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Dental Tribune United Kingdom Edition

I t is known that the clinician must have knowledge of not only the normal anato- my of the root canal but also its variations1 . Also known that the success of the root canal treat- ment is fully dependent on the understanding of the root canal anatomy and morphology and how the entire system is debrid- ed, disinfected and filled2 . How- ever, doubts still remain in how to be more efficient in the disin- fection of the root canal system. Various intracanal irrigant delivery devices and techniques have been described to increase the distribution of the irrigating solution within the root canal system. However, only the En- doVac combines safety, when measuring the apical extrusion of irrigants3,4, with efficiency, when using the irrigation to de- bride root canals in the apical third5-7 . This case report shows how efficient and successful the dis- infection of the root canal sys- tem can be when using the En- doVac irrigation system. Case Report A 65-year-old female patient was referred for root canal treat- ment of 15 by her general dental practitioner. Her complaint was a “throbbing pain and a swell- ing” over 15 which started two months after the cementation of a new porcelain fused to metal crown (PFM). The clinical findings, radio- graphic findings, and vitality tests led to a diagnosis of irre- versible pulpitis, necessitating endodontic therapy. After thor- ough examination it was decid- ed that the root canal treatment should be carried out through the PFM crown as it was in good conditions and the patient did not want to have the crown out. Her medical history was consid- ered normal. Radiographic evaluation of 15 revealed possible two nar- row sclerotic canals (Fig 1). The tooth was anesthetised and iso- lated using the rubber dam. Ac- cess cavity was performed and the two narrow sclerotic canals were found. The pulp chamber was frequently flushed with five per cent sodium hypochlorite combined with Slick Gel ES (SybronEndo) to help the ne- gotiation of the sclerotic canals removing debris and bacteria. Sodium hypochlorite was deliv- ered into the pulp chamber with the EndoVac and the Master Delivery Tip (MDT) (SybronEn- do). After the establishment of the patency, working length (WL) radiograph was taken (Fig 2). A crown down technique was performed using Twisted File (SybronEndo) and a thorough irrigation was performed with the EndoVac and the MacroCan- nula. The final irrigation was performed with the EndoVac and the MicroCannula according to the final sequence in each canal (Fig 3): 1 Place MicroCannula to full WL and deliver NaOCl from MDT for 10 seconds. Stop delivery and watch for Micro- Cannula to suction (PURGE) all NaOCl from the canal. Why would you use the EndoVac? This case report by Daniela Mancuso shows how efficient and successful the disinfection of the root canal system can be when using the EndoVac irrigation system page 22DTà 21ClinicalNovember 12-18, 2012United Kingdom Edition