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Irrigating the root canal: A case report

Post-operative radiograph (Image: Dr Vittorio Franco, UK and Italy)
Dr Vittorio Franco, UK and Italy

Dr Vittorio Franco, UK and Italy

Mon. 22 January 2018

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The patient reported on in this article is a student in dentistry and his parents are both dentists. They referred their son to a good endodontist, who then referred the case to me. As always, peers are more than welcome in either of my practices, in Rome and London, so when I treated this case, I had three dentists watching me, a future dentist on the chair, placing a great deal of pressure on me.

The 22-year-old male patient had a history of trauma to his maxillary incisors and arrived at my practice with symptoms related to tooth #21. The tooth, opened in an emergency by the patient’s mother, was tender when prodded, with a moderate level of sensitivity on the respective buccal gingiva. Sensitivity tests were negative for the other central incisor (tooth #12 was positive), and a periapical radiograph showed radiolucency in the periapical areas of both of the central incisors. The apices of these teeth were quite wide and the length of teeth appeared to exceed 25 mm.

My treatment plan was as follows: root canal therapy with two apical plugs with a calcium silicate-based bioactive cement. The patient provided his consent for the treatment of the affected tooth and asked to have the other treated in a subsequent visit.

After isolating with a rubber dam, I removed the temporary filling, and then the entire pulp chamber roof with a low-speed round drill. The working length was immediately evaluated using an electronic apex locator and a 31 mm K-type file. The working length was determined to be 28 mm.

As can be seen in the photographs, the canal was actually quite wide, so I decided to only use an irrigating solution and not a shaping instrument. Root canals are usually shaped so that there will be enough space for proper irrigation and a proper shape for obturation. This usually means giving these canals a tapered shape to ensure good control when obturating. With open apices, a conical shape is not needed, and often there is enough space for placing the irrigating solution deep and close to the apex.

I decided to use only some syringes containing 5 per cent sodium hypochlorite and EDDY, a sonic tip produced by VDW, for delivery of the cleaning solution and to promote turbulence in the endodontic space and shear stress on the canal walls in order to remove the necrotic tissue faster and more effectively. After a rinse with sodium hypochlorite, the sonic tip was moved to and from the working length of the canal for 30 seconds. This procedure was repeated until the sodium hypochlorite seemed to become ineffective, was clear and had no bubbles. I did not use EDTA, as no debris or smear layer was produced.

I suctioned the sodium hypochlorite, checked the working length with a paper point and then obturated the canal with a of 3 mm in thickness plug of bioactive cement. I then took a radiograph before obturating the rest of the canal with warm gutta-percha. I used a compomer as a temporary filling material.

The symptoms resolved, so I conducted the second treatment only after some months, when the tooth #11 became tender. Tooth #21 had healed. I performed the same procedure and obtained the same outcome (the four-month follow-up radiograph showed healing).

Editorial note: A complete list of references are available from the publisher. This article was published in roots - international magazine of endodontology No. 04/2017.

One thought on “Irrigating the root canal: A case report

  1. The ultimate reason why root canals fail is bacteria. If our mouths were sterile there would be no decay or infection, and damaged teeth could, in ways, repair themselves. So although we can attribute nearly all root canal failure to the presence of bacteria, I will discuss five common reasons why root canals fail, and why at least four of them are mostly preventable.

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GC celebrates 105 years of excellence: Tradition, ethics and innovation

GC describes the 21st century as the “century of health” and aims to support well-being and quality of life through comprehensive dental care worldwide. (All images: OEMUS MEDIA)

Thu. 16 July 2026

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LEUVEN, Belgium: GC Corporation is marking a special anniversary in the dental world this year as it looks back on 105 years of history. What began in 1921 as a research laboratory founded by three visionary chemists in Tokyo in Japan has developed into a leading global oral health company. Today, GC is associated not only with innovative products, such as glass ionomer materials, but also with a corporate culture that places the well-being of society above short-term profit.

Three chemists and one vision: It all began in 1921 in the Ikebukuro district of Tokyo. Three young, visionary chemists founded the GC Chemicals Research Laboratory. Their goal was modest in means but enormous in ambition: They wanted to develop materials that would improve people’s oral health in a lasting way. This small laboratory grew into a multinational company that now markets about 1,200 products in more than 100 countries and is firmly established on five continents.

The soul of the company: Semui and GC no Kokoro

GC’s corporate culture is rooted in Japanese values. The foundation of the company’s sustained success lies in the semui corporate philosophy. This term from Buddhist teaching refers to acting without self-interest and placing the well-being of others—in this case, patients, dental professionals and society—at the centre. This is complemented by GC no Kokoro, the heart of GC, a corporate culture based on trust, transparency and sincerity. At GC, employees are considered part of a community and are referred to worldwide as Nakama, a Japanese term for companions pursuing a shared goal.

The bridge to Europe: From Kortrijk to Leuven and Lucerne

The expansion into Europe more than 50 years ago marked a decisive turning point. What began in 1972 in Kortrijk in Belgium, has developed into a highly efficient network. Today, GC Europe in Leuven, Belgium, is the centre of European operations. The architecture of the buildings reflects this ambition, with open spaces and contemporary design. Its proximity to KU Leuven facilitates the exchange of knowledge between industrial production and academic research.

In 2013, GC International was established in Lucerne in Switzerland to manage complex global flows of goods and support the development of new product lines for Europe, the Americas and Asia. From there, the company oversees the market introduction of innovations and works to ensure that its high quality standards remain consistent worldwide.

Technological milestones: Leadership in glass ionomer materials

Today, GC is a recognised global market leader in glass ionomer and glass-hybrid materials. The development of its products draws on nearly a century of experience in research and production in dental adhesive technology. However, GC does not just supply materials; the company has helped promote new approaches in dentistry.

One example is the concept of minimum intervention dentistry, which is also promoted through the International Society for Minimum Intervention Dentistry. The idea is not merely to restore carious lesions, but to preserve as much natural tooth structure as possible through early diagnosis and minimally invasive treatment. The concept reflects GC’s philosophy: Prevention and preservation before restoration.

Vision 2031: A healthy and long-lived society

GC’s 105-year history also provides a foundation for its future direction. Through Vision 2031, the company has set itself ambitious goals. Its aim is not only economic growth, but also to help shape a society in which healthy ageing is supported by excellent oral health.

GC’s achievements in quality management also support this ambition: GC Europe was the first company in the dental sector to receive the EFQM Global Excellence Award. In addition, its platinum rating in the EFQM Global Excellence Index, in the Healthcare category, reinforces GC’s position as a benchmark for quality.

Education as a legacy: Training for tomorrow’s dentistry

Professional education is an important part of supporting quality in patient care, and GC promotes this approach through an extensive network of educational centres across Europe. The flagship facility in Leuven, complemented by other specialised centres, serves as a hub for knowledge transfer in dentistry. The training focuses on practical expertise: In intensive courses, trainers and experts teach innovative technologies and evidence-based treatment methods that support contemporary, safe dentistry.

The next century of dental excellence: Consistency in a changing world

For GC, 105 years of history also means 105 years of consistency in a changing world. The company shows that it is possible to be a global market leader while remaining connected to its roots and ethical values. Driven by the passion of its Nakama around the world and guided by Vision 2031, GC looks with confidence towards the next century of dental excellence. More information about the company can be found at www.gc.dental.

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