scholarly journals Factors influencing apical debris extrusion during endodontic treatment - A review of the literature

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.

2019 ◽  
Vol 7 (2) ◽  
pp. 47 ◽  
Author(s):  
Mario Dioguardi ◽  
Giovanni Di Gioia ◽  
Gaetano Illuzzi ◽  
Claudia Arena ◽  
Vito Carlo Alberto Caponio ◽  
...  

The primary objective of endodontic therapy is to create a biologically acceptable environment within the root canal system that allows for the healing and maintenance of the health of the peri-radicular tissue. Bacteria are one of the main causes of pulp problems, and they have different methods of penetrating and invading the endodontic space such as through carious lesions, traumatic pulp exposures, and fractures. The types of bacteria found range from facultative anaerobes to aerobes, up to the most resistant species able to survive in nutrient-free environments; the bacterial species Enterococcus faecalis belongs to this last group. Enterococcus faecalis is considered one of the main causes of recurring apical periodontal lesions following endodontic treatment, with persistent lesions occurring even after re-treatment. The review presented in this paper was performed in accordance with the PRISMA protocol and covers articles from the related scientific literature that were sourced from PubMed, Scopus, and Google Scholar using the following terms as keywords: “endodontic treatment”, “endodontic bacteria”, “microbial endodontic”, and “endodontic failure”. Only the articles considered most relevant for the purposes of this paper were read in full and taken into consideration for the following review. The results show that Enterococcus faecalis, Actinomycetes, and Propionibacterium propionicum are the species most frequently involved in persistent radicular and extra-radicular infections.


2021 ◽  
Vol 67 (2) ◽  
pp. 101-106
Author(s):  
Sanziana Adina Scarlatescu ◽  
◽  
Irina Gheorghiu ◽  
George Nicola ◽  
Andrei O. Al Aloul ◽  
...  

The objectives of root canal treatment are to prevent the apical parodontitis, to heal the acute or cronic apical periodontits and to maintain the results, keeping the teeth on the arch in a functional stage. Thus, accuratelly elimination of soft and hard tissues (cleaning and shaping of the root canal system), disinfection and complete, homogeneous and tridimensional filling of the root canal system are very important to successful endodontic treatment. Modern concepts in endodontic treatment rely on technological progress and therefore many cases are successfully fulfilled, but the practitioner may be put in front of procedural erorrs both during and after endodontic treatment. Apical blockage, ledging, zipping, stripping, perforations in the floor of the pulp canal chamber or root canals perforations are the most common errors, but in many clinical situations they can be prevented and even surpassed once happened.


2020 ◽  
Vol 18 (1) ◽  
pp. 27-30
Author(s):  
S. N. Razumova ◽  
A. S. Brago ◽  
Haydar Barakat ◽  
L. M. Khaskhanova ◽  
R. M. Bragunova

The success of endodontic treatment depends on many factors. The most important of them are the knowledge and manual skills of the dentist.Materials and methods. We analyzed the condition of teeth after endodontic treatment in 300 patients aged 20 to 70 years. Were studied 300 images of CBCT, the number of treated teeth and the number of cases of unsuccessful endodontic treatment was analyzed.Results. According to CBCT data, high-quality obturation of the root canal system was observed in 1335 (75%) endodontically treated teeth. The reasons for successful endodontic treatment are under-sealing of the root canal (16%), removal of material beyond the apex (5.6%), and missed root canals (3.4%).Conclusion. Clinical dental patient examination revealed that maxillary and mandibular molars most often undergo endodontic treatment.


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.


2015 ◽  
Vol 16 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Dilek Helvacioglu-Yigit

ABSTRACT Aim C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth. Background This case report presents endodontic management of a mandibular first molar with a C-shaped canal system. Case report Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with selfadjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology. Clinical significance The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology. How to cite this article Helvacioglu-Yigit D. Endodontic Management of C-shaped Root Canal System of Mandibular First Molar by using a modified Technique of Self-adjusting File System. J Contemp Dent Pract 2015;16(1):77-80.


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 57 (3) ◽  
pp. 163-169
Author(s):  
Jugoslav Ilic ◽  
Mirjana Vujaskovic ◽  
Ruzica Nedeljkovic

The most important requirements for successful endodontic treatment are accurate diagnosis and good knowledge of canal morphology. A mandibular second premolars rarely have more than one root and one root canal. Data from the literature indicate low percentage of a mandibular premolars with three or more root canals. Unusual morphology of the root canal system is diagnostic and therapeutic challenge. It is very important to analyze preoperative radiograph and to explore thoroughly the entrance of the root canal. The aim of this study was to present two patients who had lower second premolars with three canals that required endodontic therapy.


Author(s):  
Pardeep Mahajan ◽  
Ruma Grover ◽  
Shikha Baghi Bhandari ◽  
Prashant Monga ◽  
Vanita Keshav

Successful outcome of endodontic treatment depends on the identification of all root canals which in turn guarantee complete extirpation of pulp tissue, proper chemo-mechanical cleaning and shaping and three dimensional obturation of the root canal system with an inert filling material. However endodontic treatment can fail for many reasons, such as diagnostic errors, persistence of the infection in the root canal system, errors in debridement and shaping of the root canal systems, instrument fractures, poor restorations and extra roots or canals if not detected are the reasons for failure. Undetected extra roots or root canals have been considered as a major reason for failure of root canal treatment. Many of the challenges faced during root canal treatment may be directly attributed to an inadequate understanding of the canal morphology of teeth. A broad knowledge of both the external and internal anatomy of teeth is of great importance for adequate endodontic treatment. We present a case report of 2 roots in mandibular lateral incisor.


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.


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