Osnovni i dodatni postupci dezinfekcije korijenskih kanala

master's thesis

• Title (english): Basic and additional procedures for disinfection of root canals
• Author: Karla Grgić
• Mentor: Bernard Janković (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Primarni cilj endodontske terapije je iskorijeniti mikroorganizme iz sustava korijenskog kanala i spriječiti njegovu ponovnu infekciju. To postižemo kombinacijom mehaničke i kemijske obrade korijenskih kanala. Kao glavno sredstvo za dezinfekciju istaknuo se natrijev hipoklorit jer ima široko antimikrobno djelovanje i otapa organska tkiva. S druge strane natrijev hipoklorit ima svoja ograničenja koja zahtijevaju upotrebu drugih sredstava. Zbog nemogućnosti otapanja anorganskog tkiva, uz natrij hipoklorit koriste se kelatori poput etilendiamintetraoctene kiseline (EDTA) i limunske kiseline. Kelatori su zbog svojih svojstava učinkoviti u uklanjanju zaostatnog sloja. Klorheksidin se također smatra učinkovitim antimikrobnim sredstvom, posebno u situacijama kada NaOCl nije prikladan. Klorheksidin zbog adsorpcije na tvrda zubna tkiva osigurava produljeno antimikrobno djelovanje, čineći njegovu ulogu kao irigans vrijednom iako nema mogućnost otapanja tkiva. Tehnika ispiranja korijenskih kanala iglom i štrcaljkom je i dalje najčešće korištena tehnika dezinfekcije korijenskih kanala unatoč svojim nedostatcima. Kako bi se poboljšala učinkovitost irigansa, napredovanjem tehnologije razvio se niz uređaja kojima možemo aktivirati irigans u korijenskom kanalu. Uređaji za aktivaciju otopina za dezinfekciju su: zvučna i ultrazvučna tehnika te uređaj za primjenu negativnog tlaka, a uz njih se još upotrebljavaju ozon i laseri. Iako se pod terminom ispiranje korijenskih kanala često razmišlja isključivo o dezinfekciji, nedavna istraživanja su dokazala da ispiranje korijenskog kanala hladnom fiziološkom otopinom dovodi do značajnog smanjenja postendodontske boli, što ju čini obećavajućom metodom za poboljšanje pacijentovog iskustva.

Abstract (english)

The primary goal of endodontic therapy is to eradicate microorganisms from the root canal system and prevent its reinfection. This is achieved through a combination of mechanical and chemical treatments of the root canals. Sodium hypochlorite has emerged as the main disinfectant due to its broad antimicrobial properties and the ability to dissolve organic tissue. On the other hand, sodium hypochlorite has its limitations, which necessitate the use of other agents. Due to its inability to dissolve inorganic tissue, chelators such as ethylenediaminetetraacetic acid (EDTA) and citric acid are used alongside sodium hypochlorite. Chelators are effective in removing the smear layer due to their properties. Chlorhexidine is also considered an effective antimicrobial agent, particularly in situations where NaOCl is not suitable. Chlorhexidine, due to its adsorption to the hard tissues of the tooth, ensures prolonged antimicrobial activity, making its role as an irrigant valuable despite its inability to dissolve tissue. The technique of irrigating root canals with a needle and syringe remains the most commonly used method of root canal disinfection despite its drawbacks. To improve the effectiveness of irrigants, a range of devices has been developed through technological advancements to activate the irrigant within the root canal. Devices for activating disinfectant solutions include sonic and ultrasonic techniques, and negative pressure devices, with ozone and lasers also being used. Although root canal irrigation is often thought of solely as disinfection, recent research has shown that irrigation of the root canal with cold saline solution leads to a significant reduction in post-endodontic pain, making it a promising method for improving patient experience.

• Keywords: endodoncija; stomatološki dezinficijensi; natrij hipoklorit; klorheksidin; sredstva za ispiranje korijenskog kanala; kelacijska sredstva; ultrazvučna terapija; krioterapija
• Keywords (english): Endodontics; Dental Disinfectants; Hypochlorous Acid; Sodium; Chlorhexidine; Root Canal Irrigants; Chelating Agents; Ultrasonic Therapy; Cryotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:127:244900
• Study programme: Title: Dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2024-09-18 08:10:52