Irrigation
Irrigation is a very important part of root canal treatment, it is performed multiple times during the whole procedure, from the start to the final step of the treatment. Today a lot of different irrigation techniques are available, mostly delivering the solutions in the access cavity or in the canal using syringes/needles. Different activation devices are used to improve the streaming of the irrigant solution, sonic, ultrasonic and laser (erbium family laser only).
The activation produce positive pressure to the solution with the aim to achieve an efficient and effective three-dimensional streaming of the fluids.
A concern that has to be considered and addressed during the irrigation procedure is possible extrusion of the irrigant from the apical foramen (Apical Extrusion AE).
This may happen in different conditions, when the apical foramen is superior to size ISO 40-50:
- in immature tooth with not complete apecification;
- in tooth with periapical patology and wider apical anatomy modified by the infection;
- in case of accidental overinstrumentation of the apical foramen;
- when high pressure is applied to the irrigant due to high setting of the device used;
- when high pressure is applied to the irrigant depending on the needle type (end port) and insertion depth;
- when high pressure is applied to the irrigant depending on the position of the laser tip in the canal;
- when different periapical infection condition (tissue type) the periapical pressure;
- etc.
Apical extrusion can result in minimum bleeding or in a severe sodium hypochlorite accident, depending on the time and pressure applied and so the volume extruded.
The Use of Endostar Apical Stopper
To prevent Apical Extrusion (AE) an instrument called Endostar Apical Stopper can be used during the irrigation. It is a smooth, non-working stainless steel file, of appropriate ISO size, fitting (equal to) the size of the apical foramen. The instrument has a slim plastic handle, colored according to ISO standard for root canal instruments.
A narrow, non-tapered file will not occlude the canal space, so that irrigant is free to stream around it and along the canal walls, allowing an efficient smear layers and biofilm removal and, at the same time, blocking apically the extrusion of the fluid.
Methodology of root canal irrigation (step by step), using Endostar Apical Stopper:
- Perform the standard root canal treatment method you normally use.
- Before to irrigate the root canal, place an Endostar Apical Stopper instrument in the canal up to the working length (WL). Use the size of the Endostar Apical Stopper, chosen during the apical foramen measurement (“gauging”). If possible, check if the Endostar Apical Stopper blocks the apical foramen.
- Irrigate the canal according to the procedure, and activate the irrigant with the prefered method.
- Take out the Endostar Apical Stopper from the canal and continue the root canal treatment procedure.
- Repeat steps 2 – 4 during the next irrigation of the root canal.
Technical specyfication
Endostar Apical Stopper is produced in ISO sizes 40, 50, 60, 70 and 80, length 25mm, packed in boxes of po 6 pcs of one size.
It can be used multiple times, 4-5 times for the instruments, sizes ISO 40-50 and 6-8 times for the instruments sizes 60, 70, 80. Instrument has a white endostopper on it, used for setting the depth of the insertion of the Endostar Apical Stopper into the canal.
Endostar Apical Stopper, by Giovanni Olivi no 40, 31mm, 6 pcs/box
EAS004031SW
Endostar Apical Stopper, by Giovanni Olivi no 50, 31mm, 6 pcs/box
EAS005031SW
Endostar Apical Stopper, by Giovanni Olivi ass 60-80, 31mm, 6 pcs/box
EAS608031SW
Files to download:
Instructions for cleaning, disinfecting and sterilizing instruments
Download
Recommended number of usage of instruments for root canal treatment
Download