Disinfection of the root canal system: what should the protocol be?

Dental Update ◽  
2021 ◽  
Vol 48 (10) ◽  
pp. 836-844
Author(s):  
Stephen J Bonsor

The presence of micro-organisms within the root canal system is the critical aetiological factor in peri-radicular periodontitis. During root canal treatment (RCT) it is imperative that this infection and other organic debris are removed from the root canal system. This is challenging because complex tooth anatomy, the presence of a biofilm and the smear layer complicate the process. There are a number of irrigant chemicals and adjunctive systems available in contemporary endodontic practice that are used to disinfect the root canal system during root canal preparation. This article reviews the available evidence concerning these disinfection methods and concludes by presenting a clinical protocol supported by the literature. CPD/Clinical Relevance: A clinical protocol, supported by the literature, is presented for effective decontamination of the root canal system during root canal therapy.

Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul

Contents. Preserving pulp vitality. The root canal system. Root canal treatment—rationale. Root canal treatment—instruments. Root canal treatment—materials. Root canal preparation—1. Root canal preparation—2. Common errors in canal preparation. Root canal obturation. Some endodontic problems and their management. Restoration of the root-treated tooth. Treatment outcomes.


Medicina ◽  
2008 ◽  
Vol 45 (5) ◽  
pp. 343 ◽  
Author(s):  
Neringa Skučaitė ◽  
Vytautė Pečiulienė ◽  
Vita Mačiulskienė

Apical periodontitis is an inflammation of dental periapical tissues developed as a response to colonization of microorganisms in root canal system. Etiology of periapical pathology is associated with different species of microorganisms that are not fully defined yet. The changes in the composition of root canal microbiota as well as other factors, such as host resistance to various infections and concomitant viral infection, etc., can influence development of the symptomatic apical periodontitis. Etiology of disease is reviewed in this article. The purpose of treatment of symptomatic apical periodontitis is to eliminate the infection in root canal system and to obtain relief of symptoms. It can be done by conventional root canal therapy, which can be combined with anti-inflammatory medication. Indications for antibiotic therapy in such cases are limited to particular occasions, which are considered in article. Nevertheless, findings show that usually dentists prescribe antibiotics improperly in clinical practice. It can render drugs ineffective against diseases of dental origin as well as against potentially fatal infectious diseases. Selection of antibiotics for the treatment of root canal infections is reviewed in this article. Importance of antimicrobial susceptibility testing is emphasized. There is a need for more research on microbial causes and interactions in different forms of apical periodontitis to improve diagnosis and treatment.


2020 ◽  
Vol 37 (1) ◽  
pp. 35-40
Author(s):  
Laura Sasser

Pulp debridement and disinfection in the pulp cavity is a critical step in achieving a successful root canal therapy. Microorganisms remaining in the root canal system after endodontic treatment are a main cause of root canal failure. The challenges faced in endodontic disinfection include the complex anatomy of the root canal system, the existence of a biofilm within the root canal, and the creation of a problematic smear layer during instrumentation of the canal. Historically, sodium hypochlorite and ethylenediaminetetraacetic acid have been utilized as irrigants and still remain as the most effective disinfectants due to their synergistic abilities to eradicate microorganisms, dissolve necrotic debris, and remove the smear layer and biofilm. This article addresses challenges in endodontic disinfection, objectives of endodontic irrigants, properties of an ideal irrigant, currently used irrigants, and irrigant delivery systems utilized in veterinary dentistry.


2021 ◽  
Vol 76 (1) ◽  
pp. 28-36
Author(s):  
Natasa Predin Djuric ◽  
Peet J Van der Vyver ◽  
Martin Vorster ◽  
Zunaid I Vally

The primary cause of a periapical inflammatory lesion is intra-radicular microbial infection. Prevention and elimination of apical periodontitis is achieved through successful endodontic treatment. Endodontic treatment is designed to maintain and restore the health of the periapical tissues and prevent periapical disease. It may be defined as the combination of mechanical instrumentation of the root canal system with bactericidal irrigation and obturation with an inert material. Technically, the goal of instrumentation and irrigation is to debride and entirely remove infected tissue debris from the root canal system and create a uniform conical shape that allows medicament delivery and adequate obturation. Microbiologically, the goal of instrumentation and irrigation is to eliminate micro-organisms, reduce their survival in the root canal system and neutralise any antigenic potential of the microbial components remaining in the canal.


