![]() The sterilization methods range from autoclaving at temperatures between 121° and 135°, the use of 2% glutaraldehyde, the use of sterilization glass bead, to dry heat sterilization. The instruments used to probe the glide path and shaping come into contact more closely with the patient's deep tissues, such as nerve tissue and vascular tissue therefore, the risk of cross infection by pathogens is very high, and disinfection procedures must necessarily be associated with sterilization procedures. ![]() Reusable instruments can be a source of infection for the professional, and if sterilization and disinfection procedures are not correct, patients may be exposed to an infectious risk too. It is important that the single-use filling material (gutta-percha or resin cones) does not come into contact with the bacteria commonly present in the oral cavity in order to not contaminate the disinfected and cleansed root canal system with the use of canal irrigants. The oral cavity hosts more than 700 bacterial species that can organize themselves into biofilms and structure themselves into plaque and tartar on the hard surface of the dental elements. The instruments according to their nature can be either disposable or reusable through sterilization processes.Ĭontamination of the disposable instruments may derive from the production phase if the latter is not supplied as sterile or during dental procedures due to environmental contamination or the patient's biological fluids (saliva, crevicular fluid, blood, and purulent exudate). In the glide path and shaping phases, instruments commonly called endodontic files are used, the latter varying depending on the technique adopted by the professional which can be manual or mechanical with constant or variable tapers and with different diameters.īesides, canal irrigants are used during the shaping phases, such as sodium hypochlorite 5%, EDTA, and chlorhexidine to which the following materials are added to obtain a three-dimensional filling of the canals: gutta-percha or resin cones, zinc oxide-eugenol-based cements, or epoxy resins. To isolate the operating area rubber dam, rubber dam punch, clamp forceps, dental floss, and spatulas are used, while to open the pulp chamber and remove the carious tissue, diamond burs, multiblades, and burs for removing amalgam and crown are used. Įndodontic instruments vary according to the operational phases and the methods adopted by the operators. In relation to other dental branches, the use of endodontic instrumentation has important factors to consider: one is the fracture of the intracanal instrumentation, not always possible to eliminate or bypass as such events depend on the torsional and flexural stress during treatment or alterations during the disinfection phase and sterilization. ![]() It is a discipline that requires the professional to stay concentrated and be accurate for long periods of time in order to perform successfully, and success cannot be separated from the efficiency of the endodontist's instruments. The qualitative analysis showed that the use of single-use or first-use instruments requires presterilization or sterilization procedures, and for reusable tools, attention must be paid to the removal of debris deposited on the blades, not easy to remove manually.Įndodontics is a section of odontology that examines all the pathologies affecting the vital and necrotic dental pulp. Results of the meta-analysis showed that the most effective method in sterilization is autoclaving. A search on PubMed and Scopus was carried out using the following keywords: “endodontic sterilization,” “endodontic autoclave,” “decontamination dental bur,” “sterilization dental burs,” and “gutta-percha points sterilization.” Eligible articles were included in the qualitative and quantitative analysis. We have performed a systematic review of different sterilization and disinfection procedures aiming at drawing up a disinfection and sterilization procedure to be used on endodontic instruments. Each step requires a series of single-use or sterilizable instruments. Endodontic treatment consists of different working procedures, such as the isolation of the operating field, pulp chamber access, and cleaning and shaping phases with at last the need of a three-dimensional filling of the canals.
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