Endodontics has seen several changes in the past decade. Teeth with seemingly hopeless prognosis are now being saved and restored with the advent of new technology, approach and treatment. Rotary drills and the microscope were considered the best possible equipment an Endodontist could possess. Now this is considered commonplace as there has been further innovative products and processes. The advances have been in all possible areas. Let’s look at a few of them:
Diagnosis
Pulp vitality tests are now done by Pulp Oximetry, Laser or Electromagnetic Flowmetry and Dual wavelength spectrophotometry to name a few.
Imaging Progress:
The Cone Beam Computerized Tomography has brought about great change. The CBCT detects the smallest of lesions and makes Dynamic Navigation and Endodontic surgery possible. Surgical stents developed by the scan allows for endodontic surgery even in the palatal root.It also facilitates the use of piezoelectric devices to make bony windows to access root apices. Magnifying devices allow better visualization. These are loupes, endoscopes and microscopes The determination of working length is facilitated by allowing working in dry and wet canals with the use of multiple frequencies. Apex Locators connected to Endodontic handpieces can be paused by the clinician at a preset location in the apical region.
Source: Cone Beam CT for Endodontics – Source Acharya Dental
Instrumentation:
Advances in materials of instrumentation most prominently Rotary NiTi instruments. These include the Hero (High elasticity in rotation), RACE (Reamer with alternate cutting edge) and the ProTaper instruments and the SAF (self-adjusting File) Lasers along with acoustic energy reinforce the concept of minimally invasive treatment. Lasers are used for diagnosis (Laser Doppler Flowmetry). The CO2 lasers are used for pulp capping and pulpectomy. Nd: YAG and Er:Cr:YSGG used to reduce bacteria and smear layer from canals Irrigation solutions such as Tetraclean and MTAD and irrigating devices such as the LAD (Light Activated Disinfection) and Endovac are popular. The recent Gentle Wave System is among the newest irrigation devices. Nanotechnology is also being used for canal disinfection.
Source: Fotona Laser
Bioceramic sealers and some biomaterials such as CEM release calcium hydroxide during and after setting, making the seal more effective. The current trend is to use the 4th generation resin based sealer like Meta Seal. MTA based sealers like MTA Obtura and Pro Endo are widely used.
Regenerative Endodontics has sparked great interest in the Endodontic world. These are biologically based procedures that replace or regenerate pulp like tissue, coronal dentin and resorbed roots. The process includes Revascularization of the Root Canal, Apexification and Apexogenesis and Stem Cell Therapy and Tissue Engineering. Endodontics is undergoing great change as it is holding out its age old promise of preserving teeth and improving the quality of life for the human race.
-Dr.Vijaylakshmi Acharya
