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apical root canal system Nair presented his research done with Jorge Vera et al in Mexico: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Feb;99(2):231-52. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after "one-visit" endodontic treatment. Nair PN, Henry S, Cano V, Vera J. Institute of Oral Biology, Center of Dental & Oral Medicine, University of Zurich, Zurich, Switzerland. nair@zzmk.unizh.ch OBJECTIVE: To assess the in vivo intracanal microbial status of apical root canal system of mesial roots of human mandibular first molars with primary apical periodontitis immediately after one-visit endodontic treatment. The residual intracanal infection was confirmed by correlative light and transmission electron microscopy. STUDY DESIGN: Sixteen diseased mesial roots of mandibular first molars were treated endodontically, each in one visit. Mesio-buccal canals were instrumented using stainless steel hand files and mesio-lingual canals with a nickel-titanium rotary system. The canals were irrigated with 5.25% sodium hypochlorite (NaOCl) during the instrumentation procedures, rinsed with 10 mL of 17% ethylenediamine tetraacetic acid (EDTA), and obturated with gutta-percha and zinc oxide eugenol cement. Thereafter, the apical portion of the root of each tooth was removed by flap-surgery. The specimens were fixed, decalcified, subdivided in horizontal plane, embedded in plastic, processed, and evaluated by correlative light and transmission electron microscopy. RESULTS: Fourteen of the 1 6 endodontically treated teeth revealed residual intracanal infection after instrumentation, antimicrobial irrigation, and obturation. The microbes were located in inaccessible recesses and diverticula of instrumented main canals, the intercanal isthmus, and accessory canals, mostly as biofilms. CONCLUSIONS: The results show (1) the anatomical complexity of the root canal system of mandibular first molar roots and (2) the organization of the flora as biofilms in inaccessible areas of the canal system that cannot be removed by contemporary instruments and irrigation alone in one-visit treatment. These findings demonstrate the importance of stringent application of all nonantibiotic chemo-mechanical measures to treat teeth with infected and necrotic root canals so as to disrupt the biofilms and reduce the intraradicular microbial load to the lowest possible level so as to expect a highly favorable long-term prognosis of the root canal treatment. Version of Rob Kaufman Magic of the Internet is if there are Proceedings of the ESE, they will take months when you have a discussion forum, it takes minutes or days at most Thank you Dean Fred for your input, if possible, can others flesh out the skeletal comments on Dr. Nair's presentation..NiTi this NiTi that.so perfunctory on the exactitude of the articles et al..the clinical empiricism, but when Ove Peters says only 65% of the canal space is cleaned by NiTi it gets glossed over and hand filing is diss'd as ante-deluvian and autofit and mating systems is the way of the world which world, the world without fins, cul de sacs, fissures, crypts et al.bio-techno babies the balance needs to reshift.it's way out of wack called commerce.you do those two steppers Frodo.cuz at the end of the day, you da man, granted sans 7 figure royalty cheques.- Robert Kaufmann Here are some pictures - Jorge
