Unique properties of Forfenan paste for use in endodontic dentistry

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A root canal is an anatomical cavity inside a tooth that contains the pulp (nervous tissue with blood and lymphatic vessels).

If for a number of reasons the dentist has removed the pulp, the remaining hollow canals must be filled.

In dental practice, several modifications of materials are used to seal them. The group of the most popular forms includes Forfenan.

Purpose and composition

Forfenan is a set of components for the preparation of a sealing paste, which is subsequently used to fill the dental canals.

The manipulation is carried out to isolate the pulpless part of the tooth from the periodontium (obturation), as well as for antiseptic treatment, filling difficult or infected root canals.

The paste is produced by SEPTODONT in France. Used to seal the canals of milk and permanent elements, i.e. applicable:

• in the treatment of pulpitis of temporary units with devital amputation of the root pulp;
• when filling permanent dental elements affected by caries.

Important! It is not recommended for the treatment of anterior teeth, since the coronal part of the pulpless unit may change color. It is problematic to neutralize such an effect, and you will have to install veneers or lumineers.

Contraindications to vaccination

The benefits and potential risks of vaccination are assessed by a doctor.
Photo from the website of the mayor and government of Moscow https://www.mos.ru/mayor/themes/18299/6980050/ The list of contraindications is indicated in the instructions for the specific vaccine. Read it carefully and consult your doctor before getting vaccinated. Let's look at the main contraindications to existing Russian vaccines.

Characteristics

Forfenan has established itself as a convenient and easy-to-use material that allows three actions to be carried out simultaneously in just one procedure:

• Carry out accelerated antiseptic treatment.
• Introduce a long-acting antiseptic.
• Seal the channels hermetically.

When mixing the components included in the Forfenan kit, the resulting paste hardens within 24 hours. The basis of the mass is formed by an antiseptic mixture and red resin.

During polymerization, the temperature of the material rises, and a certain volume of gaseous formaldehyde is released from it, penetrating into the dentinal canals . This substance converts the albumins present in the components into insoluble antiseptic mixtures.

Herculite filling material and instructions for its use.

Let us discuss here the features of the dental material Ionosit.

At this address https://www.vash-dentist.ru/lechenie/zubyi/plombyi/pastyi-kalasepta-v-stomatologii.html we will look at the properties of Kalasept paste.

Advantages

Forphenan differs from analogue materials in the following advantages:

• Convenient to use , i.e. it does not depend on the level of moisture during filling and hardening, is characterized by a high plasticity index, does not stick to instruments when working, and retains its primary properties during long-term storage.
• It is well introduced into the canals and fills them tightly - it has a good fit to the canal walls and chemical adaptation to the tissues, fills their entire volume without leaving cavities.
• It is resistant to chemical influences and has a minimal degree of solubility , therefore, it is not destroyed by dentinal fluid or saliva.
• Keeps the volume constant , which means it does not shrink.
• It is radiopaque, i.e. there are substances (in this case it is barium), thanks to which it is possible to monitor the condition of the treated tooth and the filling placed using X-rays.
• It has a pronounced disinfectant effect - it blocks the activity of pathogenic microflora and prevents its further spread.
• Biocompatible - does not harm the mucous membrane, dental tissues and the body. There are no toxic components in the composition, the drug is safe for health workers and patients.

Thanks to these advantages, the material is an important addition when performing any type of root canal filling.

Kneading technique

To properly prepare the paste for closing canals from the materials included in the kit, you need to perform all the steps in the following sequence:

• Pour 1 powder dispenser onto a special glass for mixing.
• Add 1 drop of each solution to it.
• Mix well.

If it is necessary to obtain a less durable paste at the output (for example, when repeated passage of the channels is assumed), then 2 drops of the medicinal solution and 1 drop of liquid for hardening must be added to the same portion of the powder.

Side effects

Mild to moderate side effects from vaccines are considered normal. You should not worry if you have a fever or cold or flu symptoms after vaccination. Within a few days, such reactions disappear on their own.

The most common side effects after vaccination against the new coronavirus include:

• pain at the injection site (the whole shoulder may hurt);
• increased body temperature;
• flu-like symptoms;
• headache;
• muscle and joint pain;
• diarrhea (diarrhea).

According to all vaccination rules, after vaccination the patient must remain in the medical facility for another 20-30 minutes. This is necessary in order to provide assistance to the patient if an allergic reaction suddenly develops.

The US, UK and some other countries maintain an open registry of side effects from vaccination. Among the very rare but serious consequences are myocarditis (inflammation of the heart) and thrombosis (blockage of blood vessels with blood clots). No such effects have been recorded from Russian vaccines. Here you need to take into account the fact that Russia does not maintain an open register of side effects.

Regarding the long-term side effects of Covid vaccines, information is collected in real time. Almost a year after the start of large-scale clinical trials, long-term side effects have not yet been established.

