Root Canal Irrigation Trends When Using Sodium Hypochlorite : A Nationwide Survey Amongst Indian Dentists (original) (raw)
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International Endodontic Journal, 2019
AimTo test the hypothesis that in the daily routine of a specialist clinic in endodontics that irrigation during root canal preparation with 3.0% NaOCl will result in fewer postoperative samples with cultivable bacteria than irrigation with 0.5% buffered NaOCl but, at the same time, will not result in a higher frequency of postoperative pain nor swelling.MethodologyTwo hundred ninety‐eight patients were enrolled in the study and were randomly assigned into two groups – 0.5% NaOCl and 3% NaOCl. All endodontic diagnoses were included. Root canal treatment was performed, and bacterial sampling was carried out prior to root filling. The patients were requested to complete a form regarding pain and swelling seven days postoperatively. Fisher’s exact test, Mann–Whitney U‐test, Mantel–Haenszel chi‐squared and the chi‐squared test with a significance level of P < 0.05 were used for statistical analysis. Multivariable logistic regression was used to adjust for confounders.ResultsIn the 0....
ABSTRACT: Sodium hypochlorite (NaOCl), a reducing agent, is a clear, straw coloured solution containing about 5% available chlorine. It is the most widely used irrigating solution. NaOCl on ionization produces hypochlorous acid and hypochlorite ion. These are responsible for the antimcrobial ability of the same. No unanimity of opinion exists as to which concentration of NaOCl can be used in root canal therapy. On the basis of published data, 0.5- 5.2% solution is an effective concentration for the use as an irrigant in the root canal. If the canal is filled with the solution during the entire cleaning and shaping procedures, the irrigant will act as an lubricant, solvent to the pulpal tissues and a potent antimicrobial of a no. of solution studied , none was more effective than 5.2% solution of NaOCl. However 2.5% concentration of the same is commonly employed as it decreases the potential for toxicity while maintaining some tissues dissolving and antimicrobial activity. The following article deals with the various accidents caused by misuse of sodium hypochlorite and their management. KEY WORDS: Accident, irrigation, sodium hypochlorite(NaOCI), prevention. | Dr VINEET VINAYAK | dr VINEET vinayak
Current Trends in Root Canal Irrigation
Cureus
Chemical and mechanical root canal debridement are the primary methods used in endodontic therapy to remove all dead tissue, bacteria, and microbial byproducts from the canal. Sodium hypochlorite, a powerful organic tissue dissolver with a broad spectrum of antibacterial properties, is an excellent choice for disinfecting surfaces. Chelating agents, on the other hand, may be used to remove the inorganic components found on the smear layer. This irrigation method is capable of removing the smear layer; however, it is less effective in the apical third. While using irrigant activation devices, irrigating solutions need to be in direct contact with the whole root canal wall surfaces, especially in the apical portions of tiny root canals. The role of irrigants is extremely important because they help not only to clean the canal but also to allow the seepage of the medicaments into the canal system. Thus, the canal needs to be healthy before the obturation procedure. Nowadays, many irrigants have been studied and hence compilation of the various available sources and their effect has to be studied both in vivo and in vitro. The correlation between the irrigants and the canal cleanliness is of utmost importance, as the success of endodontic root canal treatment depends on its proper activation and characteristics. Hence, this review incorporates the current use of various irrigating solutions and their advantages and disadvantages. In the future, endodontists may employ the novel irrigants and irrigant activation devices that were discovered in this study.
Background: One of the main purposes of root canal treatment is the complete debridement of root canals. Regardless of the instrumentation technique used 35% or more of the root canal surfaces have been observed to remain uninstrumented. To remove debris and address these uninstrumented surfaces, it is necessary to copiously irrigate the root canal. Many adjuncts have also been developed and being used in an effort to improve the delivery and effectiveness of these irrigants. Although much research have been conducted on different root canal treatment regime and irrigants used in dentistry, only a little data can be found on the widespread practice or acceptance of such methods. Aims and Objectives: The purpose of this survey was therefore to ascertain the current trends in the use of root canal irrigants and irrigation protocol followed by Endodontists and Postgraduate students across Central India (Madhya Pradesh). Material and Methods: A questionnaire-based survey was conducted and participants were asked to fill in responses to some questions regarding their preferences for root canal irrigation like irrigant selection, irrigant concentration, technique used for delivery and activation of irrigants, etc. Results: The majority of the respondents considered both irrigations as well as instrumentation to be of equal importance. Also, the majority of respondents prefer full-strength sodium hypochlorite (5.25%) while only a few have been found to use its lower concentration (3%). Conclusion: It is essential for future prospects to get an awareness of the properties and actions of irrigants and incorporate them into practice for executing a successful endodontic treatment.
