Comparative evaluation of postoperative pain, periapical damage and bacterial disinfection after using endodontic needle and Eddy tips during root canal irrigation

INTRODUCTION
• Goals / objectives of irrigation
• Post-endodontic pain
• Solutions used in the irrigation of the root canal
o Ideal endodontic irrigation solutions
o Advantages /disadvantages of irrigants mainly used
• Old and new equipment for irrigation / activation of the irrigant
o Irrigant Agitation techniques and Devices:
 Manual:
• Syringe irrigation with needles / cânulas: end-venting; side-venting
• Brushes: Endobrush; NaviTip FX
• Manual-dynamic agitation: Hand-activated well-fitting gutta-percha
 Machine-assisted:
• Rotary brushes: Ruddle brush; CanalBrush
• Continuous irrigation during rotary instrumentation: Quantec-E
• Sonic: Rispisonic file; EndoActivator; EDDY
• Ultrasonic
o Continuous: Nusstein’s needle holding device
o Intermittent: Ultrasonic file; smooth wire
• Pressure alternation devices: EndoVac; RinsEndo
• LAI (laser-activated methods)
• PIPS (photon-induced photoacoustic streaming)
• Some of the dilemas in selecting the best irrigating protocol during endodontic treatment:
o Duration of irrigation: How much time do I need to disinfect the canal?
o Concentration of irrigating solutions: which concentration of NaOCl should I use?
o Disinfection of apical third of the canal: How can the irrigant reach the apical portion?
o Irrigation sequence: which sequence of irrigants should I use?