Starting at: Rs.1,996.92
Starting at: Rs.1,996.92
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Louis I. Grossman, DDS, DMD : Three discoveries during the latter part of the last century that changed the course of root canal treatment were anesthesia, asepsis and the discovery of X rays.The control of pain up to that time was crude. When the pulp was exposed, various caustic solutions, such as nitric, sulfuric, or hydrochloric acid, were applied to the pulp. This caused more pain initially, but it apparently had the effect at least of necrotizing the pulp and thus ultimately deadening the pain. Another method of pain control was to thrust a red-hot wire or pointed instrument into the pulp. Sharp wooden pegs were also commercially available for that purpose. The peg was placed against the pulp of the tooth and given a sharp blow with a dental mallet, to knock out the "nerve." A skillful dentist could knock out the pulp with a wooden peg quite painlessly. The ancients also used a general anesthetic or narcotic in the form of a decoction of mandrake root, or mandragora, to control the pain of a toothache. The juice of the poppy, from which morphine is obtained, was also used to achieve a narcotic effect, enabling the dentist to remove a pulp or an aching tooth. In 1836, Shearjashub Spooner recommended the application of arsenic to destroy the pulp before removing it. This was a slightly more humane method of preparing the pulp for pulpectomy. In his book, Spooner said, "The most effectual and least painful means of destroying nerves of teeth is arsenic." A paste of arsenic trioxide made with oil of cloves and asbestos fiber was used for more than a century. It destroyed the pulp painlessly in some cases, but in others, it converted a mild pain to a severe pain. Arsenic was commonly used in the 1920s; I used it early in the days of my practice. If the arsenic was not sealed properly, it leaked out of the cavity, destroying the gingiva, periodontal ligament, and adjacent bone, which resulted in considerable pain and loss of the tooth.
Later Pierre Fauchard (1678-1761), considered the founder of modern dentistry, who in his textbook “Le chirurgien dentiste” precisely described the dental pulp and dispelled the legend of the “tooth worm,” which had been considered the cause of caries and toothaches. Further research and knowledge regarding the root canal systems in the tooth have resulted in an array of endodontic treatment modalities, enhancing endodontic health.
Endodontic materials are used to clean, shape and fill the root canal system of teeth in which the pulp tissue has been destroyed. Pulp devitalization materials, Endodontic files, root canal irrigants, obturation materials and root canal filling materials aid the dental professional in delivering quality endodontic treatment.
Endodontic treatment involves removal of the infected or degenerated pulp tissue followed by biomechanical preparation of the root canal which results in eradication of the infective agents that caused pulpal degeneration. Root canal irrigants and intracanal medicaments further reinforce this process. The cleaned and shaped root canal is then filled with an inert substance such as gutta percha along with root canal sealants.
Materials used in endodontic therapy may be categorized according to their usage in the phases of treatment as:
The first step in endodontic treatment involves the access cavity preparation which ideally results in gaining a straight line access. Endodontic burs such as the round bur with collar, non-end cutting bur aid in preparing the access cavity and deroofing the pulp chamber. Endodontic probes can be used in locating the root canal orifices.
Pulp devitalization materials help render the infected pulp, nonvital facilitating extirpation. Barbed broaches help extirpate the degenerated pulp tissue. Gates Glidden drills are used to enlarge the coronal and middle portions of the canal through the bulk removal of the tooth structure. In retreatment procedures, gutta percha solvents dissolve the existing root canal filling which makes the process of removal smoother. Peeso reamers are used for bulk removal of debris and gutta percha.
Biomechanical preparation of the root canals is carried out to shape them, to suitably receive a permanent filling material.
Gates Glidden drills are used to enlarge the coronal and middle portions of the canal through the bulk removal of the tooth structure.Endodontic files such as K files, H files, K flex files, NiTi files and others, available as hand operated and rotary instruments are used in shaping the canal.Materials such as EDTA act as chelating agents assists in negotiating calcified canals.
Endodontic files have been engineered in both hands operated and rotary systems. They are the primary instruments used in shaping the root canal. Currently, files made of stainless steel and nickel titanium are available. NiTi files having excellent flexibility and shape memory properties are highly useful in the endodontic treatment of teeth having curved canals and dilacerated roots.
Obturation or obliteration of the root canal in the three dimensional filling of the entire root canal system with an inert filling material. An ideal obturation material should be impervious to moisture, bacteriostatic, radiopaque, sterile, be easily inserted into the root canal and removed if necessary.Based on the biomechanical preparation gutta percha points are selected as master cones and accessory cones to ensure a hermetic seal. Root canal sealers serve as fillers to overcome minor discrepancies between the walls of the root canal and the core filling material. They further are useful in obturating lateral canals, lubrication, radiopacity and ensuring an impervious seal.
Root canal Irrigants are used in combination with shaping instruments to loosen debris, pulp tissue, and microbes so that they can be removed from the canal. Sodium hypochlorite, chlorhexidine, EDTA, MTAD are among the frequently used RC irrigants.
Accidental perforation of the floor of the pulp chamber, furcation or any other part of the root canal although undesirable happens in certain situations. Root repair materials such as MTA, GIC, Biodentine and PRF serve as remedies in such scenarios.
When dealing with the endodontic treatment of severely mutilated teeth, where the remaining tooth structure is less, posts and core build up materials are used to reinforce the tooth so as to increase its resistance to occlusal forces.
Posts are available as steel posts, ideal for posterior teeth and fiber posts which are more esthetic options when dealing with anterior teeth.
Meta Biomed, Sybron Endo, Dentsply, Ivoclar Vivadent, 3M ESPE, Tokuyama, GC, Ultradent, Voco, Angelus, DiaDent, Ammdent, DMG Germany are some of the premium brands manufacturing endodontic dental materials available online at Dentalkart.com
Dentalkart.com presenting a wide range of materials suitable for every dentist. Materials used in endodontics manufactured by over 50 brands are available on the website providing comprehensive catalogue products to choose from. Endodontic burs, endodontic files both rotary and hand operated, barbed broaches, pulp devitalization materials, root canal sealers, endodontic posts, core build up materials, root canal irrigants, root repair materials and many more products formulated and engineered by both premium and economical brands are easily obtainable in a few simple steps. Having varied forms of payment including credit and debit cards, net banking and cash on delivery (CoD), Dentalkart.com ensures prompt delivery of products.