Cleanliness, disinfection, and sterilization of the root canal.

Disinfection is a key aspect in the preparation of root canals prior to obturation. Irrigation and intracanal medicaments are the chemical means of debridement. The bacterial role is significant, and intracanal medicaments must be cidal in their effect on bacteria and the dentinal tubules. Topical application of medicaments seem to be as effective or more effective than antibiotic applications. Glutaraldehyde and calcium hydroxide are two of the more recently studied medicaments. Calcium hydroxide shows promise as an effective microbicide. The importance of removal of bacteria and necrotic debris from the canal by chemomechanical means--mechanical preparation, cidal irrigation, antimicrobial medicaments--will enhance the successful outcome of endodontic therapy.