Dentaltown July 2020 - 41

Cleaning the canals
Let's talk about irrigation. In endodontics, we know that what we remove from
the root canal space through "cleaning
and shaping" is far more important to a
successful result than what we put in (i.e.,
what we obturate with or how we obturate).
We clean the root canal system in
two ways: mechanically and chemically.
Mechanically, we use rotary instruments to
grossly debride the canal space and canal
walls, and to create spaces conducive to
the introduction and action of irrigants
and medications. Chemically, we augment
rotary instrumentation by using one or
more irrigants that work on pathology with
different mechanisms of action. But no matter
the choice of irrigants, the goal of chemical
cleansing is to remove as much tissue, debris,
toxins and bacteria as possible from the
main canal lumen, from dentinal tubules
and from canal ramifications not accessible
to rotary instruments, such as lateral canals,

anastomoses, isthmuses and complex apical
bifurcations or multibranching.
Clinicians could also augment their
protocols to enhance the effectiveness of
chemomechanical instrumentation. For
example, the EndoActivator, a tool that
sonically activates sodium hypochlorite
and other irrigants, can get those irrigants
into lateral canals. And EDTA or QMix
can debride canals of the smear layer and
also gain entry into complex anatomy. But
does this happen in every tooth with any
degree of regularity? I'm not sure we have
the answer to that.
For me, GentleWave has treated complex anatomy and all of its variations
in a consistent and thorough manner.
I'm seeing this happen more regularly in
cases in my office (Figs. 2a-c and 3a-b).
It does so through a completely different
way of creating an environment in which
the body can heal itself, which allows us to
more thoroughly, regularly and consistently

Fig. 2a: Preoperative PA radiograph.

Fig. 2b: Postoperative PA radiograph.

Fig. 3a: Preoperative PA radiograph.

Fig. 2c: Six-month recare.

Fig. 3b: Postoperative PA radiograph.

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Dentaltown July 2020

Table of Contents for the Digital Edition of Dentaltown July 2020

Dentaltown July 2020 - Intro
Dentaltown July 2020 - Cover1
Dentaltown July 2020 - Cover2
Dentaltown July 2020 - 1
Dentaltown July 2020 - 2
Dentaltown July 2020 - 3
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Dentaltown July 2020 - Cover3
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