All thumbs! my dental practice, meanwhile in Japan.

  The sealer-puff is a characteristic appearance of sealer overflow outside the apical foramen on the confirmatory dental photograph after root canal filling.  This is caused by a small amount of sealer overflowing outside the apical foramen when the dentists pressurize the area around the apical constriction to achieve a tight root canal filling. It is also caused by sealer penetrating the lateral branches of the apical-delta due to pressure at the apex. The sealer puff is, after all, an overflow of foreign material into the periapical tissue of the root apex. Of course, dentists must always try to prevent foreign material to overflow from the root apex into the apical periapical tissue. However, if we take into account the cause of sealer puffs, we can evaluate them from a different perspective. Sealer puffs are... The area around the root apex is properly cleaned and free of debris, ensuring the patency of the root canal. And Be caused by the application of a good flow of s...

 An important aspect of root canal cleaning is just disinfection, especially at the root apex. This consists of removal of the smear layer of the dentinal wall and disinfection with sodium hypochlorite solution in the apical delta. Normally, dentists perform positive pressure irrigation using a syringe for root canal irrigation. They use saline solution, hydrogen peroxide solution, EDTA, or sodium hypochlorite solution as the cleaning solution. If the needle is thin enough to rinse deep into the root canal, dentists will usually feel that can clean the root canal. However, the reality is that the cleaning is not satisfactory. This is because only positive pressure irrigation makes it difficult to exert the chemical action of the irrigants. In particular, a narrow path such as the apical delta is difficult for the cleaning solution to reach. Therefore, it will be necessary to use some other method in addition to positive pressure washing. The agitation of root canal irrigation is. T...

Summary I think that the cause of post endodontic pain after root canal treatment is the extrusion of debris, not the mechanical damage by the files at the periapical tissues. The debris, in this case, means, which caused during root canal preparation procedures, dentin chips, pulp tissue, microorganisms. And I also think that it is very important that the irrigation of the root canal, especially in its apical third. The post endodontic pain after endodontic treatment, of course, we don’t like it. It is because the patient will be in pain.  Therefore, we are an effort to prevent occurring the post-endodontic pain after the root canal treatment. Post endodontic pain after the root canal treatment usually occurs from apically extruded debris, not the mechanical damage by the files. The debris stem from the root canal shaping procedure. In general, those were made of dentin chips, pulp tissue, microorganisms. If they extruded into periapical tissue, whatever the degree, we should assu...