Skip to main content
Erschienen in: Der Freie Zahnarzt 6/2018

01.06.2018 | Endodontie | Fortbildung

Die Desinfektion des Wurzelkanalsystems

verfasst von: Felix Zimmermann, PD Dr. Tina Rödig

Erschienen in: Der Freie Zahnarzt | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die chemomechanische Aufbereitung des Wurzelkanalsystems stellt den wichtigsten Bestandteil der endodontischen Therapie dar und beeinflusst den Erfolg der Behandlung maßgeblich. In diesem Beitrag werden die mikrobiologischen Grundlagen endodontischer Erkrankungen, die Eigenschaften und Limitationen verschiedener Spülflüssigkeiten sowie unterschiedliche Systeme und Techniken für die Applikation und Aktivierung dieser Spülflüssigkeiten vorgestellt. Weiterhin werden die Vor- und Nachteile ein- und mehrzeitiger Wurzelkanalbehandlungen diskutiert und verschiedene intrakanaläre Medikamente hinsichtlich ihrer antimikrobiellen Wirksamkeit bewertet. Abschließend werden Desinfektionsprotokolle für verschiedene klinische Situationen abgeleitet.
Literatur
1.
Zurück zum Zitat Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed
2.
Zurück zum Zitat Sundqvist G (1994) Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol 78:522–530CrossRefPubMed Sundqvist G (1994) Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol 78:522–530CrossRefPubMed
3.
Zurück zum Zitat Sedgley C, Nagel A, Dahlén G, Reit C, Molander A (2006) Real-time quantitative polymerase chain reaction and culture analyses of Enterococcus faecalis in root canals. J Endod 32:173–177CrossRefPubMed Sedgley C, Nagel A, Dahlén G, Reit C, Molander A (2006) Real-time quantitative polymerase chain reaction and culture analyses of Enterococcus faecalis in root canals. J Endod 32:173–177CrossRefPubMed
4.
Zurück zum Zitat de Paz LC (2007) Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm Communities. J Endod 33:652–662CrossRef de Paz LC (2007) Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm Communities. J Endod 33:652–662CrossRef
5.
Zurück zum Zitat Siqueira JF, Rôças IN, Lopes HP (2002) Patterns of microbial colonization in primary root canal infections. Oral Surg Oral Med Oral Pathol 93:174–178CrossRef Siqueira JF, Rôças IN, Lopes HP (2002) Patterns of microbial colonization in primary root canal infections. Oral Surg Oral Med Oral Pathol 93:174–178CrossRef
6.
Zurück zum Zitat Peters OA, Schönenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34:221–230CrossRefPubMed Peters OA, Schönenberger K, Laib A (2001) Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 34:221–230CrossRefPubMed
7.
Zurück zum Zitat Byström A, Sundqvist G (1981) Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 89:321–328PubMed Byström A, Sundqvist G (1981) Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 89:321–328PubMed
8.
Zurück zum Zitat Cergneux M, Ciucchi B, Dietschi JM, Holz J (1987) The influence of the smear layer on the sealing ability of canal obturation. Int Endod J 20:228–232CrossRefPubMed Cergneux M, Ciucchi B, Dietschi JM, Holz J (1987) The influence of the smear layer on the sealing ability of canal obturation. Int Endod J 20:228–232CrossRefPubMed
9.
Zurück zum Zitat Haapasalo M, Shen Y, Qian W, Gao Y (2010) Irrigation in Endodontics. Dent Clin North Am 54:291–312CrossRefPubMed Haapasalo M, Shen Y, Qian W, Gao Y (2010) Irrigation in Endodontics. Dent Clin North Am 54:291–312CrossRefPubMed
10.
