Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review

By Peters, OA

Date: 01/2004
Journal: JOE

Summary:

  • No studies have been done to identify if NiTI instruments increase the success
  • A noninstrumental technique (NIT), relying exclusively on activated disinfecting and tissue-dissolving solutions, may be preferred . The technique uses a vacuum pump and an electrically driven piston, generating alternating pressure and bubbles in the irrigation solution, inside the root canal.This is expected to enhance the ability of sodium hypochlorite to dissolve organic pulp tissue. Unfortunately, a recent clinical evaluation revealed that only 21% of the tested roots were sufficiently cleaned with this method, indicating a need for further modifications before this technique can be used in routine clinical practice
  • Standardized root-canal preparation to an apical stop coronal to the constriction may be problematic because the “classical” singular constriction was not present in 50% of the canals evaluated ( and because of possible sequelae of canal over-enlargement, in particular vertical root fracture
  • The use of a patency file, i.e., a fine file that is passively passed through the apical foramen, has been suggested for most rotary techniques. However, this issue I controversial, in particular, because infected dentin chips may be forced into periapical areas
  • Extrusion of debris, dentin mud, or microorganisms is considered to play a role in flare-ups and failures
  • Niti Files have better resistance to cyclic fatigue
  • Canal Trasnportation was correlated with leakage