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ePaper created 2017-09-12, 09:26:18 | version 1.38.0
| technique root canal preparation The effect of partial vacuum on the chemical preparation of the root canal system: The Sleiman sequence Authors: Prof. Philippe Sleiman & Dr Alfredo Iandolo, Lebanon/Italy Fig. 1a: Sleiman-Iandolo testing. Showing a gas bubble locked inside a lateral canal as a result of passive ultrasonic irrigation (PUI). Fig. 1a Introduction From the early 20th century, when Walter Hess and Ernest Zürcher1 demonstrated root canal anatomy with an unprecedented visual clarity, its complexity has fascinated researchers armed with ever better imaging tools—from blue dyes to CT, from CBCT to confocal microscopy, from clear tooth preparations to micro-CT2–4, to name just a few. Thanks to rigorous research and discussion, the diverse intricacy of root canal morphology is well understood and accepted today. However, the question of how to best prepare this space to restore homeostasis remains open to debate, which is conducted both in the scientific and, unfortunately, commercial domains. Our task as scholars and clinicians is to investigate which ap- proaches would be practical and applicable to bring teeth and periodontium back to health in accord- ance with evidence-based endodontics and princi- ples of minimally-invasive dentistry. it is the irrigation process that provides a level of cleanliness that can, hopefully, create conditions for the body to heal. Thus, given that the shaping is ac- ceptable (i.e. the files used remove the bulk of the pulp and/or infected dentine without blocking the system with debris as well as maintain the original shape of the canal without any micro-crack forma- tion), it is the chemical preparation that is responsi- ble for treating the system in all its complexity. For a long time, irrigation remained a somewhat mystical part of the process, with a general agree- ment that a good rinse is necessary, but without a standardised sequence of irrigation. While various tools for irrigation and activation of solutions were studied extensively, the first sequence was suggested only in 2005,5, 6 and it made clinicians aware that alternating solutions could be as beneficial as the use of negative pressure in order to achieve a clean root canal space and diminish postoperative pain. As yet another array of new file systems are launched in the market, we seem to share an under- standing that files do not have the ability to clean root canal space, only preparing, i.e. shaping it, while Below you will find descriptions and outcomes of several studies that led to a suggested protocol of irrigation that is presented in the conclusion of the present publication. 32 roots 3 2017