Endodontie - Online Die Wurzelbehandlung

Cleaning and disinfection

The correct mechanical preparation of the root canal is an essential step in endodontic treatment. Diseased tissue and infected dentin are removed and ​​the canal is prepared for cleaning and disinfection.

The root canal will be extended with special instruments until enough space is created for disinfecting irrigants and for a dense root filling. The preparation is done with hand instruments and / or motor driven rotating files.

Instruments for preparation

Modern file systems consist of a nickel-titanium alloy (NiTi) and are very flexible. They follow the course of the root canal better, but are prone to breakage. With stainless steel instruments a fracture is less likely. But as they are more rigid, there is a higher risk to alter the original course of the root canal or to perforate the canal wall.

Disinfection

For disinfection and cleaning of the root canal several irrigation is used to dissolve nerve tissue, to kill bacteria and to transport dentine debris out of the canal. The more completely they can penetrate into the root canal system and the longer they interact, the better it can be disinfected. Shaping of the root canal must therefore not only be just before the root tip, but also be dimensioned sufficiently.

Ultrasonic instruments

Recent studies show that only about 60% of the root canal wall can be cleaned mechanically. This leaves a large amount of tissue and bacteria in the root canal and can cause the failure of treatment. With the help of rapidly oscillating metal tips (ultrasonic), irrigation solutions in the canal can be set in motion and reach inaccessible areas. The cleaning and disinfecting is thus improved.

More information is available in this video.

 

Picture: Dr. Jörg Schröder, Berlin

---