![]() ![]() Wayman et al.6 showed that 10,25, and 50% solutions of citric acid were all effective in removing calcium when used as a root canal irrigant.The demineralization effect of citric acid is apparently very rapid. Citric acid has been recommended as a canal irrigant because of its ability to demineralize and to remove the smear layer6 which is thought to be mostly inorganic. Sodium hypochlorite is probably the most widely used irrigant for root canal preparation.5įor this procedure sodium hypochlorite is not recommended because this irrigant targets organic tissue and not the inorganic tissue that is meant to be demineralized in this situation. ![]() The objective here is to create straight line access to the coronal aspect of the separated fragment for predictable removal as well as to provide a reservoir to hold an adequate volume of solution. ![]() This reservoir can be created with the use of modified gates glidden drills, #1 and #2 sectioned at their maximum cross-sectional to obtain a flat end and a predictable caliber (gg1=50, gg2=70), and an LA access bur (Sybron Endo) of appropriate size. One of the most important factors prior to instrument removal is the creation of a reservoir coronal to the separated fragment in order to receive the liquid.3 The irrigation protocol used in this clinical study included the alternating use of a citric acid “50%” chelating solution, distilled water and chlorhexidine 0.12 or 0.2%. Recently, the use of piezoelectric ultrasonic units with their numerous compatible tips have facililated the incremental removal of dentin surrounding separated instruments as well as their vibratory removal.2 The use of a chelating agent will be shown to facilitate the removal and/or the dissolving of the debris trapped between the instrument flutes and the debris caught between the instrument itself and the dentinal wall. Examples of such systems include but are not limited to the Masseran Endodontic Kit (Micro-Mega, Lynnewood, Washington),1 the Cancellier Instrument Removal System (SybronEndo, Orange, CA) and the Ruddle IRS (Dentsply, Tulsa, OK). If the coronal aspect of the fragment to be removed is accessible, it has the ability to be withdrawn from the canal by a variety of instrument systems. Several methods and techniques have been advocated over the years for the removal of solid objects such as silver points and fragments of endodontic instruments that have been separated. The purpose of this article is to correlate the importance of irrigating with chelating agents (and their chemical reaction in eliminating the debris from between the flutes of separated nickel titanium files), with the ability to retrieve and/or bypass instruments separated within the root canal system. ![]()
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