-
Explore (New York, N.Y.) 2021This report provides a perspective on the relevance of saline water gargling and nasal irrigation to the COVID-19 crisis. While there is limited evidence concerning... (Review)
Review
This report provides a perspective on the relevance of saline water gargling and nasal irrigation to the COVID-19 crisis. While there is limited evidence concerning their curative or preventive role against SARS-CoV-2 infection, previous work on their utility against influenza and recent post-hoc analysis of the Edinburgh and Lothians Viral Intervention Study (ELVIS) provide compelling support to their applicability in the current crisis. Saline water gargling and nasal irrigation represent simple, economical, practically feasible, and globally implementable strategies with therapeutic and prophylactic value. These methods, rooted in the traditional Indian healthcare system, are suitable and reliable in terms of infection control and are relevant examples of harmless interventions. We attempt to derive novel insights into their usefulness, both from theoretical and practical standpoints.
Topics: COVID-19; Humans; Nasal Lavage; Pharynx; SARS-CoV-2; Saline Solution; Saline Solution, Hypertonic; Therapeutic Irrigation
PubMed: 33046408
DOI: 10.1016/j.explore.2020.09.010 -
Surgical Infections Apr 2021Management of open fractures remains a major clinical challenge because of the higher energy involved in the injury, the greater local trauma, tissue necrosis, and... (Review)
Review
Management of open fractures remains a major clinical challenge because of the higher energy involved in the injury, the greater local trauma, tissue necrosis, and extensive contamination. Even though early surgical debridement was thought to be critical, limited available operative techniques have minimized surgery in favor of early antibiotic administration. No clear agreement on the surgical approach, debridement, or irrigation technique exists. Surgeons continue to argue about the use of various fluids, the appropriate pressure of irrigation, antiseptics, and other factors. The current work reviews the available data and summarizes the capabilities of modern orthopedic irrigation solutions. To delineate available research on the topic, the PubMed database was queried for the most common techniques, fluid variables, and chemical adjuvants utilized in current open fracture and wound irrigation methodologies. Modes of delivery, volume, pressure, temperature, timing, solution type, and additives are evaluated in the context of known outcomes to determine which solutions may be preferable. Various methods have been described with their own advantages as well as limitations. Particular solutions may apply to specific clinical scenarios, presence of implants, and degree of tissue contamination. Desired irrigation solutions are isotonic, non-toxic, non-hemolytic, transparent, sterilizable, efficient in removing debris and pathogens, as well as affordable; however, no current irrigant achieves all these desired characteristics. Despite being crucial for the healing of open fractures, there is no clear gold standard for irrigation. Although there are some novel irrigation solutions, there has been a paucity of research on finding new, safer, and more effective irrigation solutions that will promote wound healing and reduce infection.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Fractures, Open; Humans; Surgical Wound Infection; Therapeutic Irrigation
PubMed: 32589513
DOI: 10.1089/sur.2020.075 -
The Canadian Veterinary Journal = La... Nov 2018
Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Conjunctivitis; Dexamethasone; Dog Diseases; Dogs; Female; Therapeutic Irrigation
PubMed: 30410183
DOI: No ID Found -
The British Journal of General Practice... Apr 2008
Topics: Cerumen; Family Practice; Humans; Self Care; Sodium Bicarbonate; Syringes; Therapeutic Irrigation; Water
PubMed: 18387246
DOI: 10.3399/bjgp08X279995 -
International Endodontic Journal Apr 2022Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to... (Review)
Review
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-computed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
Topics: Dental Pulp Cavity; Humans; Models, Theoretical; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Therapeutic Irrigation; X-Ray Microtomography
PubMed: 35171506
DOI: 10.1111/iej.13710 -
BMC Oral Health Dec 2022To examine post-operative pain (PP) after conventional irrigation and sonic activation methods, with and without laser disinfection in mandibular molars. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
To examine post-operative pain (PP) after conventional irrigation and sonic activation methods, with and without laser disinfection in mandibular molars.
METHODS
Eighty patients with symptomatic apical periodontitis were included in this randomized clinical study. There were four study groups. In group 1, conventional irrigation only was applied. In group 2, a sonic irrigation activation system (EDDY (VDW, Munich, Germany)), was applied. In groups 3 and 4, irradiation with a 980-nm diode laser was performed, following irrigation with the conventional method and sonic irrigation activation system, respectively. The patients were instructed to record their PP and analgesic intake using a numerical rating scale 8, 24, 48 h and 7 days post-procedure. A chi-square test, Fisher's exact chi-square test and Fisher-Freeman-Halton exact test were used to assess qualitative data. Inter-group and intra-group parameters were assessed using the Kruskal-Wallis test and Wilcoxon's test at a significance level of p < 0.05.
RESULTS
There was no statistically significant difference among the groups in terms of age, sex, pre-operative pain, PP and analgesic intake (p > 0.05).
CONCLUSIONS
The use of sonic irrigation activation system in the final irrigation protocol and irradiation with the 980-nm diode laser did not significantly reduce PP levels and analgesic intake.
Topics: Humans; Root Canal Irrigants; Root Canal Preparation; Disinfection; Therapeutic Irrigation; Molar; Pain, Postoperative; Dental Pulp Cavity
PubMed: 36514017
DOI: 10.1186/s12903-022-02651-y -
Journal of Oral Science Jun 2021Despite scientific evidence that root canal debridement is the cornerstone for successful treatment, the effectiveness of a combination of delivery and activation...
