Universitat Internacional de Catalunya
Irrigation
Other languages of instruction: Catalan, Spanish
Teaching staff
Introduction
The aim of this subject is:
-To understand why a root canal gets infected and all the microbiological processes that take place and how can we desinfect and improve the prognosisi of our irrigation step as a part of the endodontic treatment
Pre-course requirements
Be an alumni in the endodontic master degree
Objectives
Be able to have a critical view of the studies they read
Understand the changes that occur in the pulp when bacteria penetrate
Learn how bacteria are structured once they colonize the canal system
Understand the systems of the pulp to defend against aggression
Knowing how to identify the different irrigants used by endodontists, what they are and when they should be used
Be able to build a final irrigation protocol suitable for each case
Competences/Learning outcomes of the degree programme
- CN01 - Identify with precision the most advanced technical processes related to endodontics.
- CN02 - Remember the theoretical and practical aspects of the methodology and work system in all fields of endodontics.
- CN04 - Recognize the origin and development of the different pathologies that affect the oral cavity, based on the transversal interrelation of biomedical sciences.
- CP02 - Resolve the main endodontic complications through the correct preparation of a treatment plan in the context of daily clinical practice.
- CP03 - Design treatment strategies for endodontic patients with special needs.
- CP04 - Generate work synergies with professionals from other areas and disciplines through the design of joint action strategies.
- CP05 - Apply advanced endodontic treatments appropriately to any patient, respecting the fundamental rights of equality between men and women, and the promotion of human rights and the values of a culture of peace and democratic values; using language that avoids androcentrism and stereotypes.
- HB02 - Apply different sources of information (scientific publications and gray literature) depending on the endodontic context found.
- HB03 - Manage the complexity of each endodontic case.
- HB04 - Classify endodontic cases as easy, moderate or complex.
- HB05 - Apply multidisciplinary knowledge acquired from other areas (periodontics, restorative and orthodontics) in an endodontic problem.
- HB06 - Quickly and effectively resolve endodontic pain situations.
- HB09 - Act rigorously in complex situations of endo-periodontal lesions, resorptions and pain of non-odontogenic origin.
- HB11 - Safely solve problems in instrumentation and irrigation of root canals.
- HB12 - Plan a defined and appropriate protocol in the event of endodontic failure.
- HB13 - Diagnose any pulpo-periapical pathology of endodontic origin.
- HB14 - Prepare, through correct prior argumentation, a treatment plan through the presentation of clinical cases and the most relevant literature.
- HB15 - Relate pulpal and systemic diseases in the specialized field of endodontics.
- HB18 - Present the final master's thesis in front of a tribunal with guarantees and scientific criteria.
- HB20 - Prepare an appropriate endodontic treatment plan based on an exhaustive clinical and radiographic analysis.
Learning outcomes of the subject
- - Biomedical Sciences - LEARNING OUTCOMES Title – CN01, CN04, HB04, HB16 Subject – Students will be able to: 1. Identify the main anatomical structures of the head and neck. 2. Recognize macro or microscopic anomalies or alterations that cause pathology in the oral cavity. 3. Identify the different pathogenic microorganisms by applying the necessary laboratory techniques. 4. Make a diagnosis of the different pathologies of the oral cavity based on the interpretation of the results obtained. 5. Analyze and interpret the results obtained to determine the impact of other complex systems. 6. Discuss the most appropriate actions or drugs for the treatment of diagnosed pathologies related to the oral cavity.
- - Diagnosis and Treatment Plan in Endodontics LEARNING OUTCOMES From title – CN01, HB03, HB05, HB12, HB14, HB18, HB20 Of matter – The students will be able to: 1. Solve the complications that undergraduate students have during their preclinical practices. 2. Make public presentations of their own clinical cases based on scientific literature, through the correct use of scientific terminology. 3. Debate and reason endodontic clinical techniques before a specialized and non-specialized audience in a clear and unambiguous way. 4. Determine the role of an endodontist within an interdisciplinary team. 5. Successfully plan, through prior analysis, any endodontic problem, as well as those directly related to restorative and aesthetic dentistry. 6. Identify and organize endodontic material and instruments in a precise and orderly manner. 7. Assess different therapeutic options for pulpo-periapical pathology according to the scientific literature. 8. Develop different isolation strategies for the surgical field to carry out a successful endodontic and restorative treatment
- - Scientific Bases in Endodontics - LEARNING OUTCOMES Title – CN02, HB06, HB07, HB11, HB13, HB17 Subject – Students will be able to: 1. Identify the etiology, etiopathogenesis and clinical presentation of pulpo-periapical pathologies in all its variations. 2. Differentiate the patient's pain based on its location, origin, pain and characteristics. 3. Apply a logical sequence of instrumentation, irrigation and obturation of the canal system, regardless of the degree of complexity of the case. 4. Classify the endodontic and restorative prognosis required by the different pulpo-periapical entities. 5. Select the most appropriate emergency treatment for each situation. 6. Design a drug administration plan in relation to pulpo-periapical pathology. 7. Modify your therapeutic strategy depending on the root status of the affected tooth. 8. Schedule the minimum radiographs necessary to perform a successful endodontic treatment without exposing the patient to excessive ionizing radiation.
