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The Canal Irrigation in Paediatric Pulpal Treatment

유치 치수 치료의 근관세척

  • Cho, Yong-Bum (Department of Conservative Dentistry, School of Dentistry, Dankook University)
  • 조용범 (단국대학교 치과대학 치과보존학교실)
  • Received : 2016.11.08
  • Accepted : 2016.11.08
  • Published : 2016.11.30

Abstract

Successful root canal treatment can be obtained by the removal of microorganisms from the pulpal space of the root canal system through biomechanical technique with instruments and irrigation. Due to the difference in the dimension of the pulpal structure such as thin wall of the root, large portion of chamber, the primary teeth should be considered in a different way of approach. Traditionally, fluids have been dispensed passively into the root canals for improve the cleansing. The use of sodium hypochlorite as an irrigant in root canal treatment is widespread and common, because it meets requirements for the ideal irrigants.

유치나 영구치를 막론하고 근관내의 세균 감염으로 인한 치수 괴사 및 이에 따른 치근단 병소의 유발은 임상의로 하여금 근관치료나 발치와 같은 도전적인 치료에 직면하게 한다. 특히 유치에 근관치료를 필요로 하는 경우, 소아 환자의 행동조절이 한계가 있고, 치아의 해부학적 차이, 또는 계승치의 존재로 인해 근관치료가 아닌 발치와 같은 차선의 치료로 접근할 수 있다. 영구치나 유치를 막론하고 치수내 잔존 세균과 유기조직 잔사를 기계적 방법과 함께 적절한 근관세척액을 사용하여 가능한 많이 제거함으로써 치근단 주위조직의 치유를 유도하여야 한다. 차아염소산 나트륨은 우수한 항균효과와 조직용해성, 독소의 무력화 또는 도말층을 제거할 수 있는 성질 등으로 이상적인 근관세척제의 조건에 거의 합당한 약제이다. 그러므로 러버댐 및 추가적인 차폐 조치를 한 다음, 저농도의 차아염소산 나트륨을 사용하는 것이 바람직하다.

Keywords

References

  1. Siqueira JF, De Uzeda M, Fonseca ME : A scanning electron microscopic evaluation of in vitro dentinal tubules penetration by selected anaerobic bacteria. J Endod, 22:308-310, 1996. https://doi.org/10.1016/S0099-2399(96)80265-2
  2. Sjogren U, Figdor D, Persson S, Sundqvist G : Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J, 30:297-306, 1997. https://doi.org/10.1111/j.1365-2591.1997.tb00714.x
  3. Molander A, Reit C, Dahlen G, Kvist T: Microbiological status of root-filled teeth with apical periodontitis. Int Endod J, 31:1-7, 1998. https://doi.org/10.1046/j.1365-2591.1998.t01-1-00111.x
  4. Schilder H : Cleaning and shaping the root canal. Dent Clin North Am, 18:269-296, 1974.
  5. Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA : UK National Clinical Guidelines in Paediatric Dentistry. Pulp therapy for primary molars. Int J Paediatr Dent, 10:248-252, 2006.
  6. Dakin HD : On the use of certain antiseptic substances in treatment of infected wounds. BMJ, 2:318-320, 1915. https://doi.org/10.1136/bmj.2.2852.318
  7. Crane AB : A predictable root canal technique. Philadelphia, Lea & Febiger, 1920.
  8. Gomes BP, Ferraz CC, Vianna ME, et al. : In vitro antimicrobial activity of several concentration of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J, 34:424-428, 2001. https://doi.org/10.1046/j.1365-2591.2001.00410.x
  9. Grossman LI : Irrigation of root canals. J Am Dent Assoc, 30:1915-1917, 1943. https://doi.org/10.14219/jada.archive.1943.0397
  10. Bystrom A, Sundqvist G : The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J, 18:35-40, 1985. https://doi.org/10.1111/j.1365-2591.1985.tb00416.x
  11. Siqueira JF, Rocas IN, Favieri A, Lima KC : Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod, 26:331-334, 2000. https://doi.org/10.1097/00004770-200006000-00006
  12. Hand RE, Smith ML, Harrison JW : Analysis of the effect of dilution on the necrotic tissue dissolution property of sodium hypochlorite. J Endod, 4:60-64, 1978. https://doi.org/10.1016/S0099-2399(78)80255-6
  13. Sirtes G, Waltimo T, Schaetzle M, Zehnder M : The effects of temperature on sodium hypochlorite shortterm stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod, 31:669-671, 2005. https://doi.org/10.1097/01.don.0000153846.62144.d2
  14. Dutner J, Mines P, Anderson A : Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod, 38:37-40, 2012. https://doi.org/10.1016/j.joen.2011.08.013
  15. Kleier DJ, Averbach RE, Mehdipour O : The sodium hypochlorite accident : experience of diplomats of the American Board of Endodontics. J Endod, 34:1346-1350, 2008. https://doi.org/10.1016/j.joen.2008.07.021
  16. Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA : UK National Clinical Guidelines in Paediatric Dentistry. Pulp therapy for primary molars. Int J Paediatr Dent, 10:248-252, 2006.
  17. Kim M, Kim J, Lim S : Accidental extrusion of sodium hypochlorite during endodontic treatment in a primary tooth. J Korean Acad Pediatr Dent, 42:264-269, 2015. https://doi.org/10.5933/JKAPD.2015.42.3.264
  18. Hulsmann M, Hahn W : Complication during root canal irrigation : literature review and case reports. Int Endod J, 33:186-193, 2000. https://doi.org/10.1046/j.1365-2591.2000.00303.x
  19. Kerbl FM, DeVilliers P, Litaker M, Eleazer PD : Physical effects of sodium hypochlorite on bone: An ex vivo study. J Endod, 38:357-359, 2012. https://doi.org/10.1016/j.joen.2011.12.031
  20. Bystrom A, Sundqvist G : Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res, 89:321-328, 1981.
  21. Siqueira JF Jr, Lima KC, de Uzeda M, et al. : Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques. J Endod, 25:332-335, 1999. https://doi.org/10.1016/S0099-2399(06)81166-0
  22. Peters OA, Schonenberger K, Laib A : Effects of four NiTi preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J, 34:221-230, 2001. https://doi.org/10.1046/j.1365-2591.2001.00373.x
  23. Zehnder M : Root canal irrigants. J Endod, 32:389-398, 2006. https://doi.org/10.1016/j.joen.2005.09.014