Session: 06-02-01: Vibration and Acoustics in Biomedical Applications

Paper Number: 145998

145998 - Systematic Review of Endodontic Irrigation- Standardization of a the Irrigation Procedure 

Root canal therapy, also called endodontic treatment, is a dental procedure to treat the infected pulp of a tooth. Root canal therapy is needed when the pulp is infected or inflamed, which could be due to internal or external factors. The following are the procedures for this therapy. Initially, the tooth is X-Rayed to be aware of the condition. The root canal treatment is only executed if there is sign of inflammation or infection in the root canal. The second procedure is to prepare the cavity in the crown for accessing the pulp chamber inside the dentin is known as mechanical preparation. After creating appropriate access to the root, the pulp is subsequently removed to make the area well-prepared to ease the filling of the material inside the root canal. Next, the root canal is irrigated so as to remove the remnant necrosis tissues and disinfect the root canal wall from the bacteria. This is a critical step in the root canal procedure and could be a major reason for the failure of root canal treatment. Finally, the cavity is filled with a material called gutta percha with adhesive cement to seal the cavity completely. Sometimes the crown cap is kept ensuring maximum protection of the tooth.

 

Despite the established aforementioned steps, no standardized endodontic irrigation procedure exists to date. A systematic literature review on existing root canal irrigation studies was conducted to identify, if any, standard practice protocol in the irrigation procedure. The review revealed numerous examples of diverse clinical scenarios and studies that did not adhere to unanimously agree on any common procedure among endodontists. Each endodontist had their own methodology, primarily based on personal judgement. For example, most endodontists used sodium hypochlorite as the antimicrobial irrigant, while some used chlorhexidine or simply water. Furthermore, there were differences in determining the working length with some endodontists utilizing only measurement radiographs while others using a combination of radiographs and electron apex locator. It was clear that discrepancies in methodology can result in inconsistent success rates, with research suggesting as low as 65% efficiency. While it is understood that there are a variety of key factors that can influence the irrigation outcome, it is troubling to note that attempts to create an endodontic database are absent. The key factors are as follows: root canal geometry; root canal preparation and enlargement; needle geometry selection; needle size; needle insertion depth; apical size and taper; irrigant solution; and irrigant flow rate. As a first step in accomplishing this, the authors designed a self-administered survey to local endodontists. The survey will assess the practitioners’ views on establishing and maintaining a universal database focusing on endodontic irrigation process. In addition, the respondents will be asked to rank the various key factors with respect to priority, while also providing insights into other case-specific factors based on their experience.

Presenting Author: Tikran Kocharian Grand Valley State University

Presenting Author Biography: Tikran (Ted) Kocharian is an affiliate faculty at School of Engineering of Grand Valley State University in Grand Rapids, Michigan.
He has joined GVSU on August of 2016 and he is part of Mechanical and Interdisciplinary Engineering committees at Grand Valley State.

Authors:

Tikran Kocharian Grand Valley State University
Sanjivan Manoharan Grand Valley State University