Comment Questions: How long to irrigate?

[@husseinalkhafaji6227]

Personally i depend on many factors 1.the initial microorganisms load whether the case is vital or necrotic 2.the initial gauge and final apical diameter 3.method(s) of activation Very informative video ..thanks❤️

[@michaellupu2080]

Thank you for adressing this question! You're the best! Take care and have a lovely time, even with the luggage mishandling!

[@2kidsnosleep]

Came for the endo, stayed for the lovely glimpses of France. Thank you for sharing both, hope you enjoy the trip

[@sergejbodnar4818]

Love your style sir!

[@firashajobeid5016]

Hello Doctor thanks for all your videos, I am a huge fan of all of them :). I would like to ask about the details regarding irrigation. Personally I start counting used syringes of NaOCl after I have already prepared all the canals to full WL. Depending on the case (necrotic/vital) I use from 2x syringes (10 ml of 5,25% NaOCl) per canal + ultrasonic activation every 5 ml to depending on the bacterial load about 4-5 syringes per canal. Before the last NaOCl syringe I use EDTA about 1,5 ml per canal and then I use distilled water/saline before drying and obturation. So from starting the case to ending canal preparation it also takes me about 30 minutes, and then i spend around another 30-35 minutes irrigating and another 15 minutes drying and obturating the canals + 10 minutes speaking with the patient, getting the tooth numb, placing rubber dam, taking pre-op/post- op x rays and placing a temporary filling. So an average molar case takes me 1,5h. However i know endodontists completing molar cases in 45 minutes. I don't know what can I do to increase my efficiency without sacrificing the quality of my treatment. Do irrigating during instrumentaion counts that I can proceed directly to obturation after 30 minutes of working with the tooth? When do I stop irrigating? If I stop seeing any bubbling and if the hypochlorite comes clear can I assume that's enough? Do you perform the final irrigation after instrumenting the canals and if yes then how many ml of each irrigants per canal in vital and non vital cases?

[@jordiperaltaportoles1931]

Very nive video! It would be nice to speak how you manage bleeding canals.

[@daktariwameno]

Enjoy your time in Nice and the wedding of course! ...as much as we enjoy your videos ;-)

[@vladimirsavenkov2424]

Спасибо. Поздравляю, желаю хорошего отдыха.

[@yazansinan931]

Dr. May i ask , about what do u prefer to put as a provisional medicine in vital cases ?

[@AANasseh]

Just Calcium Hydroxide is enough and works.

[@abdelkarim8381]

Have you done a video about gauging yet?

[@martinchrom4444]

Thank you! The problem is that we are fighting an invisible enemy, as we cannot see the biofilm, unlike caries which is visible and you know when it is completely removed.

[@AANasseh]

💯

[@DrMohammadAhmadiBell]

Thanks for thinking about educating us even in that heavenly beautiful city. As you know to remove the smear layer we need Sodium Hypo Chloride and Chealating agent such AS EDTA solution for irrigation. My question is can the EDTA in RC-PREP be considered that Chealating agent? It is15 percent EDTA . THANK YOU VERY MUCH IN ADVANCE

[@AANasseh]

Thank you! Yes it can. It’s still EDTA and it will work. I’m not a big fan of RC prep as it’s difficult to make sure you have removed all of it from the canal and that won’t affect the seal during Obturation. But if you like it keep on using it since we don’t have a specific study on that claim. 👍

[@dr.aymanfayoumi5518]

What is RC-prep means?

[@DrMohammadAhmadiBell]

@@dr.aymanfayoumi5518 Root Canal preparation cream.

[@AANasseh]

@@dr.aymanfayoumi5518 RCT Prep is a EDTA based gel that also lubricates.

[@marrceliuslonhardt5999]

What would be the beste Endo-Activator today? I use EDDY (VDW) and it works well for me.

[@AANasseh]

I use ultrasonics as ultrasonics is better than sonics... but sonics is better than nothing... so keep on using it. Cheers!

[@dr.aymanfayoumi5518]

@@AANasseh how long you put the ultrasonic tip in side the canal doctor?

[@drtayyabfaraz_10]

You are My Love.

[@dr.abojadalkhalil733]

We need new product "Mini ruber dam , "which designed for single tooth and provide long soacking by irrigant no leakage , without block all the oral cavity

[@AANasseh]

But if it doesn't block the whole oral cavity then it defeats its own purpose of preventing bacteria in the breath and saliva and contact with the mucosal tissues contaminating the area. There are large Rubber Dam clamps that do something like that but they are not adequate for RCT.

[@jsvlad]

How do you lose a carry on??? You carried it on the plane with you!!!

[@AANasseh]

You’re right… I meant to say I checked in my carry on last minute to avoid having to drag it across the airport … turned out to be a poor idea! 😂

[@ZACY1234]

Hey Dr. Naseh! Hope you had a great time k. France. Another question that maybe you could answer is : Does eugenol have a place in modern endodontics? For example using it in pain management or any other indication?

[@AANasseh]

Great question. I really should make a video about that one! But to give a short answer. No, not really. Everything it does can be done with Ca(OH)2 and because it's so highly hydrophobic and inhibitory to bonding there is really no need for is use. Thanks for the question! :)