Endo Tribune Middle East & Africa Edition No. 2, 2018

PUBLISHED IN DUBAI www.dental-tribune.me March-April 2018 | No. 2, Vol. 8 Understanding sonic-powered irrigation SUBSCRIBE NOW www.me.dental-tribune.com/e-paper/ issn 2193-4673 Vol. 13 • Issue 4/2017 roots international magazine of endodontics 42017 By Dr Vittorio Franco, Italy system—including Thoroughly irrigating the entire root canal isthmi and lateral canals—is important for success of endodontic treatment. Research has shown that sonic acti- vation of irrigants offers significant improvement in cleaning efficacy, since it removes considerably more debris and smear layer than needle irrigation. Besides cleaner root ca- nals, it increases the effectiveness of disinfectant solutions to support long-term success. We spoke with leading Italian endodontist Dr Vitto- rio Franco about his daily irrigation protocol, passion for endodontics and experience with EDDY, a sonic- powered irrigation tip. What do you like most about endodontics? Nothing is clearly visible in endodon- tics, so one has to constantly adapt one’s strategy. In the end, one must discover the anatomy, understand the difference between one’s imagi- nation and reality, and find a good treatment solution. Many recent dental studies have confirmed the importance of retaining the natural dentition and thus of endodontics as opposed to implantology. Now is the right time to be an endodontist. We now have more possibilities for preserving natural teeth and that is a wonderful thing. Why is proper rinsing so important, and how can one see when the canal has been cleaned properly? I think that the cleaning of the canal is the most important aspect of an endodontic procedure. Of the three major steps, shaping and obturation are less important than eliminating bacteria from the root canal. The main purpose of endodontic treat- ment is to clean the canal. Other- wise, root canals can become a good environment for bacteria to grow in. If the dentist retains vital tissue that will then become necrotic, it will facilitate bacterial growth. The main reason for retreatment is the presence of an infection due to poor cleaning in the first place. There are many published studies on the time required for proper ir- rigation. We have many variables to consider—contact time, refresh- ment of the solution, amount of tis- sue/bacteria, volume, temperature, shear stress and so on—so we can- not standardise this process and fi- nal result. There are studies that say one needs 30 minutes to achieve the complete elimination of bacteria, but they did not consider activation pos- sibilities. If you ask me how I decide when irrigation has been sufficient, from my point of view, the only clini- cal way to determine whether the ir- rigating solution is working is from seeing bubbles in the solution. That means that the solution is reacting research Photodamage of dental pulpa stem cells during 700 fs laser exposure case report Apexification treatment with MTA REPAIR HP interview Understanding sonic-powered irrigation with something inside the root ca- nal system—obviously if there is no communication like a large foramen or perforation. If bubbles stop being produced, the clinician can stop cleaning the canal ÿPage A2 Technology Enhanced irrigation and debridement FKG Dentaire SA www.fkg.ch

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