Syllabus
Histological and functional relationship between the pulp and the oral microbiota
Inflammatory response at the molecular level in pulp pathology
How bacteria affect the prognosis of root canal treatment
Be able to determine the type of infection and what is the best tool to combat them
Apply the most appropriate disinfection protocol in each case
Determine how each irrigant affects the tooth structure
Be able to modify the irrigation protocols and adapt it to each case Applications and limitations of Sodium Hypochlorite Applications and limitations of Chlorhexidine
Applications and limitations of Calcium chelators
Applications and limitations of activation systems
Teaching and learning activities
In person
Discuss the syllabus read and prepared at home with the teacher and students
Evaluation systems and criteria
In person
Class participation will be assessed and at the end of the course there will be a written exam to assess the level
Bibliography and resources
Aetiology of root canal treatment failure: why well-treated teeth can fail. Siqueira JF Jr. Int Endod J. 2001 Jan;34(1):1-10.
A Microbiological Profile of Symptomatic Teeth with Primary Endodontic Infections. Luciana M. Sassone, Rivail A. Fidel, Marcelo Faveri, Rafael Guerra, et al. J Endod. 2008 May 2008 (Vol. 34 | No. 5 | Pages 541-545)
Autoaggregation and Coaggregation of Bacteria Associated with Acute Endodontic Infections Saengusa Khemaleelakul, John Craig Baumgartner, Sumalee Pruksakom. April 2006 (Vol. 32 | No. 4 | Pages 312-318)
New Bacterial Compositions in Root-filled Teeth with Periradicular Lesions Jörg F. Schirrmeister, Anna-Lisa Liebenow, Klaus Pelz, Annette Wittmer, et al. February 2009 (Vol. 35 | No. 2 | Pages 169-174)
Clinical Implications and Microbiology of Bacterial Persistence after Treatment Procedures. José F. Siqueira, Isabela N. Rôças. November 2008 (Vol. 34 | No. 11 | Pages 1291-1301.
Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm CommunitiesLuis Chávez de Paz . June 2007 (Vol. 33 | No. 6 | Pages 652-662)
Mechanism of action of sodium hypochlorite. Estrela C, Estrela CR, Barbin EL, Spanó JC, Marchesan MA, Pécora JD. Braz Dent J. 2002;13(2):113-7.
The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. Sirtes G, Waltimo T, Schaetzle M, Zehnder M. J Endod. 2005 Sep;31(9):669-71.
Chlorhexidine substantivity in root canal dentin. Rosenthal S, Spångberg L, Safavi K. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Oct;98(4):488-92.
Interaction between sodium hypochlorite and chlorhexidine gluconate. Basrani BR, Manek S, Sodhi RN, Fillery E, Manzur A. J Endod. 2007 Aug;33(8):966-9.
The smear layer in endodontics - a review. Violich DR, Chandler NP. Int Endod J. 2010 Jan;43(1):2-15.
Chelating agents in root canal treatment: mode of action and indications for their use. Hülsmann M, Heckendorff M, Lennon A. Int Endod J. 2003 Dec;36(12):810-30
Antagonistic interactions between sodium hypochlorite, chlorhexidine, EDTA, and citric acid. Rossi-Fedele G, Doğramaci EJ, Guastalli AR, Steier L, de Figueiredo JA. J Endod. 2012 Apr;38(4):426-31.
Final rinse optimization: influence of different agitation protocols. Paragliola R, Franco V, Fabiani C, Mazzoni A, Nato F, Tay FR, Breschi L, Grandini S. J Endod. 2010 Feb;36(2):282-5
Apical extrusion of sodium hypochlorite using different root canal irrigation systems. Mitchell RP, Baumgartner JC, Sedgley CM. J Endod. 2011 Dec;37(12):1677-81.
The Synergistic Antimicrobial Effect by Mechanical Agitation and Two Chlorhexidine Preparations on Biofilm Bacteria Ya Shen, Sonja Stojicic, Wei Qian, Ingar Olsen, et al.January 2010 (Vol. 36 | No. 1 | Pages 100-104)
An In Vitro Comparison of New Irrigation and Agitation Techniques to Ultrasonic Agitation in Removing Bacteria From a Simulated Root Canal Cameron Townsend, James Maki. July 2009 (Vol. 35 | No. 7 | Pages 1040-1043)
Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. J Endod. 2010 Jul;36(7):1216-21.
Dynamic movement of intracanal gas bubbles during cleaning and shaping procedures: the effect of maintaining apical patency on their presence in the middle and cervical thirds of human root canals-an in vivo study. Vera J, Arias A, Romero M. J Endod. 2012 Feb;38(2):200-3.
The efficacy of dynamic irrigation using a commercially available system (RinsEndo) determined by removal of a collagen 'bio-molecular film' from an ex vivo model. McGill S, Gulabivala K, Mordan N, Ng YL. Int Endod J. 2008 Jul;41(7):602-8.
Passive ultrasonic irrigation of the root canal: a review of the literature. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Int Endod J. 2007 Jun;40(6):415-26. Epub 2007 Apr 17.
In vivo antibacterial efficacy of ultrasound after hand and rotary instrumentation in human mandibular molars. Carver K, Nusstein J, Reader A, Beck M. J Endod. 2007 Sep;33(9):1038-43.
In vitro comparisons of debris removal of the EndoActivator system, the F file, ultrasonic irrigation, and NaOCl irrigation alone after hand-rotary instrumentation in human mandibular molars. Klyn SL, Kirkpatrick TC, Rutledge RE. J Endod. 2010 Aug;36(8):1367-71.