Evidence-Based Complementary and Alternative Medicine
During endodontic treatment, eliminating microorganisms from the root canals should be considered with utmost importance. Before filling the canal, every effort should be made to ensure optimal shaping and adequate disinfection of the root canal system. This systematic review aimed to compare the efficacy of herbal agents with sodium hypochlorite (NaOCl) in reducing the microbial load while used as a root canal irrigant. The research question in the present study was to assess “Is there a significant difference in reducing microbial load comparing sodium hypochlorite (NaOCl) and herbal agents.” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to November 2020 using strict inclusion and exclusion criteria and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Only in vitro studies comparing herbal agents with NaOCl regarding antimicrobial efficiency were included. Two reviewers indep...
Endodontic Irrigation Solutions: A Review
International Dental Research, 2017
The goal of endodontic treatment is to remove all the vital and necrotic tissues, microorganisms and microbial byproducts from root canal system. This goal can be achieved through chemical and mechanical debridement of root canals. This article narrates the specifics and requirements of the irrigation solutions. Sodium hypochlorite is proposed as the primary irrigant by virtue of its organic tissue dissolution capacity and broad antimicrobial properties. On the other hand, chelation solutions are recommended as auxiliary solutions to remove the smear layer or to hinder its formation on dentin surface. Thus, it's hoped that sealers and root canal fillers can penetrate to dentin tubules and obturate the canals hermetically. There are new studies on traditional irrigants especially on some irrigants that can replace sodium hypoclorite. This article reviews the new irrigants which can be used in future endodontic practice, and their advantages and limitations. Moreover, actions and ...
A Review on Root Canal Irrigation Solutions in Endodontics
2021
Introduction: This paper aims to review the different characteristics of root canal irrigants including sodium hypochlorite (NaOCl), chlorhexidine (CHX), hydrogen peroxide (H2O2), iodine potassium iodide (IKI), antibiotic-based irrigants, photo-activated disinfection, electrochemically activated water, and QMix. The literature on root canal irrigation solutions in the context of endodontics up to June 2020 was reviewed using PubMed and MEDLINE. NaOCl was identified as the most likely effective irrigation solution that could be used for endodontics. Its antimicrobial activity is at least comparable or even greater than that of other common irrigants. Tetraclean was also proposed to be more effective than CHX against endodontic microorganisms. In addition, Hypoclean was suggested as the most potent and effective irrigant against Candida albicans. Similarly, IKI was introduced as a successful irrigant in killing Candida albicans and Enterococcus faecalis. MTAD is also known to be effec...
In Vivo Antimicrobial Effect Of 5.25% Sodium Hypochlorite In Root Canals Treatment In Duhok City
The Internet Journal of Microbiology, 2019
Aim: This study aims to evaluate the bacterial reduction after conventional root canal treatment using 5.25% sodium hypochlorite. Materials and Methods: The study criteria included 100 patients requiring root canal treatments due to pulpitis. The diagnosis was made based on objective clinical signs (examination, probing, percussion, palpation) and X-ray investigation. The clinical procedures were carried out under strict aseptic precautions. All patients were subjected to biomechanical preparation followed by irrigation using sodium hypochlorite at a concentration of 5.25% which is considered the highest concentration without causing any toxic effect on the patient. All microbiological samples were taken immediately after the access preparation baseline (S1) and after the completion of the root canal instrumentation and disinfection with 5.25% sodium hypochlorite (S2) and sent for microbiological analysis. Results: One hundred patients with infected root canal were selected for this in vivo study. All S1 samples were positive for microbial isolates, 71 samples harbored cultivable bacterial isolates, 22 were fungus (Candida albican), and 7 samples showed no growth so in total adding up to 151 isolates identified from 100 patients. Bacterial isolates before chemomechanical treatment showed the highest prevalence belonging to Enterococcus faecalis followed by Streptococci, Staphylococci and Candida albican. After the chemomechanical treatment with 5.25% of sodium hypochlorite no cultivable bacteria were isolated from 38 patients root canals, and therefore the treatment managed to eradicate 54% of the 151 isolated bacterial species from the 71 infected root canals. Conclusion: The antimicrobial effect of 5.25% sodium hypochlorite was effective in eradicating a high number of the bacterial isolates along with the fungus identified in infected root canals. This high concentration of sodium hypochlorite presented no toxic damage to the root canal or the area around it when handled with care.
