(044) 572 55 12

Kyiv, 1 B. Gmyri Str.

 

Mechanical Preparation of Root Canals

In our work we use the new nickel-titanium mechanical files Pro Taper, Path Files and System GT Rotary Files. These files represent a revolutionary progress in the area of root canal preparation.

They are characterized by excellent flexibility, incomparable performance and enhanced safety. Unique design features of these instruments make it possible to more thoroughly create an even conical shape in strongly curved canals and the canals with anatomic difficulties, which further facilitates the process of filling these canals.  

 

 


Ultrasound Treatment of Root Canals with Sonic Tip and
Piezon Master 600 Ultrasound Tips  

Recently, attention is increasingly given to antibacterial treatment of the root canal system. The reason for this is that even the most thorough preparation of the main root canal system by modern nickel-titanium rotating instruments is sometimes insufficient and in the long run endodontic treatment complications may occur, such as pockets of destruction in periapical tissues. For a long time dentistry used only mechanical and chemical antiseptic methods. Today, along with the development of new solutions for antiseptic treatment, such additional means as ultrasound treatment of root canals is increasingly applied.  

At our clinic we have used ultrasound treatment of the root canal system for several years and we are already in a position to compare the first long-term results of mechanical endodontics with and without ultrasound application.

Besides doing the primary endodontics, we also monitored the treatment results for teeth with periapical changes detected at the beginning of treatment. All teeth were X-rayed to confirm the diagnosis of periapical pockets of various size and density. Endodontic treatment of such teeth involved the combination of mechanical preparation by nickel-titanium rotary tools, medicinal treatment and ultrasound treatment. One year later, X-ray of all teeth showed improvement.  

Based on our data, it is possible to conclude that ultrasound treatment of root canal system results in considerable reduction of possible endodontic treatment complications.

 

Correct filling of the root canal is the key stage of endodontic treatment.  

The most state-of-the-art technique in the world today is the technique of thermoplasticized (warm) gutta-percha.

For the first time the technique of gutta-percha vertical condensation (three-dimensional obturation) was described by Schilder in 1967 as “Softened Gutta-Percha Technique”. This technique involves warming a gutta-percha cone with the help of a hot instrument and condensing it in apical direction with the help of a plugger.

It is very important to have no cavities left inside the canal after the filling is done, because they provide a space for the remaining microflora to develop and cause new inflammatory processes.  

 A tooth root has a complex branched structure. Пломбировка горячей гуттаперчей позволяет запломбировать не только основной канал, но и его ответвления.  Warm gutta-percha filling makes it possible to fill not only the main canal, but also its branchings. Gutta-percha fills all of the canal space, including the places the instrument could not get to during the mechanical preparation of the canal. Gutta-percha gets into the canal under pressure with the help of a gun-shaped appliance with a silver needle at its tip (System B and Obtura). Through this needle a therapist introduces gutta-percha to its destination and compacts (condenses) it by pressing the next portion vertically on top of it. Therefore, the technique bears a name of vertical condensation.

The technique of warm vertical condensation makes it possible to achieve high quality of filling even in curved canals and in canals with a large number of additional lateral branchings, root bifurcation or bent root apex. Before the invention of this technique such teeth were impossible to fill.

Another important property of warm vertical condensation technique is a high level of sealing the canalicular system of the tooth. Repeat infection (contamination) of the filled canal is impossible, as gutta-percha introduced in liquid state seals the canal and all its branchings tightly.

 

Presented below is a clinical case of root canal treatment

 

Also presented here are some results of root canal treatment in our clinic

 

Clinical case with periapical and interradical inflammatory
process in the area of tooth 47
:

 

Examples of root canals treatment with the use of warm gutta-percha:
Case 1:

 

Inflammation in periapical area of tooth 25:
Case 2:

 

Apexification ProRoot MTA combined with vertical condensation:
Case 3:

 

At our clinic (the only one in Kyiv at the moment) we have unique ultrasound endodontic tips. They are used for the:

  • removal of broken instruments,
  • removal of restoration materials,
  • removal of pins,
  • removal of amalgam, composites and cement stumps from pulp chamber,
  • removal of pulp stones,
  • detection of scleroid, diverging from normal position or lost canals,
  • removal of filling materials from root canals.

The benefits of such tips:

  • Abrasive coating enhances performance and durability.
  • Designed for dry treatment with the aim of improving visibility.
  • Patented counter-angle (shape) improves access to all teeth.
Titanium instruments  Tools with abrasive coating