Sydorak K. Prevention of root canal treatment complications

The thesis focuses on the issue of increasing the effectiveness of root canal treatment by improvement the chemo-mechanical cleaning of root canal surface. Successful root canal treatment is mostly dependent on the quality of chemo-mechanical cleaning of root canal system. But anatomical complexities of the root canal system serve as the foremost challenge in root canal instrumentation. That is why, untouched area has to rely on chemical irrigation and effective irrigation protocol is a key factor affecting the prognosis of endodontic disease. The main purpose of this study was to seek a protocol of irrigation to improve the quality of root canal cleaning before the obturation that will enhance the results of root canal treatment. In accordance with our experimental and laboratory studies, alternating the use of 6 % NaOCl and 17 % EDTA with Sodium Thiosulfate in between during chemo-mechanical treatment comparing to conventional irrigation protocol, showed significantly better ability to clean the root canal surface. A scanning electron microscope was used to evaluate the cleanliness of root canal surface after chemo-mechanical treatment according to the M. Torabinejad and A. Khademi classification (2003). It should be noted that this protocol has succeeded good results in cleaning apical part of the root canal, the most important area in treatment prognosis and the most difficult for chemo-mechanical treatment. The average data of root dentin microhardness before and after root canal chemo-mechanical treatment using the improved irrigation protocol were determined. Under the conditions of the current study, in all groups, no negative effect when continuously using alternation of irrigants during the chemo-mechanical treatment was found, although root dentin microhardness was reduced. Data outcome showed root dentin microhardness changes in permissible limits, doesn't have harmless effect on tooth and doesn't contradict with previous studies. Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Debridement efficacy of different agitation techniques was studied. XP-endo Finisher application for the final irrigants agitation during chemo-mechanical treatment of the root canals showed better results of cleaning the dentine surface compared to passive ultrasonic activation and manual dynamic activation with a master gutta-percha. A scanning electron microscope was used to evaluate the results. Application the improved irrigation protocol to the practice established clinical efficacy both in the initial endodontic treatment and retreatment cases.