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ePaper created 2017-09-12, 09:26:18 | version 1.38.0
biomaterial for root canal filling technique | Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 In the past, this type of disease would have been completed into two steps. The first step involves fill- ing the root canal up to the level of the perforation, taking care to avoid any extrusion of materials through the perforation, and the second step involves filling the last third of the canal with a silicate-based material such as Biodentine (Septodont). Because BioRoot is a tricalcium sillicate-based filling material, it was decided to combine the two steps in one by filling the canals and the perforation in the same time. Just as the two previous cases, the root canals were dried with paper points, BioRoot RCS was in- jected into the canals with a spiral used at low speed (800 rpm) and gutta fitted gutta-percha points were inserted into each canal up to the working length (Fig. 12). A small extrusion of material is visible on the postoperative radiograph, as a confirmation of perforation closure (Fig. 13). The tooth was restored with a bonded overlay (Figs. 14 & 15) and the patient was recalled at six months after the treatment (Fig. 16). The tooth is asymptomatic and functional; the peridontal probing is normal, and the six-month recall radiograph confirm the bone healing of the interradicular lesion. These cases are used to illustrate some specific situation in which we used BioRoot RCS because its valuable properties. These are three of a large number of cases we have completed in the last 18 months. Before the launch of this product, 22 clinical cases were completed in the frame of a randomised clinical trial comparing the succes of an endodontic treatment using warm vertical compaction of gutta-percha versus the above described Bio Root RCS. The RCT registration num- ber is NCT01728532 and the full protocol is available online (https://clinicaltrials.gov). The results are, at the time of writing, under anal- ysis and very encouraging, which allows us to consider this technique as reliable enough to be described here. Conclusion Endodontics is continously under evolution. In the last 20 years, instrumentation research and de- velopment have been very active. Currently, disin- fection and irrigation procedures are the two most focused on aspects of endodontic research. The shaping procedures and root canal disinfec- tion have been considerably simplified. Thereby, every practitioner interested in endodontics is now able to complete any easy/middle difficulty root ca- nal treatment with reproducible results without any issue. Obturation, the final step of the procedure, is usually the most difficult and time-consuming as- pect. However, with this new approach of root canal filling, this milestone may be overcome. Considering the fluidity of BioRoot RCS as a filler and not only as a sealer, this represents a true paradigm shift. The preliminary results of the randomised clinical trial are very encouraging. More clinical investigations will be necessary in the future to confirm this new vision of a simpler root canal obtruation._ Editorial note: A list of references is available from the publisher. BioRoot RCS is a registered trademark of Septodont. Fig. 16 Fig. 10: Preoperative radiograph of tooth #36 of a 31-year-old female patient. Fig. 11: Highlight of the stripping perforation on the mesial side of the distal root canal. Fig. 12: Postoperative radiograph after completion of endodontic treatment. Fig. 13: Decentered postoperative radiograph showing the slight extrusion of material in the interradicular area. Fig. 14: Clinical view of the access cavity before restoration. Fig. 15: Final prosthetic restoration with a bonded crown (Dr Alexandre Sarfati, Paris). Fig. 16: Six-month postoperative recall. contact Prof. Stéphane Simon acts as a scientific consultant for Septodont company. Université Paris Diderot, Paris 7 5 rue de garancière, 75006 Paris CHU de Rouen Hôpital Saint Julien stephane.simon@ univ-paris-diderot.fr www.simendo.com roots 3 2017 51