HISTORY

 Root canal irrigants are as old as root canal treatment. From the beginning
several irrigating solutions of different properties, for different function have been
described by several authors. These are as follows:

 In 1908 - Barner used sulfuric acid to irrigate canals.

 In 1912 - Zsigmondy irrigated the canals with sodium dioxide.
 In 1915 - Henary Dakin sodium hypochlorite was first recommended as an
antiseptic solution by during world war. It was used extensively to irrigate
wounds.
 In 1920- 1940 - strong acids like 20-50% sulfuric acid, hydrochloric acid, nitric
acid and 50% aqua regia.
 In 1936 - Walker and Grossman advocated the irrigation of root canals with a
double strength chlorinated soda solution.
 Prior to 1940 - water was the most commonly used endodontic irrigant. It was
readily available, inexpensive, and, like all nonviscous fluids, provided a
lubricating effect making instrumentation of the canal walls easier. The number
and types of irrigants that have been recommended for use in endodontic therapy
are legion. They include acids, chelating agents, proteolytic enzymes, alkaline
solutions, and other chemical agents such as oxidising agents and normal saline
solution.

 Acids and Chelating Agents:

Acids and chelating agents were recommended as endodontic irrigants because of
their ability to soften dentin, making enlargment of the canal system easier. Acids,
such as 30% hydrochloric acid and 50% sulfuric acid, were used as late as the
1940s with little or no understanding of the hazards these agents posed for the
periradicular tissues. These caustic acids dissolved the inorganic structure of dentin
and the remaining oragnic matrix offered far less resistance to instrumentation of the
canal walls. Chelating agents came into increasig use in the 1970s because they not
only soften dentin better than the more caustic acids, but were far more biological
acceptable to the soft tissues. Chealting agents combine with and inactivate calcium
ions in the dentin. This decalcification effect also results in less resistance to
instrumentation of the canal walls. Recommended chelating agents included EDTA
 HISTORY

(ethylenediaminetetra-acetic acid), REDTA (EDTA buffered with sodium hydroxide in

an aqueous vehicle), RC-Prep (EDTA and urea peroxide), and citric acid.

 Proteolytic Enzymes:
Proteolytic enzymes were utilized in the 1930s and 1940s for their tissue solvency
property. It was theorized that they would aid in debridement of the canal system by
dissolving pulpal debris. The enzymes did not gain wide acceptance and it was
ultimately shown that they possessed very little necrotic tissue solvency property
within root canal systems. Enzymes used in endodontic therapy included
streptokinase, streptodoronase, papain, enzymol, and purified trypsin.

 Alkaline Solutions:
Alkaline solutions used as endodontic irrigants included sodium dioxide, sodium
hydroxide, potassium hydroxide, urea, and sodium hypochlorite. Of this group, only
sodium hypochlorite (NaOCl) has been proved clinically acceptable. It is currently the
most commonly used irrigant in endodontics. The other alkaline solutions did little
more than act as lubricants during instrumentaion.

 Sodium Hypochlorite:
Sodium hypochlorite solution has been used as an endodontic irrigant for well over
four decades. It is inexpensive, has an extremely long shelf life, provides a
lubricating effect for instrumentation of the canal walls, exerts a bleaching action on
discoloured teeth, and increases the permeability of dentinal tubules for easier
penetration by an intracanal medicament, it is readily available commercially in the
form of common household bleaching solutions (Clorox, Purex, Linco). The
concentration of NaOCl in these commercial bleaching solutions is approximately
5.25%.

 Oxidizing Agents:
In 1943, Grossman introduced the concept of using an oxidizing agent as an irrigant
in conjunction with NaOCl. He recommended that a solution of 3% hydrogen
peroxide (H2O2) be alternated with a solution of 5.25% NaOCl, so that the foaming
action resulting from the chemical reaction would help to remove debris from the
canal system. More recently, another oxidizing agent, Gly-Oxide, has been
 HISTORY

recommended as an irrigant, particularly for narrow, curved canals. It contains

carbamide peroxide in an anhydrous glycerol base. Gly-Oxide is highly viscous, but
the glycerol base provides very good lubrication during instrumentation of small
canals. However, it has little antibacterial activity and is not an effective necrotic
tissue solvent. If one examines the scientific evidence relating to the desirable
properties for an endodontic irrigant, there can be little argument that a solution of
5.25% NaOCl remains the irrigant of choice in modern endodontic therapy.