 Hello everyone, welcome back to another session in dentistry and more. Today we have Irrigation and intracanal medicaments from endolontics. So this session explores various reagents used as irrigating or intracanal medicaments during root canal therapy So what are the ideal requirements for an irrigate? So it should be having broad spectrum anti-microbial properties it should aid in debridement of the root canal system and It should be able to dissolve the necrotic tissues or deprise should be having lower toxicity level It should be a good lubricant So it so it should be having low surface tension to flow into in accessible area So there are many accessory canals present which are basically unnoticed in preparation So a reagent with low surface tension would be able to flow into those inaccessible area. Then it should be able to sterilize the canal and it should prevent or dissolve the smear layer and it should inactivate endotoxin So what are the basic functions of these irrigants? So the functions to remove the Tentenal treatments via physical flushing should increase the efficiency of instruments It should dissolve the necrotic tissue to remove debris from lateral and accessory canals should be Geomicidal as well as anti-material should be bleaching action Irrigants with lubricating agent further increase efficiency and opening of Tentenal reviews by the removal of smear layer. See these are the functions of Irrigants, so what are the factors modifying the activity of these irrigating solution? The first one is a concentration So the tissue dissolving capability of sodium hypochloride is higher at 5.2 percentage Second one is a contact that is to be effective these Irrigants must come in contact with the substrate. So more contact more effectiveness and presence of organic tissues So organic tissues will always hamper the process. So organic tissues must be removed for Effective irrigation then quantity of the irrigant used. So increase in quantity will directly or proportionally improve the effectiveness then gauge of the irrigating needle 27 or 28 gauge, this is gauge sorry is preferred for better penetration in the canal Then the surface tension should be having low surface tension so that it moves well within the canal Temperature so warming the sodium hypochloride increases its efficacy study has proven that Then frequency so more frequent better than the result then canal diameter wider the canal better is action of irrigant Then age of irrigant freshly prepared solutions are more efficient than the older ones Now moving on to the commonly used irrigating solutions. So chemically non-active solutions are water saline and local anaesthetic So chemically active materials they includes alkalis chelating agents oxidating agents and the bacteria acids enzymes and detergents So the first one is alkali So the most common alkali sodium hypochloride where point five to five point two five percentage concentration Is used for the used as a irrigating solution second one is a chelating agent that is EDTA which chelates the Calcium ions that is ethylene, diamine, tetra, acetic acid then oxidizing agent They are hydrogen peroxide, carbamide peroxide antibacterial agents of chloroxidene and Biskualenium acetate then the acid 30 percentage hydrochloric acid enzyme the streptokinase, pine and trypsin, detergent, sodium, laurel sulphate. So we'll start with the first one that is sodium hypochlorate The mechanism of action So the reactive chlorine in aqueous solution exist in basically two forms The first one is hypochlorate and then the hypochlorous acid So the state of available chlorine depends on the pH of solution that is above 7.6 it will be alkylene in nature. So it is mainly hypochlorate this OCL form and below this pH This more of acidic because it is going down the pH is going down that is H OCl So the presence of five percentage of free chlorine and sodium hypochlorate is responsible for breakdown of proteins into amino acid Okay, so that is how it works as a reagent Irrigating solution. So the pH of commonly used sodium hypochlorate is 12 more of alkylene At which the OCL form exists this hypochlorate So the hypochlorate which dissolves Necrotic tissue because of its high alkylene nature So this is a chart which shows the Efficacy or the factors affecting its efficacy when the volume of solution if there is a heating or time of contact is high the efficacy will improve whereas storage time and Chemical agents are involved the cap present then the efficacy of the soda hypochlorate will Decrease some more storage means a decreased Storage time that means specially prepared sodium hypochlorate will be more effective than the stored one So the advantages are it causes tissue dissolution as antibacterial and also bleaching action Causes lubrication of canals. It is very economical and easily available But the problems with sodium hypochlorate because of its high surface tension its ability to it then 10 is less Which is quite irritant to tissues if Extruded periapaclete can result in severe cellular damage. So it is very problematic to the surrounding tissues and It can also irritate the gen chiva if it comes contact with Because of its caustic nature. It