Reaching the Depths through Three-Dimensional Irrigation – A Review

Abstract

The main goal of an endodontic therapy is thorough debridement of root canal system thus, ``THREE DIMENSIONAL{''} cleaning is an essential factor in an endodontic procedure. The irrigant facilitates the removal of biofilm / microorganisms, tissue remnants and dentine chips from the root canal. It also acts as a lubricating agent and helps in the root canal instrumentation by reducing the excess friction that is generated. Only the three dimensional cleaning of the canals can guarantee the three dimensional sealing along with the long term success of endodontic treatment. Large areas of the main canal remain untouched after instrumentation thus, emphasising the importance of chemical cleaning and disinfection. The classic irrigant delivering approach is ineffective particularly in the apical third, isthmus, curves and fins. As there is no ideal root canal irrigant that serves all the objectives, they are used in combinations or in a specific sequence. Currently, there exists difference in opinions regarding the potential to three-dimensional cleaning of the canal system leading to the introduction of several mechanical devices for improving the penetration and safety of the entire process. These devices can be divided into 2 broad categories, manual agitation techniques and machine-assisted agitation devices. The manual irrigation system using needles is still widely accepted by general practitioners and endodontists while the newer machine assisted devices are making their way in leaps and bounds. This review focuses on the hydrodynamic disinfection of canals and provides us with the cutting-edge information on the most recent developments while making it evident that integration of newer technologies, coupled with enhanced techniques and materials may help in elevating our everyday clinical practice. Also brief description of various endodontic irrigation devices and their mechanism governing their efficacy is given.