Expert Article: Latest Trends In Root Canal Treatment (RCT)

An endodontist is a dentist who specializes in root canal therapy (RCT), which is a part of endodontics. The last ten years have seen a paradigm shift in dentistry in terms of accuracy and technology. This holds true for endodontics as well.

Let's discuss present endodontic trends:

1. Single appointment RCT: When is a single appointment RCT a viable option?

No pus or swelling-accompanied acute or persistent infection exists.
The anatomy of teeth is conventional and simple.
One can accomplish adequate cleaning in a single visit.
Neither the doctor nor the patient is under any time constraint.

Pros:

• There are fewer visits.
• It is quicker for smile-designing cases.
• Multiple rounds of anaesthesia are avoided.
• The patient is more assured.

Cons :

• Insufficient recovery time
• Can result in a painful flare-up.
• Both the patient and the endodontist may get tired during the lengthy appointment.

2. Microscopical endodontics: For a clearer view of the tooth, the tech-savvy endodontist uses a Dental Operating Microscope (DOM).

Pros:

• The precise root canal anatomy, which is invisible to the unaided eye, is seen.
• Fractured segments and accessory canals are clearly visible.
• The fillings are more accurate.
• Microleakage and re-infection are less likely.

Cons:

• High cost.
• There are fewer endodontists who have received DOM training.
• Few clinics have the time or resources to use it.
• The days of high-exposure x-rays and x-ray plates are long gone in imaging techniques. This radiation-conscientious generation demands options that are healthier and more accurate.

3. Cone Beam Computed Tomography (CBCT) produces a very precise 3D image of the teeth and bone. It is important to spot fractured teeth, curved root canals, and accessory canals. The muscles and tissues nearby are accurately depicted by USG (Ultra SonoGraphy).

4. Disinfection of root canals: R&D has produced highly effective, biocompatible medicinal pastes and disinfectants to prevent infection during the RC process.

• Antibacterial nanoparticles (NP) are much more effective than traditional disinfectants at penetrating the tiny crevices of root canals.
• Long-lasting chronic infections can be improved by using LASER or photon-induced photoacoustic streaming (PIPS).

5. Advanced root filling:

The sealer used in conventional RCTs may leave a chance for microleakage. For a better seal and fewer chances of reinfection, traditional filler materials with nanometric bioactive particles embedded in them are used.

6. To improve flexibility and ease of use, nickel titanium alloys (NiTi-alloys) have recently replaced the conventional metals used to manufacture endodontic instruments.

7. The most recent and exciting area of endodontics is regenerative endodontics. It stimulates tissue growth close to the tooth root using stem cells. Some of the materials used are platelet-rich plasma and fibrin.

Pros:

• The recovery is organic.
• The infection around the tooth roots can be treated.

Cons:

• It is a field that is still undergoing research and trials.
• It is time-consuming, technique-sensitive, and primarily dependent on the patient's body response.
• It is pricey.

Conclusion

The field of endodontics is rapidly developing. There is a lot of ongoing research to improve the relationship between doctor and patient.