Endodontic irrigating devises


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Endodontic irrigating devises

  2. 2. IRRIGATION DEVICES IN ENDODONTIC І- MANUAL 1.Syringe irrigation with needles/ cannulas (end/side vent) 2.Brushes A. Endobrush B.Navitip FX 3.Manual Dynamic Agitation (hand activated well fitting gutta percha) ІІ- MACHINE ASSISTED 1.Rotary brushes A.Ruddle brush B.Canal brush 2.Continuous irrigation during rotary instrumentatin (Quantec-E) 3.Sonic A.Rispisonic file B.Endoactivator 4.Ultrasonic 5. Pressure alternating devices A.EndoVac B.Rinse Endo 6. Recent advance system A. Lasers b. Light activated disinfection (LAD) C. Electrochemically activated water (ECA) D.Oxidative potential water (OPW)
  3. 3.  Different sizes (1-20 ml)  Luer-Lok design Modifications of tip of the needles A) Bivelled B) Monoject C) Safe ended (A) (B) (C ) І- MANUAL 1.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
  4. 4. 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
  5. 5. 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
  6. 6. 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
  7. 7. 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 .
  8. 8. 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 vibration Two types of ultrasonic irrigation : A. Active ultrasonic irrigation (AUI) B. Passive ultrasonic irrigation (PUI) ІІ- MACHINE ASSISTED A. Active ultrasonic irrigation (AUI) 4.Ultrasonic
  9. 9. 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
  10. 10. 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:
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. 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
  15. 15. 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
  16. 16. 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)