2017 ◽  
Vol 18 (9) ◽  
pp. 851-855
Author(s):  
Livio Gallottini

ABSTRACT Aim The aim of this scientific work is to illustrate the technique of shaping the root canal system using the multistep technique. Background Over time, various endodontic instrumentation techniques have been put forward, from the “step-back” technique (apical–coronal) to the “crown-down” technique (coronal–apical), the “double-flared” technique, and the most recent “single-length” technique. Technique The multistep technique involves six steps, one of the main objectives of these being the safety of the use of mechanical instruments with a reduction in the risk that they fracture. This technique (“mixed”) provides for the use of both manual instruments in stainless steel and mechanical instruments in nickel titanium (Ni-Ti). Conclusion The multistep technique is based on a standardized, flexible, and clinical protocol, which can provide for a reduction in the number of endodontic passages and instruments used and, therefore, a simplification of the operating procedure depending on both the difficulty of the root canals and the competence of the operator. Clinical significance This technique is a technique for shaping the endodontic space that allows the set objectives of endodontic therapy to be reached in a predictable way with a reduced risk of iatrogenic complications. How to cite this article Gallottini L. Shaping of the Root Canal System: A Multistep Technique. J Contemp Dent Pract 2017;18(9):851-855.


2005 ◽  
Vol 58 (3-4) ◽  
pp. 203-207
Author(s):  
Tatjana Brkanic ◽  
Slavoljub Zivkovic ◽  
Milan Drobac

Introduction The main purpose of endodontic treatment is to clean the root canal system, eliminate the infected and toxic contents, and shape it in order to get a tridimensional obturation. The aim of this paper is to inform dental practitioners about crown-down techniques for root canal preparation using nickel-titanium rotary instruments. Root canal preparation Today most endodontists believe that root canal preparation is more officious, cleaning and shaping are better, if pre-enlargement of coronal two thirds is performed first, and shaping of the apical part later. Machine driven rotary instruments provide much quicker and better root canal preparation. Conclusion Contemporary endodontic rotary files vary in regard to their taper, cutting blades, guiding tip and material they are made of. The usage of rotary nickel-titanium files adds a new quality to root canal preparation.


2010 ◽  
Vol 1 (1) ◽  
pp. 21-29
Author(s):  
Francis W Allen

ABSTRACT Cleaning and shaping of root canal system forms the most important step in root canal root canal therapy. Unfortunately most of the instruments and techniques advocated are unable to remove residual debris and bacteria, ultimately resulting in pain and failure. To eliminate the causes of pain, and ensure success, we must use instruments and employ a technique that can best accomplish proper cleaning and shaping. Virtually all canals have parallel walls, and are curved and oval in shape. Hence tapered instruments are unable to clean the canal effectively and increase the chances of ledges and transportation and extrusion of debris beyond the apex. With the introduction of Light Speed technology primary goal of endodontics which includes removal of debris safely and effectively can be achieved. This article focuses on the use of Light Speed technology to overcome the difficulties posed by the other instrumentation and techniques to achieve debris and bacteria free canal system.


2015 ◽  
Vol 3 (45) ◽  
pp. 8884-8891 ◽  
Author(s):  
Xiaoman Li ◽  
Bing Han ◽  
Xiaoyan Wang ◽  
Xuejun Gao ◽  
Fuxin Liang ◽  
...  

The treatment of apical periodontitis (AP) remains challenging because traditional root canal therapy (RCT) outcomes are limited by the complexity of the root canal system, drug toxicity, and host immune factors.


1997 ◽  
Vol 14 (1) ◽  
pp. 31-33 ◽  
Author(s):  
D. H. DeForge ◽  
A. L. Golden

Videofluoroscopy was used as a radiographic technique to visualize a canine tooth during root canal therapy in a Siberian tiger. Videofluoroscopy was useful because the procedure was performed in a zoo setting with no access to an on-site darkroom. The fluoroscopic screen and videotape allowed for immediate viewing of the root canal system.


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