It has been used as an endodontic irrigant for more than 70 years Its now one of the most common solutions for this purpose

1. Sodium hypochlorite and its use as
an endodontic
irrigant
Australian Dental Journal
Roger M. Clarkson*Alex J. Moule†
1998;43:(4)
Australian Dental Journal 1998;43:(4) 1

2. INTRODUCTION
It has been used
as an endodontic
irrigant for more
than 70 years
Its now one of
the most
common
solutions for this
purpose
strong
oxidizing
agents
corrode most
metals except
titanium and
some forms of
stainless steel
Australian Dental Journal 1998;43:(4) 2

3. SODIUM HYPOCHLORITE
concentrations ranges from 1
per cent to 5.25 per cent
Used as wound
irrigants since at least
1915,4 and as an
endodontic irrigant
as early as 1920
Bactericidal and
proteolytic.
Australian Dental Journal 1998;43:(4) 3
0.5 to 6%
-Dent Clin N Am 54
(2010) 291–312
0.5 to 7%
-Ingle
0.5 to 5.25%
-Cohen
0.5 to 5.25%
-nisha garg

4. Concentrations
NaOCl-
• 0.5,
• 0.005%,
• 1%
• 2.5%
• 3%
• 5%
• 5.25%
• 6%
• 7%
• 8%
Australian Dental Journal 1998;43:(4) 4

5. Production and properties of sodium
hypochlorite
Traditionally it has been produced
by bubbling chlorine gas through
a solution of sodium hydroxide, to
produce sodium hypochlorite
Australian Dental Journal 1998;43:(4)
5
Cl2 + 2NaOH –> NaOCl + NaCl + H2O

6. Commercial
sodium
hypochlorite
have nominal
concentrations
of 10 to 14 per
cent available
chlorine.
They deteriorate
with time,
temperature,
exposure to light,
and contamination
with metallic ions.
Excess chlorine
in sodium
hypochlorite
solutions leads
to an acid
solution which
is unstable.
Concentrations
over about 5 per
cent available
chlorine require
vented containers
to prevent build up
of the oxygen
produced
Australian Dental Journal 1998;43:(4)
6

7. An alternative method
It uses
electrolysis
of a
saturated
brine
solution to
produce
sodium and
chloride ions.
The sodium
ions diffuse
through a
membrane,
where they
combine with
water to
produce
sodium
hydroxide.
The chloride
ions from the
first
compartment
combine to
give chlorine
gas which is
dissolved in
the sodium
hydroxide to
give sodium
hypochlorite,
salt and water.
Australian Dental Journal 1998;43:(4)
7

8. Chemical changes
Australian Dental Journal 1998;43:(4) 8
2NaOCl –> 2NaCl +O2
3NaOCl –> 2NaCl + NaClO3

9. Its both an
oxidizing and
hydrolyzing
agent.
dissolves
proteins
Its use as an
infant sanitizer
is nearly
universal
Cheap
Australian Dental Journal 1998;43:(4) 9

10. Disadvantages
Damages all living tissues except keratinized epithelia.
Extremely corrosive to metals
strongly alkaline
hypertonic
unpleasant taste.
Use of rubber dam and careful irrigation techniques are vital.
Australian Dental Journal 1998;43:(4)
10

11. If sodium hypochlorite gets extruded into
periapical tissues, it causes excruciating pain
periapical bleeding & swelling
Nisha garg page no 214
11

12. Management of extruded NaOCl
Patient should be
informed as regard
severity of complications
Local anesthesia for
immediate relief
Vimal sikri page no 248 12

13. Wet compresses continuously applied to the face relieved the
pain and the burning sensation felt by the patient.
Advised antibiotics and analgesics
The patient can also be advised to replace the cold compresses
by hot compresses to stimulate local systemic circulation.
Sodium hypochlorite in endodontics: an update review by Zahed Mohammadi Yazd, Iran
International Dental Journal (2008) 58, 329-341 13
Management of extruded NaOCl

14. Discussion
• NaOCl solutions require careful handling to
• maximize their advantages as endodontic irrigants and their costs
vary widely
Australian Dental Journal 1998;43:(4) 14

15. EXTRANEOUS COMPOUNDS
Excess sodium hydroxide was present in all products,
with a resulting high pH, but the level would appear to
be below that likely to cause tissue damage.
Australian Dental Journal 1998;43:(4) 15

