One of the steps of endodontics is irrigation within the canal to remove and clean the root canals during this dental treatment.
The irrigation in endodontic treatment, it consists of washing and suctioning all the remains and substances that may be contained within the pulp chamber or root canals.
Irrigation is intended to:
- ANDremove residual layer, composed of organic and inorganic remains (pulp remains, dentin chips and necrotic remains).
- Decrease the bacterial florato.
- Moisten or lubricate the walls of the dentin to facilitate the action of the instruments used to perform endodontics.
- Increase surface energy of the duct walls, favoring the contact of drugs used to heal temporarily and allow retention when plugging the ducts.
One of the main irrigating solutions in the treatment of endodontics is sodium hypochlorite, being the most recommended alternative for endodontic irrigation.
The sodium hypochlorite (NaOCl) is a halogenated compound that has been used as an irrigating solution in endodontics since 1920, complementing the biomechanical preparation of root canals. It is defined, according to the American Association of Endodontists, as a clear, pale, yellowish-green, extremely alkaline liquid with a strong chlorine odor, which has a dissolving action on necrotic tissue and organic remains and is also a powerful antimicrobial agent.
The main properties of this irrigating solution are:
- Dissolve pulp tissue remains (It is effective in both vital tissue and necrotic tissue). It is the most effective solvent for pulp tissue.
- Antibacterial action. Destroying bacteria (including viruses) and neutralizing their components and antigenic products.
- Debridement. Irrigation with sodium hypochlorite expels the debris generated by the biomechanical preparation of the canals.
- Lubrication. It moistens the walls of the root canal, favoring the action of the instruments.
- Low surface tension. Hypochlorite penetrates all irregularities in the root canal.
The bactericidal and tissue dissolving action of sodium hypochlorite can be modified by the concentration of this, the temperature and the pH of the solution.
Its clinical use is generalized, from lower concentrations of 0.5% to higher concentrations of 5.25%. The higher the concentration, the better the solvent and antibacterial properties, but its toxic effect is also increased. If the temperature rises, the action of sodium hypochlorite increases significantly. The pH of hypochlorite is approximately 11.6, being an alkaline solution.
Sodium hypochlorite solutions must be renewed frequently, as they lose effectiveness over time.
In cases of root canal treatment with pulp vial, it is recommended to use 1% sodium hypochlorite solutions. In the case of infected teeth with pulp necrosis, the concentration must be at least 2.5%.