Zurück zum Zitat Spratt DA, Pratten J, Wilson M, Gulabivala K (2001) An in vitro evaluation of the antimicrobial efficacy of irrigants on biofilms of root canal isolates. Int Endod J 34:300–307CrossRefPubMed Spratt DA, Pratten J, Wilson M, Gulabivala K (2001) An in vitro evaluation of the antimicrobial efficacy of irrigants on biofilms of root canal isolates. Int Endod J 34:300–307CrossRefPubMed
12.
Zurück zum Zitat Byström A, Sundqvist G (1985) The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 18:35–40CrossRefPubMed Byström A, Sundqvist G (1985) The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 18:35–40CrossRefPubMed
13.
Zurück zum Zitat Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CCR, de Souza-Filho FJ (2004) In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol 97:79–84CrossRef Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CCR, de Souza-Filho FJ (2004) In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol 97:79–84CrossRef
14.
Zurück zum Zitat Gomes BP, Vianna ME, Zaia AA, Almeida JF, Souza-Filho FJ, Ferraz CCR (2013) Chlorhexidine in Endodontics. Braz Dent J 24:89–102CrossRefPubMed Gomes BP, Vianna ME, Zaia AA, Almeida JF, Souza-Filho FJ, Ferraz CCR (2013) Chlorhexidine in Endodontics. Braz Dent J 24:89–102CrossRefPubMed
15.
Zurück zum Zitat Naenni N, Thoma K, Zehnder M (2004) Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod 30:785–787CrossRefPubMed Naenni N, Thoma K, Zehnder M (2004) Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod 30:785–787CrossRefPubMed
16.
Zurück zum Zitat Herrera DR, Santos ZT, Tay LY, Silva EJ, Loguercio AD, Gomes BP (2013) Efficacy of different final irrigant activation protocols on smear layer removal by EDTA and citric acid. Microsc Res Tech 76:364–369CrossRefPubMed Herrera DR, Santos ZT, Tay LY, Silva EJ, Loguercio AD, Gomes BP (2013) Efficacy of different final irrigant activation protocols on smear layer removal by EDTA and citric acid. Microsc Res Tech 76:364–369CrossRefPubMed
17.
Zurück zum Zitat Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP, Martín-Peinado FJ, González-López S (2008) Decalcifying effect of 15% EDTA, 15% citric acid, 5% phosphoric acid and 2.5% sodium hypochlorite on root canal dentine. Int Endod J 41:418–423CrossRefPubMed Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP, Martín-Peinado FJ, González-López S (2008) Decalcifying effect of 15% EDTA, 15% citric acid, 5% phosphoric acid and 2.5% sodium hypochlorite on root canal dentine. Int Endod J 41:418–423CrossRefPubMed
18.
Zurück zum Zitat Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LWM (2010) Evaluation of Irrigant Flow in the Root Canal Using Different Needle Types by an Unsteady Computational Fluid Dynamics Model. J Endod 36:875–879CrossRefPubMed Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LWM (2010) Evaluation of Irrigant Flow in the Root Canal Using Different Needle Types by an Unsteady Computational Fluid Dynamics Model. J Endod 36:875–879CrossRefPubMed
19.
Zurück zum Zitat Wu MK, Wesselink PR (1995) Efficacy of three techniques in cleaning the apical portion of curved root canals. Oral Surg Oral Med Oral Pathol 79:492–496CrossRef Wu MK, Wesselink PR (1995) Efficacy of three techniques in cleaning the apical portion of curved root canals. Oral Surg Oral Med Oral Pathol 79:492–496CrossRef
20.
Zurück zum Zitat Gulabivala K, Ng Y, Gilbertson M, Eames I (2010) The fluid mechanics of root canal irrigation. Physiol Meas 31:R49–84CrossRef Gulabivala K, Ng Y, Gilbertson M, Eames I (2010) The fluid mechanics of root canal irrigation. Physiol Meas 31:R49–84CrossRef
21.
Zurück zum Zitat Huffaker SK, Safavi K, Spangberg LS, Kaufman B (2010) Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod 36:1315–1318CrossRef Huffaker SK, Safavi K, Spangberg LS, Kaufman B (2010) Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod 36:1315–1318CrossRef
