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Canal irrigation during root canal treatment is an important component of chemo-mechanical debridement of the root canal system. Traditional syringe irrigation can be enhanced by activating the irrigant to provide superior cleaning properties. This activation can be achieved by simple modifications in current technique or by contemporary automated devices. Novel techniques are also being developed, such as the Self-adjusting File (Re-Dent-Nova, Ra'anana, Israel), Ozone (Healozone, Dental Ozone, London, UK), Photo-activated Disinfection and Ultraviolet Light Disinfection.
This paper reviews the techniques available to enhance traditional syringe irrigation, contemporary irrigation devices and novel techniques, citing their evidence base, advantages and disadvantages.
Clinical Relevance: Recent advances in irrigation techniques and canal disinfection and debridement are relevant to practitioners carrying out root canal treatment.
Article
Endodontic treatment encompasses a range of procedures for the prevention or treatment of apical periodontitis. These include treatments to maintain the health of the vital pulp, and to treat teeth of which the pulps are irreversibly damaged or necrotic, with the aim of retaining functional tooth units. This ultimately presents clinicians with the challenge of negotiating, disinfecting, debriding and filling anatomy that is complex and infected with a plethora of micro-organisms and that may be inaccessible to conventional instruments.
There are many challenges involved with achieving disinfection of the root canal system. Root canal anatomy is highly varied and often presents with many difficulties in terms of allowing access to the whole canal system. A recent study1 investigated the effect of anatomical factors on working length accessibility and found, unsurprisingly, that complex anatomy such as canal curvature and calcification significantly increased the difficulty of achieving working length. Other variations include multiple and lateral canals, apical deltas and variations in the transverse plane such as C-canals. Peters et al2 showed that mechanical instrumentation left between 36% and 57% of the canal surface uninstrumented which may, of course, harbour pathogenic organisms.
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