Irrigation And Intracanal Medicaments Question And Answers

Irrigation And Intracanal Medicaments Important Notes

• Sodium hypochlorite
  • It acts as
    • Lubricant during instrumentation in root canal
    • Solvent for dissolution of pulp
    • Antiseptic and disinfectant by combining both protoplasm of bacterial cell and destroying it
    • Bleaching agent by releasing nascent oxygen
  • It is used in concentration varying from 0.5-75%
  • Very Potent antimicrobial agent
  • Effectively dissolves pulpal remnants
  • Disadvantages
    • Inability to remove smear layer
    • Unpleasant taste
    • Toxicity
• Advantages of alternate use of sodium hypochlorite and hydrogen peroxide in root canal preparation
  • Effervescent reaction which pushes debris out of the canal
  • Solvent action of sodium hypochlorite on the organic debris of pulp tissue
  • Disinfecting and bleaching action of both solutions

Irrigation And Intracanal Medicaments Long Essays

Intracanal Medicaments In Endodontics

Question 1. What are various root canal irrigants? Write in detail requirements and techniques of irrigation.
Answer.

Irrigant:

Irrigant is a liquid used to lubricate the canal walls and flush out the debris and micro-organisms from the root canals

Irrigant Types:

Chemically Non-Active

• Water:
  • Saline
  • LA
• Chemically Active [ACDE]:
  • Alkali – Sodium Hypochlorite
  • Acids – HCl
  • Antibacterial agents – Chlorhexidine
  • Chelating agents – EDTA
  • Detergents – Sodium lauryl sulfate
  • Enzymes – Streptokinase
  • Oxidizing agents – Hydrogen peroxide
    Requirements:
    • Should have antimicrobial activity
    • Should be non-toxic and biocompatible
    • Should dissolve necrotic and vital pulp tissues
    • Should be tissue or debris solvent
    • Should serve as lubricant
    • Should have low surface tension
    • Should be non-reactive to periapical tissues
    • Should not be easily neutralized in the canal and should retain its effectiveness
    • It should be of moderate cost and ease to store

Read And Learn More: Endodontics Question and Answers

Irrigant Techniques:

Irrigant Techniques Manual

• Syringe Irrigation With Needles:
  • It involves dispensing an irrigant into the root canal using irrigation needles of varying gauges
  • Gauge 27-30
  • Depth of insertion 2-3mm from the working length
  • Design – blunt-ended size vented needle
• Brushes:
  • Bristles help in cleaning the uninstrumented recesses of the radicular pulp spaces
• Manual Dynamic Agitation:
  • In this, a well-fitted greater taper gutta-percha master cone is moved up and down the instrumented canal containing irrigant in short 2-3mm strokes

Irrigant Techniques Machnine Assisted

• Rotary brushes
  • Consist of micro brushes attached to rotary handpieces
• Continuous irrigation during instrumentation
  • It contains an irrigant delivery unit attached to the Quantec-E-irrigation system
• Sonic irrigation
  • involves sonic waves
• Ultrasonic irrigation
  • Operates at frequencies of 25-30kHz
• Pressure alternation devices
  • EndoVac
  • RinsEndo

Question 2. Enumerate the various root canal irrigants. What are the functions of irrigants? Write in detail on chlorhexidine and sodium hypochlorite as intracanal irrigants.
Answer.

Intracanal Medicaments In Endodontics

Irrigant: Irrigant is a liquid used to lubricate the canal walls and flush out the debris and micro-organisms from the root canals

Irrigant Types:

Irrigant Chemically Non-Active

• Water:
  • Saline
  • LA
• Chemically Active [ACDE]:
  • Alkali – Sodium Hypochlorite
  • Acids – HCl
  • Antibacterial agents – Chlorhexidine
  • Chelating agents – EDTA
  • Detergents – Sodium lauryl sulfate
  • Enzymes – Streptokinase
  • Oxidizing agents – Hydrogen peroxide

Functions Of Irrigant In Endodontics

• Remove dentinal shaving
• Germicidal
• Increase efficiency of instruments
• Dissolve necrotic tissue and remove it
• Bleaching action

Chlorhexidine:

• Chlorhexidine is biguanide
• Available as oral rinses
• Used in concentration 0.2-2%

Chlorhexidine Advantages:

• Longer antibacterial action
• Used with sodium hypochlorite
  • When chlorhexidine comes in contact with sodium hypochlorite there is the formation of parachloroaniline which is cytotoxic
  • It interferes with the seal of the root filling
  • Flushing with normal saline is a must
• Biocompatible

Chlorhexidine Disadvantages:

• Does not dissolve pulp tissue

Sodium Hypochlorite Solution

• It is a clear, pale, green-yellow liquid
• A strong odour of chlorine
• Easily miscible with water
• Decomposes by light

Sodium Hypochlorite Mechanism:

Factors Affecting Sodium Hypochlorite Mechanism Activity:

• Increases:
  • Volume of solution
  • Heating of solution
  • Time of contact
• Decreases:
  • Strong time
  • EDTA

Hypochlorite Mechanism Activity Advantages:

• Dissolve tissue
• Antibacterial and bleaching action
• Lubricate canal
• Economical

Hypochlorite Mechanism Activity Disadvantages:

• High surface tension
• Irritate tissue
• Irritate eyes
• Causes inflammation of the gingiva
• Bleaches clothes
• Bad odour and taste
• Corrosive to instruments

Intracanal Medicaments In Endodontics

Hypochlorite Mechanism Activity Combined With:

• Calcium hydroxide
• EDTA
• Chlorhexidine

Irrigation And Intracanal Medicaments Short Essays

Question 1. Irrigating Solution.
Answer.

