Establishment and maintenance of asepsis in endodontics - a review of the literature.
OBJECTIVE
Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance.


METHODS
A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria.


RESULTS
There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study.


CONCLUSIONS
No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed.
a The Specialist Clinic of Endodontics, The Public Dental Service of Västra Götaland County, Uddevalla Hospital , Uddevalla , Sweden ;
Leona
L
Malmberg
b Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden ;|c Department of Endodontics, Faculty of Odontology , Malmö University , Malmö , Sweden.
Annika Elisabeth
AE
Björkner
b Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden ;
Gunnar
G
Bergenholtz
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000985:Antisepsis / Q000379:methods*; D001207:Asepsis / Q000379:methods*; D003786:Dental Pulp Cavity / Q000382:microbiology; D004203:Disinfection / Q000379:methods; D004708:Endodontics; D006801:Humans; D010485:Periapical Periodontitis / Q000628:therapy*; D012390:Root Canal Therapy / Q000379:methods*; D013242:Sterilization / Q000379:methods
D000891:Anti-Infective Agents, Local
Antiseptics; aseptic; in-vivo; operation field; root canal treatment