What is tougher for patients other than endodontic treatment? Having endodontic treatment done again! Considering that the failure rate of root canals are somewhere around 5% to 22%, its astonishing to think that the US could have 750,000 to 3.3 million root canal failure cases per year. The criterion for a successful root canal is the elimination of the bacterial load at the apex of the root being treated. Any bacteria remaining at the apex can proliferate and therefore re-infect the root apex and the peripheral tissues – leading to re-treatment or extraction of the tooth.
At the University of Toronto, Dr. Kishen has lead the way to develop a methodology that promotes the body to heal itself, following root canal treatment. This treatment protocol involves the use of a chitosan and calcium alginate composed nanosystem. Chitosan being derived from the shells of crustaceans is biocompatible. This compound is packed at the apex of the root being treated, after minimally enlarging the canal system.
How it works
Transforming growth factor (TGF-B) and dexamethasone (Dex) are loaded into the nanosystem, which in turn is delivered at the root apex. The molecules attract the body’s host immune cells, therefore triggering the body’s repair and growth systems. It has been shown that these molecules can attract the growth of blood vessels and connective tissues in peripheral areas, thus controlling the risk of future infections. This treatment protocol was carried out in a guinea pig model, where cell migration, adherence and odontogenic stem cells differentiation was observed.
Clinical testing is to be done, where a great stride in endodontic healing can possibly be made.