ABSTRACT
This article reviews irrigation techniques for removal of intracanal medicament in endodontic practice. Microorganisms are the primary etiological factors for pulpal and periradicular diseases. So primary purpose is to completely eradicate microorganism from the root canal. It is done through chemo-mechanical preparation of the canal. Complete disinfection of the pulp space cannot be achieved with most sophisticated instrumentation techniques. Therefore use of inter appointment intracanal medicaments is mandatory. Removal of the medicament is mandatory, as its remnants may mechanically block the apical area of the root canal system. Also affects viscosity, working time, tubule penetration and adhesion of root canal sealers. Remnants of Ca(OH)2 in the canal react with unreacted eugenol present in ZOE based sealer to form calcium eugenolate. Today’s irrigation armamentarium presents a diverse variety of tools and techniques , that can assist the practitioner in reducing bacteria, debris, intracanal medicament within the canal system. Conventional syringe irrigation is a routinely practiced method for removal of medicament. It consists of delivering the irrigant in the canal passively or by agitation. Rotary brush does not actually render irrigating solution for removal of medicament. This acts like auxiliaries during removal of medicament from canal or for increased movement of irrigating solution. Ultrasonic irrigation is done with or without simultaneous ultrasonic instrumentation. EndoVac is negative pressure irrigation, which can be used as an alternative method that helps in safe removal of medicament in apical thirds. RinsEndo is also based on pressure alteration technology like EndoVac. Sonically driven system safely activates various intracanal reagents and vigorously produces the hydrodynamic phenomenon as it includes EndoActivator and Vibringe. Laser activated irrigation is more effective for cleaning of root canal. Er:YAG is most commonly used laser in endodontics. Therefore, the aim of this article is to highlight the irrigation techniques used for removal of the intracanal medicament in endodontic practice.
ABSTRACT
The advances in adhesive techniques for bonding dental cements to teeth have long been advantageous in dentistry. Adhesive systems offer retaining areas that permit dental restorations to be placed. Bonding to tooth includes bonding to both enamel and underlying dentin. Adhesion to dentin is the main concern as most of damaged teeth have significant amount of misplaced enamel and require good adhesion to dentin. However, dentin exhibits complex structure which makes it difficult to bond with various materials. Hence to enhance bonding between dentin/tooth and adhesive material, it vital to pre-treat dentin with different gents. Various agents are used to treat dentin before restoration is placed. The agents used are chlorhexidine, sodium hypochlorite, benzalkonium chloride, iodine-based disinfectants, ozone, lasers, glutaraldehyde and proanthocyanidins, added hydrophobic resin layer application, ethanol, biomimetic, remineralizing agents, ethylene diamine tetra acetic acid, polyacrylic acid. 2% Chlorhexidine digluconate wash has been shown to successfully conserve the bond strength, when etch-and-rinse adhesive systems were used for up to 6 months. This can be due to inhibitory ability of CHX to the matrix metalloproteinases (MMPs) found in etched dentin. Dentinal pre-treatment is also done to eliminate bacteria remaining in cavity wall. 2.5% NaOCl pretreatment decreased the shear bond strength (SBS) of self-etch adhesive system and suggested NaOCl disinfectant to be used with etch-and-rinse bonding systems. The residual bacteria left behind after restorative procedure may endure and multiply which may lead to pulpal irritation, threat of recurrent caries and / or postoperative sensitivity, and therefore leads to failure of the dental restoration. The occurrence of secondary caries is the most common reason for the restorations failures.Attention to the antimicrobial agents and their effects on the pulp began in the early 1970s by Brännström and Nyborg, who focused on the significance of eliminating residual bacteria remaining on cavity walls.Use of 5.25% NaOCl solution for 15 seconds to eradicate “Staphylococcus aureus, Candida albicans, Porphyromonas gingivalis, and Prevotella intermedia, Porphyromonas endodontalis. Iodine based compounds have capacity to destroy the bacterial cell by affecting its proteins, nucleotides, and fatty acids. EDTA composition are highly successful in eliminate existing biofilms. It prevents biofilm formation by decreasing the adhesion of bacteria.This article reviews various agents, their mechanisms of action on dentin, effect on bond strength, their antibacterial activity, effect of agents on pulp, and comparative studies of these pretreatments. Several available agents have various advantages and disadvantages. Therefore, it is necessary to select appropriate agent for better bonding.