This presentation gives you about the different techniques and properties about the irrigation in endodontics.

1. Irrigation in
RCT
Thilanka Umesh
Sugathadasa(D/10/64)

2. 1
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Definition
Medicaments left in the canal to
exerts there effect over short period
of time.
Ideal Requirements
1. Should have broad spectrum
antimicrobial property.
2. Aid in the debridement of the
root canal system.
3. Low toxicity level., Low cost.
4. Ease of using.
5. Ease of storage. Availability
6. Ability to dissolve necrotic
tissue or debris.
7. Good lubricants.
8. Inactivate endotoxin.
9. Prevent or dissolve smear
layer.
Functions of the irrigants.
1. Remove dentinal shavings by
physical flushing.
2. Increase the efficiency of
instrumentation.
3. Dissolve necrotic tissues.
4. Remove debris from lateral &
accessary canals.
5. Bleaching action.
6. Opening of dentinal tubules by
removal of the smear layer.
7. Lubricating agents further
increase the efficiency.[good
wettability].
Factors that modify activity of
the intracanal irrigating
solutions.
Some modification factors such as
host resistance, bacterial virulence,
microbial susceptibility, is beyond
our control.
Factors which can be controlled
1. Concentration - Tissue
dissolving ability of the sodium
hypochlorite is greater at the
concentration of 5.2% other
than the 2.5%/0.5%. But
higher concentrations are more
cytotoxic.
2. Contact - The agent should
contact with the substrate
otherwise the action will not be
activated. So the canal should
be mechanically enlarged.
3. Surface tension of the irrigants
– Lower surface tension is
having better wettability.
4. Temperature(Irrigants) - with
temperature increase in a
range increase efficiency of
irrigants.
5. Presence of organic tissues – So
organic tissues should be
removed mechanically or
chemomechanically by
simultaneous use of irrigants &

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the instruments. Otherwise
form a coagulated barrier.
6. Quantity of irrigants use –
Increase ability of debride.
7. Frequency of irrigation – more
irrigation cause better
debridement of tissues.
8. Canal diameter – Wider the
canal debridement become
effective.
9. Agitation
Main choices of irrigation
solutions
Sodium Hypochlorite (NaOCl)
Presence of 5% free chlorine In
sodium hypochlorite is responsible for
the breakdown of protein in to the
amino group. The pH of the commonly
used sodium Hypochlorite is 12, at
which the OCl-
form exist. So due to it’s
high alkaline value necrotic tissues
dissolve.
Increase efficacy
Contact time.
Heat
Volume of NaOCl (syringe type)
Ultrasonic activation.
Precautions to be taken
5.25% NaOCl can cause serious
damages If inject periapically.
 It causes excruciating pain.
 Perapical bleeding & swelling
 Tissue destruction
Analgesics, Antibiotics,
Antihistamines should prescribe
accordingly.
Advantages
1. Easily available
2. Economical
3. Tissue dissolution easily occurs.
4. Causes lubrication of canals.
5. It’s having antibacterial effect
6. Bleaching action present.
Disadvantages
1. It is having bad odor & the taste.
2. It’s corrosive to the instruments.
3. It can bleach the clothes if split
4. Vapors of the NaOCl can irritate
to the eye.
5. Because of it’s high surface
tension. Wettability of the
solution has decreased.
6. Irritant to the tissues if it
extruded periapically.
7. If comes contact it can lead to
inflammation.(if contacts with

