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See discussions, stats, and author profiles for this publication at: Modern Endodontic Principles Part 4: Irrigation Article in Dental update · February 2016 DOI: 10.12968/denu.2016.43.1.20 CITATIONS 6 READS 4,248 5 authors , including: Some of the authors of this publication are also working on these related projects: Prediction of competency in longitudinal observations View project Greater Manchester Trauma Network View project James Darcey The University of Manchester 32 PUBLICATIONS 211 CITATIONS SEE PROFILE Carly Taylor The University of Manchester 20 PUBLICATIONS 49 CITATIONS SEE PROFILE Reza Vahid Roudsari The University of Manchester 16 PUBLICATIONS 67 CITATIONS SEE PROFILE All content following this page was uploaded by James Darcey on 31 May 2016. The user has requested enhancement of the downloaded file.
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Endodontics 20 Dental Update January/February 2016 Modern Endodontic Principles Part 4: Irrigation Abstract: The complex anatomy of the tooth limits the ability to eradicate pathogens by mechanical means alone. Irrigation is the key to solving this problem. This paper highlights the importance of irrigation, the key irrigants available and methods of improving the performance of irrigants within the canal. CPD/Clinical Relevance: To provide advice on which irrigants to use, how to use them effectively and safely and what to do if irrigants are extruded beyond the apex. Dent Update 2016; 43: 20–33 RCT to achieve these goals. These include: Sodium hypochlorite; Chlorhexidine; Sterilox; EDTA; Iodine potassium iodide; Hydrogen peroxide; Local anaesthetic, saline and/or water; Mixtures of irrigants (QMIX ® ). See Table 1 for a summary of their differing properties. 8 When used alone, very few irrigants offer a complete spectrum of ideal properties. Sodium hypochlorite Sodium hypochlorite (NaOCl) was first described as an endodontic irrigant in 1919. 9 It possesses many of the attributes of an ideal antimicrobial agent; it is fast acting, has a broad spectrum of action and is relatively inexpensive. 10 Its activity stems from several key aspects. Hydroxyl ions damage both bacterial lipid membranes and DNA and the high pH created denatures proteins and impairs ideal cell conditions. Chloride ions break peptide bonds dissolving protein and releasing further chloramines that are antibacterial. It remains the gold standard of endodontic irrigants and, although bacteria can still be cultured James Darcey , BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent, Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Sarra Jawad , BDS, BSc, MFDS, Specialty Registrar/Honorary Clinical Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, Carly Taylor , BDS, MSc, MFGDP FHEA, Clinical Lecturer/Honorary Specialty Registrar in Restorative Dentistry, Dental School, University of Manchester, Reza Vahid Roudsari , DDS, MFDS, MSc, PGCert(OMFS), Clinical Lecturer/Honorary Specialty Registrar
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