22.
Zurück zum Zitat Sabins RA, Johnson JD, Hellstein JW (2003) A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 29:674–678CrossRef Sabins RA, Johnson JD, Hellstein JW (2003) A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 29:674–678CrossRef
23.
Zurück zum Zitat Carver K, Nusstein J, Reader A, Beck M (2007) In Vivo Antibacterial Efficacy of Ultrasound after Hand and Rotary Instrumentation in Human Mandibular Molars. J Endod 33:1038–1043CrossRef Carver K, Nusstein J, Reader A, Beck M (2007) In Vivo Antibacterial Efficacy of Ultrasound after Hand and Rotary Instrumentation in Human Mandibular Molars. J Endod 33:1038–1043CrossRef
24.
Zurück zum Zitat Gutarts R, Nusstein J, Reader A, Beck M (2005) In Vivo Debridement Efficacy of Ultrasonic Irrigation Following Hand-Rotary Instrumentation in Human Mandibular Molars. J Endod 31:166–170CrossRef Gutarts R, Nusstein J, Reader A, Beck M (2005) In Vivo Debridement Efficacy of Ultrasonic Irrigation Following Hand-Rotary Instrumentation in Human Mandibular Molars. J Endod 31:166–170CrossRef
25.
Zurück zum Zitat Sathorn C, Parashos P, Messer H (2007) Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis. Int Endod J 40:2–10CrossRef Sathorn C, Parashos P, Messer H (2007) Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis. Int Endod J 40:2–10CrossRef
26.
Zurück zum Zitat Bergenholtz G, Spångberg L (2004) Controversies in endodontics. Crit Rev Oral Biol Med 15:99–114CrossRef Bergenholtz G, Spångberg L (2004) Controversies in endodontics. Crit Rev Oral Biol Med 15:99–114CrossRef
27.
Zurück zum Zitat Buck RA, Cai J, Eleazer PD, Staat RH, Hurst HE (2001) Detoxification of endotoxin by endodontic irrigants and calcium hydroxide. J Endod 27:325–327CrossRefPubMed Buck RA, Cai J, Eleazer PD, Staat RH, Hurst HE (2001) Detoxification of endotoxin by endodontic irrigants and calcium hydroxide. J Endod 27:325–327CrossRefPubMed
28.
Zurück zum Zitat Haenni S, Schmidlin PR, Mueller B, Sener B, Zehnder M (2003) Chemical and antimicrobial properties of calcium hydroxide mixed with irrigating solutions. Int Endod J 36:100–105CrossRefPubMed Haenni S, Schmidlin PR, Mueller B, Sener B, Zehnder M (2003) Chemical and antimicrobial properties of calcium hydroxide mixed with irrigating solutions. Int Endod J 36:100–105CrossRefPubMed
29.
Zurück zum Zitat Dahlén G, Samuelsson W, Molander A, Reit C (2000) Identification and antimicrobial susceptibility of enterococci isolated from the root canal. Oral Microbiol Immunol 15:309–312CrossRefPubMed Dahlén G, Samuelsson W, Molander A, Reit C (2000) Identification and antimicrobial susceptibility of enterococci isolated from the root canal. Oral Microbiol Immunol 15:309–312CrossRefPubMed
30.
Zurück zum Zitat Trope M (2002) Clinical management of the avulsed tooth: present strategies and future directions. Dent Traumatol 18:1–11CrossRefPubMed Trope M (2002) Clinical management of the avulsed tooth: present strategies and future directions. Dent Traumatol 18:1–11CrossRefPubMed
Metadaten
Titel
Die Desinfektion des Wurzelkanalsystems
verfasst von
Felix Zimmermann
PD Dr. Tina Rödig
Publikationsdatum
01.06.2018
Verlag
Springer Medizin
Erschienen in
Der Freie Zahnarzt / Ausgabe 6/2018
Print ISSN: 0340-1766
Elektronische ISSN: 2190-3824
DOI
https://doi.org/10.1007/s12614-018-7259-0

Weitere Artikel der Ausgabe 6/2018

Der Freie Zahnarzt 6/2018 Zur Ausgabe

zu guter letzt

ANGEBOHRT

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.