16. All sodium hypochlorite products contain some salt from the production
process, but Milton contains added salt (16.5 per cent) to change the
equilibrium of the breakdown reaction below:
2NaOCl –> 2NaCl + O2
This results in a more stable solution.
Australian Dental Journal 1998;43:(4) 16

17. Endodontic use of hypochlorite
Requires the removal of dentine debris, the destruction of
microorganisms and dissolution of protein.
Australian Dental Journal 1998;43:(4) 17

18. Hypochlorite is the only root-canal irrigant of those in general use that
dissolves necrotic and vital organic tissue.
It is difficult to imagine successful irrigation of the root canal without
hypochlorite.
Although hypochlorite alone does not remove the smear layer, it affects
the organic part of the smear layer, making its complete removal
possible by subsequent irrigation with EDTA or citric acid (CA
Irrigation in Endodontics Haapasalo et al Dent Clin N Am 54 (2010) 291–312 18

19. The lowered
surface tension
permits ‘wetting’
of the small
particles, allowing
them to be
suspended in the
irrigating solution,
and then removed
along with it
Australian Dental Journal 1998;43:(4) 19

20. Australian Dental Journal 1998;43:(4)
20
Cohen and Burns state that the most
important factors in reducing dentinal
debris are
volume and frequency of irrigant
used

21. Both the presence of metallic ions
and higher concentrations of
available chlorine reduce the shelf
life of hypochlorite solutions, and
these two factors are interdependent
Australian Dental Journal 1998;43:(4) 21

22. CONCENTRATION
While Delta West produces a
0.05 per cent solution of sodium
hypochlorite,
it was eliminated as a possible
endodontic irrigant, because the
concentration is far lower than
typically recommended.
Australian Dental Journal 1998;43:(4) 22

23. Milton which has 1 per cent
available chlorine, is
manufactured with more controls
and at a greater cost than other
products except Delta West.
Australian Dental Journal 1998;43:(4) 23

24. Cameron has shown that
concentrations greater than 2 per
cent
remove protein remnants from
root canals when combined with
ultrasound, where lower
concentrations do not
Australian Dental Journal 1998;43:(4) 24

25. Storage and handling
1) The stability of hypochlorite solutions
is reduced by lower pH, presence of
metallic ions, exposure to light, open
containers, higher temperatures, and
higher concentrations.
Australian Dental Journal 1998;43:(4) 25

26. (2) To ensure good shelf life, all
solutions should be stored in light-
proof (opaque glass or polythene),
airtight containers, in a cool place.
Australian Dental Journal 1998;43:(4) 26

27. 3) If diluted, they should be diluted as
soon as possible after purchase,
because dilute solutions deteriorate
less rapidly than concentrated
solutions.
Australian Dental Journal 1998;43:(4) 27

28. (4) Domestic bleach solutions
produced and stored in this manner
will deteriorate more rapidly than
Milton, because they do not have the
added salt to give stability.
Australian Dental Journal 1998;43:(4) 28

29. (5) A practitioner electing to use a Group 3
bleach undiluted, should simply ensure that the
bottle is always tightly sealed, and discard by the
‘use by’ date. Similarly for Milton, as long as the
container and lid are intact, the product should
be effective until the expiry date.
Australian Dental Journal 1998;43:(4) 29

30. (6) Frequent opening of the container
or failure to close securely, would
have an effect akin to an open
container, similarly reducing the shelf
life.
Australian Dental Journal 1998;43:(4) 30

31. (7) Metallic containers should never
be used for sodium hypochlorite, as
the hypochlorite will react with the
metal in the containers.
Australian Dental Journal 1998;43:(4) 31

32. (8) The corrosive nature of
sodium hypochlorite must be
considered before disposal.
Australian Dental Journal 1998;43:(4) 32

33. Irrigant extrusion
Australian Dental Journal 1998;43:(4) 33

34. An appropriate volume of
irrigant is used at least 1 to 2 ml
each time the canal is flushed.
Standard regimen of irrigation
used routinely is 0.1-5.2% NaOCl
with 17% EDTA.
Grossman’s 13th edition pg no 150 ,Pathways of cohen 6th edition. Page no:199 34

35. Extrusion of irrigant beyond the periapex termed as sodium
hypochlorite accident, may be one of the cause of endodontic flare ups.
Australian Dental Journal 1998;43:(4) 35

