An Irrigation Protocol Used for the Devitalisation Process of a Right Mandibular Central Incisor with a Moderate Abrasion - a Case Report

Abstract

Introduction : Chronic dental trauma of the permanent dentition can lead to a pulp canal obliteration. The condition might be difficult to resolve if a proper irrigation technique isnâ€ot performed. Only the simultaneous use of mechanical and chemical preparation techniques allows the endodontist to properly prepare the root canal. The aim of this case report is to present an irrigation technique which effectively removes denticles, residual pulpal tissues and bacteria during endodontic treatment of obliterated root canals. Materials and Methods : For prosthetic purpose the endodontium of a right mandibular central incisor was negotiated. A terminal anaesthesia with 4% Ubistesin was administered. A vital pulpectomy was performed. The root canal was partially obliterated. EDTA-gel (15%) and solutions of 0.9% NaCl (physiological solution), NaOCl (1%) and citric acid (40%) lubricated the canal and evacuated the debris. STEP-BACK technique was used to prepare the canal. Cold lateral condensation was performed to obturate the canal. Glass ionomer cement was applied to restore the occlusal defect. Radiographs were done at the start of the endodontic treatment to determine the working length and at the end - to evaluate the obturation of the root canal. Results : EDTA gel and citric acid solutions proved their effectiveness during the preparation of the obliterated root canal. The smooth walls of the root canal allowed excellent obturation. It was possible to immediately refer the patient for prosthetic treatment. Conclusion : It is imperative to decently lubricate the obliterated canal so as to facilitate the preparation. The chances of fracturing a root canal instrument, forming an apical stop or prepressing debris into the periapical tissues are significantly lowered.