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[Importance of the number of treatment sessions in the success of root canal therapy].

Root canal therapy is usually performed in single or multiple-visit treatment. The choice of single or multiple visit depend on dentist and patient available time. In general dentistry, multiple-visit is widely chosen by dentist whereas endodontic speciality recommend single-visit. In this study we analyzed 120 root canal therapy performed by students, to determine the number of visits needed to achieve treatment from endodontic-cavity-access to root canal filling and its possible, influence in the successful rate. Results showed that globally, 60% of treatments were performed in multiple-visit. Results showed also hat 89.3% of anteriors teeth were performed in single-visit but there is a higher rate of fail: 31.78%. Nevertheless, these results do not condemn endodontic single visit therapy.

Female↗

Restoration of exposure sites prior to root canal therapy.

Root canal therapy may be the treatment of choice following pulpal exposure during restorative procedures. The exposure site is not, however, always in the line of the proposed access cavity. This article outlines the problems this situation may pose and presents a solution that may be used in some clinical situations.

Dental Cavity Preparation↗

The smear layer: a phenomenon in root canal therapy.

When the root canals are instrumented during endodontic therapy, a layer of material composed of dentine, remnants of pulp tissue and odontoblastic processes, and sometimes bacteria, is always formed on the canal walls. This layer has been called the smear layer. It has an amorphous, irregular and granular appearance under the scanning electron microscope. The advantages and disadvantages of the presence of smear layer, and whether it should be removed or not from the instrumented root canals, are still controversial. It has been shown that this layer is not a complete barrier to bacteria and it delays but does not abolish the action of endodontic disinfectants. Endodontic smear layer also acts as a physical barrier interfering with adhesion and penetration of sealers into dentinal tubules. In turn, it may affect the sealing efficiency of root canal obturation. When it is not removed, the durability of the apical and coronal seal should be evaluated over a long period. If smear layer is to be removed, EDTA and NaOCl solutions have been shown to be effective, among various irrigation solutions and techniques, including ultrasonics, that have been tested. Once this layer is removed, it should be borne in mind that there is a risk of reinfecting dentinal tubules if the seal fails. Further studies are needed to establish the clinical importance of the absence or presence of smear layer.

Chelating Agents↗

[Root canal therapy--clinical results].

Clinical and radiographic evaluations of root canal therapy indicated, that after correct patient selection endodontic therapy is technically feasible in most cases (even in posterior teeth). Only in few cases (3%) did symptoms of flare ups (5.4-13.4%) last for more than one week. This rate could be further reduced by additional measures, such as the local application of antibiotics and steroids. Long-term success rates for root canal therapy have been reported to range between 71 and 96%. The patient's age and the type of tooth affected had no effect on prognosis. Teeth with periapical resorptions displayed slightly lower success rates. Failures were primarily attributable to overfilling or inadequate instrumentation and/or filling. Root canal therapy should be part of an overall treatment plan including considerations of primary and secondary prevention as well as each patient's individual needs.

Humans↗