The effect of Qmix and sodium hypochlorite as root canal irrigants on root canal cleanliness using different irrigation Techniques.

Abstract

Removal of vital and necrotic remnants of pulp tissues, microorganisms, and micro-bial toxins from the root canal system is essential for endodontic success. Although this might be achieved through chemomechanical debridement, it is impossible to shape and clean the root canal completely because of the intricate nature of root canal anatomy. Therefore, irrigation is an essential part of root canal debridement because it allows for cleaning beyond what might be achieved by root canal instrumentation alone. Ideal root canal irrigants should meet all the conditions described above for endodontic success. However, there is no one unique irrigant that can meet all these requirements, even with the use of methods such as lowering the pH, increasing the temperature , as well as addition of surfactants to increase the wetting efficacy of the irrigant. Thus, in contemporary endodontic practice, dual irrigants such as sodium hypochlorite (NaOCl) with ethylenediaminetetraacetic acid (EDTA) or chlorhexidine (CHX) (Qmix) are often used as initial and final rinses to complement the shortcomings that are associated with the use of a single irrigant. More importantly, these irrigants must be brought into direct contact with the entire canal wall surfaces for effective action, particularly for the apical portions of small root canals. Throughout the history of endodontics, endeavors have continuously been made to develop more effective irrigant delivery and agitation systems for root canal irrigation. These systems might be divided into 2 broad categories, manual agitation techniques and machine-assisted agitation devices. The endodontic smear layer has been described as one that is formed during instrumentation, consisting of not only dentin but also necrotic and viable tissue, including remnants of odontoblastic processes, pulp tissue and bacteria. The smear layer plays an important role in the lateral sealing of the root canal, by acting as an intermediate physical barrier that may interfere with adhesion and penetration of the root canal sealer into the dentinal tubules. Moreover it may slowly disintegrate and dissolve around leaking filling margins, thus creating voids between root canal walls and filling material / sealer.