36. Australian Dental Journal 1998;43:(4) 36

37. If sodium hypochlorite gets extruded into
periapical tissues, it causes excruciating pain
periapical bleeding & swelling
Grossman’s 13th edition pg no 150 Nisha garg page no 214
37

38. Safety
Staff should wear gloves, protective glasses and protective clothing
when loading syringes.
Only Luer-Lok syringes and needlesshould be
considered for use because taper seat needles may
dislodge in use, with eye and other tissue damage
r e s u l t i n g .
Australian Dental Journal 1998;43:(4) 38

39. Conclusions and guidelines for use
1. Always use fresh solutions.
2. Use only demineralized water for dilution.
3. Store solutions in opaque glass, or coated polyethylene containers
which are tightly sealed.
4. Use Luer-Lok plastic syringes.
Australian Dental Journal 1998;43:(4) 39

40. 5. Do not inject forcibly, or allow needle to bind in canal.
7. Discard syringes and unused solutions at conclusion of appointment,
flushing drains with copious quantities of water.
Australian Dental Journal
1998;43:(4)
40

41. Wet compresses continuously applied to the face relieved the
pain and the burning sensation felt by the patient.
Advised antibiotics and analgesics
The patient can also be advised to replace the cold compresses
by hot compresses to stimulate local systemic circulation.
Sodium hypochlorite in endodontics: an update review by Zahed Mohammadi Yazd, Iran
International Dental Journal (2008) 58, 329-341 41
Management of extruded NaOCl

42. Safety
Staff should wear gloves, protective glasses and protective clothing
when loading syringes.
Only Luer-Lok syringes and needlesshould be
considered for use because taper seat needles may
dislodge in use, with eye and other tissue damage
r e s u l t i n g .
Australian Dental Journal 1998;43:(4) 42

43. Conclusions and guidelines for use
1. Always use fresh solutions.
2. Use only demineralized water for dilution.
3. Store solutions in opaque glass, or coated polyethylene containers
which are tightly sealed.
4. Use Luer-Lok plastic syringes.
Australian Dental Journal 1998;43:(4) 43

44. 5. Do not inject forcibly, or allow needle to bind in canal.
7. Discard syringes and unused solutions at conclusion of appointment,
flushing drains with copious quantities of water.
Australian Dental Journal
1998;43:(4)
44

45. Australian Dental Journal 1998;43:(4) 45
How to recognize a NaOCl accident

46. Patient Complains of Immediate
severe and excruciating pain
(for 2 to 6 min) especially when
he/she is not under anaesthesia
Grossman’s 13th edition page no 150 ,Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 46

47. Ballooning or immediate
edema in adjacent soft tissue,
because of perfusion to the
loose connective tissue
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 47

48. Extension of edema to a large
site of the face such as cheeks,
per orbital region, or lips.
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 48

49. Ecchymosis on skin or
mucosa as a result of
profuse interstitial bleeding.
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 49

50. • Profuse intraoral bleeding directly from root canal
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 50

51. Chlorine taste or smell,
because of injected
NaOCl to maxillary sinus
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 51

52. How to treat a NaOCl accident
Journal of Dentistry and Oral Hygiene Vol. 5(3), pp. 21-24, March 2013 52

53. Remain calm and
inform the patient
about the cause and
nature of the
complication.
Australian Dental Journal 1998;43:(4) 53

54. Immediately irrigate with
normal saline to decrease
the soft-tissue irritation
by diluting the NaOCl.
Australian Dental Journal 1998;43:(4) 54

55. • Recommend ice bag compresses for 24 h (15 min intervals) to
minimize swelling
Australian Dental Journal 1998;43:(4) 55

56. Wet compresses continuously applied to the face relieved the pain and
the burning sensation felt by the patient.
Advised antibiotics and analgesics
The patient can also be advised to replace the cold compresses by hot
compresses to stimulate local systemic circulation.
Recommend rinsing with normal saline for 1 week to improve
circulation to the affected area.
Sodium hypochlorite in endodontics: an update review by Zahed Mohammadi Yazd, Iran
International Dental Journal (2008) 58, 329-341 56

57. Australian Dental Journal 1998;43:(4) 57
25-gauge needles were
common place for
endodontic irrigation a
few years ago, they were
first replaced by 27-G
needles, now 30-G and
even 31-G needles are
taking over for routine use
in irrigation

58. Side vented nedles are used
Australian Dental Journal 1998;43:(4) 58

59. Australian Dental Journal 1998;43:(4) 59
Flexiglide needle for irrigation also easily
follows curved canals

60. Australian Dental Journal 1998;43:(4) 60

61. Pathways of cohen 86th
edition. Page no:197 61
Irregular surface and may
retain cellular debris.
Tubules coated with the
smear layer
SEMs from the canal system of a mandibular molar
Cellular fragment and a small
vessel-like structure
remain
All cellular debris has been
removed by the action of
5.25% NaOCl
The tubules
are clean and open. No smear
was formed.

