• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.180-187
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• 2011

Introduction: Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. Review: The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser Conclusion: Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.390-396
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• 2009

The aim of this study was to evaluate endodontic irrigation methods with $EndoVac^{(R)}$ and $EndoActivator^{(R)}$ in the elimination of Enterococcus faecalis from the root canals. Extracted 70 human single-rooted teeth were used. The canals were instrumented by a crown-down technique with .04 taper ProFile to ISO size 40. After the teeth were autoclaved, the canals were inoculated with E. faecalis and incubated for 48 h. The teeth were randomly divided into three experimental groups of 20 teeth each according to canal irrigation methods and two control groups as follows: group 1 - $EndoVac^{(R)}$; group 2 - $EndoActivator^{(R)}$; group 3-Conventional needle irrigation method. After canal irrigation using 2.5% NaOCl. first samples (S1) were taken using sterile paper point. And the canals were filled with sterile brain heart infusion (BHI) broth and incubated for 24 h, then second samples (S2) were taken. The samples were cultured on BHI agar plate to determine the numbers of colony forming units (CFU). In first sampling (S1), only one canal of conventional method among the all experimental groups was positive cultured. In second sampling (S2), $EndoVac^{(R)}$ group showed the least positive culture numbers of E. faecalis. There was statistically significant difference between the $EndoVac^{(R)}$ and conventional needle irrigation methods in the mean value of Log CFU. According to the results of this study, $EndoVac^{(R)}$ showed better efficacy than conventional needle irrigation method in the elimination of E. faecalis from the root canal.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.467-472
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• 2016

Successful root canal treatment can be obtained by the removal of microorganisms from the pulpal space of the root canal system through biomechanical technique with instruments and irrigation. Due to the difference in the dimension of the pulpal structure such as thin wall of the root, large portion of chamber, the primary teeth should be considered in a different way of approach. Traditionally, fluids have been dispensed passively into the root canals for improve the cleansing. The use of sodium hypochlorite as an irrigant in root canal treatment is widespread and common, because it meets requirements for the ideal irrigants.

• Korean Journal of Dental Materials
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• v.45 no.4
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• pp.275-286
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• 2018

The purpose of this study was to evaluate the effect of needle tip design and position, and irrigant flow rate on apical pressure (AP) during root canal irrigation. Five human mandibular premolars were instrumented up to #35 (0.06 taper) using nickel-titanium rotary instruments. Three different needles according to change of needle tip design (notched, side-vented, and flat) were positioned at the point of 1, 3, and 5 mm from the apical constriction (needle tip position). For each needle tip design and position, APs were measured with varying flow rates of 0.05, 0.1, 0.2, and 0.3 ml/s. When the other conditions were controlled, AP increased with decreasing needle tip position or increasing irrigant flow rate (p<0.05). The AP of flat needle was the highest, followed by notched, side-vented needle for the same needle tip position and irrigant flow rate. The APs at needle tip position of 1 mm or with more than 0.1 ml/s flow rate were higher than central venous pressure (5.88 mmHg) for all conditions. Flat needle was not recommended for clinical use due to sharp increase of AP with changing needle tip position and irrigant flow rate. For safe and effective root canal irrigation, irrigant should be applied with the needle tip position of 3 mm and flow rate of less than 0.05 ml/s.

• Restorative Dentistry and Endodontics
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• v.34 no.3
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• pp.215-222
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• 2009

The aim of this in vitro study was to evaluate the cleaning efficacy of various irrigation methods in the mandibular mesial roots. The forty five mesial root canals were shaped by Profile .06 instruments to apical size #30 and irrigated with 5ml of 3.5% NaOCl. The teeth were divided into 3 groups and irrigated finally for 1 minute; Group 1: syringe irrigation. Group 2: ultrasonic irrigation. Group 3: RinsEndo irrigation. After histological processing, the cross sections of apical 1, 3, and 5 mm level were examined with an optical microscope. The cleanliness values of canals and isthmuses were calculated and analyzed by Mann-Whitney U test. 1. There were no significant differences in both canal and isthmus cleanliness between syringe irrigation and ultrasonic irrigation except 5 mm level of isthmus. 2. RinsEndo irrigation had significantly higher canal cleanliness values than syringe irrigation at 1 mm and 3 mm levels (p<0.05). Also, RinsEndo irrigation had significantly higher isthmus cleanliness values than syringe irrigation at all levels evaluated (p<0.05). 3. There were no statistical differences in both canal and isthmus cleanliness between ultrasonic irrigation and RinsEndo irrigation except 3 mm level of canal. From this study, RinsEndo irrigation can be useful as an additional irrigation procedure.

