Abstract
Infection control is very fundamental in the clinical and surgical setting. This is mainly because many health workers as well as the patients are always exposed to various microorganisms via respiratory secretions and blood. Proper aseptic technique is very vital in curbing such microorganisms. Aseptic techniques help in breaking the cycle of infection as well as eliminating cross-contamination. There are two major aseptic techniques ways of controlling such infections. These are Non surgical aseptic technique and the surgical aseptic technique. In this paper, we shall examine the importance of infection control in endodontic field. The major emphasis shall be in the non surgical root canal therapy. We shall also explore the risk of introducing bacteria in the root canal during the process of NSRCT. Finally, the paper shall examine current aseptic technique protocol for NSRCT.
Specific Aims
We would like to revise and increase the awareness about the infection control guidelines as applied in common procedures in the endodontic field, particularly in non-surgical root canal therapy (NSRCT). In AAE, the acronym NSRCT stands for Non-Surgical Root Canal Therapy. In other words, NSRCT is the most widespread form of treating root canal. in this procedure, the dentist can get access to the inner facets of the tooth through an “entrance hollow” that broaden through the crown segment of the tooth to the chamber of the pulp and the duct hole, which is in direct natural contact though the apical foramen with the periapical tissues like periapical bone and PDL and blood vessels.
The NSRCT is considered a non-surgical procedure even if the tooth and the roots and the canal space are in intimate contact and in direct communication with the bone through the apical foramen and accessory foramina’s. During the NSRCT there is an imminent risk of touching the bone and the PDL by taking WL (working Length), which is a standard procedure to all teeth and all roots during a NSRCT. It is not uncommon to go beyond the final working length 1-2 mm. additionally during the NSRCT there is a filing procedure that is preformed with files of different sizes in which there is also a potential risk of touching the bone each time a file is introduced into the canal system. The estimate number of files used per case and per root during the NSRCT varies from 4 to 6 files or sometimes more, including manual and rotary files.
During the NSRCT in vital cases (vital pulp) there is also an intact blood supply. The fact that the vital pulp is a vital tissue in intimate contact with the bone, the PDL, and blood supply there is a high potential for cross contamination. We consider that the NSRCT done without non-surgical protocol is a potential threat to inoculating local and systemic bacteria thought the canal system and foramen toward the periapex (Bone, PDL and circulation system). The size from the main foramen could range from ……to.which i. The size of the main apical foramen range from ……………….to… and there are also multiple foramina’s with smaller sizes. Bacteria do need much space to travel because their size ranges from.to. Bacteria and toxins require micro spaces to migrate. Toxins migrate faster than bacteria.
The outcome post treatment of NSRCT in vital teeth range from 88% to 93%. There is a range of 6% to 12 of failures. We believe bacteria are responsible of most of the failures in NSRCT. (more…)