The only constant in endodontics is that the field is always changing. Here, DPS explores how modern advancements are reshaping procedures, enhancing outcomes, and ultimately, improving patient care.
There is an old saying that implant dentistry is a restorative treatment with a surgical component. “Endodontics is the same,” said Dr. Gregori Kurtzman, a general dentist who practices in Silver Spring, MD. “It is a restorative treatment with an endodontic component. If we cannot preserve tooth structure, then we cannot preserve the teeth long-term.”
Today, it seems both restorative dentists and endodontists have more than received the memo—recognizing and thoroughly understanding this concept. As a result, they’re able to increase the success and overall predictability of their endodontic treatments.
“Endodontic access has become geared more toward the preservation of the coronal tooth structure, especially in the cervical area,” Dr. Kurtzman noted. “With that, there is also more conservative instrumentation being used in the canals, so they are not over-prepared with greater taper files used in the past.”
Minimally invasive rotary file systems are just one example of how endodontic treatment has evolved and advanced over the past few decades. Here, Dr. Kurtzman points to several other products and technologies that work together to create more precise and efficient endodontic procedures and outcomes.
CBCT: Cue the 3D View
“Vertical root fractures are often difficult to diagnose, as they can lie parallel to an intraoral sensor,” Dr. Kurtzman explained. “But improvements in intraoral radiographs have aided in better diagnosis and treatment, thanks to developments made in digital sensors and CBCT.”
By effectively providing a 3D view, CBCT allows the tooth to be examined from various angles, further assisting with the visualization and identification of vertical root fractures, additional canals, and surrounding anatomy. “CBCT is used increasingly to detect pathologies on the root structure before endodontics is initiated, so surprises are greatly
minimized,” Dr. Kurtzman added.
Lasers for Cleaner Canals
Additionally, lasers have become valuable tools in endodontics, as they facilitate more thorough disinfection compared to traditional methods. They not only offer clinicians greater control over minimizing tissue damage but also reduce postoperative discomfort for patients.
“Using a laser to clean the canal system following instrumentation yields a bacteria-free canal system prior to obturation,” Dr. Kurtzman assured. “The laser reaches further into the dentinal tubules and accessory anatomy where files cannot reach.”
The Bioceramic Benefit
When it comes to obturation, a critical step during root canal treatment, Dr. Kurtzman emphasizes the benefits of transitioning from zinc oxide eugenol (ZOE) materials to bioceramics.
“ZOE materials can cause complications if they extrude out the apex, and they are prone to dissolutions that could lead to recurrent endo issues,” he said. “By contrast, bioceramics adhere firmly to the canal walls and do not dissolve after setting. They also significantly reduce the risk of coronal leakage.”
As the field continues to evolve, incorporating the latest tools and technologies into your endo routine is the best way to ensure effective, efficient patient care, and ultimately, successful results.
