Are you wasting your time, Giving Multiple Intracanal Dressings?

One study just published clearly shows that intra canal dressings are a waste of time.

Reference
M. E. Vianna, H.-P. Horz, G. Conrads, A. A. Zaia, F. J. Souza-Filho, B. P. F. A. Gomes (2007)
Effect of root canal procedures on endotoxins and endodontic pathogens
Oral Microbiology and Immunology 22 (6), 411–418. Read on ..........

Method: Twenty-four teeth were selected for the present study. Chemo-mechanical preparation was performed using 2% CHX gel and three different intracanal medicaments [Ca(OH)₂ paste; 2% CHX gel; and Ca(OH)₂ + 2% CHX gel]. A quantitative chromogenic Limulus amoebocyte lysate assay was used to measure the amount of endotoxin. Aerobic and anaerobic techniques were used to isolate and identify bacteria, and to determine the bacterial reduction by counting colony-forming units (CFU).

Results: Endotoxins and bacteria were present in 100% of the initial samples, with endotoxin concentration ranging from 62.93 to 214.56 UE/ml and CFU ranging from 4 × 10⁵ to 2.6 × 10⁶. After chemo-mechanical preparation a mean endotoxin reduction of 44.4% was found. Eight (33.3%) root canals were still positive by culture analysis with a mean reduction of bacteria (CFU) of 99.96%. After 7 days of intracanal dressing, endotoxin concentration decreased by only 1.4% compared with S2, and residual bacteria were recovered by culture analysis in 13 cases (54.1%). No significant difference was found among different intracanal medicaments.

Conclusion: Relatively high values of endotoxin were still present in the root canal after chemo-mechanical preparation although the majority of bacteria were eliminated. No improvement was achieved by 7 days of intracanal dressing.

To achieve best possible chemo Mechanical cleaning, you need to use non tapered instruments.

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New approach to perio Treatment

A new study published in the November issue of the Journal of Dental Research shows that application of beneficial bacteria as an adjunct to traditional therapy may become a valid, non-antibiotic treatment approach for periodontitis (gum disease). In this small-scale animal study, researchers applied a mixture of beneficial bacteria after scaling and root planing (removal of bacterial plaque from the crown and root of the tooth surface), a concept called Guided Pocket Recolonization, or GPR. With the emergence of antibiotic resistance and the lack of non-antibiotic treatment options, this GPR approach may provide a valuable addition or alternative to treatment options for periodontitis.

This is the first study to test the concept of bacterial replacement therapy in the treatment of plaque-related periodontal disease, and analysis of the data showed, in a beagle dog model, that when beneficial bacteria were applied in periodontal pockets adjunctively after root planing, repopulation by bacteria associated with gum disease was delayed and reduced, as was the degree of inflammation, at a clinically significant level. So keep watching for new developments in this area.