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Optimal Irrigation Protocol: Characteristics of An Ideal Irrigant

The document discusses the ideal properties and protocol for irrigating root canals during endodontic procedures. An ideal irrigant should disinfect, dissolve tissues, maintain moisture, and remove debris without harming tissues. The proposed protocol recommends copiously irrigating with sodium hypochlorite and alternating it with EDTA or citric acid to further clean the canals, using small-gauge needles and ultrasonic agitation to fully debride all areas.

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Daniel Vivas
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50 views2 pages

Optimal Irrigation Protocol: Characteristics of An Ideal Irrigant

The document discusses the ideal properties and protocol for irrigating root canals during endodontic procedures. An ideal irrigant should disinfect, dissolve tissues, maintain moisture, and remove debris without harming tissues. The proposed protocol recommends copiously irrigating with sodium hypochlorite and alternating it with EDTA or citric acid to further clean the canals, using small-gauge needles and ultrasonic agitation to fully debride all areas.

Uploaded by

Daniel Vivas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Optimal 

Irrigation Protocol 

Characteristics of an Ideal Irrigant 

The irrigant must create sustained copiously wet environment, act as a lubricant to prevents tissue compaction ie. 
File Eze, dissolve vital and necrotic tissues, organic and inorganic matter, be germicidal – antibacterial, possess a 
degree of bleaching ability, remove the smear layer, be non­irritating and not cytotoxic. 

Sodium Hypochlorite – (ChlorCid® and ChlorCid® V):  NaOCl is a 
proteolytic solution that effects organic dissolution.  Its concentration levels 
can vary from 1­ 5.25% and its pH is in the 
range of 12 to 13. There are those who 
recommend heating the solution to accelerate 
its chemical reactivity, however, given the 
volumes involved this is of questionable 
effectiveness. It is most important that the 
solution be kept in a light resistant container and that it not be left exposed to 
air as this will inactivate it. Residual solution should be discarded after 
treatment and fresh solution used for each new case. 

EDTA ­ File­Eze is a 19% EDTA, water soluble, viscous solution for 
chelating, lubricating, and debriding root canal preparations. It is used 
preferably at the outset of treatment, particularly in vital cases to prevent 
tissue compaction.  After the bulk of residual tissue is removed, it is 
advisable to use Ultradent® EDTA 18% which removes the inorganic 
component of the smear layer and decalcifies up to 50µm and is self limiting. 

Instruments debride and shape a canal. Irrigants are designed to assist in debridement and disinfection of the canal 
space. There are always spaces in every canal that instruments cannot reach. Fins, webs and anastomoses are 
only going to be effectively reached through irrigation. 

Ideal Irrigation Protocol

· Irrigate copiously throughout with NaOCl
· Evacuate NaOCl after each instrument use and 
replenish constantly

1 
· Rotate liquid EDTA into canal in sequence
· Evacuate EDTA and introduce ethanol…….this acts as a surfactant to reduce the wetting angle of the 
NaOCl and facilitate greater degrees of canal penetration –
· All materials are delivered with Endo­Eze Irrigatior Tips 27 gauge 1.25 
sterile side venting needles
· It is advisable to use Ultradent Citric Acid 10% solution as well in the 
process…..this acts as a conditioner of the root canal dentin and while the 
studies are not as yet conclusive, may prove more effective than EDTA in 
removing the smear layer.
· Sonication ensures maximal particulate removal through the effect of 
acoustic streaming.
· All materials can be removed from the pulp chamber with a water spray from a Triplex syringe. It is highly 
recommended that a Sterilox generator be used to produce the 
electro­chemically activated water used through all dental unit water 
lines.
· Consepsis® can be used throughout the procedure but must not be 
brought into contact with resin coated gutta­percha as it will remove 
the resin layer………the cones can be soaked in the antimicrobial 
CHX before obturation.

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