Modern technologies in Endodontics

Abstract Aim In Endodontics, a complete chemo-mechanical cleansing of the root canal system is essential to achieving success, which is gained through adequate tridimensional obturation of the endodontic space. Materials and methods Today, thanks to modern technologies as Operative Microscope, ultrasonic tips, M-Wire Files, devices to activate irrigation and tridimensional obturation performed with thermo plasticized gutta-percha, satisfactory results can be obtained. Results This study shows all the technologies that are available today to increase the chemo-mechanical cleansing and obturation of the entire and complicated endodontic system. Conclusions The positive results highlighted by these clinical cases demonstrate how the use of modern technologies are essential to avoid iatrogenic injury, and guarantee, on the other hand, safe and reproducible results

Modern technologies in Endodontics

AbstractAimIn Endodontics, a complete chemo-mechanical cleansing of the root canal system is essential to achieving success, which is gained through adequate tridimensional obturation of the endodontic space.Materials and methodsToday, thanks to modern technologies as Operative Microscope, ultrasonic tips, M-Wire Files, devices to activate irrigation and tridimensional obturation performed with thermo plasticized gutta-percha, satisfactory results can be obtained.ResultsThis study shows all the technologies that are available today to increase the chemo-mechanical cleansing and obturation of the entire and complicated endodontic system.ConclusionsThe positive results highlighted by these clinical cases demonstrate how the use of modern technologies are essential to avoid iatrogenic injury, and guarantee, on the other hand, safe and reproducible results

Nonsurgical management of complex endodontic cases with several periapical lesions: a case series

Abstract Aim Today, thanks to modern technologies as operative microscope, ultrasonic tips, devices to activate irrigation and tridimensional obturation performed with thermo plasticized gutta-percha, excellent results could be obtained. Materials and methods In this study, we present 5 patients with the presence of periapical lesions in molars and incisors with history of pain. Modern endodontic technologies were used. The rationale of using these technologies was to obtain a chemo-mechanical cleansing and obturation of the entire endodontic system and to gain the lesion resolution with a non-surgical approach. Results A success rate of 100% was obtained. Radiographs and clinical examinations were done until 10 years. All the cases highlighted the success achieved in the short and long term through the complete resolution of the lesions and therefore the reconstitution of the lamina dura. Conclusions The positive results highlighted by these clinical cases demonstrate how the use of modern technologies is essential to avoid iatrogenic damage and to gain safe and reproducible results

Endodontic retreatment of maxillary first molar: the importance of the fourth canal

Abstract Aim The targets of the endodontic therapy are damaged tissue and bacteria removal from the canals and dentinal tubules and the prevention of recontamination after the treatment. Introduction Correct endodontic treatment has to follow several parameters: proper diagnosis, isolation of operating field, full chemo-mechanical preparation of the complex endodontic system, three-dimensional obturation of the root canals, post endodontic restoration. Respecting all these parameters short and long term success can be achieved. Materials and methods In this article an orthograde retreatment of maxillary first molar has been described, which showed at pre-operative X-ray, an incongruous endodontic therapy, the failed finding of the fourth canal and the presence of periapical lesions. Discussion A high percentage of failures is due to missed root canals and therefore not cleansed, shaped and it is essential to use modern technologies to achieve safe and reproducible results. Conclusions The endodontic retreatment of this right maxillary first molar was performed with the proper protocols and sophisticated tools, with which we can achieve success in the short- and long-term treatments

IG-File: un nuovo strumento per l’ottimizzazione della detersione canalare e per la misurazione del diametro apicale

