Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis

Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis

A textbook on root canal disinfection, emphasizes that microorganisms, particularly biofilms in complex root canal anatomies, are the primary cause of endodontic treatment failures despite technological advancements over the past four decades. The text systematically examines various disinfection techniques and irrigants, such as Sodium Hypochlorite and Chlorhexidine, detailing their mechanisms, efficacy against biofilms, and limitations, including apical vapor lock (AVL) and potential toxicity. Newer methods like Apical Negative Pressure (ANP) irrigation systems are presented as superior for achieving complete debridement in the apical third, while sonic, ultrasonic, and laser-activated irrigation (LAI) are also discussed as adjuncts. Finally, the sources address the host response to infection, including the healing kinetics of apical lesions, and provide an overview of apical microsurgery techniques for refractory cases involving extraradicular infection.

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