endodontic irrigation

2. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Instrument-
ation
Obturation
Restoration
Endodontic Circuit

3. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020

4. Fluid Dynamic
 Study of fluid in motion & its subsequent effects on boundaries
 Root canal irrigation is microscale ( microfluidics) flow of a liquid (irrigant) inside an
irregularly shaped domain of very small dimensions (root canal system).
 Two ways for the Irrigants to reach the pulp:-
1. Convection ………. flow developed during delivery (or during
agitation), In his way, chemically active particles (molecules/ions) are
transported quickly and efficiently by the fluid motion, that applies
forces on the targeted material ( mechanical effect ).
1. Diffusion………. The random movement of particles in a fluid
In areas of the root canal where a flow cannot be created,
irrigant transport by diffusion without mechanical effect .

5. Endodontic irrigation must achieve 4 aims
1- Efficient. Flow rate ………. To the full extent of the root canal system and subsequently to the
canal orifice, in order to:-
a) come in close contact with microorganisms/biofilm,
debris, and tissue remnants, carry them outside the canal
d) provide lubrication for the instruments.
2- Chemical Effects ……… Frequent refreshment of the irrigant, in order to retain a high
concentration of its active component(s) at the sites of interest
and compensate for their rapid consumption
(applicable only to chemically active irrigants).
3- Mechanical Effects ………. Application of force on the root canal wall (wall shear stress),
in order to detach/disrupt microorganisms/biofilm, debris,
and tissue remnants.
4- Safety …………….Restriction of the flow within the root canal system and prevention
of irrigant extrusion towards the periapical tissues.

6. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Turbulent Flow Laminate Flow
Fluid moves in irregular paths or layers Fluid moves in smooth paths or layers
 In endodontic lamina flow is recommended because it gives
steady constant flow rate and sufficient volume of irrigant .
 In order to achieve lamina flow during canal irrigation ,the flow rate must be;-
0.01 mL/s steady lamina flow rate
0.26 mL/s unsteady lamina flow rate
o.53-0.79 mL/s turbulent flow rate
A high pressure can cause extrusion of the irrigant into
the periapical tissue (Hulsmann et al. 2009).

7. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
 Flow Rate directly proportional
Internal diameter of the needle
Pressure differences along the needle
 Flow Rate inversely proportional
Viscosity of the irrigant
Length of the Needle
Factors determine the flow rates

8. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Three essential Components for
positive pressure irrigation
Leur Lock
Rubber stopper.. WL
Close ended with side
vented
Which syringe size ???
5 ml
P --- pressure developed inside syringe barrel
F --- tactile force applied to syringe plunger
A --- cross-section area of the syringe plunger
Variable capacities 20—1 ml

9. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Type of endodontic Needles
Two Types
Open end Tip Close end Tip
Recommended

10. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
45
M3 pro gold
35/4%
70
70
Needle Sizes

11. Dr.Abdalazim Badraldin
SudaneseDentalCe
Khartoum-Suda
April. 2020
Flat tip Beveled Notched Side vented double Multi vented
side vented
Needles kept 5 mm short of WL
3 mm3 mm3 mm
1 mm 1 mm 1 mm
Stagnation area
Stagnation area
Needle Position during Canal Irrigation

12. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Canal taper
Stagnation area
(dead space) 35/4%
o.39
0.57
0.61
0.65
0.69
0.53
23 G 30 G close end side vented
Needle Position during Canal Irrigation

13. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020Close ended
1mm
short WL
Open ended
3mm
short WL
Not recommended
in endodontic
clinical practice
Needle Position during Canal Irrigation

14. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
 Is the frictional forces occurring between the
flowing irrigant and canal walls.
 Wall shear determines the mechanical effects,
because it detached material from the root canal wall.
 In open-ended needles, an area of increased shear
stress is developed apically to the needle tip, in the
region of jet breakup.
 closed-ended needles (side-vented and double-side-
vented) lead to almost twice as high maximum shear
stress, but limited near their tip, on the wall facing the
needle outlet .
 The high wall shear stress around the needle tip,
for this reason it is recommended to move the
needle up and down along the canal wall
( longitudinal movement) and also in a rotation
movement in side vented closed ended needle.

15. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
Jet
 High – velocity fluid stream force out of a small – diameter opening
 During needle irrigation the jet extends along the root canal,
apically to their tip, within a certain distance, which depends on :-
 The shape of the root canal
 The insertion depth of the needle
 The flow rate,
 The jet appears to break up gradually and
reverse flow towards the canal orifice .
 In open-ended needles (flat, beveled,
notched), the jet is very intense .
 In closed-ended needles are used (side vented,
double-side-vented), the jet is formed near the apical
side of the outlet (the one proximal to the tip for the
double-side-vented needle), and it is directed apically
with a slight divergence.
C. Boutsioukis and L.W.M. van der Sluis
Endodontic irrigation

16. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
In Syringe Irrigation , Minimum apical size 30 or 35 is Required
More preparation size
 More Micro-leakage
 More Transportation
 Weaken the root
 More chance for VRF

17. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
 Enlargement of canal to 3 sizes larger than the first FABF is adequate
 Further enlargement – No additional benefits in treatment. Outcome

18. Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan
April. 2020
1- Dentinal tubules Disinfection
2- Apical Deltas Penetration
3- Biofilm removable
4- Isthmuses cleaning
Traditional needles irrigation fail to clean these areas,
this is why we need to activate the irrigant by creation of
Tsunami effect in order to push the irrigant to these areas

19. Khartoum … Sudan
Tuesday 18 Ramadan 1441
Dr.Abdalazim Badraldin
SudaneseDentalCenter
Khartoum-Sudan