Glutaraldehyde in endodontic therapy: philosophy and practice

Abstract

The generally accepted philosophy that in endodontics disinfection of the root canal is a primary condition for lasting results should be supplemented by the statement that irreversible fixation of the remaining proteins is also an important prerequisite for success. Irreversible fixation without any adverse tissue reactions can be achieved by the use of a 2 per cent aqueous solution of glutaraldehyde. This medicament is to be preferred to formaldehyde, the other commonly used fixative, because it has three additional properties: 1. 1. Irreversible bonding with proteins. 2. 2. Limited diffusion into tooth structure. 3. 3. No periapical irritation. When the root canal is flushed with glutaraldehyde, mechanical preparation automatically results in obturation, both of the main root canal and of the dentinal tubules in the apical area, by plugs of fixed dentine chips. Five-year clinical results of root-canal treatment completed in one appointment only using glutaraldehye show a success rate of 96 per cent for chronic and 89 per cent for acute periapical conditions.