod. 2005;3:166-170. 96 Pouch D, Bohne W, et al. Cleaning qualities of Rinsendo: an in vitro study. Eur Cells Mater. 2007;13:7. 97 Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009;35(4):545-9. 98 Hülsmann M, Hahn W. Complications during root canal irrigation: literature review and case reports. Int Endod J. 2000;33:186-93. 99 Shin SJ, Kim HK, Jung IY, Lee CY, Lee SJ, Kim E. Comparison of the cleaning efficacy of a new apical negative pressure irrigating system with conventional irrigation needles in the root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):479-84. 100 Klyn SL, Kirkpatrick TC, Rutledge RE. In vitro comparisons of debris removal of the EndoActivator System, the F File, ultrasonic irrigation, and NaOCl irrigation alone after handrotary instrumentation in human mandibular molars. J Endod. 2010;36(8):1367-71. 101 Susin L, Parente JM, Loushine RJ, et al. Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system. Int Endod J. 2010;43(12):1077-90. 102 Mehdipour O, Kleier DJ, Averbach RE. Anatomy of sodium hypochlorite accidents. Compend Contin Educ Dent. 2007;28(10):544-6. 103 Pashley EL, Birdsong NL, Bowman K, Pashley DH. Cytotoxic effects of sodium hypochlorite on vital tissue. J Endod. 1985;11:525- 8. 104 Bowden JR, Ethunandan M, Brennan PA. Life-threatening airway obstruction secondary to hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):402-4. 105 Markose G, Cotter CJ, Hislop WS. Facial atrophy following accidental subcutaneous extrusion of sodium hypochlorite. Br Dent J. 2009;206(5):263-4. 106 Linden J. When Irrigation Leads to Litigation. Dental Products Report. Sept. 2010, 75-81. 107 Hülsmann M, Rödig T, Nordmeyer S. Complications during root canal. Endo Topics. 2009;16:27-63. 108 Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis PR. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod. 2010;36(5):875-97. 109 Mitchell RP, Yang SE, Baumgartner JC. Comparison of apical extrusion of NaOCl using the EndoVac or needle irrigation of root canals. J Endod. 2010;36(2):338-41. 110 Gondim E Jr., Setzer F, dos Carmo CD, Kim S. Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod. 2010;36;(8):1295-1301. 111 Siu C, Baumgartner JC. Comparison of the debridement efficacy of the EndoVac irrigation system and conventional needle root canal irrigation in vivo. J Endod. 2010;36(11):1782-5. 112 Parente JM, Loushine RJ, Susin L, Gu L, Looney SW,Weller RN, et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J. 2010;43(11):1001-12. 113 Cohenca N, Heilborn C, Johnson JD, Flores DS, Ito IY, da Silva LA. Apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing on root canal disinfection in dog teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(1):e42-6. 114 da Silva LA, Nelson-Filho P, da Silva RA, et al. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs’ teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(5):779-87. 115 Eickholz P, Kim TS, Bürklin T, et al. Nonsurgical periodontal therapy with adjunctive topical doxycycline: a double-blind randomized controlled multicenter study. J Clin Periodontol. 2002;29:108-17. 116 de Paz S, Perez A, Gomez M, Trampal A, Dominguez Lazaro A. Severe hypersensitivity reaction to minocycline. J Invest Allergol Clin Immunol. 1999;9:403-4. 117 Schoeffel GJ. The EndoVac method of endodontic irrigation: Part 4, Clinical Use. Dent Today. 2009;28(6):64, 66-67. Author Profile Gary Glassman DDS, FRCD(C) Dr. Gary Glassman graduated from the University of Toronto School of Dentistry in 1984 and graduated from the Endodontology Program at Temple University in 1987 where he received the Louis I. Grossman Study Club Award for academic and clinical proficiency in Endodontics. The author of numerous publications, Dr. Glassman lectures globally on endodontics and is on staff at the University of Toronto, Faculty of Dentistry in the graduate department of endodontics. Gary is a Fellow of the Royal College of Dentists of Canada, and the endodontic editor for Oral Health dental journal. He maintains a private practice, Endodontic Specialists, in Toronto, Ontario, Canada. He can be reached through his website www.rootcanals.ca. Disclaimer The author of this course has no commercial ties with the sponsors or the providers of the unrestricted educational grant for this course. Reader Feedback We encourage your comments on this or any PennWell course. For your convenience, an online feedback form is available at www.ineedce.com. 12 www.ineedce.com
