Summary
The role of microorganisms within the root canal system in causing pulp and periapical pathosis has been investigated and well documented. Bacteria that persist in biofilms show a wide range of characteristics that differ from planktonic cells including increased protection from host defence, increased antimicrobial resistance and the ability to survive and adapt despite ecological changes such as nutrient deprivation. Endodontic instruments alone have been shown to touch only 30–50 % of canal walls regardless of the instrument selected. When considering the complex anatomical irregularities (such as fins, isthmuses and recesses) within the root canal system, the emphasis on chemical disinfection and correct irrigation protocols are of paramount importance.
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Stenhouse, M., Patel, B. (2016). Irrigation and Disinfection. In: Patel, B. (eds) Endodontic Treatment, Retreatment, and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-19476-9_5
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