Thermal injury through intraradicular heat transfer using ultrasonic devices

Risk Management in Endodontics

“…In certain cases the patient experiences permanent physical injury or disability such as facial deformation (10)(11)(12)(13), significant alveolar bone loss (14,15), and/or neurologic complications (16)(17)(18)(19).…”

Analysis of Temperature Rise and the Use of Coolants in the Dissipation of Ultrasonic Heat Buildup During Post Removal

“…Although caution is required in drawing conclusions about simultaneous use of coolants and instrumentation in this study because that was not tested, there is ample evidence to show that irrigation during post removal has a significant impact on the heat transfer to the external root (5)(6)(7)(8)(9)12). The data in this study show that there is a small statistical probability (8.4%) of damaging an individual tooth with as little as 20 seconds of continuous dry ultrasonic instrumentation.…”

“…To date, a small number of investigators and authors have cautioned that ultrasonic energy can be harmful because intense heat can be generated within a metallic object (5)(6)(7)(8)(9).…”

“…As evidence accumulates in the literature for the considerable heat buildup and transfer that occur during ultrasonic vibration in the removal of posts, a number of studies during the past few years have cautioned the practitioner regarding the need for adequate coolant to counter heat buildup (5)(6)(7)(8)(9)12). There is far less evidence for how to reliably accomplish this goal in light of the clinical reality that many practitioners will use ultrasonic vibratory energy for various periods of time without any coolant.…”

“…There is far less evidence for how to reliably accomplish this goal in light of the clinical reality that many practitioners will use ultrasonic vibratory energy for various periods of time without any coolant. Studies consistently recognize that temperatures can rise to destructive levels within very short periods of time in the absence of adequate and sufficient coolant (5,6,8).…”