Doubletake: A dental clincian's view on SybronEndo's EndoVac irrigation system

Dr. Stephen Gordon was never that interested in doing root canals. He’s always been fascinated by the latest and greatest in technology, and root canals didn’t really fit. But that all changed two years ago at the Chicago Dental Society Midwinter Meeting. He sat in on Dr. Garry Bey’s lecture about the EndoVac and suddenly had a different view of root canals and couldn’t wait to incorporate this negative pressure irrigation system into his practice.

What are the EndoVac’s benefits?
This system uses negative pressure to get Sodium Hypochlorite (bleach) down the root canal. Before this was developed, dentists could only irrigate and disinfect the root canal with positive pressure.

I was concerned with putting syringes into the canal and forcing Sodium Hypochlorite past the apex. This could really cause medical problems for patients that could be life threatening. So I was hesitant to use that bleach into the canal, and instead would use Chlorhexidine Gluconate, although bleach has been shown for decades to be the most effective disinfecting solution. I was always concerned that with even moderate pressure and using a side-vented syringe, I would push the bleach past the apex.

Plus, it has been shown the positive pressure syringe never actually gets solution in the apical end where you need it to kill off the bacteria. Because of apical pressure, (simple hydraulic force) you may only get your solution within a few millimeters of the apex. Using the EndoVac we can actually place the included microcannulas into the canal and thereby bring the Sodium Hypochlorite down to the apex so it cleans thoroughly without going past the apex. We can finally clean all the way down to the entire length of the root.

How does this set the EndoVac apart?
There are three important components to the EndoVac. The Master Delivery Tip (MDT), which permits the dentist to saturate the pulp chamber with disinfectant and suction excess off simultaneously. The macrocannula, which allows the dentist to suction out large particles of pulpal tissue and the microcannula, which is narrow enough to be inserted to working length and once inserted, causes a suction to the apex, pulling Sodium Hypochlorite and subsequently  EDTA, that is placed into the pulp chamber with the MDT.

All of these devices are easily attached to the chairside highspeed evacuation system. It is a well designed system from the MDT master delivery tip to the macrocannula and the microcannula.

Why would you encourage other clinicians to try the EndoVac?
This system uses clear tubing so you can actually watch the debris coming out of the canal. You can monitor how clean the canal is and when you’re getting a clear flow you can visually tell that the canal is thoroughly clean and ready for obturation. Using any other system, how are you going to know that? If you’re not using this type of technology you’re not going to see these things. Visual verification is important. When you see a nice clear solution you know you’ve done a good job, and therefore you know your treatment has a better chance of success.

As a result of great engineering, the procedure is easier and makes performing root canal treatment far less stressful to me. It makes cleaning out the canal much more predictable, and isn’t that what we want in dentistry? If you can have predictability in your procedures you can sleep better at night knowing you did the best job you possibly can do.