Comparative Evaluation of Various Endodontic Irrigants on Apical Extrusion of Debris

Root canal treatment encompasses thorough cleaning and shaping of the canal. Cleaning is achieved through proper instrumentation and irrigation for debridement and dis­ infection of the root canal system in addition to creating a suitable shape for complete three dimensional obtura­ tion. Various irrigants and medicaments have been used for cleaning root canals with different results. These in­ clude saline, sodium hypochlorite (NaOCl), chlorhexidine (CHX), EDTA, citric acid and MTAD. Till date, all of the techniques and instruments used to clean and shape canals produce some amount of apically extruded debris (AED). In 1968, Chapman et al. [1] demonstrated expulsion of in­ fective material from the root canal system during endo­ dontic instrumentation. In 1975, Vande Visse and Brilliant [2] showed that instrumentation with irrigation produced significantly more extruded debris than instrumentation alone. Extrusion of debris in periradicular tissue is one of major causes of periapical inflammation and postoperative flare­ups which have been a persistent problem over the years [3]. It is most often associated with pain and swelling during or after completion of root canal therapy. Hence, the importance of minimizing AED needs to be emphasized. Most of previous investigations have evalu­ ated the amount of AED obtained with various instru­ ments or techniques and different types or concentrations of irrigants [4­11]. 5.25% solution of NaOCl has shown the greatest amount of extruded debris [12]. No study has investigated the effect of various types of irrigants on the amount of AED. The aim of the study was to compare the effect of NaO­ Cl, MTAD and CHX on the amount of AED following root canal preparation.