[Experimental scanning electron microscopic study of canal filling according to Schilder's vertical condensation technic].
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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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The application of corticosteroids to cut dentine following cavity preparation, to carious dentine in indirect pulp capping, to the exposed pulp or to pulp remnants and periapical tissues during root canal therapy has been claimed to eliminate post operative pain and inflammation. Other investigators have thrown doubt on the validity of these claims and have reported continued inflammation progressing to necrosis following such applications. This paper reports detailed clinical and histological findings in a series of over 500 teeth some of which received conventional treatment while others were treated with various corticosteroids including Mosteller's solution, tritiated prednisolone, and Ledermix paste and cement. The results confirm the fact that no clear correlation exists between symptoms and histological findings in pulp disease. The absence of pain following application of corticosteroids cannot therefore be taken as evidence of a specific therapeutic effect. In some cases pain returned after a period and histologic examination showed the slow development of inflammatory changes coupled with calcification in pulp tissue and on the walls of the canal. Further investigation is needed to clarify the relative contribution of the removal of toxic products by instrumentation and the anti-inflammatory properties of corticosteroids in the reduction of pain of pulpal origin.
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Mouse peritoneal macrophages were reacted with gutta percha, a kind of natural rubber, widely used as a root canal filling material in endodontic therapy. Fine gutta percha particles were phagocytized by mouse peritoneal macrophages in vitro. Gutta percha particles injected intraperitoneally stimulated peritoneal macrophages and accumulated in milky spots on the omentum. Pure gutta percha membranes implanted intraperitoneally were covered and penetrated by macrophages. Gutta percha point membranes were partly digested in the same environment. Thus, evidence was obtained that gutta percha is not biologically inert in the strict sense, but can activate the body's defensive mechanisms.
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