Enhancing root canal success strategic use of orifice opener one step synthesis gels orifice barriers

Title : Enhancing root canal success strategic use of orifice opener one step synthesis gels orifice barriers

Abstract:

Modern endodontics comprises of chemico-mechanical phases aimed at eliminating microorganisms to prevent apical periodontitis. According to Swartz et al., the failure rate of endodontically treated teeth is nearly double when adequate post-endodontic restoration is absent. The four key phases: access and mechanical preparation, chemical cleaning, filling, and endodontic sealing- each phase plays a critical role in ensuring successful outcomes.

Coronal flaring of root canals is a vital technique in contemporary cleaning and shaping procedures, as it enables unobstructed access and enhances the effectiveness of subsequent steps. Specialized nickel-titanium instruments, known as orifice openers or shapers, are designed with a conical shape to effectively widen the canal.

Silver nanoparticles (AgNPs), have gained interest in this context because they can penetrate hard-to-reach areas, such as dentinal tubules, effectively inhibit the growth of microorganisms like Enterococcus faecalis. Every effort should be made to prevent infectious contamination. To ensure long-term success, the use of one-step synthesis gels for enhanced disinfection is recommended.

The American Association of Endodontists emphasizes in a white paper that a definitive coronal restoration is an integral part of the root filling process to prevent recontamination of the pulp space. Roghanizad and Jones further advocate for placing a coronal seal at the orifice, recommending the replacement of 3 mm of coronal gutta-percha to enhance protection.

To ensure long-term success, the use of orifice openers for effective canal shaping, one-step synthesis gels for enhanced disinfection, and orifice barriers after final obturation should be strongly emphasized as critical techniques for preventing recontamination, apical periodontitis and for promoting durable outcomes.

Keywords –Orifice openers, One-step synthesis gel, Orifice barriers & Apical periodontitis

Biography:

Dr. Emmanuel Samson earned his Bachelor’s in Dental Surgery in India in 1999 and completed his Master’s in Endodontics at KLE Society’s Institute of Dental Sciences, Belgaum, India, in 2003. Building on this strong academic foundation, he has established a distinguished career in both academia and clinical practice. He has served as Professor & Head at Government Medical College and Hospital, Miraj, India, and also as Professor, Head, and Postgraduate guide at HSRSM Dental College and Hospital, India. His extensive clinical experience, spanning nearly 20 years in endodontics, includes affiliations with prestigious institutions such as Manipal (Cure & Care), Total Dental Care, and an Honorary Consultant role at Inlaks and Budhrani Hospital. His areas of expertise and research interests include cytotoxicity of endodontic sealers, hydraulic condensation in endodontics, and one-step synthesis gels.