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Let's Consider Root Canal Irrigation

In my opinion, an extremely important step in root canal treatment is root canal irrigation.


Cleaning the inside of the root canal is a more difficult procedure than the dentist may think and, in practice, often results in inadequate cleaning.

Root canal irrigation is not as simple as simply placing fluid into the root canal. As the name "irrigation" implies, it is the act of physically and chemically removing the dirt inside the root canal using a cleaning solution - some kind of liquid. The root apex is the most important area of the root canal where cleaning is required. 


In root canal treatment, aseptic preparation of the root canal by the dentist can prevent apical periodontitis. Once the root canal has been ideally enlarged with a NiTi file, it must then be thoroughly cleaned; if there is debris, it should be physically flushed out, and if there is inorganic or organic residue, it must be chemically cleaned.


In addition, the root canal must be perforated and patency must be ensured to irrigate the root apex with root canal irrigants. If the root canal is not negotiated and the patency is not secured, irrigants will be repelled by the debris during root canal cleaning.



Endoactivator for inexpensive, simple, and reliable root canal cleaning

The Endoactivator is a device that I am currently finding useful when cleaning root canals. 

It consists of a non-cutting polymer tip that vibrates in the root canal to agitate irrigants in the canal. Unlike ultrasonic irrigation, the Endoactivator is not expected to produce a cavitation effect, but it is effective enough for clinical use. Most importantly, the flexible plastic tip does not generate a smear layer when in contact with the root canal "dentine" wall.


Above all, this device is excellent in that it enables three-dimensional root canal cleaning of the root apex. 

If the root apex is ideally cleaned, the sealer used in conjunction with the root canal obturation will appear as a "puff" that overflows from the lateral branches and root apex due to obturating pressure. Puffing, by itself, is not evidence of healing of the periapical lesion. However, the presence of puffs in the post-obturating photographs can be used as a basis for assuming that proper root canal cleaning has been achieved. 

The Endoactivator can be used to make the root canal easier to obtain a puff. In other words, the Endoactivator is a device that allows for three-dimensional cleaning of the root apex.


It is simple to use: 60 seconds of 17% EDTA application per canal followed by 30 seconds of root canal rinsing with hypochlorite.


For a specific and precise protocol, please refer to the following article.

13D. Endodontic Disinfection 2022


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