can bleach the clothes It has had a bad order and taste and vapors of sodium hypochlorate can irritate the eyes and it can be corrosive to the Operative instruments The second one is a hydrogen peroxide. We commonly use 3% a solution So what happens is it rapidly dissociates into water and nascent oxygen So on coming in contact with tissue enzymes catalase and peroxidase the nascent oxygen produced which act as a bactericidal and This effect is transient one and diminishes in presence of organic debris So if organic debris are present the effectiveness of hydrogen peroxide will be less Next is a chloroxidene Which is optimal anti microbial action with ph 5.5 to 7 commonly used in 2 percentage concentration So it act as a bacteriostatic agent at low concentration Whereas at higher concentration it causes coagulation and precipitation of cytoplasm So it is a bactericidal at higher and bacteriostatic at low concentration So the advantages are a 2 percentage solution is used as a root canal Irrigent then 0.2 percentage it can be used in controlling plague activity Then it is more effective on gram positive bacteria than gram negative one So it is basically not considered as a main arrogant in standard root canal procedure It is unable to dissolve necrotic tissue remnants and it is also less effective on gram negative. So actually this was Disadvantage This basically works on gram positive and anaerobic bacteria's effectiveness is quite less Next is a chelating agent that is EDT and other chelating agents like citric acid, poorly acrylic acid are used for this purpose Basically chelating agents are chemical compounds that react to with metal ions to form a stable water soluble complex so they are also known as chelens or Sequestrating agents. So these chelating agents have a ring like center which forms at least two bonds with metal ion Allowing it to be excreted. So it creates a complex So basic functions of this EDTA is lubrication Nullification holding debris and suspension or smear layer removal The uses are it has dentine dissolving properties that is the most unique property of EDTA It helps in enlarging the narrow canals Makes easier manipulation of instruments and reduces time needed for deprivement So next we have the intra canal medicaments. So medications they basically destroy the remaining bacteria and also limits the growth of new Arrival of bacteria. They are useful in treatment of pachyl pyridontitis So if there is inflammation, which is caused by our instrumentation So usual is a commonly used intra canal medicament In low doses it inhibits prostaglantin synthesis Inhibits nerve activity. It inhibits white cell chemotaxis. Whereas the high dose It directly induces cell death and inhibits cell respiration So it is used as an intra canal medicament used as a root canal sealer And it also used as a temporary sealing agent Next we have the intra canal medication phenol It has strong inflammatory potential. So at present it is rarely used as an intra canal medicament But as a liquefied phenol that is carbolic acid which consists of nine parts of phenol and one part of water She's used for disinfection Before the periapyrichal surgery is also used for Tracing tissue tags that resist removal with brooches or files Now we have the recent one CMCP that is Camphorated monoparachlorophenol. It is probably the most commonly used medicament and around is presently Even though it's used as decrease considerably in the past few years. So it's composition two parts of parachlorophenol and three parts of gum camphor Which Gura is true CMCP. It is used as a dressing of choice of infected teeth Now the Fomocressol the CMCP has asked alone as a short note Next medication is Fomocressol. It contains formaldehyde as its main ingredient and Is still widely used as medicament for the pulpotomy procedure in primary teeth It's toxic and mutagenic properties are of a concern So that it's side effects it is a little bit of toxic and mutagenic in nature So it's commonly used in pulpotomy to fix the retain pulpal tissues So composition it has a 19 percentage of formaldehyde 35 percentage of gressol and 46 percentage of water and glycerin Next one is a calcium hydroxide which is very commonly used Medication that is used in weeping canals and treatment of phoenix hepsis in Resorption cases or for Apexification during pulpotomy for non-surgical treatment of periapical lesion or in cases of direct and indirect pulp capping as Cylophore obturation to decrease the post-operative pain after over instrumentation So functions it inhibits root resorption stimulates periapical healing and Encourage mineralization That was all about intra canal arrogance and medications. This was very very brief Explanation or detailing of the arrogance and medications. It was in fact a very big chapter The many things which can be added as extra points So this is very commonly asked essay question for to write for an essay. I think all these compressed bullet points will be sufficient sometimes the Single solution or a single arrogant can be asked as a short note So that was all about the intra canal arrogance and medications. I'll come up with a new topic in Operating history and electronics. Thank you