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ENDDNT
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FINALS
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IRRIGANTS 2
level: IRRIGANTS 2
Questions and Answers List
level questions: IRRIGANTS 2
Question
Answer
IRRIGATING SOLUTIONS USED IN ENDODONTICS:HEBP is also called
Etidronic acid
IRRIGATING SOLUTIONS USED IN ENDODONTICS:HEBP
I-hydroxyethylidene-1, 1-bisphosphonate (HEBP)
IRRIGATING SOLUTIONS USED IN ENDODONTICS:A substance that prevents bone resorption, has been used in medicine for patients suffering from osteoporosis or Paget's disease and was suggested as a substitute for traditional chelators due to fewer effects observed on dentin structure
HEBP (Etidronic acid)
IRRIGATING SOLUTIONS USED IN ENDODONTICS: Ability to remove the smear layer similar to that of EDTA or citric acid, and it can be mixed with NaOCl without any loss of the NaOCl antimicrobial activity
HEBP (Etidronic acid)
IRRIGATING SOLUTIONS USED IN ENDODONTICS:could be used as a single irrigant during and after instrumentation, replacing the final rinse with a chelating agent
HEBP (Etidronic acid)
TRUE OR FALSE: You can use EDTA alone as an irrigant. Irrigation with 17% EDTA for 1 min. followed by a final rinse of NaOCl is recommended
FALSE
TRUE OR FALSE: Longer exposures of EDTA can cause excessive removal of both peritubular and intertubular dentin
TRUE
COMBINATIONS AND SOLUTIONS WITH DETERGENTS: The irrigant flow can be affected by ___________- of the irrigant
density, viscosity, contact angle, and wetting behavior
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Even though density and viscosity always affect the flow, ____only affects the flow when 2 immiscible (incapable of mixing) fluids are present.
surface tension
TRUE OR FALSE: Because the dentin is hydrophilic and dentinal tubules always contain water, there is no need in endodontic irrigants to add detergents
TRUE
Some added detergents in the market are: SmearClear
EDTA + detergents
Some added detergents in the market are:Chlor-XTRA
NaOCl + detergents
Some added detergents in the market are:CHX-Plus
CHX + detergents
Some added detergents in the market are:Tetraclean
50 mg/mL doxycycline + polypropylene glycol + citric acid,
Some added detergents in the market are:MTAD
3% doxycycline hyclate + 4.25% citric acid + Tween 80
Some added detergents in the market are:QMIX:
CHX + EDTA + detergent
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Capable of removing both the smear layer and organic tissue from the infected root canal system
BioPure MTAD and Tetraclean
BIOPURE MTAD AND TETRACLEAN:a broad-spectrum antibiotic; type of tetracycline
3% doxycycline
BIOPURE MTAD AND TETRACLEAN:a demineralizing agent
4.25% citric acid
BIOPURE MTAD AND TETRACLEAN:a detergent
0.5% polysorbate
IRRIGATING SOLUTIONS USED IN ENDODONTICS:An alternative solution to EDTA for removing smear layer
BioPure MTAD
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Developed as a final rinse to disinfect RC system and remove smear layer
BioPure MTAD
IRRIGATING SOLUTIONS USED IN ENDODONTICS:AAE - effectiveness of MTAD to completely remove smear layer is enhanced when a low concentration of ___ is used as an intracanal irrigant before placing MTAD in a canal for __ min and rinsing it with additional _ml of MTAD as the final rinse
NaOCI (1.3%); 5; 4
IRRIGATING SOLUTIONS USED IN ENDODONTICS:It is superior to CH in antimicrobial activity; Has sustained antibacterial activity, biocompatible, and enhances bond strength
BioPure MTAD
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Combination product similar to MTAD
Tetraclean
BioPure MTAD and Tetraclean:doxycycline for MTAD
150 mg/5 ml
BioPure MTAD and Tetraclean:doxycycline for Tetraclean
50 mg/5 ml
BioPure MTAD and Tetraclean: detergent MTAD
Tween 80
BioPure MTAD and Tetraclean: detergent Tetraclean
polypropylene glycol
TETRACLEAN MOA: is effective against
Aa. capnocytophaga, P. gingivalis, and P. intermedia
TETRACLEAN MOA: affects what gram bacteria
both gram-positive and gram-negative (more gram-negative effect).