The Internet journal of microbiology, 2019
Aim: This study aims to evaluate the bacterial reduction after conventional root canal treatment using 5.25% sodium hypochlorite. Materials and Methods: The study criteria included 100 patients requiring root canal treatments due to pulpitis. The diagnosis was made based on objective clinical signs (examination, probing, percussion, palpation) and X-ray investigation. The clinical procedures were carried out under strict aseptic precautions. All patients were subjected to biomechanical preparation followed by irrigation using sodium hypochlorite at a concentration of 5.25% which is considered the highest concentration without causing any toxic effect on the patient. All microbiological samples were taken immediately after the access preparation baseline (S1) and after the completion of the root canal instrumentation and disinfection with 5.25% sodium hypochlorite (S2) and sent for microbiological analysis. Results: One hundred patients with infected root canal were selected for this...
IOSR Journal of Dental and Medical Sciences
Aim: The aim of this study is to compare the effect of different intermediate irrigant in removing residual sodium hypochlorite before irrigating with chlorhexidine by elemental analysis of precipitate formed by the residual sodium hypochlorite using Environmental Scanning Electron Microscopic Energy Dispersive X-Ray Spectroscopy (ESEM-EDS) system. Methodology: Forty extracted single rooted premolars were decoronated and divided into four groups GROUP I (positive control): The irrigation of the canal was done in the sequence 5 ml of 17% EDTA 5 ml of 5% NaOCl 5 ml of 2% chlorhexidine (CHX). GROUP II (70% isopropyl alcohol): The irrigation of the canal was done with 5 ml of 17% EDTA 5 ml of 5% NaOCl, 5 ml of 70% isopropyl alcohol as intermediate irrigant 5 ml of 2% CHX. GROUP III (distilled water): The irrigation of the canal was done with 5 ml of 17% EDTA 5 ml of 5% NaOCl, 5 ml of distilled water as intermediate irrigant 5 ml of 2% CHX. GROUP IV (normal saline). The irrigation of the canal was done with 5 ml of 17% EDTA 5 ml of 5% NaOCl, 5 ml of 0.9% normal saline as intermediate irrigant 5 ml of 2% CHX. Using a chisel and mallet, the roots were split longitudinally. One half of the split tooth was selected for the examination of smear layer under SEM. Five samples from the remaining ten halves of each group was taken for ESEM-EDX examination Results: The deposition of the precipitate layer was scored according to the criteria for evaluating smear layer given by Gutmann et al. Kruskal Wallis ANOVA was employed to compare precipitate scores between different groups and teeth levels. There is no statistically significant difference (P>0.05) between the three levels of the Group I. There is a highly significant difference (P<0.001) between the three levels of the teeth of Group II (Isopropyl alcohol group). There is a significant difference (P<0.05) between the levels of the teeth of Group III (Distilled water) and Group IV (Normal saline). There is highly statistically significant difference (P<0.001) in the scores between the irrigants in the coronal and middle third of the root canals. There is a significant difference in between the groups in the apical third (P<0.05). The elements present in the root canal wall of each group recorded and subjected to Analysis of variance (One Way ANOVA) was performed as parametric test to compare different groups as well as different teeth sites. For all statistical evaluations, a two-tailed probability of value, P< 0.05 was considered significant. Conclusion: Isopropyl alcohol removed more residual sodium hypochlorite from the root canal leaving minimum precipitate occluding the dentinal tubules. Elemental analysis of the precipitate showed presence of chlorine. In coronal and middle third contains more chlorine than apical thirds. Isopropyl alcohol removed more chlorine from the root canal.