Endodontic Predictability: “Are You Making the Right Decisions?”

Decision No. 7: What Cleaning Techniques Should I Choose (Figure 4f)? Q: What does 3-D endodontic cleaning mean and how do you do it?

A: The purpose of cleaning the root canal system is to remove bacteria, biofilm, smear layer, and any remaining viable and nonviable irritants that are capable of sustaining or creating lesions of endodontic origin where the root canal system’s portals of exit are not permanently sealed. Full strength sodium hypochlorite should be used in the development of the GlidePath and then switch to EDTA during rotary. Finish with the following irrigation sequence: EDTA to remove remaining smear layer, sodium hypochlorite to remove any remaining detached necrotic tissue, and alcohol to dry the root canal system prior to obturation. The EndoActivator (DENTSPLY Tulsa Dental) has been shown to significantly increase the effectiveness of all endodontic irrigants.⁹

Guideline No. 7: Irrigate and agitate irrigants constantly during cleaning and shaping. Remember, what the dentist takes out of the root canal system is as important as what he/she puts into the root canal system.