(TC28) Vacuum-generated Pressure Fields in the Root Canal System

Abstract: Vacuum-assisted closure (VAC) therapy, also known as negative-pressure wound therapy (NPWT), has been widely applied in the medical field to reduce the bacterial load and accelerate wound healing in soft tissues. Foundational evidence gleaned from research conducted in animal models also supports the acceleration of bone regeneration via the intermittent application of negative pressure. In endodontics, hydrodynamic applications of alternating pressure fields have been applied to energize and vaporize sodium hypochlorite for the dissolution of organic tissues. In addition, it may assist in the removal of puss, inflammatory mediators, and extruded debris from the periradicular tissues. The purpose of this table clinic is to illustrate the efficacy of the negative pressure generated in the root canal system on the removal of extraradicular fluid.  A novel in-vitro model will be presented and the effect of vacuum-generated pressure will be demonstrated in 4 treatment protocols (root system access without canal instrumentation, instrumentation 1mm short of apex, instrumentation to apex, and instrumentation beyond apex). For cases of endodontic disease with large resorptive lesions or those with chronic presentation, intermittent vacuum-assisted closure therapy may aid in the complex management of these lesions, encouraging more predictable and accelerated healing.