Clinical Case Reports Of The Single-visit Root Canal Therapy For The Infected Root Canals

Objective: Teeth with root canal infection of 30 patients were conducted single-visit root canal therapy,postoperative reactive and efficacy were observed to provide guidance for clinical application of single-visit root canal therapy.Methods: Conduct detailed tooth body and periodontal examination of the affected tooth before surgeries,including intraoral examination,X-ray examination as well as inquiry of the medical and treatment history of the affected tooth to exclude that with no conservation value and enroll 30 cases of affected teeth in the research.The inclusion criteria of the object of study are as follows:1.mature apical foramen;2.good health condition to tolerate root canal therapy;3.mobility degree ≤ grade II;4.patients with periodontal diseases are cooperative enough to receive systemic periodontal treatment.The exclusion criteria are as follows: 1.the patients refuse root canal therapy;2.severe progressive periodontal diseases;3.odontoclasis,cracked tooth,and external root resorption;4.overfilling of the retreated affected tooth,perforations of pulp floor,instrumental separation,perforations of the side wall,and irremovable post crown repairing.Observe the X-ray films of the apex obtained before surgery to understand the dental defect,the morphology of the pulp cavity,the size of dentin triangle,the number,length as well as curve of the tooth root,whether there is calcification of the root canal,and whether there is filling in the root canal,assess the treatment difficulty,and determine therapeutic schedules.Wear rubber dam for the affected tooth under local anesthesia,remove the detritus with the guidance of X-ray examination,conduct cavity preparation,open the top of the pulp chamber,remove the degenerative and necrotic tissue in the pulp cavity,and probe the root canal orifice on the basis of anatomic morphology of pulp floor.After determining the location of root canal orifice,probe the root canal with8# or 10# C c-pilot file,and remove dentin triangle with Sx and S1 so that a rectilinear pathway can be formed.Reach the endpoint of the apex with 15# hand use stainless steel file and determine the working length according to the instruction of root canal apex locator and X-ray comparison.Open the middle part of the root canal with S2,and prepare the root canal with F1,F2 and F3(all of which reach the working length)successively.Use META to lubricate the root canal wall every time when a root canal file is used to prepare the root canal,and use 1%NaClO and 0.9%NaCl solution to alternately wash the root canal cavity every time when a root canal file is replaced.After preparing root canal,insert the gutta percha point that matches the working width in the root canal,take photos of the trial point,take out the gutta percha point for disinfection when exact filling is showed,wash the root canal cavity repeatedly,apply lap for moisture insulation and drying of the root canal,lead in AH-Plus paste filler and fill the root canal through lateral condensation,and eventually seal the crown cavity with permanent materials.Results:1.Teeth of 30 patients chosen in the present thesis were cured by using the single-visit root canal therapy.2.During the observation in one week after operation,teeth of one patient with acute apical periodontitis developed moderate pain;patients with acute pulpitis,chronic pulpitis and chronic apical periodontitis,each had one case developing mild pain.3.During 22-month follow-up observation to occlusion of teeth with apical periodontitis,occlusion pain of teeth with acute apical periodontitis of 3 cases disappeared in one month after operation.In teeth with chronic apical periodontitis,occlusion pain of 6 cases disappeared in 3 month after operation,occlusion pain of 2cases disappeared in 6 month after operation,occlusion pain of 1 case disappeared in 12 month after operation.When returning visit in 22 months after operation,teeth of 30 cases had no occlusion discomfort.Conclusion: Single-visit root canal therapy has obvious efficacy to infectious apical,which can be conducted in pulpitis,apicitis,acute or chronic teeth inflammation.However,single-visit root canal therapy should be chosen reasonably according to pathological state,anatomical structure of the teeth and physical condition of the patient to reduce postoperative reaction as far as possible.