Modern issues of the root canal treatment

Abstract

The chronic inflammatory diseases of the pulp and of the periodont after the treatment may become sources of infection which trigger or support pathological reactions in the human body. That’s why a proper endodontic treatment is needed, in order to obtain a complete healing of the inflammatory sources. Although therapeutical dentistry has achieved a great progress in recent years, regarding endodontics, the quality of the root canal treatment still remains a major problem, up till now. The investigations made by Sirbu S. and the authors (1999) establishing that in those 86,5% endodontic treated teeth, the qualitative root canal obturation consists only 3,5%, and the other cases are considered to be different failures. The therapeutical success in the gangrenous pulpitis and granulated chronic periodontitis is supported by different factors: biomechanical preparation, root canal irrigations and medicamentary dressing with antibacterial and osteoinductive proprieties, root canal tridimensional sealing with full crown restoration. The objective was to evaluate the modem methods of the root canal treatment in pulpitis and periodontitis with the use of the ProTaper System and Thermafil System as a way of mechanical preparation and obturation of the root canal. There were selected, examined and endodontic treated 21 patients aged between 21 and 45 years, diagnosed with gangrenous pulpitis and granulated chronic periodontitis. Besides the clinical and instrumental exam there were used paraclinical methods such as: electric pulp tester, apex location, and the radiography. The X-Ray exam was applied: at the beginning, during the treatment and after 3, 5 and 12 months pursuing the treatment. There were used methods of modem treatment in all patients, such as, root canal preparation by the ProTaper System, antibacterial irrigations with natrium hypochlorite -2,5% and root filling with Thermafil. In periodontitis, the root canals were temporary filled with a calcium hydroxide paste, Ultracal XS. Results and discussions: Clinical observations during 3, 5 and 12 months after the treatment show the absence of the clinical accuse and the entire participation of the endodontic treated teeth in the masticatory act. The study of the X-rays revealed the following data: complete healing in 12 examined cases; 4 cases presented bone regeneration more than half of its initial inflammatory process, 5 cases of pulpitis didn’t indicate any periodontal changes. The root canal preparation with the ProTaper System and the three-dimensional obturation with Thermafil represent modem methods of treatment which assure treatment effectiveness in endodontic therapy.