Irrigating Solution Properties:

• Broad spectrum
• Inactive endotoxin
• Dissolve debris
• Debride the canal
• Good lubricant
• Less toxic
• Prevent/dissolve smear layer

Irrigating Solution Functions:

• Remove dentinal shaving
• Germicidal
• Increase efficiency of instruments
• Dissolve necrotic tissue and remove it
• Bleaching action

Irrigating Solution Commonly used:

• Chemically Non-Active:
  • Water:
  • Saline
  • LA
• Chemically active [ACDE]:
  • Alkali – Sodium Hypochlorite
  • Acids – HCl
  • Antibacterial agents – Chlorhexidine
  • Chelating agents – EDTA
  • Detergents – Sodium lauryl sulfate
  • Enzymes – Streptokinase
  • Oxidizing agents – Hydrogen peroxide

Question 2. Ideal requirements of intracanal medicaments. Describe in detail about medicaments.
Answer.

Intracanal Medicaments Functions:

• Destroy remaining bacteria
• Useful in treatment of apical periodontitis

Intracanal Medicaments Properties:

• Germicidal
• Non-irritant
• Stable
• Low surface tension
• Should not induce immune response
• Should not interfere with repair
• Should not stain tooth

Intracanal Medicaments Chemicals Used:

• Essential oils – Eugenol
• Phenolic compounds – Phenol, Aldehydes
• Calcium hydroxide
• Chlorhexidine gluconate
• Corrticosteroid antibiotic
• Antibiotic
• Halogens – Sodium hypochlorite, Iodine

Question 3. Calcium Hydroxide.
Answer.

Calcium Hydroxide

Intracanal medicament

Calcium Hydroxide Forms:

• Paste form
• Powder form

Calcium Hydroxide Indication:

• Weeping canal
• Treatment of Phoenix abscess
• Resorption
• Apexification
• Pulp capping
• Decrease post-operative pain
• As sealer
• For periapical lesion

Calcium Hydroxide Disadvantages:

• Difficult to remove
• Decreases setting time

Calcium Hydroxide Functions:

• Inhibits root resorption
• Stimulates periapical healing
• Encourage mineralization

Question 4. Composition and uses of mineral trioxide aggregate.
Answer.

Mineral Trioxide Aggregate Composition:

• Tricalcium silicate
• Tricalcium aluminium oxide
• Silicate oxide
• Bismuth oxide
• Calcium
• Phosphate
• Water

Mineral Trioxide Aggregate Uses:

• As root end filling material
• Used in Pulpotomy

Irrigation And Intracanal Medicaments Short Questions And Answers

Question 1. Hydrogen Peroxide.
Answer.

Hydrogen Peroxide

Hydrogen Peroxide is clear, odourless liquid

Hydrogen Peroxide Mechanism:

Use: As an irrigating solution

Combine with: 5.2% NaOCl

Question 2. Eugenol.
Answer.

Eugenol

Eugenol is an intracanal medicament

Eugenol Effects:

Eugenol Low Dose [Beneficial]:

• Inhibits PG synthesis
• Inhibits nerve activity
• Inhibits chemotaxis

Eugenol High Dose [Harmful]:

• Induces cell death
• Inhibits cell respiration

Eugenol Uses:

• Intracanal medicament
• Root canal sealer
• Temporary sealant

Question 3. RC Prep.
Answer.

RC Prep Composition:

• EDTA
• Urea peroxide
• Carbowax

RC Prep Properties:

• Lubricant
• Cleaning agent
• Antibacterial

RC Prep Uses:

• Allows deeper penetration of medicament into the dentin

Question 4. Ledermix.
Answer.

Ledermix Composition:

• Gluco corticosteroid
• Triamcinolone
• Dimethyl chlortetracycline

Ledermix Uses:

• Initial dressing agent
• Reduces incidence of pain
• Provide rapid relief
• Useful in cases of infection and inflammation

Question 5. PBSC.
Answer.

PBS

PBSC Route Of Administration:

PBSC Form-Paste Form:

• Injected into root canals
• Impregnated on paper points

Advance – Nystatin Replaces Caprylate

PBSC Disadvantage:

• The patient may have an allergy to penicillin

Question 6. Schilder’s Objectives for cleaning and shaping of Canal.
Answer.

Schilder’s Objectives For Cleaning And Shaping Of Cana

• Root canal preparation should develop continuously tapering cone
• Making preparations in multiple planes to introduce the concept of flow
• Making the canal narrower apically and wider coronally
• Avoid transportation of foramen
• Keep the apical opening as small as possible

Irrigation And Intracanal Medicaments Viva Voce

• EDTA is used at a concentration of 15%
• MTAD is a Mixture of Tetracycline, Acid [citric acid], and Detergent