IRRIGATION DEVICES IN ENDODONTIC
DONE BY DR.MARWA AHMED
IRRIGATION DEVICES IN ENDODONTIC
І- MANUAL
1.Syringe irrigation with needles/ cannulas(end/side vent)
2.BrushesA. Endobrush B.Navitip FX
3.Manual Dynamic Agitation(hand activated well fitting gutta percha)
ІІ- MACHINE ASSISTED
1.Rotary brushes A.Ruddlebrush B.Canal brush
2.Continuous irrigation during rotary instrumentatin(Quantec-E)
3.SonicA.Rispisonic file B.Endoactivator
4.Ultrasonic
5. Pressure alternating devicesA.EndoVacB.Rinse Endo
6. Recent advance systemA. Lasersb. Light activated disinfection (LAD)C. Electrochemically activated
water (ECA)D.Oxidative potential water
(OPW)
Different sizes (1-20 ml) Luer-Lok designModifications of tip of the needles
A) BivelledB) MonojectC) Safe ended (A) (B) (C )
І- MANUAL1.Syringe irrigation with needles/ cannulas(end/side vent)
Modifications of needles A) Bending the tip B) Flexiglide needle
(A) (B)
27-31 gauge recommended should not bind in the canal easily controlled
Advantages
not enough flushing action deliver solution only 1 mm deeper than the tip of the needle
Disadvantages
2.Brushes
B. NaviTip FX
A. Endobrush used only as an adjuncts Nylon bristles set in twisted wire
Can’t be used till working length Dislodgement of radiolucent bristles
recently introduced 30-gauge needle covered with brush
І- MANUAL
Disadvantages
3.MANUAL DYNAMIC AGITATION
Effect of “apical vapor lock” Technique: Gently moving a well-fitting gutta-percha master cone up and down in short 2- to 3-mm strokes within an instrumented canal Principles: 1. changes in intracanal pressure 2. frequency of 3.3Hz, 100 strokes per 30 seconds 3. viscously dominated flow (mixing of fresh spent solution with the reacted irrigant)
І- MANUAL
1. ROTARY BRUSHES
A.Ruddle brush
B.Canal brush
2. Continuous Irrigation During Rotary Instrumentation (Quantec-E)
Self contained fluid delivery unit uses a pump console, 2 irrigation reservoirs & tubing
- no significant results in middle & apical in cleaning efficiency
ІІ- MACHINE ASSISTED
A.Ruddle brush B.Canal brush
(Quantec-E)
Disadvantages
3.SONIC IRRIGATION
A. Rispisonic file
Vibringe
combines battery-driven vibrations (9000 Cycle per Minute) with manually operated irrigation of the root canal
ІІ- MACHINE ASSISTED
A.Rispisonic file
B. Endoactivator
consists of a portable handpiece and 3 types of disposable polymer tips of different sizes 10,000 cycles per minute .
IT is the simultaneous combination of ultrasonic irrigation and instrumentation. it has been almost discarded in the clinical
Ultrasonically activated files have the potential to prepare and debride root canals mechanically. Files are driven to oscillate at ultrasonic frequencies of 25–30 kHz in a transverse vibrationTwo types of ultrasonic irrigation :A. Active ultrasonic irrigation (AUI)B. Passive ultrasonic irrigation (PUI)
ІІ- MACHINE ASSISTED
A. Active ultrasonic irrigation (AUI)
4.Ultrasonic
PASSIVE ULTRASONIC IRRIGATION (PUI)
During PUI, the energy is transmitted from an oscillating file or a smooth wire to the irrigant in the root canal by means of ultrasonic waves. The latter induces acoustic streaming and cavitation of the irrigant.
Irrigant Application Methods During PUI: a) Continuous Ultrasonic Irrigation Nusstein’s needle holding devices
needle is simultaneously activated by the ultrasonic handpiece, while an irrigant is delivered from an intravenous tubing connected via a Luer-lok to an irrigation-delivering syringe.
b) Intermittent Flush Ultrasonic Irrigation
Acoustic streaming cavitation
1-PUI is more effective than syringe needle irrigation in removing pulpal tissue remnants and dentin debris.
2-smear layers were effectively removed from the apical, middle, and cervical thirds of the canal walls by EDTA plus Cetavlon (EDTAC) and NaOCl by using a size 15 file energized by ultrasonic agitation.
High-power ultrasound causes de-agglomeration of bacterial biofilms via the action of acoustic streaming
Cavitation may produce temporary weakening of the cell membrane
Removal of Bacteria:
B.PASSIVE ULTRASONIC IRRIGATION (PUI)
Removal of smear layer:
5. PRESSURE ALTERNATION DEVICES
A. The EndoVac System….
Multi-Port Adapter (MPA)
ІІ- MACHINE ASSISTED
(B)
(C) (D)
(A)
(A) Macrocannula with handpiec (B) Microcannula with fingerpiece(C) Master delivery tip (D) Tip of microcannula
The EndoVac System….
APPLICATION OF MICROCANNULE IN THE CANAL :
Negative pressure
Positive pressure
Advantages OF ENDOVAC SYSTEM
1.Safety:Less apical extrusion risk using the EndoVac system compared with needle irrigation
2.Efficacy:Better debridement 1 mm from working length using the EndoVac system compared with needle irrigation
3.SUCCESS:Negative apical pressure irrigation system EndoVac results in significantly less postoperative pain & necessity for analgesic medication than a conventional needle irrigation protocol
B. The RinsEndo System
65 mL of a rinsing solution oscillating at a frequency of 1.6 Hz is drawn from an attached syringe and transported to the root canal via an adapted cannula. Suction phase (100 times per minute)
higher risk of apical extrusion of the irrigant
ІІ- MACHINE ASSISTED
Disadvantage
5. PRESSURE ALTERNATION DEVICES
6.RECENT ADVANCES IN IRRIGATION SYSTEM
A. LASERS
Nd: YAG :1064 nm (neodymium-doped yttrium aluminum garnet) laser irradiation significantly reduced the number of bacteria (E. faecalis), but its inferior to NaOCl irrigation, which effectively disinfected the canals.
Ho : YAG : 2.1 μm ( Holmium- yttrium aluminium garnet ) laser shows excellent antibacterial efficiency against E. faecalis while CO2 laser shows a mixed response
CO2(carbon dioxide) : 10.6 μm laser removed and melted the smear layer on the instrumented canal walls, while the Er: YAG 2940 nm (erbium yttrium aluminium garnet) laser was the most effective in removing the smear layer
ІІ- MACHINE ASSISTED
B. Light-activated Disinfection (LAD)
Photodynamic antimicrobial chemotherapy Photosensitizer (toluidine blue dye, methylene blue dye, etc) The canal is then filled with a photosensitizer and then illuminated with a light source (laser, white light, red light, or a light-emitting diode).
.FotoSan: comercially available LAD
Application of photosensitizer Light Activated Disinfection
ІІ- MACHINE ASSISTED
6.RECENT ADVANCES IN IRRIGATION SYSTEM
C. Electrochemically activated water (ECA)
produced with a new and unique anode–cathode system extremely biocompatibility ECA produced much clearer dentinal walls compared to NaOCl
D. Oxidative potential water (OPW)
electrolyzed NaCl in a special machine called aquacida
6.RECENT ADVANCES IN IRRIGATION SYSTEM
ІІ- MACHINE ASSISTED
Oxidative potential water (OPW)