Online Completion Use this page to review the questions and answers. Return to www.ineedce.com and sign in. If you have not previously purchased the program select it from the “Online Courses” listing and complete the online purchase. Once purchased the exam will be added to your Archives page where a Take Exam link will be provided. Click on the “Take Exam” link, complete all the program questions and submit your answers. An immediate grade report will be provided and upon receiving a passing grade your “Verification Form” will be provided immediately for viewing and/or printing. Verification Forms can be viewed and/or printed anytime in the future by returning to the site, sign in and return to your Archives Page. 1. Endodontic success rates of up to _______ are being achieved. a. 68% b. 78% c. 88% d. 98% 2. There is clear evidence that apical periodontitis is a _______ disease. a. fungal b. viral c. biofilm-induced d. all of the above 3. The root canal system contains _______. a. cul-de-sacs b. arborizations c. isthmuses d. all of the above 4. _______ from the root canal is one of the challenges for successful endodontic treatment. a. The removal of pulp tissue b. The removal of debris and the smear layer c. The removal of microorganisms and microtoxins d. all of the above 5. The nickel-titanium instruments currently available act on the _______ of the root canal. a. isthmi b. central body c. lateral body d. all of the above 6. _______ penetrates deep into the dentinal tubules. a. Actinomyces israelii b. Candida albicans c. Enterococcus faecalis d. a and c 7. To be effective, root canal irrigants must _______. a. eliminate bacterial contamination b. remove the smear layer c. dissolve the organic component of the dental pulp d. all of the above 8. _______ is a desired attribute for a root canal irrigant. a. Bacterial decontamination b. A broad antimicrobial spectrum c. The ability to enter deep into dentinal tubules d. all of the above 9. _______ is currently used as a root canal irrigant. a. Chlorhexidine gluconate b. Hydrogen peroxide c. Sodium hypochlorite d. all of the above Questions 10. Chlorhexidine gluconate _______. a. offers a wide antimicrobial spectrum b. is biocompatible c. lacks the ability to dissolve necrotic tissue d. all of the above 11. Hydrogen peroxide _______. a. is an effective antibacterial irrigant b. exhibits no tissue toxicity c. dissolves necrotic tissue d. a and c 12. The irrigant that satisfies most of the requirements for a root canal irrigant is _______. a. polyalkenoic acid b. sodium hypochlorite c. saline d. chlorhexidine gluconate 13. Sodium hypochlorite _______. a. dissolves necrotic tissue b. dissolves the organic components of the smear layer c. kills sessile endodontic pathogens d. all of the above 14. EDTA has been recommended as an adjuvant in root canal therapy because it is a _______. a. remineralizing agent b. dilutant c. demineralizing agent d. b and c 15. The combination of _______ has been used worldwide for antisepsis of root canal systems. a. sodium hypochlorite and calcium chloride b. EDTA and chlorhexidine gluconate c. sodium hypochlorite and EDTA d. all of the above 16. _______ is a general safety precaution prior to root canal irrigation. a. Use of a rubber dam b. Protecting the patient’s eyes with safety glasses c. Use of a temporary sealing material if deep caries is present adjacent to a rubber dam d. all of the above 17. Apical extrusion of an endodontic irrigant _______ occurs. a. never b. rarely c. routinely d. always 18. Root canal irrigation systems are available that work using _______. a. manual agitation techniques b. manual rotation techniques c. machine-assisted agitation techniques d. a and c 19. When irrigating the root canal system, it is important to consider if _______. a. the irrigation system can deliver the irrigant to the whole extent of the root canal system b. the irrigant can debride areas that cannot be reached mechanically c. the irrigant contains any dye d. a and b 20. An apical vapor lock effect _______. a. prevents the flow of irrigant into the apical region of the root canal b. results in gas entrapment at the apical third c. resists displacement by instrumentation d. all of the above 21. The _______ of sodium hypochlorite liberates ammonia and carbon dioxide. a. dessication b. hydrolysis c. cross-linking d. none of the above 22. An apical vapor lock occurs in root canals with _______. a. an open-ended channel b. a close-ended channel c. multiple isthmuses d. all of the above 23. _______ have confirmed the presence of apical vapor lock. a. Histological tests b. Micro-CT scans c. Radiographs d. a and b 24. For a root canal irrigant to be mechanically effective in removing all the particles, it has to _______. a. reach the apex b. create a current c. carry the particles away d. all of the above 25. The apical vapor lock and consideration for the patient’s safety has always prevented the thorough cleaning of the _______. a. apical 3 mm b. lateral 3 mm c. apical 5 mm d. lateral 5 mm 26. The most common and conventional set of irrigation techniques is _______. a. mechanical irrigation b. manual irrigation c. hydrodynamic theory irrigation d. all of the above www.ineedce.com 13
Page 1 and 2: Publication date: January 2011 Expi
Page 3 and 4: ial decontamination. The desired at
Page 5 and 6: Manual Agitation Techniques By far
Page 7 and 8: During irrigation, the Master Deliv
Page 9 and 10: One study found apical negative pre
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