In 1912, German doctor Albert proposed a new method of treating infected tooth canals, which consisted in the use of resorcinol-formalin paste. It was believed that the latter has bactericidal and mummifying properties that can stop the decay of pulp. This made it possible to seal and clean the dental canal of pathogenic microflora.
Factors influencing the popularity of the method
Such a method of filling channels has gained wide popularity due to its budget. In the territory of the former USSR, it was actively used to treat chewing teeth. Factors that influenced the popularity of this method were as follows:
- the doctors were absolutely convinced that the composition of the resorcinol-formalin paste was reliable and safe;
- the complexity of the procedure, even specialists with little experience undertook to carry out it;
- obtaining the desired result with a minimum set of manipulations;
- accessibility.
Resorcinol-formalin method: preparatory phase
The essence of this method is to convert the pulp into a plastic-like aseptic strand that would not dissolve under the influence of tissue microflora. Therefore, in order to avoid the development of “residual pulpitis”, pulp should be devitalized before impregnation begins.
Canal filling using Albrecht technology is carried out in several stages. At the preparatory stage, attention is paid to filling the root canals, which were able to pass along the entire length. Others are filled to the extent possible. Then, for necrotic tissue residues of damaged pulp, the mouth of each of them is reamed. For all manipulations, three sessions are assigned.
At this stage, the specialist is preparing the solution. Begin to make a paste with 5 drops of formalin, for which a glass plate is used. After, resorcinol is gradually added to it. Thorough stirring ensures its complete absorption with formalin.
During impregnation, the patient must be placed in the dental chair in the position that would allow the impregnating solution to flow into the channel under the influence of gravity. Filling of the dental units of the lower jaw implies its smooth landing, meanwhile, a lying position with the head thrown back will be required in case of treatment of teeth of the upper jaw.
Solution impregnation of channels
After this, the procedure for impregnating the channels with the solution begins. How does this happen:
- saliva is isolated and the entire surface of the oral cavity is dried;
- no more than 2 drops of the substance are squeezed out of the prepared treatment mixture by means of a pipette;
- using an endodontic instrument in dentistry, a solution is injected to the maximum possible channel depth of the affected tooth;
- in the presence of residual components of the substance with the help of a cotton swab, they are eliminated;
- all actions are repeated three times;
- when there is no opportunity to penetrate directly to the mouth, a swab pre-moistened in a medical solution is applied to the area to be treated;
- at the end, a special dentin bandage is used to tighten the mouth.
Subsequent steps
The next patient session awaits a few days later. The doctor removes the dentin dressing and re-performs all the manipulations to which the affected areas were exposed during the first procedure. Thus, their additional impregnation with resorcinol-formalin mass occurs.
Then the applied solution is modified. A specialist on a pre-prepared glass plate adds a catalyst to it. The latter is represented by 3 drops of chloramine, in other cases - 2 drops of sodium hydroxide. The prepared mixture completely seals the affected canal. Its filling with resorcinol-formalin substance is brought to a state of tight mass. All surplus is removed. Then a phosphate-cement gasket is used, which covers the mouth. In addition to it, a non-replaceable filling material is fixed on the dental crown, due to which the treated cavity is closed.
Disadvantages of the method
At the time when this method was proposed, no one wondered how safe it is, and whether there are contraindications to its use. Gradually, certain shortcomings were discovered, which prompted doctors to resort to less dangerous methods of treating carious lesions. To date, the following disadvantages of the resorcinol-formalin method are known.
Firstly, it is a high concentration of dangerous oncogenic substances. It is known that their presence provokes the occurrence of malignant tumors in different parts of the human body. Many doctors agree that a high percentage of cancers in that period is associated with such a dental intervention. Excessive toxicity of the substance affected the body with other pathologies, which could not be completely cured.
Secondly, it is the penetration of the composition into the bloodstream. Its gradual spread throughout the body has a detrimental effect on the cardiovascular and muscle systems, as well as the proper functioning of the liver, lungs, kidneys and other important organs.
It is also noted that some time after the filling procedure, tooth enamel and dentin begin to acquire a pink tint. Such an unaesthetic effect is caused by irritation of periodontal tissues as a result of resorcinol formalin entering the apical fissure. Even through high-quality whitening, you can’t completely get rid of it. Clinical experience shows that the so-called resorced teeth fuse with adjacent bone tissue.
A lot of difficulties arise when analyzing radiographs. The reason for this is the non-radiopacity of the resorcinol-formalin paste used to fill the root canals. A good specialist, having visually determined the void in the channel, will definitely recommend re-filling it. But given that over time, the durability of the mixture becomes comparable to the strength of the glass, it will be difficult to follow the recommendations.
The danger of the resorcinol-formalin method
Significantly worsens the elasticity and stability of the hard tissues of the tooth. The combination of formalin with resorcinol provokes coagulation of proteins in tissues. As a result, dentin, considered to be a fairly solid substance, loses all its quality indicators. The patient is once again forced to seek help at a dental clinic. However, the disturbed dentin structure reduces the specialist’s chances to bring the oral cavity to a perfect appearance. The presence of such a filling can develop hypercementosis, which is manifested by intensive coating of the roots with cement. When using dental instruments, it tends to crumble. Doctors say that installing a crown on such a tooth is impossible. And there is only one way out - removal of the unit with subsequent prosthetics.
This treatment method is the cause of frequent inflammatory processes in the surrounding tissues. In view of the medical preservation of the pulp, the patient is not aware of the presence of latent infectious processes. Their spread affects neighboring gums and roots. Due to the toxicity of the substance used, the gradual destruction of periodontal tissues begins. In addition, other foci of infection are formed in the form of a cyst or phlegmon. The danger lies in the asymptomatic nature of these processes.
Effects
Scientific studies confirm that formaldehyde-containing endodontic filling materials lead to irreversible destruction of connective tissue and bone, lower jaw paresthesia. Chronic maxillary sinus infections are not excluded. In this case, the damage from formaldehyde is not limited to damage to tissues of only the root canal. The components contained in the proposed sealants tend to penetrate the body itself.
Resorcinol-formalin paste in dentistry, the consequences of which are very dangerous and irreversible, is prohibited in most countries of the world. So, in Switzerland she was expelled more than 70 years ago. In America, a doctor who dares to offer the patient this method runs the risk of losing his license.
Resorcinol-formalin technology in Russia
Despite the fact that dental practice offers safe methods of root canal treatment, the resorcinol-formalin method continues to exist in Russia. Basically, it is resorted to by peripheral link specialists who are probably aware of its harmful effects. But the lack of funds for high-quality materials and equipment for endodontics forces them to use readily available means.
The indestructibility of the method is also associated with its budget and the unwillingness of citizens to pay for quality service. In 2001, the All-Russian Dental Association requested the Central Commission for Higher Education to exclude the resorcinol-formalin method from the curriculum of dental faculties.
In conclusion
Since the patient who came to the dentist’s appointment does not have the necessary qualifications, because of his inexperience, he fully trusts the dentist. Such trust is not always justified, which is confirmed by the resorcinol-formalin method of dental treatment practiced by our dentists so far.
Therefore, you should always be interested in the doctor what type of material he will use in the treatment of the tooth. It is necessary not only to trust, but also to verify. Be careful!