IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 10 Ver. II (Oct. 2017), PP 38-44 www.iosrjournals.org DOI: 10.9790/0853-1610023844 www.iosrjournals.org 38 | Page Root Canal Irrigation Trends When Using Sodium Hypochlorite: A Nationwide Survey Amongst Indian Dentists. * Urvashi Sunil Keswani 1 Ajinkya Mansingh Pawar 2 1 ( Intern) Department Of Conservative Dentistry And Endodontics, Nair Hospital Dental College, Mumbai, India 2 (Professor) Department Of Conservative Dentistry And Endodontics, Nair Hospital Dental College, Mumbai, India. Corresponding Author: *Urvashi Sunil Keswani Abstract: Introduction. It is a well known fact that microorganisms either remaining in the root canal space after endodontic therapy or recolonizing the canal system post-therapy are the main cause of endodontic failure. While most practitioners spend a great deal of time on shaping procedures, not much emphasis is paid on irrigation. There is a great deal of confusion regarding the choice of irrigant, methods and protocols followed during irrigation of the canal systems. The purpose of the current survey was to find the various irrigation techniques and protocols followed by practitioners nationwide and discuss sodium hypochlorite as an irrigant. Methodology: An anonymous questionnaire with ten questions covering all aspects of irrigation protocols pertaining to sodium hypochlorite was formulated using google forms ® (http://docs.google.com/forms) and was sent to the intended participants across different platforms like whatsapp ® , facebook ® and email, responses to which were duly noted. Results. We received 818 responses giving us a response rate of 40.9%. Majority of practitioners who took the survey were general dentists. A total of 45.7% of dentists said they used 5.25% sodium hypochlorite as their irrigant of choice, and 67.7% of the respondents said they stored the irrigant in its original container. 59.2% of the dentists taking the survey used side vented needles for the purpose of irrigation. 56.2% of the respondents claimed to use 5ml of irrigant per canal. When questioned regarding the adjuncts used for irrigation 43.8% dentists said they used Manual Dynamic Agitation Technique for agitation. When questioned regarding the most common complication witnessed, 61.5% dentists complained of damaged clothing. 62.4% of the practitioners said they used sodium hypochlorite in retreatment cases. Conclusion. Dental practitioners in the country use sodium hypochlorite with a majority of them preferring 5.25% concentration as a primary irrigant. Also, during retreatment cases most of them use sodium hypochlorite which calls for attention. The major complications witnessed by the dentists were damaged clothing. Keywords: irrigation; irrigation protocols; root canal treatment; sodium hypochlorite, survey -------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 25-09-2017 Date of acceptance: 05-10-2017 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction The major objective in endodontic treatment is to disinfect the entire root canal system (RCS) and rid it off microorganisms and infected pulpal tissue remnants along with prevention of re-infection [1] . Even with modern techniques in endodontics that use motorized nickel-titanium (niti) files, more than 35%of the root canal’s surface is left un-instrumented. [2] This unmet goal of disinfection may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. [1] Copious irrigation of the root canal helps by eradicating microorganisms, flushing debris, and removing both the organic and inorganic portions of the smear layer from the RCS. [3] Irrigating solutions have adequate antimicrobial activity and are capable of complete smear layer removal, nevertheless they can be irritating to the periapical tissue if they gain entry, causing severe pain, inflammation, and delayed healing. However, mechanical debridement and copious irrigation for a minimum of 20 minutes with 2.5% to 6% solutions of sodium hypochlorite followed by a rinse with 17% solution of ethylenediaminetetraacetic acid and a final rinse with 2% chlorhexidine has been the recommended choice. [4] Sodium hypochlorite, an excellent non-specific proteolytic and antimicrobial agent, is the most commonly used irrigating solution in root canal treatment. However, it exerts no effect on the inorganic component of the smear layer. [4] Thus, chelating acid solutions have been recommended for removing the smear layer from instrumented root canals, including ethylenediaminetetraacetic acid, citric acid and phosphoric acid. [5] In an effort to improve