Irrigation in Endodontics - The Endoexperience

308
Haapasalo et al
debridement of anastomoses between double canals, isthmuses, and fins. 78–80 The
effectiveness of ultrasonics in the elimination of bacteria and dentin debris from
the canals has been shown by several studies. 81–85 However, not all studies have
supported these findings. 80
Van der Sluis and colleagues 84 suggested that a smooth wire during ultrasonic
irrigation is as effective as a size 15 K-file in the removal of artificially placed dentin
debris in grooves in simulated root canals in resin blocks. It is possible that preparation
complications are less likely to occur with an ultrasonic tip with a smooth, inactive
surface.
SUMMARY
Irrigation has a key role in successful endodontic treatment. Although hypochlorite is
the most important irrigating solution, no single irrigant can accomplish all the tasks
required by irrigation. Detailed understanding of the mode of action of various
solutions is important for optimal irrigation. New developments such as CFD and
mechanical devices will help to advance safe and effective irrigation.
ACKNOWLEDGMENTS
The authors would like to thank Ingrid Ellis for her editorial assistance in the final
preparation of this manuscript.
REFERENCES
1. Peters OA, Schönenberger K, Laib A. Effects of four Ni-Ti preparation techniques
on root canal geometry assessed by micro computed tomography. Int Endod J
2001;34:221–30.
2. Hülsmann M, Hahn W. Complications during root canal irrigation: literature review
and case reports [review]. Int Endod J 2000;33:186–93.
3. Mcdonnell G, Russell D. Antiseptics and disinfectants: activity, action, and resistance.
Clin Microbiol Rev 1999;12:147–79.
4. Barrette WC Jr, Hannum DM, Wheeler WD, et al. General mechanism for the
bacterial toxicity of hypochlorous acid: abolition of ATP production. Biochemistry
1989;28:9172–8.
5. McKenna SM, Davies KJA. The inhibition of bacterial growth by hypochlorous
acid. Biochem J 1988;254:685–92.
6. Zehnder M, Kosicki D, Luder H, et al. Tissue-dissolving capacity and antibacterial
effect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 2002;94:756–62.
7. Gomes BP, Ferraz CC, Vianna ME, et al. In vitro antimicrobial activity of several
concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination
of Enterococcus faecalis. Int Endod J 2001;34:424–8.
8. Radcliffe CE, Potouridou L, Qureshi R, et al. Antimicrobial activity of varying
concentrations of sodium hypochlorite on the endodontic microorganisms Actinomyces
israelii, A. naeslundii, Candida albicans and Enterococcus faecalis. Int
Endod J 2004;37:438–46.
9. Vianna ME, Gomes BP, Berber VB, et al. In vitro evaluation of the antimicrobial
activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 2004;97:79–84.
10. Waltimo TM, Ørstavik D, Siren EK, et al. In vitro susceptibility of Candida albicans
to four disinfectants and their combinations. Int Endod J 1999;32:421–9.