INTRODUCTION region of root canal and anastomoses

INTRODUCTION  Root canal irrigation and instrumentation is to clean and disinfect the root canal which comprises the endodontic therapy1. The irrigation technique uses chemical solutions to remove debris, lubricate canal walls, dissolve organic tissues, and eliminate bacteria. The endodontic microorganisms have been greatly eliminated by the mechanical action of irrigation2. Different irrigation needles and gauges have been used be the dentists in root canal treatment. But the effectiveness varies with every needles. This is due to the ability of the needles to reach the apical third and delivering the solution to the full working length of the root canal3,4,5.

  In a study, it was shown that irrespective of the tip design the optimal sized needle were more effective in cleaning the apex. Similar results were reported from a study in which radiopaque medium was mixed with dentin shavings6. In another study by Hsieh, the flow of root canal irrigation could be adversely affected by the usage of large diameter needles7.

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 2 or more irrigating solutions have been used in a specific sequence to obtain effective irrigation. Irritants are conventionally delivers into the root canal by needles of various sizes and tip design. According to many researchers, this results in ineffective irrigation, particularly in the apical region of root canal and anastomoses around the apex. Hence, various chemical irritants have been developed and modified  and several mechanical instruments have been developed in order to improve the penetration and effectiveness.

  25-gauge needles were used commonly a few years ago, but then they were replaced by 27-G needles and then now 30-G and 31-G needles have been used routinely. Mostly smaller needles are preferred. Researchers have found that the chemical agents have only a limited effect beyond the tip of the needle as the air in the apex prevents the solution to reach the apical tip, hence preventing effective cleansing. However smaller needles allow the solution to enter the apex of root canal, but with safety concerns. Several modifications of the needle-tip designs have been introduced in recent years to facilitate effectiveness and minimise safety risks.  There are few comparative data about the effect of needle design on effectiveness of irrigation.

It is hoped that ongoing CFD and clinical studies will change this situation. This review will show some lights on the types of needles used in irrigation technique, efficacy of those needles, and procedures for safe and efficient irrigation and provides cutting-edge information on the most recent developments.

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