Activation of Alkaline Irrigation Fluids in Endodontics

Abstract

In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled.

Evaluation of antimicrobial Effectiveness of EndoVac and Laser for treatment of infected permanent root Canals

“…So in order to simulate the resistant biofilm conditions, in the present study E. faecalis biofilm was formed by incubating the colonies for 3 weeks at 37°C and in order to ensure the viability of the bacteria, fresh broth was added every alternate day so that no bacteria died of starvation. An important concept that has emerged over recent years was used in this study, which is the use of active physical methods for agitating the irrigating solution to improve its penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of this alkaline fluid against planktonic microorganisms, biofilms, and soft tissue remnants and smear layers (18) . Among various lasers available, Nd: YAG laser is probably one of the most effective lasers for disinfection of root canal infected with E. faecalis (19) .…”

COMPARATIVE EVALUATION OF SMEAR LAYER REMOVAL USING EDTA, PASSIVE ULTRASONIC IRRIGATION & DIODE LASER: A SCANNING ELECTRON MICROSCOPIC STUDY.

“…By using ultrasonic the temperature of the irrigants increased causing reduced surface tension along with increased vibrational energy. [9] The conventional needle irrigation technique does not provide complete cleaning of the root canal system. The effectiveness and safety of irrigation depends on the means of delivery.…”

Novel Approaches to Detect and Treat Biofilms within the Root Canals of Teeth: A Review

“…To address such issues, novel laser protocols and optical fiber tips have been developed to enhance cavitation and the movement of irrigation fluids in the root canal system. These remove debris as well as organic residues created by instruments (termed the smear layer) [46,47]. This enhanced removal effect occurs because of greater physical contact of the irrigant solution with the biofilm on the root canal walls, as well as a mild elevation in the temperature of the irrigant solution.…”