An improved endodontic irrigation technique

An improved endodontic irrigation technique Henry Kahn, D.D.S.,+ Robert Zelikow, D.D.S.,** Gary Ritchie, Major, DC, USA,‘** Marshall H. Smulson, D.D.S.,**++ and Franklin 8. Weine, D.D.S., M.S.D.,***** Maywood and Chicago, Ill. LOYOLA

UNIVERSITY

SCHOOL

ILLINOIS

COLLEGE

OF DENTISTRY,

MEDICAL

DEPARTMENT,

An efficient method This is accomplished tip as a single unit.

FORT

OF DENTISTRY,

SILL,

for irrigating by combining

CHICAGO,

MAYWOOD,

UNIVERSITY

OF

AND

OKLA.

and aspirating an irrigating

root canals has been described. syringe and a modified aspirator

R

oot canal irrigation fulfills important functions during endodontic therapy.le3 Most of the commonly used irrigating solutions are necrotic tissue solvents4 Therefore, they aid in the removal of tissue, debris, and microorganisms when used with broaches and files.5 The mechanical action of washing out the canal flushes away the dentinal filings which might block the preparation to the apex, and the moistened dentinal walls decrease the chance for instrument breakage.6 To date, the methods for recovering irrigating solutions and drying the canal have entailed the withdrawal of the plunger of the irrigating syringe, and the use of cotton rolls or pellets, gauze sponges, aspirators, and paper points. Each has some disadvantages. This article presents another technique for removing the solutions used in irrigating the chamber and canal by means of a simple, efficient device which accomplishes both irrigation and aspiration at the same time. The materials required for assembling the device are : A 25-gauge needle-ll/4 to 2 inches long *Associate Professor of Endodontics, Loyola University School of Dentistry. **Instructor in Endodontics, University of Illinois, College of Dentistry. ***Chief of Endodontics, Dental Activities Medical Department, Fort Sill, Okla. ****Professor and Chairman, Department of Endodontics, Loyola University Dentistry. *****Associate Professor and Director, Postgraduate Endodontics, Loyola School of Dentistry.

School

of

University

887

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Kahn et al.

Fig. 2. The irrigating about a/4 inch.

syringe

needle punctures

the Teflon

tubing

so that the tip protrudes

Fig. 8. The opposite end of the tubing is placed into an adaptor receptacle in order to obtain the needed negative pressure for aspiration tion.

for the saliva-ejector of the irrigating solu-

A 5 cc. glass or plastic syringe A 24-inch length of plastic tubing (I.D. %e inch ; O.D. % inch; wall 1/3einch) polyvinyl or Teflon* A l-inch length of Teflon tubing (AWG 17, standard wall) * An adaptor to saliva ejector-from adaptors included with “monojet saliva ejectors”t The plastic tubing is fitted at one end with the adaptor. This will, in turn, fit into a saliva-ejector receptacle. The other end of the plastic tubing is fitted with the Teflon tubing, which should project from the plastic tubing about s/4 inch. The needle penetrates the wall of the plastic tube and exits through the end of the Teflon tube (Figs. 1 and 2). If there is insufficient suction, it will be necessary to use a valve to inactivate the saliva ejector when irrigating. The assembly may be sterilized by autoclave or the Harvey vapor method, *Cadillac Plastics and Chemical Co., Chicago, Ill. @herwood Medical Industries, St. Louis, MO.

Volume 36 Number 6

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Fig. S. As the solution is deposited into the canal or floor of the chamber from the syringe, the excess irrigant ia aspirated through the tubing. Aspiration only may be accomplished by adjusting the tubing so that it is flush with the tip of the needle, and the assembly is placed to the orifice of the canal to be evacuated.

Fig. 4. When not in use, the syringe is held by a split piece of plastic tubing (arrow) riveted to a cloth which may be attached with an alligator clip to the patient’s towel.

either alone or in an endodontic pack. Should the needle portion become contaminated during use, it may be dipped into a hot bead or salt sterilizer for 10 seconds. IRRIGATING TECHNIQUE

The device is placed into the saliva ejector receptacle of a standard dental unit, or into any suction device. Then, the barrel of the syringe is attached to the needle, filled with irrigating solution, and fitted with the plunger. Air is removed from the syringe. The assembly is carried to the tooth, and the needle is placed without binding into the orifice of the canal or to the floor of the chamber. The solution is deposited into the canal and is aspirated as it returns to the pulp chamber (Fig. 3). The amount of solution remaining in the root canals and chamber may be regulated very easily. Allowing the syringe tip to protrude farther through the

890

Oral Surg. December, 1973

Kahn et al.

tubing keeps the solution in the canals. If the tubing is placed into the chamber without irrigating, most of the solution will be removed along with the dentin filings. For ease of access to the syringe during endodontic treatment, a holder also may be fabricated. A 3/4-inch piece of plastic tubing” which has been slit horizontally is riveted to a piece of cloth with Speedyt or similar rivets. The cloth is attached to the patient’s towel by means of an alligator clip, and the tubing snugly holds the syringe in place within close reach of the operator (Fig. 4). ADVANTAGES

OF TECHNIQUE

1. Irrigation, as well as aspiration, may be accomplished with one hand, leaving the other free to hold the mirror, or perform other necessary functions. 2. Solutions will not leak between the tooth and rubber dam into the mouth, nor will they drop onto the face or clothing. 3. Sterilization may be accomplished by any acceptable method. 4. The irrigating device is inexpensive, easy to construct, and requires minimal maintenance. *Cadillac Plastics and Chemical Co., Chicago, Ill. tColumbia Fastener, subsidiary of United Can Co., Chicago, 111. REFERENCES

1. Weine, F. 5. : Endodontic Therapy, 2. Heuer, M. A.: The Biomechanics 341-359, July, 1963. 3. Stewart, G. G.: The Importance

St. Louis, 1972! The C. V. Mosby Company, pp. 216-220. of Endodontlc Therapy, Dent. Clin. North Am., pp. of

Chemomechanical

Preparation

of

the Root

Canal,

ORAL SURG.8: 993-997,1955.

4. Penick, E. Clin. North 5. Healey, H. 6. Grossman,

C., and Osetek, E. M.: Intracanal Medications in Endodontic Therapy, Dent. Am. 14: 743-756, 1970. J.: Endodontics, St. Louis, 1960, The C. V. Mosby Company, pp. 138-139. L. I.: Guidelines for the Prevention of Fracture of Root Canal Instruments,

ORAL SUFCG.~~:746-749, 1969. Reprint bequests to: Dr. Franklin S. Weine Loyola University School of Dentistry 2160 South First Ave. Maywood, Ill. 60153