Sonics and ultrasonics in endodontics
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This document discusses the use of sonics and ultrasonics in endodontics. It begins with an introduction and history of endosonics. It then covers the physics behind ultrasonics and sonics. Next, it discusses the biophysical effects of endosonics like cavitation and acoustic streaming. It provides an overview of irrigants and compares ultrasonics and sonics. It analyzes the use of ultrasonics and sonics for various endodontic procedures like shaping canals, debridement, post removal and offers a conclusion with references.
Sonics and ultrasonics in endodontics
- 1. SONICS AND ULTRASONICS IN ENDODONTICS
- 2. INTRODUCTION EVOLUTION AN INSIGHT – The Physics behind Ultrasonics – The Physics behind Sonics BIOPHYSICAL EFFECTS OF ENDOSONICS Cavitation Acoustic Streaming IRRIGANTS ULTRASONICS SONICS A COMPARATIVE ANALYSIS • Shaping of Root Canals • Canal Debridement • Root end Preparation • Endodontic Re-treatment Intraradicular Post Removal Silver Point Removal Gutta Percha Removal Sealer Placement and Gutta Percha Obturation CONCLUSION REFERENCES CONTENTS
- 3. INTRODUCTION • Successful endodontic treatment - requirements • Scientific and technologic advances – increased the ability • Clinician – thorough knowledge AN INSIGHT Endosonics? Difference? EVOLUTION Richman – ultrasound – 1957 Martin – commercial system – 1976 Tronstadt – sonic instruments - 1985
- 4. The Physics behind Ultrasonics Two basic methods of producing ultrasound • Magnetostriction • Piezo-electric principle
- 5. The Physics behind Sonics Sonic instruments rely on the passage of pressurized air through the instrument hand piece in order to use, operating at either or around 3-6 kHz The sonic instruments have a main driver, which in contrast to the ultrasonic driver produces an elliptical pattern of oscillation during activation
- 6. BIOPHYSICAL EFFECTS OF ENDOSONICS CAVITATION Cavitation is defined as the growth and subsequent violent collapse of a small gas filled cavities pre-existing in homogeneity in the bulk fluid ACOUSTIC STREAMING Acoustic streaming creates small, intense, circular fluid movement (i.e., eddy flow ) around the instruments (Cohen 8th edition) Fluid from apical to coronal Low velocity- high velocity Hydrodynamic shear stresses Disrupt biological material
- 7. IRRIGANTS GOALS OF IRRIGATION LUBRICATION LAVAGE OF DEBRIS ANTIBACTERIAL TISSUE DISSOLUTION TYPE QUANTITY TEMPERAT URE SHELF LIFE IMPORTANT ASPECTS OF IRRIGATING ROOT CANALS Preliminary debridement- hand instruments Shih et al, moodnik et al & spangberg et al Irregular canals- organic tissue Rely on lavage + chemical dissolution
- 8. ULTRASONICS • which sound as an energy source (at 20 to 42 kHz), activates an endodontic file resulting in three dimensional activation SONICS Similarity Imparting vibrational type of movement Involves only a hand piece Use compressed air Options for irrigating The frequency of 1.5 – 3 kHz Power souce Holder and adaptor Endo file A. Rispi sonic B. Shaper sonic C. Trio sonic
- 9. CT TIPS First ultrasonic tips for endodontic surgery made of stainless steel Designed by Dr.Gary Carr First available in early 1990 KiS TIPS 1999 by Dr.Syngcuk Kim designed for use in endodontic microsurgery Diamond coating provides a micro-rough surface of the inner wall of the retro prepared cavity ADVANTAGES increased cutting efficiency due to their diamond coating. The dentin surface is left smooth, yet microscopically rough, which results in better adaptation of filling materials, fewer microfractures and less leakage. PRO ULTRA TIPS Exists in two types namely Proultra endo 1-8 Proultra surgical endo tips 1-6 These tips are designed by Dr.Clifford J. Ruddle
- 10. CPR TIPS •CPR 1-5 are diamond coated and active along the side of the tips •CPR 6-8 are titanium series BUC TIPS Designed by L. Stephen Buchanan •BUC-1: cutting and refining line angles, smoothing access walls •BUC-2: The Planer Disk Tip, medium diamond grit - planing pulp chamber floors and safely plane attached pulp stones out without cutting the chamber floor. •BUC-2a: Smaller Disk-used for corners of molar and bicuspid access preparations. 1mm in diamater •BUC-3: The sharp tipped, fine diamond grit - very active tip for cutting into calcified roots and around posts BK 3 TIPS • three bends for easy access to any preparation including MB2 canals. • provides increased visibility and can finish an entire prep with one tip. • use with any application.
- 11. COMPARATIVE ANALYSIS Ultrasonics High efficiency Reduced operator fatigue Ideal power driven One of the uncharted problems-enlarging instrument – the K file Replacing k-files with k- flex Curved canals : 15-k Factors affecting final shape: Power setting Interfacial force Geometry Irrigant Superimposition SHAPING OF ROOT CANALS SONICS Oscillatory pattern Free to oscillate 20K for 15 Cutting effeciency Rispi, shaper, ultra K Straight canals Ultra diamond Curved canals Sonics Debris extrusion Sonics Flaring Ultra sonics
- 12. ROOT END PREPARATION MOST CRUCIAL FACTOR ULTRASONIC RETRO PREPARATION TECHNIQUE ADVANTAGES – conservative, bevelling, clean walls and features RETRO PREPARATION TIPS – SONICS
- 13. ENDODONTIC RE-TREATMENT INTRARADICULAR POST REMOVAL Ultrasonics – high efficient Involves: –Coronol cement removal –Buildup material –Activating tip –Sonic – ineffective –Frequency or amplitude SILVER POINT REMOVAL The tightly fitted, well cemented silver cone that is flush with the canal orifice is a challenge to remove In such cases, removal is enhanced through the use of ultrasonic devices A conservative approach - advocated by Krell GUTTA PERCHA REMOVAL Ultrasonic instrumentation - with a solvent The ultrasonic-chloroform technique may produce residual slurry that may coat the canal wall Halothane - quick retrieval of the bulk Although ultrasonic instrumentation require less time than hand instrumentation to attain the working length, it uses significantly more solvent because the solvent not only acts as an irrigant but also gets volatilized
- 14. SEALER PLACEMENT & GUTTA PERCHA OBTURATION Sealer placement significantly superior to hand reamer placement lateral and accessory canals well Filled A common - “whipping up” of the cement replacing the ZnO-Eugenol sealer with a resin sealer like AH-26 The Helio Sonic files are also equally useful for coating the canal wall with sealers and for placing calcium hydroxide pastes Moreno first suggested the technique of plasticizing gutta percha in the canal with an ultrasonic instrument
- 15. CONCLUSION • Currently endosonics have wider applications in endodontics. The multiple effects of endosonics are physical, Chemical and biological actions. Thus is developed the Endosonic Ultrasonic Synergistic System
- 16. REFERENCES Pathways of Pulp – Cohen 4th, 6th,8th editions Endodontic practice-Ingle 4th edition DCNA-Modern endodontic practice JOE-1987 Current trends in EndodontologyDr.A.Parmeswaran, Dr.B.P.Rajan FACE-1 Tooth Resorption- Dr.M.R. Srinivasan
- 17. Thank you