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.

dentaltown.com \\ JULY 2020

DT0720_Axx_Endodontics_MM.indd 41

41

6/22/20 12:36 PM



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
Dentaltown July 2020 - 4
Dentaltown July 2020 - 5
Dentaltown July 2020 - 6
Dentaltown July 2020 - 7
Dentaltown July 2020 - 8
Dentaltown July 2020 - 9
Dentaltown July 2020 - 10
Dentaltown July 2020 - 11
Dentaltown July 2020 - 12
Dentaltown July 2020 - 13
Dentaltown July 2020 - 14
Dentaltown July 2020 - 15
Dentaltown July 2020 - 16
Dentaltown July 2020 - 17
Dentaltown July 2020 - 18
Dentaltown July 2020 - 19
Dentaltown July 2020 - 20
Dentaltown July 2020 - 21
Dentaltown July 2020 - 22
Dentaltown July 2020 - 23
Dentaltown July 2020 - 24
Dentaltown July 2020 - 25
Dentaltown July 2020 - 26
Dentaltown July 2020 - 27
Dentaltown July 2020 - 28
Dentaltown July 2020 - 29
Dentaltown July 2020 - 30
Dentaltown July 2020 - 31
Dentaltown July 2020 - 32
Dentaltown July 2020 - 33
Dentaltown July 2020 - 34
Dentaltown July 2020 - 35
Dentaltown July 2020 - 36
Dentaltown July 2020 - 37
Dentaltown July 2020 - 38
Dentaltown July 2020 - 39
Dentaltown July 2020 - 40
Dentaltown July 2020 - 41
Dentaltown July 2020 - 42
Dentaltown July 2020 - 43
Dentaltown July 2020 - 44
Dentaltown July 2020 - 45
Dentaltown July 2020 - 46
Dentaltown July 2020 - 47
Dentaltown July 2020 - 48
Dentaltown July 2020 - 49
Dentaltown July 2020 - 50
Dentaltown July 2020 - 51
Dentaltown July 2020 - 52
Dentaltown July 2020 - 53
Dentaltown July 2020 - 54
Dentaltown July 2020 - 55
Dentaltown July 2020 - 56
Dentaltown July 2020 - 57
Dentaltown July 2020 - 58
Dentaltown July 2020 - 59
Dentaltown July 2020 - 60
Dentaltown July 2020 - 61
Dentaltown July 2020 - 62
Dentaltown July 2020 - 63
Dentaltown July 2020 - 64
Dentaltown July 2020 - Cover3
Dentaltown July 2020 - Cover4
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com