Revolutionary Advances: Active Disinfection

The following article appeared at Dentistry Today, and features an annotated model of pupal anatomy courtesy of Dr. Eric Herbranson. Thanks for visiting Modern Endodontic Care of San Leandro, CA.

Revolutionary Advances, Part 2: Active Disinfection

Modern endodontic treatment has been shaped by revolutionary improvements in our armamentarium. This article is the second in a 3-part series that highlights the areas of endodontics that have been impacted the most by these recent advances. The first article in this series demonstrated how 3-dimensional (3-D) evaluation of root canal systems and their surrounding structures with cone beam computed tomography allows for precise diagnosis as well as aids in guiding successful treatment. This second article illustrates advances in disinfection that contribute to a more thorough, 3-D disinfection of the entire root canal system. Finally, the third article in this series will discuss recent advances in our ability to provide an accurate and consistent 3-D seal of the entire root canal system.

The necessity to achieve thorough disinfection of diseased pulpal systems is well understood and documented.1 Our relentless aspiration to eliminate all irritants within a diseased pulpal system remains a committed objective. Unfortunately, our ultimate goal to completely disinfect every root canal system has not yet been practical. Hence the terminology of disinfection opposed to sterilization. The challenge of dissolving tissue and killing or eliminating all bacteria from deep complexities that exist within the randomness that is pulpal anatomy has been a difficult challenge to overcome. Figures 1a to 1d reveal original anatomy of premolars reconstructed from a microcomputed tomography technique.2 Adding to the challenge of pulpal anatomy is the porosity of the dentin and the ability of bacteria to penetrate and flourish within the root structure. However, our pursuit for complete disinfection through root canal treatment has gained significant advancement with the help of recent technological improvements. In addition to improving debridement, these innovative advances have greatly increased our potential to safely and actively disinfect even the most anatomically complex spaces.

This article outlines modern modalities of irrigation, current irrigants, and proposes a protocol for their delivery and activation after shaping the root canal system.

Continue reading HERE.