Tetracycline is a ____ antibiotic
bacteriostatic
in high concentrations, tetracycline may also have a ____effect
bactericidal
MTAD MOA: may have a synergistic effect on the disruption of the bacterial cell wall and on the cytoplasmic membrane.
Doxycycline, citric acid, and Tween 80
IRRIGATING SOLUTIONS USED IN ENDODONTICS:introduced in 2011
QMiX
IRRIGATING SOLUTIONS USED IN ENDODONTICS:It is recommended to be used at the end of instrumentation, after NaOCl irrigation
QMiX
Qmix mixed with NaOCl can produce
PCA (4-chloroaniline).
IRRIGATING SOLUTIONS USED IN ENDODONTICS:broad spectrum; root canal disinfectant
Iodine Potassium
Iodine Potassium: Concentration
2% to 5%.
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Acts as an oxidizing agent by reacting with free sulfhydryl groups of bacterial enzymes, cleaving disulfide bonds; Shows relatively low toxicity in experiments using tissue cultures
Iodine Potassium
IRRIGATING SOLUTIONS USED IN ENDODONTICS:may be able to kill Ca/OH/2-resistant bacteria (E. faecalis) more efficiently
combinations of IKI and CHX
IRRIGATING SOLUTIONS USED IN ENDODONTICS:facilitate manipulation of hand files during cleaning and shaping
Lubricants
IRRIGATING SOLUTIONS USED IN ENDODONTICS:They are an aid in initial canal negotiation, especially in small and constricted canals without taper
Lubricants
mild alcohol that is inexpensive, nontoxic, aseptic, and somewhat soluble; main component of lubricants
glycerin
One advantage to paste lubricants is that they can ____ dentinal debris and prevent ____
suspend; apical compaction
When nickel-titanium rotary techniques are used, _____(e.g., NaOCI), rather than paste lubricants, should always be present in the root canal to reduce torque
aqueous solutions
IRRIGATING SOLUTIONS USED IN ENDODONTICS: recommended as a pre-irrigation step or final irigation step prior to intra-canal medicament placement or obturation of the canal
95% ethyl alcohol
TRUE OR FALSE: The evaporation of the alcohol is thought to aid either irrigant or sealer penetration
TRUE
IRRIGATING SOLUTIONS USED IN ENDODONTICS:A final rinse of approximately __ml of 95% Ethyl alcohol can be recommended in order to improve the sealing ability of the root canal filling
3-5
reduces the surface tension of either the irrigant fluid to be used thereafter or sealer during obturation
alcohol
IRRIGATING SOLUTIONS USED IN ENDODONTICS:been used in concentrations ranging from ____ alternating with sodium hypochlorite as part of the irrigation protocol
3 to 5%
HYDROGEN PEROXIDE:The release of _____, which produces ____, was thought to help dislodge debris, which could drain out of the canal with the irrigant
nascent oxygen; effervescence
HYDROGEN PEROXIDE: not recommended as final irrigant due to_____
nascent oxygen
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Also called electrochemically activated water or oxidative potential water
Superoxidized Water
IRRIGATING SOLUTIONS USED IN ENDODONTICS:Is effectively saline that has been electrolyzed; This solution is nontoxic to biologic tissues yet able to kill microorganisms
Superoxidized Water
Superoxidized Water is composed of
superoxidized water, hypochlorous acid, and free chlorine radicals
chemical compound consisting of three oxygen atoms /O3-triatomic oxygen), a higher energetic form than normal atmospheric oxygen (02).
Ozone
produced naturally - is a very powerful bactericide that can kill microorganisms effectively.
