DOI:

10.37988/1811-153X_2022_3_6

Increasing the effectiveness of repeated endodontic treatment by mechanical removal of root canal biofilm — а review

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Authors

  • E.V. Ivanova 1, PhD in Medical Sciences, full professor of the Therapeutic dentistry Department
    ORCID: 0000-0002-6330-6942
  • E.G. Sabantseva 1, PhD in Medical Sciences, associate professor of the Therapeutic dentistry Department
    ORCID: 0000-0001-8146-236X
  • E.V. Petushkova 1, postgraduate at the Therapeutic dentistry Department
    ORCID: 0000-0001-7692-569X
  • 1 Russian Medical Academy of Continuous Professional Education, 125993, Moscow, Russia

Abstract

Complication of chronic apical periodontitis after primary endodontic treatment occurs in an average of 2% of patients, which indicates the need to improve the quality of both primary and repeated endodontic treatment. Recent literature sources on the topic of repeated endodontic treatment of teeth with chronic apical periodontitis were studied. Results and discussion. Many factors influence the quality of root canal re-treatment. A lot of difficulties during endodontic treatment are directly related to the lack of awareness of clinicians about the anatomical and morphological features of root canals: the presence of fins, deltas, ramifications and curvatures. The main task of endodontics is the elimination of infection from the root canal system. Microorganisms in the root canal are in the form of biofilm, fixed to the walls of the main canal, in the anastomosis and lateral canals, which becomes a permanent source of infection of periapical tissues. Choice of instruments and irrigants. Root canal irrigation is carried out using 3-5% sodium hypochlorite solution, 2.2% of chlorhexidine solution, 17% of EDTA solution. For mechanical treatment of the root canals, manufacturers produce endodontic systems for primary root canal passage, for their enlargement, for removal of the filling material from the canals, and for their qualitative cleaning. There are flexible “shape memory” tools for straight and curved root canals on the market. Recent studies on the effectiveness of these systems were conducted in vitro, comparing the degree of destructive action of the files on the root canal wall, visual detection of residual restorative material, and removal of artificially introduced into the root canals microorganisms, namely E. faecalis. There is little data on the long-term results of these endosystems and studies describing their effectiveness in the oral environment. . Studies of modern endodontic systems designed exclusively for the removal of filling material, such as Reciproc (VDW), XP-endo Retreatment (FKG), R-Endo (Micro-Mega) have mostly been conducted in in vitro conditions, the effectiveness of removal of filling material from root canals and artificially created biofilm has been studied. There are few data on the effect of these systems on the composition of the biofilm of root canals in vivo after mechanical treatment. There is no comparison of their effectiveness of root canal treatment (removal of filling material and biofilm) in oral conditions and analysis of long-term results of their use in patients, which certainly makes the research in this area relevant.

Key words:

chronic apical periodontitis, root canals, revision, biofilm, endodontic systems, root canal anatomy

For Citation

[1]
Ivanova E.V., Sabantseva E.G., Petushkova E.V. Increasing the effectiveness of repeated endodontic treatment by mechanical removal of root canal biofilm — а review. Clinical Dentistry (Russia).  2022; 25 (3): 6—12. DOI: 10.37988/1811-153X_2022_3_6

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Received

July 2, 2022

Accepted

August 2, 2022

Published on

October 30, 2022