Ramachandran Nair, BVSc, DVM, Dr Odont.h.c.
Institute of Oral Biology,
Center of Dental and Oral Medicine,
University of Zurich Switzerland
Sunday, February 3, 2013
International Academy of Endodontics, Annual Meeting
The Fairmont Hotel
“Endodontic Biofilm, Biology and Technology: Where do We Go From Here?”
Apical periodontitis (AP) is a biofilm disease. Therefore, the treatment of the disease consists of disrupting the biofilms, washing off the root canal microbes by irrigation and preventing reinfection by orthograde obturation. When the treatment is done properly, healing of the periapical lesions usually occur with osseous regeneration. However, for various reasons, a satisfactory “healing” of the apical radiolucency may not be achieved in all root canal-treated teeth. Such cases of non-heal- ing post-treatment periapical radiolucencies occur when treatment procedures have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful clinical procedures are followed, some apical radiographic lesions still may not heal because of the anatomic complexity of the root canal system with regions that cannot be debrided and obturated with existing instruments, materials, and technique. Residual biofilms continue to exist in treated canals in the uninstrumented recesses of the main canals, the isthmus communicating between them and in accessory canals.
Collaborative studies from Switzerland, Sweden and Mexico will be summarized to set the stage for discussing the limita- tions of technologies used in endodontics in addressing the biological challenges associated with treating apical periodonti- tis. The complex anatomy of the root canal system resulting in inaccessibility to canal ramifications, presence of biofilms and additional factors extending beyond the root canal system will be highlighted.
Attendees will learn:
1. About apical periodontitis - a biofilm disease.
2. About residual biofilms in treated root canals - a norm and not an exception.
3. The limits to technology in endodontics.
4. The future: bleak or bright?