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UBC Theses and Dissertations

A survey of the irrigation protocols used by dentists in British Columbia, Canada Abtin, Houman


The goal of endodontic treatment is to prevent and eliminate infection. This is achieved by mechanical and chemical cleaning of the root canal. Chemical cleaning is a process in which irrigants are introduced in the root canal to eradicate bacteria and flush out debris. A study was conducted to assess the type, concentration of sodium hypochlorite (NaOCl), volume, sequence and method of delivery system of different irrigants used by general practitioners (GP) and endodontists (ENDO) in treating teeth with vital (VP) or non-vital pulp (NVP). We hypothesized that there are no significant differences between the groups regarding the method of irrigation in root canal treatment. Methods: 1) A total of 68 samples of bleach were collected from GP offices in Vancouver. Using titration, the concentration of hypochlorite in these bleach samples was calculated. 2) A questionnaire was sent to 150 GP and 42 ENDO registered with the College of Dental Surgeons of British Columbia. Results: The overall response rate to our questionnaire was 70.3%. Irrigants used in treating teeth with VP were NaOCl: ENDO 93.4%, GP 89.9% (p=0.445), EDTA: ENDO 72.9%, GP 35.1% (p<0.001), and RC-Prep™: ENDO 29.7%, GP 67.2% (p< 0.001). Irrigants used in treating teeth with NVP were NaOCl: ENDO 95.7%, GP 94.2% (p= 0.657), EDTA: ENDO 76.2%, GP 36.2% (p< 0.001), and RC-Prep™: ENDO 31.9%, GP 71.9% (p< 0.001). Majority of the ENDO (82.3%) used 5-6% NaOCl whereas 55% of the GP used 3-5% NaOCl. Commonly used irrigation needle by both groups was stainless steel with a tip size of 27G (ENDO 28.0%, GP 36.0%). The irrigation needle was inserted in the pulp chamber ENDO 79.8%, GP 75.2%, the coronal/mid canal: ENDO 79.8%, GP 85.3%, and the apical area ENDO 50.3%, GP 25.2%. Except for EDTA and saline, there were no statistically significant difference between both groups in their choice of the initial, in-between or final irrigant used. Conclusion: The ENDO and GP followed the recommended “best practice” for irrigation regarding the use of antimicrobial agents, such as NaOCl. However, the use of demineralizing agents for removing the smear layer was less frequent, particularly among the GP.

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