Despite scientific evidence that root canal debridement is the cornerstone for successful treatment, the effectiveness of a combination of delivery and activation systems in cleaning root canals remains unknown. This study is the first to demonstrate the remaining pulp tissue in root canals after irrigation with various techniques such as positive pressure syringe-and-needle irrigation, ultrasonic activation, negative pressure irrigation and ultrasonic activation after negative pressure irrigation. The results showed that negative pressure irrigation alone and its combination with ultrasonic activation resulted in significantly superior effectiveness than positive pressure irrigation and ultrasonic activation alone in the apical-third of root canals.
Topics: Debridement; Dental Pulp Cavity; Root Canal Irrigants; Root Canal Preparation; Therapeutic Irrigation; Ultrasonics
PubMed: 34108301
DOI: 10.2334/josnusd.21-0095 -
The Journal of Bone and Joint Surgery.... May 2007Modern principles for the treatment of open fractures include stabilisation of the bone and management of the soft tissues. Wound debridement and irrigation is thought... (Review)
Review
Modern principles for the treatment of open fractures include stabilisation of the bone and management of the soft tissues. Wound debridement and irrigation is thought to be the mainstay in reducing the incidence of infection. Although numerous studies on animals and humans have focused on the type of irrigation performed, little is known of the factors which influence irrigation. This paper evaluates the evidence, particularly with regard to additives and the mode of delivery of irrigation fluid. Normal saline should be used and although many antiseptics and antibiotics have been employed, no consensus has been reached as to the ideal additive. Despite the advocates of high-pressure methods highlighting the improved dilutional ability of such techniques, the results are inconclusive and these irrigation systems are not without complications. New systems for debridement are currently being investigated, and an ideal method has yet to be determined.
Topics: Animals; Anti-Bacterial Agents; Bacteria; Debridement; Fractures, Open; Humans; Intraoperative Care; Pressure; Sodium Chloride; Therapeutic Irrigation
PubMed: 17540739
DOI: 10.1302/0301-620X.89B5.19286 -
Scientific Reports Feb 2021In root canal therapy, irrigating solutions are employed to eliminate the bacterial load and also prepare dentin for sealer interaction. The aim of this research was to...
In root canal therapy, irrigating solutions are employed to eliminate the bacterial load and also prepare dentin for sealer interaction. The aim of this research was to assess how irrigating solutions employed on their own or in sequence affected the tooth structure. The best way to prepare the tooth for obturation using hydraulic calcium silicate cement (HCSC) sealers and gutta-percha, thus guiding clinicians on a matched irrigation-obturation strategy for optimized root canal treatment was investigated. The effect of irrigating solutions on dentine was investigated by assessing changes in dentin microhardness, ultrastructure and mineral content, organic/inorganic matter, surface roughness and Young's modulus. The interaction of four root canal sealers with the dentin was analysed by assessing the changes in microhardness of the dentin after sealer placement and also the sealer to dentin interface by scanning electron and confocal laser microscopy. The irrigating solutions damaged the dentin irreversibly both when used on their own and in combination. The best sequence involved sodium hypochlorite followed by chelator and a final rinse with sodium hypochlorite and obturation using HCSC sealers that enabled the restoration of dentin properties. The HCSC sealers did not rely on chelator irrigating solutions for a good material adaptation to dentin.
Topics: Humans; Materials Testing; Root Canal Obturation; Root Canal Therapy; Therapeutic Irrigation
PubMed: 33633128
DOI: 10.1038/s41598-021-83849-y -
Journal of Endourology Jan 2019To develop a physical understanding of ureterorenoscopy irrigation, we derive mathematical models from basic physical principles and compare these predictions with the...
PURPOSE
To develop a physical understanding of ureterorenoscopy irrigation, we derive mathematical models from basic physical principles and compare these predictions with the results of benchtop experiments. Mathematical modeling can be used to understand the role of inlet pressure, tip deflection, the presence of working tools, geometric properties of the instruments used, and material properties of the irrigation fluid on resulting flow rate.
MATERIALS AND METHODS
We develop theoretical models to describe irrigation flow in an idealized setup and compare with benchtop experiments for flow through a straight scope, a scope with a deflected tip, and a scope with a working tool inserted. The benchtop experiments were performed using Boston Scientific LithoVue ureteroscope and a variety of Boston Scientific working tools. Standard ureteroscope working channels have circular cross sections, but using theoretical models we investigate whether modifications to the cross-sectional geometry can enhance flow rates.
RESULTS
The theoretical flow predictions are confirmed by experimental results. Tip deflection is shown to have a negligible effect on flow rate, but the presence of working tools decreases flow significantly (for a fixed driving pressure). Flow rate is predicted to improve when tools are placed at the edge of the channel, rather than the center, and modifying the cross-sectional shape from a circle to an ellipse can further increase flow rate.
CONCLUSIONS
A mathematical framework is formulated and shown to accurately predict the properties of ureteroscope irrigation flow. The theoretical approach has significant potential in quantifying irrigation flow and improving ureteroscope design.
Topics: Equipment Design; Models, Theoretical; Therapeutic Irrigation; Ureteroscopes; Ureteroscopy
PubMed: 30421625
DOI: 10.1089/end.2018.0707