title: Thermal injury through intraradicular heat transfer using ultrasonic devices: precautions and practical preventive strategies.
abstract: 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 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Endodontics, Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94115, USA. agluskin@pacific.edu
authors.forename: Alan H
authors.initials: AH
authors.lastname: Gluskin
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Ruddle
authors.forename: Edwin J
authors.initials: EJ
authors.lastname: Zinman
mesh_terms: D000328:Adult; D000539:Alveolar Process / Q000293:injuries*; D001831:Body Temperature / Q000502:physiology; D002056:Burns / Q000209:etiology* / Q000517:prevention & control; D003738:Dental Cements / Q000737:chemistry; D003786:Dental Pulp Cavity / Q000293:injuries*; D004735:Energy Transfer; D004869:Equipment Safety; D005260:Female; D005881:Gingiva / Q000293:injuries*; D006358:Hot Temperature; D006801:Humans; D008875:Middle Aged; D011176:Post and Core Technique; D014464:Ultrasonic Therapy / Q000009:adverse effects / Q000295:instrumentation*
chemical_list: D003738:Dental Cements