Reduce the Time and Cost of Irrigation

Allen Ali Nasseh, DDS, MMSc, on the Triton™ All-in-One Irrigation Solution

Three important properties of root canal irrigants include the ability to disinfect, the ability to dissolve organic tissues such as collagen, and the ability to chelate inorganic tissues such as dentinal chips from inside the root canal system. These functions are all necessary adjuncts to mechanical instrumentation, but it has not previously been possible to perform them all with a single irrigation solution. As a result, clinicians have had to meet these needs by utilizing multiple solutions in different syringes during endodontic irrigation. The best results thus far have been achieved by using the gold standard of disinfection and organic tissue dissolution, a 3% to 5% solution of sodium hypochlorite (NaOCl), along with ethylenediaminetetraacetic acid (EDTA), a chelating agent that helps remove inorganic tissue. However, because EDTA and NaOCl neutralize and buffer each other shortly after mixing, clinicians have been forced to deliver them separately from different syringes, which has added to the cost and inefficiency of endodontic irrigation procedures.

Recently, a new irrigation solution was introduced that represents the culmination of 10 years of research on chelating agents that are not readily buffered and inactivated by sodium hypochlorite. This solution, the Triton^™ All-in-One Irrigation Solution from Brasseler USA, features a notable delivery system consisting of a dual-barrel bottle with a mixing chamber where two separate solutions are mixed when a syringe draws from the dispensing nozzle. One solution contains NaOCl and the other contains a proprietary blend of 14 chelating agents and surfactants. Upon attaching a syringe to the Luer-lock connection and drawing the plunger, the appropriate amount of each solution is drawn from the bottle and mixed into a new solution that consists of 4% NaOCl, chelators, surfactants, and lubricants all in one syringe.

The resulting solution is stable for a minimum of 3 hours of reactivity, during which time it can be used to disinfect, dissolve organic tissue, and chelate inorganic tissue-all while providing an additional surfactant and detergent for lubrication and the reduction of torque during instrumentation. This combination has the potential to address most irrigation needs during root canal procedures, and because of its stability, clinicians can draw enough Triton for an entire case at the beginning of the procedure, saving even more time. Although this volume can vary from 3 cc to 6 cc, depending on the needs of the case, a single bottle of Triton provides 480 cc of solution, which amounts to approximately 80 endodontic cases at the full 6 cc/case volume, and it can be stored unrefrigerated for a period of 6 months to 1 year. If refrigerated, the shelf life can be extended to 2 years.

The Triton All-in-One Irrigation Solution enables efficient endodontic irrigation through the combination of multiple solutions into one syringe, which not only saves time but also reduces the number of syringes and needles needed during irrigation. Its formula has managed to simplify the irrigation protocol for clinicians while still using the gold standard, NaOCl, as the primary active ingredient.

Key Takeaways

• Multifunctional single-bottle irrigation solution that reduces chair time, procedural steps, and the overall cost of irrigation

• Patent-pending formula allows for a lower concentration of NaOCl to be delivered while providing improved efficacy

• More effective at smear layer removal when compared with the use of NaOCl with EDTA

• Dissolves organic tissue up to 1.7 times faster than traditional NaOCl irrigants

MANUFACTURER INFORMATION
Brasseler USA
brasselerusa.com
800-841-4522

Allen Ali Nasseh, DDS, MMSc
Clinical Instructor
Postdoctoral Endodontics
Harvard University
School of Dental Medicine
Boston, Massachusetts
Private Practice
Boston, Massachusetts