RiassuntoObiettivoLo scopo del lavoro è la descrizione di un nuovo tipo di file, con design innovativo, ideato sia per l’attivazione sonica degli irriganti durante la fase di detersione sia per la misurazione del diametro apicale.Materiali e metodiPer valutare l’efficacia delle Sonic-Tip è stato condotto un test alla MicroCT. È stata selezionata una radice di un premolare superiore che presentava canali laterali; dopo la preparazione chemio-meccanica del canale radicolare sono stati effettuati due lavaggi endocanalari con una soluzione radiopaca: il primo lavaggio è avvenuto erogando passivamente la soluzione radiopaca nel canale con un ago di piccolo calibro a 2mm dalla lunghezza di lavoro; il secondo lavaggio è avvenuto erogando passivamente la soluzione radiopaca all’interno del canale a 2mm dalla lunghezza di lavoro, la quale poi è stata attivata con la Sonic-Tip numero 20. Dopo ogni lavaggio la radice è stata osservata alla MicroCT.RisultatiI risultati dimostrano come sia stato possibile, grazie all’attivazione sonica dell’irrigante all’interno dello spazio endodontico, far penetrare la soluzione nei canali laterali.Discussione e conclusioniDetersione, sagomatura e otturazione tridimensionale dello spazio endodontico sono le tre fasi principali della terapia endodontica. La detersione è raggiunta congiuntamente tramite l’azione meccanica degli strumenti e l’azione chimica delle soluzioni irriganti. Quindi, le soluzioni irriganti devono avere azioni differenziate: dovrebbero rimuovere il substrato organico, avere un effetto battericida e infine rimuovere lo strato di materiale inorganico prodotto dalla limatura degli strumenti (smear layer). A tutt’oggi non vi sono soluzioni irriganti che ottengono tutti e tre questi risultati. Da molti studi si evince come l’attivazione sonica o ultrasonica degli irriganti, all’interno di canali radicolari ben sagomati, assuma un ruolo strategico nella detersione di tutte le complessità dello spazio endodontico. Altra fase fondamentale della terapia endodontica è l’otturazione tridimensionale del sistema dei canali radicolari con guttaperca termoplasticizzata. Prima di procedere alla fase di otturazione è fondamentale conoscere il diametro apicale del canale preparato, in modo da scegliere i materiali da otturazione più idonei (coni di guttaperca, portatori di calore, otturatori thermafil), ottimizzare le forze di condensazione ed evitare fenomeni di overfilling.SummaryObjectiveThe purpose of this article is to describe a new file featuring a unique design created for both the sonic activation of irrigants during cleaning and measuring the apical diameter.Materials and methodsTo assess the effectiveness of Sonic-Tips, a MicroCT scan was performed on an upper premolar root with lateral canals. After a chemio-mechanical (cleaning and shaping process) preparation of the root canal, the same root canal was irrigated twice with a radiopaque solution. The first irrigation was done by injecting the radiopaque solution passively in the root canal through a small gauge needle, 2mm from working length. The second irrigation again was done by delivering the radiopaque solution passively in the root canal through a small gauge needle, 2mm from working length, but in the latter case a Sonic-Tip number 20 was activated. After each cleaning (irrigation) the root was observed under MicroCT scan.ResultsThe results demonstrate how Sonic-Tips enabled flushing and made it possible for the irrigant to penetrate into lateral canals.Discussion and conclusionsCleaning, shaping and three-dimensional obturation are the three main phases of the endodontic treatement. The goal of proper cleaning of a complex root canal is not easily achieved. From previous studies, it is clearly evident how “Sonic and Ultrasonic activation of irrigants” plays a strategic role in the cleaning of a well-shaped complex root canal. Another key stage of the endodontic treatment is the “three-dimensional filling” of root canals with thermoplastic guttapercha cones. Before the filling phase, it is essential to know the accurate apical diameter of the canal, in order to choose the suitable filling material (gutta percha points, Thermafil obturators or heat carriers), followed by applying optimal condensation pressure in order to prevent overfilling

The activation of irrigation solutions in Endodontics: a perfected technique

AbstractAimIn endodontics a complete chemo mechanical cleansing of the complex root canal system is essential in order to achieve a theraupetic success.MethodologySodium hypoclorite due to its antimicrobial and proteolytic characteristic, is an efficient endodontic irrigant and it is the most commonly used.The following article introduces a refined technique in order to increase the degree of cleansing during endodontic treatment.The technique involves intracanal heating of the irrigants through a heat source.ResultsThe described technique is able to enhance simply and considerably the use of sodium hypochlorite, making it easily accessible even to generic operators.ConclusionsTo confirm the validity of this improved technique, further research and scientific studies are needed, although at the clinical level, the results by using it are very satisfactory

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