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endodontics - 3 Questions
The main objective of obturation is to fill the canal and prevent apical percolation of fluids. This primary goal involves: 1) Creating a fluid-tight seal at the apical foramen, 2) Preventing bacterial penetration from oral cavity, 3) Eliminating pathways for tissue fluid seepage, 4) Preventing recontamination of treated root canal system. While preventing discoloration and providing support for restoration are secondary benefits, the fundamental purpose is to achieve biological seal that prevents apical periodontitis by eliminating bacterial access to periapical tissues.
Most failures of replanted teeth are due to external resorption. This includes both inflammatory and replacement resorption: 1) Inflammatory resorption occurs due to infected necrotic pulp and damaged periodontal ligament, 2) Replacement resorption (ankylosis) occurs when periodontal ligament is severely damaged, 3) External resorption is progressive and often leads to tooth loss, 4) It is more common than internal resorption in replanted teeth, 5) Prevention involves proper handling, appropriate storage media, and prompt endodontic treatment when indicated.
Inflammatory resorption after reimplantation of an avulsed tooth is a multifactorial process.
Presence of microorganisms: Infection of the pulp or periodontal ligament can trigger inflammatory resorption.
Resorption of cementum: Damage or loss of cementum exposes dentin, which is more susceptible to resorption.
Dehydration of root surface: If the tooth is kept dry before reimplantation, periodontal ligament cells die, increasing the risk of resorption.
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