CLEANING AND SHAPING PART II

(Irrigation and Intracanal Medicaments)

Ratih Widyasari, drg., SpKG. PRODI GIGI UNJANI

CLEANING AND SHAPING

INSTRUMENTS SHAPE, IRRIGANTS CLEAN

Properties of ideal irrigation solution:

Broad spectrum antimicrobial properties Aid in debridement of root canal system Ability to dissolve necrotic tissue or debris Low toxicity level Good lubricant Low surface tension to flow into an inaccessible area Ability to sterilize the canal Prevent/dissolve smear layer Inactivate endotoxins

Funtions of irrigants

Perform physical and biologic functions-remove dentin shavings by irrigation Increase the efficiency of instruments Dissolve necrotic tissues Remove debris from lateral and accessory canal Germicidal as well as antibacterial properties Irrigants with lubricating agent further increase the efficiency Bleaching action Opening of dentinal tubules by removing smear layers

NaOCL (sodium hypochloride)

Methods to increase efficacy

- Time of contact - Temperature - Specialized irrigation syringe - Ultrasonic activation (streaming effect)

Others irrigation solutions:

Urea Hidrogen peroxide Urea peroxide Chlorhexidine Chelating agent ---- EDTA Ruddle's solution MTAD

Composition,advantages and disadvantages!!!

Combination to increase efficacy

NaOCL + Chlorhexidine NaOCL + EDTA Calcium Hydroxide + NaOCL

INTRACANAL MEDICAMENTS

FUNCTIONS:

- Destroy the remaining bacteria and also limits the growth of new arrivals - Useful in treatments of apical periodontitis for example inflammation due to over instrumentation or irrigation extruding apical (flare-ups)

A root canal disinfectants (medicaments) should have the following properties:

Effective germicide and fungicide Non irritating to pulpal tissue Remain stable in the solution Prolonged antimicrobial action Remain active in presence of blood, pus, etc Have low surface tension Not interfere repairing of periapical tissue proccess Non staining Capable of inactivation in culture media Not induce immune response

CALCIUM HYDROXIDE
High pH : - effective in weeping canal - triggers mild inflamation to start tissue repair (calcifying actions) Hydrolyses the lipid part of bacterial lipopolysaccharide (LPS) Prolonged effectiveness

Others medicaments: compositions, advantages, disadvantages and uses!!!