Do We Really Need to Activate Our Irrigant?

Topic Description:

Abstract:

The major causative role of microorganisms in the pathogenesis of pulp and periapical diseases has clearly been demonstrated, hence the goal of endodontic treatment is to remove all the vital and necrotic tissues, microorganisms and microbial by-products from root canal system. This goal can be achieved through chemical and mechanical debridement of root canals. However, the root canal complexity and the sophistication of the microbial biofilm suggested a shift from the static needle- delivered irrigation method to the dynamic activated irrigation techniques. In the last decades, several methods of irrigant activation was developed, tested and adopted by endodontists all over the world.

Introduction:

In the era of evidence-based dentistry it is important to understand that laboratory studies are required for the development of endodontic instruments, materials and techniques, and when they are designed with the same scientific rigour used for in vivo studies, they provide valid information that can inform the design of clinical research. However, considering the limitations of extrapolating the results of laboratory studies to clinical reality, the biological basis of clinical outcomes, bacterial reduction, etc… has to be evaluated by a clinical trial.  Therefore, clinicians have to carefully evaluate available scientific data before adopting irrigant activation techniques.

Learning Objectives:

• Review on root canal disinfection challenges.
• Analyzing the limitation of static irrigation
• Different activation and agitation protocols.
• Evidence synthesis of the efficacy of different activation and agitation protocols.
• Identification of gaps in knowledge, to suggest future research strategies