Ozone
Itis an unstable gas, capable of oxidizing any biological entity; Itis present naturally in air and can be easily produced by ozone generator
Ozone
It was reported that ozone at low concentration, ___, is sufficient to inactivate bacterial cells including their spores
0.1 ppm
Muray et al. evaluated ______ in conjunction with EDTA as a possible alternative to NaOCl
Morinda citrifolia juice
is an Indian ayurvedic herbal formulation consisting of dried and powdered fruits of three medicinal plants
Triphala
3 medicinal plants in Indian ayurvedic herbal formulatio
Terminalia bellerica, Terminalia chebula, and Emblica officinalis
HERBAL:is used as a solvent for Triphala and GTP, although they are readily soluble in water
Dimethyl sulfoxide (DMSO)
Combination of NaOCl and CHX produces a change of color and a precipitate which is
4- chloroaniline (PCA)
been shown to be toxic in humans with short-term exposure, resulting in cyanosis, which is a manifestation of methemoglobin formation
4- chloroaniline (PCA)
Combination of CHX and EDTA produces a
white precipitate
CHX was found to form a __ with EDTA rather than undergoing a chemical reaction
salt
TRUE OR FALSE: EDTA loses its calcium-complex ability when mixed with NaOCI
TRUE
caused NaOCl to lose its tissue-dissolving capacity, with virtually no free chlorine detected in the combinations
EDTA
EDTA will leave a layer of ___ on the surface of the root canal lumen, and collagen can be important for the binding of bacteria; therefore, a final rinse with a low concentration of NaOCl can be applied at this time
collagen
______temperature of low-concentration NaOCI-improves their immediate tissue dissolution capacity
Increasing
TRUE OR FALSE: Heated hypochlorite solutions remove organic debris from dentin shavings more efficiently
TRUE
Chelators have a clear temperature range at which they work best. Heating from ____will decrease the calcium binding capacity of EDTA and citric acid
20 to 90 °C
Cameron et al reported that an increase in the intracanal temperature from ____occurred close to the tip of the instrument when the NaOCl solution was ultrasonically activated for 30 s without replenishment
37 to 45°C
In 2009, Basrani et al published a paper showing that CHX at room temperature and at 37°C did not result in a _____ when diazotized, therefore indicating that there is no aromatic amine present
yellow end product
when CHX that was heated to __was diazotized, the result was a yellow end product, indicating the presence of PCA or another aromatic amine
45 °C
Adjunctive Irrigation Techniques:Conventional Synge and Needles Plastic syringes of different sizes
MANUAL PASSIVE IRRIGATION
All endodontic syringes should have a _____ design, which avoids potential needle disengagement and irigant spray, which can be harmful on skin/mucosal/eye contact and damage to clothing.
luer-Lok hub
Adjunctive Irrigation Techniques: can be performed with hand files, brushes, or a well- fitting tapered guttapercha point
MANUAL DYNAMIC IRRIGATION
Planktonic and in vitro biofilm E. faecalis cultures as well as mixed-species biofilms respond better to _____ than MTAD
tetraclean
IRRIGATING SOLUTIONS USED IN ENDODONTICS:obtained by the electrochemical treatment of a saline solution.
Superoxidized Water
IRRIGATING SOLUTIONS USED IN ENDODONTICS:obtained from regular tap water and low-concentration salt solutions by electrochemically activating (ECA) them.
Superoxidized Water
Concentration: The tissue dissolving power of NaOCl is higher at 5.2% than at 2.5% and 0.5%, and therefore, the ___the concentration, the greater the effectiveness
higher
Touch: To be effective, the irrigant must ___the substrate. The presence of organic tissue must be for irrigation to be successful.
contact; removed
Quantity of irrigant utilized: The ___ irrigant is used, the more effective it is.
more
Irrigant's surface tension: The ___ the surface tension, the better the wettability.
lower
Irrigant's temperature: ___ the NaOCl boosts its efficacy.
Warming
Irrigation frequency: The ___ the frequency, the better the outcomes.
higher
Canal diameter: The ____ the canal, the better the irrigant's effect.
wider
Irrigant's age: Newly produced solutions are __efficient than older solutions.
more
Irrigating needle gauze: _____gauze is used for improved canal penetration.
27 or 28
Irrigation is dependent on the canal's size and shape. If the apical region is to be adequately disinfected, the canals must be stretched to a diameter of at least ___
30
To effectively clean both front and posterior dental canals, a __-degree blunt bend in the needle's core may be used
30
Canal walls must be in direct contact with an irrigant in order for it to work. Due to the _______, it is difficult for the irritant to reach the canal's apical portion.
vapour lock effect