62. condition irrigant
Necrotic pulp NOCl
Final rinse with chlorhexidine
Vitl pulp exposure NOCl
Final rinse with EDTA
Calcified/sclerotic canal EDTA
NOCl
Infected canal( exudate present) NOCl
Chlorhexidine
Periapical abcess( to establish drainage) Hot water /saline
NOCl
Open apex/apical perforation Chlorhexidine
Curved canals Glyoxide
NOCl
Canals left open for drainage 3% hydrogen peroxide
saline
Re – treatment cases Chlorhexidine
NOCl
Removing smear layer in non-infected cases EDTA/ citric acid
NOCl
62

63. Australian Dental Journal 1998;43:(4) 63

64. HISTORICAL REVIEW
Sodium hypochlorite, the
active ingredient in
household bleach, was
discovered by the French
chemist Berthollet, in Javel on
the outskirts of Paris, in 1787
Australian Dental Journal 1998;43:(4) 64

65. HISTORICAL REVIEW
Louis Pasteur discovered
sodium hypochlorite's
potent effectiveness against
disease-causing bacteria,
and it became widely used
as a disinfectant.
Australian Dental Journal 1998;43:(4) 65

66. HISTORICAL REVIEW
It was 1st
introduced during
the World WAR I
by chemist Henry
Drysdale Dakin
for treating
infected wounds.
Its also known as
‘Dakin’s solution’
The original
concentration
suggested by
Dakin was 0.5%
but concentration
commonly used in
practice is 5.25%
Nisha Garg 2nd edition page no 213 66

67. HISTORICAL REVIEW
Walker -1936
first suggested
to use in root
canal therapy
Grossman
1941
used it as an
intracanal
medicament
Spangberg
1973
0.5%- NaOcl
has good
germicidal
activity
) 67Nisha Garg 2nd edition page no 213

68. HISTORICAL REVIEW
Madden-1977
compared the
different
concentrations of
NaOCl
Foley et al-
1983
compared
effectiveness of
0.5%NaOcl &
Glyoxide
Kazol , et al
concluded that
NaOCl was
detrimental to
neutrophilic chemo
taxis & toxic to
fibroblasts &
endothelial cells
Nisha Garg 2nd edition page no
213
68

69. Australian Dental Journal 1998;43:(4) 69

70. ) 70
Excellent
antimicrobial
It kills all microbes
including spore-
forming bacteria and
viruses
Pathways of pulp by cohen 6th edition. Page no:198

71. Australian Dental Journal 1998;43:(4) 71
Dissolution of pulp
remnants
Dissolves necrotic
tissue, vital pulp
tissue and organic
component of dentin
& biofilms
Pathways of pulp by cohen 6th edition. Page no:198

72. Sodium hypochlorite in endodontics: an update review by Zahed Mohammadi Yazd, Iran
International Dental Journal (2008) 58, 329-341
72
Grossman and Meiman reported that 5% sodium
hypochlorite dissolves this tissue in 20min to 2h.

73. Australian Dental Journal 1998;43:(4) 73
NaOCl in low
concentration (below
2.5%) predictably
eliminates infection
but does not
consistently dissolve
pulpal
remnants unless
excessive time is spent
in treatment
Pathways of pulp by cohen 6th edition. Page no:198

74. Australian Dental Journal 1998;43:(4) 74
 Baumgartner and Mader8 confirmed that 2.5% NaOCl is
extremely effective in removing vital pulp tissue from dentinal
walls.
 They also noted that walls untouched by files were cleaned
when adequate concentrations of NaOCl were used
Pathways of pulp by cohen 6th edition. Page no:198

75. 75
The dissolving efficacy NaOCl is influenced by the structural integrity of the connective
tissue components of the pulp.
If the pulp is already decomposed, it take less time to dissolve the remaining soft
tissue remnants. If the pulp is vital and little structural degeneration has occurred,
it will take longer for NaOCl to dissolve the remnants.
cleaning procedures should not be hurried, especially when the pulpal tissues are
still supported by circulation.
Pathways of pulp by cohen 6th edition. Page no:198

