Basic Root Canal Treatment for Primary Oral Health Care

Methods: After ethical approval, in The Republic of The Gambia, a minimal invasive methodology of root canal treatment was developed for the potential use in training and treatment by dental auxiliaries employed in rural health centers with no staff of dentists.

Results: The basic root canal treatment procedure was tested under these circumstances. Step by step manual was documented dividing the procedure into following steps: Indicated in single-rooted teeth with carious or iatrogenic pulp exposure during ART with a bleeding pulp; tooth tender to percussion, nectrotic dental pulp tissue and molars were defined as exclusion criteria. After local anesthesia, the pulp chamber was opened with a periodontal Sugarman file; initial path and tissue removal was performed with a barbed broach, and the root canal was enlarged and shaped with reamers in three different sizes. Working length was determined manually according to current recommendations. Saline and 0.2% chlorhexidine rinse were used as irrigating agent. Root canal obturation was performed by using a single-cone gutta-percha technique and GROßMAN cement. Finally, the tooth was restored according to ART.

Conclusions: A basic root canal treatment could be of benefit in areas of developing oral health care to reduce the need of extractions. Also, the concept of a shortened dental arch with removed molars but anterior teeth in function could be promoted in under-served communities.