Cleaning and preparation of the root canal system are the basic conditions for the success of endodontic treatment. However, many researchers described limitations smile direct club vs byte in the quality of manual or machine preparation of root canals. Numerous studies have shown smile direct that neither manual preparation nor the use of rotary tools allows for complete cleaning of the canal, especially in the apical segment in the case of curved canals.
Cleaning and shaping is easy with straight run canals. However, many canals show moderate to severe curvature, which increases the risk of steps, perforation and apical blockage during the procedure.
Removal of the pulp, tissue debris, smear layer and bacteria from the root canal space before its filling is one of the main goals of endodontic treatment. The level of difficulty of the cleaning and preparation procedure depends on the degree of canal curvature, access to the canal, its length and diameter. Undoubtedly, microorganisms that remain in the lumen of the root canal after its treatment or recolonize the filled canal are the main reasons for endodontic treatment failure.
Rinse liquids such as sodium hypochlorite (NaOCl) effectively dissolve organic residues, but thorough mechanical preparation is required. The effectiveness smile direct of cleaning the lumen of the canal depends on both its mechanical preparation and flushing.
Rinse liquids play an important role in effective cleaning and disinfection. The most commonly used fluid during endodontic treatment is NaOCl in concentrations of 0.5-5.25%. The ability to dissolve tissues and the antibacterial activity of NaOCl make it an excellent preparation for this purpose.
Of all the substances in use today smile direct club vs byte, NaOCl appears to be the closest to the ideal as it meets more of the requirements of a rinse aid than any other compound. Sodium hypochlorite has a unique ability to dissolve necrotic tissues and organic components of the smear layer. Inactivation of toxins under the influence of sodium hypochlorite has been reported. However, this effect is weaker compared to calcium hydroxide dressings.
To remove the smear layer, it is recommended to use acid solutions, e.g. EDTA, which reaches its maximum activity at a concentration of 15-17% and pH 7-8, and citric acid solutions used at concentrations of 10, 25 and 50%. Moreover, calcifications are often found in the root canals, which make mechanical preparation difficult smile direct.
Compounds with a demineralizing effect, such as EDTA, effectively remove the smear layer. Chelating agents not only have cleansing properties, but can also remove the biofilm adhering to the walls of the root canal. This may explain why EDTA irrigants eliminate the microbes in the canal more effectively than saline smile direct club vs byte, despite their limited antiseptic activity.
Antibacterial substances were added to the rinsing fluids containing EDTA or citric acid: quaternary amines (EDTAC) or tetracyclines (MTAD), respectively, to increase their antiseptic activity. However, the clinical significance of these additives is uncertain.
EDTAC removes the smear layer as effectively as EDTA, but is more corrosive. With regard to MTAD, resistance to tetracyclines is not uncommon among bacteria isolated in the root canals. In general, the use of antibiotics instead of bactericides such as hypochlorite or chlorhexidine is unjustified.
Antibiotics are designed for systemic use rather than local disinfection of wounds, and have a much narrower spectrum than the other compounds mentioned.MTAD was used to remove the smear layer and to remove the marginal shunt from the coronal side of the filled root canals.
Chlorhexidine:
Chlorhexidine is a strong base, the most stable as a salt. Initially, chlorhexidine acetate and hypochlorite were used, but they are relatively poorly soluble in water. Therefore smile direct club vs byte, they were replaced with chlorhexidine digluconate.
Chlorhexidine is a powerful antiseptic that is widely used to control plaque in the mouth. For this purpose, it is recommended to use aqueous solutions in a concentration of 0.1-0.2%, in endodontic literature, most often a 2% solution is recommended for rinsing root canals.