76. Factor affecting the efficacy of sodium hypochlorite
Time of contact
Greater the contact time ,more
effective it is, especially in
necrotic cases
Heat (960-70 C)
Specialized irrigating
syringes
Side venting endodontic syringes
with 32 gauze aid in getting
irrigant closer to apex
storage time
Chemical agents
( EDTA)
Nisha Garg 2nd edition page no 213 76

77. To warm NaOCl , syringes are filled with NaOCl
are placed in 60-70 C (140 F) Water bath.
Nisha Garg 2nd edition page no 213 77

78. Australian Dental Journal 1998;43:(4) 78
Removal of the smear
layer

79. NaOCl + EDTA
No evidence to support any claims for the
antimicrobial action of EDTA
Partial inhibition of the action of NaOCl
Australian Dental Journal 1998;43:(4) 79
Grawehr et al. 2003; Zehnder et al. 2005

80. Is NaOCl equally effective in dissolving
vital, non-vital, or fixed tissue ???
Demonstrated that 5.25% sodium hypochlorite dissolves vital
tissue. (Rosenfeld et al. 1978 )
As a necrotic tissue solvent, 5.25% sodium hypochlorite was found
to be significantly better than 2.6%, 1%, or 0.5%. (Hand et al.1978)
3% sodium hypochlorite was found to be optimal for dissolving
tissue fixed with parachlorophenol or formaldehyde (Thé SD.1979)
Australian Dental Journal 1998;43:(4) 80

81. USE OF NaOCl in Combination with other
Medicaments
Efficacy as antimicrobial agent is increased
Australian Dental Journal 1998;43:(4) 81
Calcium
hydroxide
chlorhexidine
EDTA

82. Irrigation in Endodontics Haapasalo et al Dent Clin N Am 54 (2010) 291–312 82
Orange precipitate formed
by mixing chlorhexidine with
sodium hypochlorite.

83. Irrigation in Endodontics Haapasalo et al Dent Clin N Am 54 (2010) 291–312 83
Mixing sodium
hypochlorite
chlorhexidine with
EDTA produces a
white cloud
precipitation.

84. Newer irrigants
MTAD TETRACLEAN
Electrochemicall
y activated
solutions
OZONATED
WATER
PHOTON-
ACTIVATED
DISINFECTION
Herbal
irrigants
Sushma jaju & prasjant jaju International journal of dentistry vol 2011 84

85. MTAD
Bio Pure MTAD (Dentsply,
Tulsa, OK) is a mixture of a
tetracycline isomer, an acetic
acid, and Tween 80 detergent
(MTAD)-was designed to be
used as a final root canal
rinse before obturation
Australian Dental Journal 1998;43:(4) 85

86. Tetracycline has many unique properties of low pH and thus can act as
a calcium chelator and cause enamel and root surface
demineralization
MTAD is effective in removing the smear layer along the whole length
of the root canal and in removing organic and inorganic debris and
does produce any signs of erosion or physical changes in dentine,
Whereas a mixture of 5.25% sodium hypochlorite and 17% EDTA does
Australian Dental Journal 1998;43:(4) 86

87. In particular, MTAD mixture is effective against E. fecalis, and it is also
less cytotoxic than a range of endodontic medicaments, including
eugenol, hydrogen peroxide (3%), EDTA, and calcium hydroxide paste
Torabinejad et al, showed that the effectiveness of the MTAD was
enhanced when low concentration of NaOCl is used as an intracanal
irrigant before the use of MTAD as a final rinse.
MTAD does not seem to significantly change the structure of the
dentinal tubules
Australian Dental Journal 1998;43:(4) 87

88. The placement of MTAD with a
cotton- wrapped barbed broach
allows intimate contact of the solution
even in the apical region of the canals
Australian Dental Journal 1998;43:(4) 88

89. TETRACLEAN
Tetraclean (Ogna Laboratori
Farmaceutici, Muggio (Mi), Italy), like
MTAD, is a mixture of an antibiotic, an
acid, and a detergent
Australian Dental Journal 1998;43:(4) 89

90. Electrochemically Activated (ECA)
Electrochemically Activated (ECA) solutions are produced from tap
water and low-concentrated salt solutions. NaOCl and ECA
solutions left a thinner smear layer with a smoother and more
even surface
The texture of the canal surfaces treated with ECA solutions was
relatively uniform in the various regions of the root canal and did
not seem to be influenced by the method of instrumentation, that
is, manually or mechanical.
Australian Dental Journal 1998;43:(4) 90