4. 3
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the larynx causes difficulty of
speaking).
Decrease efficacy of NaOCl
Storage time
Chemical agents like EDTA.
Normal saline
Advantages
1. Biocompatible in nature.
2. No adverse reaction even if
extruded periapically (Because
osmotic pressure of the normal
saline is same as that of the
blood)
Disadvantages
1. No tissue dissolution &
disinfection properties.
2. Cannot very effectively clear
areas such as accessory
canals.
3. No bleaching action.
4. No antimicrobial property.
5. Do not remove the smear
layer.
Chlorhexidine
Most stable form is Chlorhexidine
gluconate. Potent antiseptic. 2% use as
a irrigant. Then 0.2% use as a mouth
wash. Here the cationic molecules
present in the chlorhexidine adsorb
with the negatively charged inner cell
membrane of the microbes & causes
leakage of intracellular components.
Additionally it causes the effect of
substantivity. Both 2% & 0.2%
chlorhexidine can cause residual
antimicrobial activity for 72 hours.
Advantages
1. Use as a plaque controller in
lower conc & higher conc as
irrigant.
2. More effective on gram +ve
bacteria than gram –ve
bacteria.

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Disadvantages
1. It’s not considered as a main
irrigant in standard
endodontic therapy.
2. Unable to dissolve the
necrotic tissue remnants.
3. Less effective on gram –ves.
Smear plugs can be seen in
dentinal tubules
Other Agents
 H2O2
 Urea Peroxide
Chelating Agents
After canal instrumented an organic
layer remains which covers the
dentinal tubules. Even though the
NaOCl is the ideal irrigation solution.
But it does not possess chelating
properties. So chelating agents are
 EDTA
 Citric Acid
 Polyacrylic Acid
EDTA
Functions
 Lubrication
 Emulsification
 Holding debris in suspension
 Smear layer removal
MOA
 It inhibit the growth of bacteria
& ultimately destroy them by
starvation. Because EDTA chelate
with the metallic ions in medium
which are needed for
microorganisms.
 EDTA has self-limiting action. It
form stable bond with calcium &
dissolve dentin

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Different forms of EDTA
 R-EDTA : combine with
cetrimide. It helps better
cleaning of canals.
 EDTAT : combine with the
taxapon. Here decreasing the
surface tension.
 EDTA-C: Enhance the cleaning
efficacy.
Can be applied in liquid or paste
form, A viscous suspension of cheater
promote the emulsification of organic
debris & facilitate the negotiation of
canal.
Smear layer has removed (NaOCl & EDTA)
Ultrasonic irrigation
Better than the conventional method.
Advantages
1. Clean bitterly
2. Remove smear layer
efficiently
3. It dislodges the debris from
canal better due to acoustic
effect
Disadvantages
1. Unpredictable
2. Excessive cutting of canal wall
& may damage to the finished
preparation.
Method of Irrigation
 The solution must be
introduced slowly & passively
in to the root canal.
 Needle should not be wedge in
to the canal & should allow
adequate back flow.
 Blunted needles 25/27 guage is
preferred.
 In case of small canals, Deposit
the solution in pulp chamber &
then file carry solutions in to
the canals
 Canal size & shape are crucial
for irrigation of the canals.For
effective cleaning of the apical
area, the canals must be
enlarge to size 30 or larger size.
 Irrigants should not forcibly
inserted.
 Tip of the needle should be
introduced until resistence if
felt. Then withdraw needle 2-3

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mm away from that point &
irrigate passively.
Plastic syringe for irrigation (Guage-25/27-
Standard/30/31)
Irrigating systems
 Strpko irrigator
 27 guage needle with notched
tip
 Needle with bevel
 Pro rinse probe
 Ultrasonic hand piece
Vibringe irrigator which create vibrations
during irrigation
30o angle bent giving efficient
irrigation.
Ideal properties of the
Irrigation needle
 Needle should be blunt
 It should allow back flow.
 It should be flexible.
 Longer in length
 Easily available
 Cost-effective
Flexible Needles

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Different type of needle designs.
Placing rubber stoppers to prevent the
extrusion of irrigant beyond apex.
Bending of the irrigation needle.

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A B C
Giving greater control of irrigant
delivery.
A- Beveled needle- Irrigant forced
apically. There is a risk of become
extrusion if the needle become
lodge in the canal
B- Mono jet tip- Irrigants can pass
sideways.
C- Safe ended tip- Irrigant can pass
side ways
Ultrasonic Irrigation devise.

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