• Restorative Dentistry and Endodontics
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• v.33 no.2
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• pp.98-106
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• 2008

The purpose of this study was to evaluate whether intracanal irrigation method could affect the adhesion between intracanal dentin and root canal filling materials (Gutta-percha/AH 26 sealer and Resilon/Epiphany sealer). Thirty extracted human incisor teeth were prepared. Canals were irrigated with three different irrigation methods as a final rinse and obturated with two different canal filling materials (G groups: Gutta-percha/AH 26 sealer, R groups: Resilon/Epiphany sealer) respectively. Group G1, R1-irrigated with 5.25% NaOCl Group G2, R2-irrigated with 5.25% NaOCl, sterile saline Group G3, R3-irrigated with 5.25% NaOCl, 17% EDTA, sterile saline Thirty obturated roots were horizontally sliced and push-out bond strength test was performed in the universal testing machine. After test, the failure patterns of the specimens were observed using Image-analyzing microscope. The results were as follows. 1. Gutta-percha/AH 26 sealer groups had significantly higher push-out bond strength compared with the Resilon/Epiphany sealer groups (p < 0.05). 2. Push-out bond strength was higher when using 17% EDTA followed by sterile saline than using NaOCl as a final irrigation solution in the Resilon/Epiphany sealer groups (p < 0.05). 3. In the failure pattern analysis, there was no cohesive failure in Group G1, G2, and R1. Gutta-percha/AH 26 sealer groups appeared to exhibit predominantly adhesive and mixed failure patterns, whereas Resilon/Epiphany sealer groups exhibited mixed failures with the cohesive failure occurred within the Resilon substrate.

• The Journal of the Korean dental association
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• v.28 no.2 s.249
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• pp.181-192
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• 1990

• Restorative Dentistry and Endodontics
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• v.33 no.4
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• pp.397-404
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• 2008

The purpose of this study was to evaluate the effects of MTAD, EDTA and sodium hypochlorite(NaOCl) as final irrigants on coronal leakage resistance to Enterococcus faecalis. Forty extracted human maxillary molars were used in this experiment. The teeth were randomly divided into positive control group (Group 1; n = 5), negative control group (Group 2; n = 5) and three experimental groups (n = 30). In Group 3 (n = 10), the root canals were irrigated with sodium hypochlorite. In Group 4 (n = 10) and 5 (n = 10), the root canals were irrigated with sodium hypochlorite and rinsed with EDTA and MTAD, respectively. The teeth in each group were cleaned and shaped to #40 profile with .04 taper, and obturated with gutta-percha and AH-26 root canal sealer. The coronal portion of each tooth was placed in contact with inoculum of Enterococcus faecalis in Brain Heart Infusion (BHI) culture media. Each root tip was placed in a vial containing sterile culture media. The vials were placed in anaerobic chamber and observed everyday for turbidity for 180 days. Statistical analysis was performed using Fisher's Exact Test. After 180 days, Group 3, 4, and 5 showed 7, 4 and 5 leaking samples respectively. The differences in leakage resistance were not statistically significant among Group 3, 4 and 5.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.186-191
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• 2012

The sodium hypochlorite is widely used in endodontic treatment. While it is effective solution for disinfection of root canal system, complications during canal irrigation are rarely reported, especially in primary teeth. This report demonstrates that sodium hypochlorite extruding through the root apex might cause severe complications. A 4-year-old female patient was referred from local dental clinic to the emergency room for the management of sudden facial swelling and pain during re-endodontic treatment of the maxillary primary central incisor using sodium hypochlorite. The patient was given systemic steroids, antihistamines, antibiotics and analgesics and the maxillary primary central incisor was extracted to prevent secondary infection. Swelling began to subside after 2 days. A negative result was obtained from skin patch test with sodium hypochlorite. Thorough care must be taken in primary teeth to prevent the inadvertent injection of sodium hypochlorite to periapical tissues during root canal irrigation. When adverse reaction occurs, proper management such as analgesia, cold compression and adequate medication should be done.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.399-407
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• 1999

Apical extrusion of canal debris is occurred inadvertently during root canal preparation and this could produce interappointment discomfort or postinstrumentation pain. The purpose of this study was to investigate the influence of canal preparation methods on the apical extrusion of canal debris by means of comparing the amounts of apically extruded debris with several kinds of instrumentation methods. In the first experiment, 40 incisors were divided into four groups of 10 each. They were instrumented using one of the four techniques: Step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation with Quantec series 2000, and Profile .04 taper series 29. Root canal irrigation was done with 2.52% sodium hypochlorite solution. In the second experiment, 80 incisors were divided into five groups of 16 each and instrumented using step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation such as Quantec SC, Quantec LX, and Profile .04 taper series 29 No irrigation procedure was performed in this second experiment. Extruded debris from each tooth was collected in a container and weighed by the use of an electronic balance after desiccation. With or without canal irrigation, step-back technique produced significantly more amount of apical debris than the other groups (p<0.05). However, there was no significant difference among crown-down pressureless technique, engine-driven instrumentation with Quantec LX, Quantec SC, or Profile. Therefore, either by hand or engine-driven instrumentation, it is concluded that to minimize apical debris, techniques using reaming motion of files should be applied rather than filing motion.