91. Irrigation With NaOCl or ECA solutions enhanced the opening of
dentine tubules and debris removal is more effective than NaOCl in
smear layer
ECA is showing promising results due to ease of removal of debris
and smear layer, nontoxic and efficient in apical one third of canal.
lt has a potential to be an efficient root canal irrigant.
91Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of dentistry vol 2011

92. OZONATED WATER
Ozone is a chemical compound consisting of three oxygen atoms (O3-
triatomic oxygen), a higher energetic form than normal atmospheric
oxygen (OZ)
Australian Dental Journal 1998;43:(4) 92

93. Ozone is a very powerful bactericide that can kill microorganisms
effectively.
It was reported that ozone at low concentration, 0,1 ppm, is
sufficient to inactivate bacterial cells including their spores.
It is present naturally in air and can be easily produced by ozone generator.
When introduced in water, ozone dissolves rapidly and dissociates rather quickly.
The concentration of ozone in ozonated watercan be measured using a dissolved
ozone meter.
93Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of dentistry vol 2011

94. Cardoso evaluated the efhciency of ozonated Water as an
irrigating agent during endodontic treatment in an attempt to
eliminate Candida albicans and Enterococcus faccalis and
toneutralize lipopolysacharides (LPSs) inoculated in root canals .
It was possible to see effective antimicrobial action after ten
minutes of water ozonization on the microbial suspension
94
Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of
dentistry vol 2011

95. PHOTON- ACTIVATED DISINFECTION
PDT is based on the concept that nontoxic photosensitizers can be
preferentially localized in certain tissues and subsequently activated
by light of the appropriate Wavelength to generate singlet oxygen
and free radicals that are cytotoxic to cells of the target tissue
Methylene blue (MB) is a Well-established photosensitizer that has
been used in PDT for targeting various gram-positive and gram-
negative oral bacteria
95
Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of
dentistry vol 2011

96. HERBAL IRRIGANTS
Murray et al. evaluated Morinda citrifolia juice in conjunction with EDTA as a
possible alternative to NaOCl. Triphala (IMPCOPS Ltd, Chennai, India) is an Indian
ayurvedic herbal formulation consisting of dried and powdered fruits of three
medicinal plants, Terminalia bellerica, Terminalia chebula, and Emblica officinalis,
and green tea polyphenols
Triphala andMTAD showed complete eradication only in 3-
week biofilm
:(4) 96
Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of
dentistry vol 2011

97. COMPUTATIONAL FLUID DYNAMICS IN THE
ROOT-CANAL SPACE
Computational fluid dynamics (CFD) is a new approach in endodontic
research to improve our understanding of fluid dynamics in the special
anatomic environment of the root canal
Irrigation in Endodontics Haapasalo et al Dent Clin N
Am 54 (2010) 291–312 97

98. :(4) 98
Particle tracking during
irrigation simulated by a
CFD model
Irrigation in Endodontics Haapasalo et al Dent
Clin N Am 54 (2010) 291–312

99. Irrigation in Endodontics Haapasalo et al Dent Clin N Am
54 (2010) 291–312 99
Streamline provides
visualization of the
irrigant flow in the canal.

100. SUMMARY
Sodium hypochlorite is the most important irrigating solution and the only
one capable of dissolving organic tissue, including biofilm and the organic
part of the smear layer.
It should be used throughout the instrumentation phase.
However, use of hypochlorite as the final rinse following EDTA or CA
rapidly produces severe erosion of the canal-wall dentin and should
probably be avoided
Irrigation in Endodontics Haapasalo et al Dent Clin N Am 54 (2010) 291–312
100

101. References
Australian Dental Journal 1998;43:(4)
Sodium hypochlorite in endodontics: an update review by Zahed Mohammadi Yazd, Iran International Dental Journal (2008) 58,
329-341
JOE VOL 38 ;2 2012
Irrigation in Endodontics Haapasalo et al Dent Clin N Am 54 (2010) 291–312
Newer root canal irrigants in Horizon:Sushma jaju & prasjant jaju International journal of dentistry vol 2011
Mechanism Of Action Of Sodium Hypochlorite carlos et.al Braz Dent J 13 (12)2002
Pathways of cohen 10th edition
Ingle’s 6th edition
Nisha garg 2nd edition
101