Following the proper steps is key to success in Endodontics. No step can be neglected; mishaps in each step will preclude the successful accomplishment of the next one.
Establishing a correct diagnosis is critical and it can be accomplished performing thorough clinical and radiographic exam, including all tests needed. Cutting edge technology, such as, laser Doppler and Cone beam CT scanner are available nowadays to aid the clinician establish the correct diagnosis.
Once a definitive diagnosis is established, endodontic therapy can be initiated. The access cavity with straight line access will facilitate the location of all root canal orifices and the correct cleaning and shaping of the whole root canal system.
Cleaning and Shaping: once an appropriate access cavity has been created, root canals are mechanically and chemically cleaned through the use of files and irrigants, often in combination with ultrasonic activation. Sodium hypochlorite, chlorhexidine and EDTA have all precise indications for use during the cleaning and shaping phase, which aims to eliminate all potential irritants including pulp tissue, debris, microorganisms, and other pathogens, thus achieving clinical success.
After thorough cleaning and shaping, the root canal system needs to receive an hermetic seal, a complete obturation, in order to minimize empty spaces within the root canal system where microorganisms may recolonize, to entomb potentially remaining debris and bacteria, creating a complete seal along the entire length of the root canal. Research has shown that remaining bacteria that survive after cleaning and shaping quickly proliferate and recolonize root canals that remain poorly obturated or empty.
In summary, following carefully each and every step of root canal therapy will result in predictable and successful outcomes, corroborating a rewarding and pleasant experience for both, patient and clinician!
Happiness is a well executed root canal treatment!
