Preparation

Do they meet? All about canal confluences

There’s something about confluences, something to beware of. The meeting of two entities often stirs up a sense of foreboding, apprehension, something not quite desired. As in literature, so in endodontics. Confluences look so innocuous and can look so satisfying on the final PA when properly treated, but handled incorrectly they may lead you to “deep water”…

Preparation

Irrigation – how should I irrigate? Part 2: irrigant agitation, interactions and protocols

Why is irrigant agitation necessary? Passively “squirting” the irrigant into the canal and expecting it to intimately contact the whole canal surface is misguided because: Surface tension prevents irrigant penetrating all the fine tributaries (isthmuses, lateral canals, apical delta, fins) in the canal system. A vapour lock may form in the canal, which is a small gas bubble that either remains trapped, or forms at the apex (Senia et al. 1971). If it does, the bubble prevents irrigant contacting the canal surface and exerting its desirable properties in what is the most critical part of the canal. Even if there is no vapour lock, if you don’t (or can’t) place the needle sufficiently…

Read More

Preparation

Irrigation – how should I irrigate? Part 1: properties and delivery of irrigants

This two part post looks at the irrigation of root canal systems. I’ll start in this post with the ‘why’ and then in the next post move on to the ‘how’ of irrigation, concentrating the practicalities of the clinical implementation of effective irrigation in general dental practice. So, part 1 deals with the why of irrigation, properties of irrigants and delivery of irrigants into the root canal. Part 2 will discuss irrigant activation and recommended irrigant protocols. First, why irrigation? Pulpal and endodontic disease are caused by microbial infection of the canal system (Kakehashi et al 1965). Root canals may be infected by a variety of microrganisms cocci,…

Read More