GERODONTOLOGY
Cite this article:
Retsas A,
Kalogeropoulos K,
Kossioni AE.
The use of rotary instruments
in endodontic therapy of older
dental patients.
Stoma Edu J. 2015;2(1):64-69
THE USE OF ROTARY INSTRUMENTS
IN ENDODONTIC THERAPY OF OLDER
DENTAL PATIENTS
Anastassios Retsas1a,
Konstantinos Kalogeropoulos2b,
Anastassia E. Kossioni3c*
1
General Dental Practitioner,Athens, Greece
Department of Endodontics, Dental School, National
and Kapodistrian University of Athens, Greece
3
Division of Gerodontology, Department of
Prosthodontics, Dental School, National and
Kapodistrian University of Athens, Greece
2
a
DDS
DDS, MSc, Clinical Instructor
c
DDS, MSc, PhD, Assistant Professor
b
Abstract
As the older population is continuously growing and many of them retain a
significant number of natural teeth, it may be speculated that more endodontic
therapies will be performed. The use of rotary instruments constantly grows
as they offer many advantages, such as reduction in working time and better
preservation of the original root canal morphology.The aim of this study was to
discuss the advantages and drawbacks of rotary instrumentation techniques in
older patients.
Many older people suffer from significant illnesses restricting access to the
dental office and demanding fewer and shorter working sessions. The use of
rotary instrumentation may offer a reduction in the number of visits and the
duration of the working sessions. They may also help access the root canal
system and achieve patency easier and faster, taking into consideration the
increased calcification rates and the secondary dentine deposition in older
teeth. The drawbacks of the method include increased risk of instrument
separation and the possibility of dentine microcracks as its elasticity reduces
with ageing.
Rotary systems may be useful tools for the contemporary dental clinician and
can offer significant help in many demanding geriatric cases. Nevertheless, they
must be cautiously applied after appropriate case selection and familiarisation
with their use. More research is necessary on the comparison between the use
of rotary instruments and hand files, particularly in older patients.
Keywords: gerodontology, older people, endodontic treatment, rotary
instruments
Introduction
Older persons (aged over 65) (1), unlike
in the recent past, can no longer be
regarded as de facto edentulous. In
many developed or even developing
countries an increase in the retention
rates of natural teeth in older persons
has been recorded over the last
decades (2-5). As the older population
Received: May, 19th 2015
is continuously growing and many of
Accepted: June, 11st 2015
them retain a significant number of
* Corresponding author: natural teeth, it is expected that more
Anastassia Koss ioni, DDS, MSc, PhD,
Assistant Professor ,Division of Gerodontology, restorative procedures will be needed
Department of Prosthodontics, including endodontic therapies (6). A
Dental School, National and Kapodistrian
large number of untreated decayed
University of Athens, Greece, Thivon 2 Goudi,
Athens 11527, Greece. teeth and few dental visitations for a
Tel: +302107461212,
regular check-up have been recorded
Fax: +302107461240,
email: akossion@dent.uoa.gr in older people in Greece (7) and other
countries, indicating a potential increase
in the need for endodontic therapy in
the near future.
A gradual change in the field of
Endodontology, which has become
a daily routine, is the use of rotary
instruments.
Rotary
systems
in
Endodontology have offered many
advantages, including reduction in
working time (8, 9). Moreover, a better
preservation of the original root canal
morphology can be achieved, as well
as a more effective standardisation of
its final shape (10). Some years ago,
skepticism existed concerning their use
(11), but today they are regarded as a
necessity rather than a luxury. To the
best of our knowledge, the international
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