[Apical root resection. Retrograde cavity preparation and retrograde root canal filling materials].
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Biomedical subjects
Publications and source records attributed to P H Guldener.
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A survey of physical and biological properties of well-known root canal filling materials are discussed and the following conclusions were drawn: --No root canal filling material fulfils all requirements of an ideal sealer. Those materials, which perfectly seal the root canal and also show minimal periradicular tissur reaction, are recommended in Endodontics. --During setting time, all sealers are more or less toxic to the periradicular tissue. Materials which contain paraformaldehyde and lead exhibit a strong and persistent toxicity. --The tissue reaction of root canal filling materials is only slight when the root canal is underfilled. Ideally, in vital cases, the root canal should be filled to the dentine-cemental junction (approx. 1 mm short of the apex), in necrotic cases to the apical foramen. --Neither a root canal cement nor a guttapercha cone will perfectly seal a root canal alone. The combination of the two materials is recommended. --Silver cones are indicated only in narrow, tortuous canals. --Success of root canal therapy depends on various factors, primarily however on thorough root canal débridement.
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It is possible to utilize a segment of multirooted tooth as a healthy abutment even though retention of the entire tooth is impossible due to advanced periodontal disease, carious lesion or endocontic failure. The criteria for success of tooth hemisection, root separation or root amputation is dependent on the following factors: -proper case selection based upon adequate diagnostic tests -periodontal condition (amount of supporting bone) surrounding the remaining segment -condition of the remaining dentition -the ability to establish optimal occlusal relationship with minimal traumatic forces -the ability to perform satisfactory endodontic procedures, using an aseptic technique -stabilization by means of fixed prosthesis -the ability to establish an environment amenable to optimal oral hygiene.
In line with the classification based on etiological principles, combined pulp and periodontal diseases are classified into three clases and the possible therapeutical measures are explained.
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