The Journal of the American Dental Association
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J Am Dent Assoc, Vol 136, No 9, 1286-1293.
© 2005 American Dental Association

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CLINICAL PRACTICE

JADA Continuing Education

Thermal injury through intraradicular heat transfer using ultrasonic devices

Precautions and practical preventive strategies



ALAN H. GLUSKIN, D.D.S., CLIFFORD J. RUDDLE, D.D.S. and EDWIN J. ZINMAN, D.D.S., J.D.

Background. The use of ultrasonic energy is a highly efficient method of removing obstructions and cements within the root canal space when re-treatment or rehabilitation of that space is planned. The ultrasonic energy dislodges and removes cemented objects from the bonded interface of the canal wall. When using this method, there is less potential for structural loss or root damage and significantly less operator stress than when using other methods.

Case Descriptions. There is little evidence in published research of the considerable heat transfer that occurs during use of ultrasonic devices to remove posts, pastes and separated instruments in teeth. The authors present three cases of patients who experienced serious burn injuries during application of ultrasonic energy for restorative dentistry. The authors also offer techniques and strategies for safe and effective use of ultrasonic devices.

Clinical Implications. On the basis of the best available evidence, the authors recommend strategies to provide safe and effective therapy while using ultrasonic devices in intraradicular obstruction removal. The intent of the suggested protocols is to provide advanced and sophisticated therapies in a safe and regulated manner with patient safety as an overriding priority.

Key Words: Ultrasonic energy; intraradicular obstruction; heat transfer; unreasonable risk







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