NaOCl dissolves organic tissue effectively (less so vital pulp tissue) and kills bacteria and yeasts. 2 Traditionally, sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA) have been the most commonly used root canal irrigants. The important differences between products are related to their ability to dissolve tissue and kill microbes, 2 key areas. 2,3Īll irrigating solutions are reasonably effective in washing, reducing friction (i.e., lubricating instruments) and balancing against a rise in temperature. The process must entail the combined use of 2 or more solutions, in a specific sequence, to achieve the goal of safe and effective irrigation. No single irrigating solution is sufficient to carry out all these functions. Irrigation has a number of important functions: mechanical washing effect, reduction of friction between instrument and canal wall dentin, temperature control, dissolution of organic and inorganic tissue and antimicrobial effect. Although instrumentation, irrigation, local medicaments (used in some cases) and root filling all contribute to the elimination of root canal microbiota, there is consensus that irrigation plays a central role in eradication of the infection. In endodontic discussions, much of the focus is on instrumentation however, in addition to removing some of the root canal contents, the main goals of instrumentation are to allow effective disinfection and to make root filling technically possible. Following these, treatment consists of preparation of access cavity, location of the root canals, instrumentation, irrigation and disinfection, root filling and coronal restoration of the tooth. The first steps in every endodontic treatment are diagnosis, decision on treatment and information to the patient. In the treatment of teeth with pulpitis, where the root canal is bacteria free, the goal is to clean and fill the root canal while preventing access of microbes to the canal space during and after treatment. For apical periodontitis, the short- and long-term success of endodontic treatment depends on elimination of microbes from the root canal system and prevention of reinfection via coronal leakage. Pulpitis and apical periodontitis are caused by invasion of bacteria deep into dentin or the root canal space.
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