Management of necrotic teeth with apical periodontitis using sonically activated irrigation

Submitted: 8 July 2022
Accepted: 12 October 2022
Published: 13 January 2023
Abstract Views: 802
PDF: 402
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Aim: To present root canal treatment using sonically activated sodium hypochlorite for cases with necrotic pulp and apical periodontitis.

Summary:  Four patients were scheduled for root canal treatment diagnosed with periapical pathosis and bone resorption with a periapical index (PAI) score not less than 3. After access cavity preparation and working length determination, the cleaning procedure was performed using sodium hypochlorite (NaOCl) 2.5% irrigation activated by EndoActivator; then, teeth were filled with gutta-percha. After a follow-up period with an average of four years, clinical and radiographic findings showed complete healing and bone reformation.

Key learning points:

  • Clinicians must appreciate the information gained from scouting about the average root canal size; based on that; we can determine the shaping & disinfection strategy.
  • Sonically activated irrigation can be a predictable approach for cleaning infected teeth with ample root canal space without apical instrumentation.
  • Activating irrigation can help to preserve dentine meanwhile achieving a successful outcome.

Hany Mohamed Aly Ahmed, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur,

Dr. Hany Mohamed Aly Ahmed

B.D.S. - H.D.D. (Endo) - M.Sc.D. conv. Ph.D. (Endo) - FICD (USA) - MDTFEd RCS (Edin) - FPFA (USA) - FADI (USA)

Senior Lecturer of Endodontics, 

Department of Restorative Dentistry, 

Faculty of Dentistry, 

University of Malaya, 50603, Kuala Lumpur, Malaysia.

 Deputy Editor-in-Chief, European Endodontic Journal,

Supporting Agencies

Primary Health Corporation will provide article publication fees if present.

Waheed Sharawy, W., Mohamed Aly Ahmed, H., & Cohen, S. (2023). Management of necrotic teeth with apical periodontitis using sonically activated irrigation. Giornale Italiano Di Endodonzia, 37(1).


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