Application Guide

The treatment process for sealing root canals with Forfenan is carried out in the following order:

• The dentist examines the oral cavity and makes a conclusion about the condition of the problem tooth. If necessary, the patient is sent for an x-ray to determine the number, location and condition of the root canals.
• Examination of an x-ray.
• Conducting topical anesthesia. Before applying a local anesthetic, the mucous membrane is dried. As soon as the anesthetic has shown its full effect, it is washed off with a stream of water.
• Injection of anesthetic. Transcortical anesthesia is usually performed, during which the lips, palate and tongue do not become numb, but the sensitivity of the area of ​​4 teeth is lost (2 elements before and 2 elements after the injection site of the anesthetic).
• Full access to the canals is created for their treatment. Burs are used to open the pulp chamber or a special cutter is used to prevent overheating of the interroot zone.
• A rubber dam (latex curtain) is applied.
• The pulp chamber is opened. Infected remains are removed from it.
• Instrumental and then medicinal treatment of the canals is carried out.
• Drying.
• Filling the canals along their entire length with Forfenan paste. The material is introduced in portions using a root needle or channel filler.

At the end of the process, an x-ray is taken. The procedure is mandatory during endodontic treatment and is necessary to assess the quality of canal sealing.

Recommendations and precautions

When working and handling Forfenan material, precautions should be followed, since it contains a potent component - formaldehyde.

This substance is toxic and negatively affects the body if vapors are accidentally inhaled or come into contact with open skin and mucous membranes. At high concentrations, formaldehyde can also cause burns.

It is for this reason that when treating canals, it is necessary to isolate the problematic element from the surrounding tissues with a rubber dam.

Before starting work, you must wear gloves. If the material gets into your eyes or mucous membranes (skin), rinse thoroughly with water.

It is also necessary to take into account the possibility that the client may be allergic to the ingredients of Forfenan paste. Usually, the doctor finds out the likelihood of this fact before starting treatment.

From many dentists you can hear arguments about the inappropriateness of using formaldehyde-based products in practice. However, SEPTODONT guarantees that the material meets all international standards in terms of quality and safety criteria.

How popular is the use of amalgam in new generation dentistry?

In this publication, we suggest that you familiarize yourself with the protocol for root canal irrigation in the treatment of pulpitis.

Follow the link https://www.vash-dentist.ru/lechenie/zubyi/plombyi/kornevyih-kanalov-metodom-lateralnoy-kondensatsii.html to learn more about the nuances of filling a canal with gutta-percha using the lateral condensation method.

Vital amputation of the pulp of a young tooth

• perform anesthesia
• isolate the area using a rubber dam
• open a cavity affected by bacteria
• open the tooth with a bur with a rapid rate of rotation and having a supply of water into the oral cavity, to prevent overheating of the hard tissues of the tooth and the development of pulpitis
• amputate the coronal pulp using an excavator and bur machine
• rinse the cavity with distilled water and dry it well
• periodically monitor bleeding and promptly eliminate it
• mix forfenan
• apply to the mouth of the canal

The drug is best suited for the treatment of pulp in the younger generation of preschool children.

Release form, storage and price

Forfenan is available in sets consisting of three containers:

1. 10 ml - with treatment solution. Active ingredient: 80.0 g formaldehyde with 100.0 g filler.
2. 20 g - with powder. Main components: 49.8 g barium sulfate, 0.2 g dexamethasone, 100.0 g excipient.
3. 10 ml - with hardening solution. Includes: 13.0 g hydrochloric acid, 25.0 g resorcinol, 100.0 filler.

The set also contains a device for mixing all ingredients and a dispensing spoon.

The material must be stored in a dry place protected from UV rays at an acceptable temperature range: from +5⁰ to +25⁰C for two years from the date of manufacture. Storage requires keeping the product in a tightly closed package.

The average cost of a set varies from 4 to 5 thousand rubles.

Comparison of Russian vaccines

For convenience, Table 1 provides comparative characteristics of Russian vaccines against the new coronavirus.
Table 1. Comparison of Russian vaccines against the SARS-CoV-2 virus.

The effectiveness of vaccines against new strains of coronavirus

Data on the effectiveness of existing vaccines (Russian and foreign) are contradictory.
Leading manufacturers of COVID-19 preventive drugs such as Pfizer, Moderna and AstraZeneca report continued high effectiveness of vaccines against the delta strain. We are talking about 90-96% protection from vaccinations against hospitalization and death. According to data from the UK, Sputnik V is also effective against the delta strain (90% effective). As for protection against symptomatic forms of Covid, in Israel the effectiveness of the Pfizer/BioNTech drug was 64%. A little later, the Israeli Ministry of Health said that this figure had dropped to 39%.

Given the likely decrease in the effectiveness of existing drugs against new strains, manufacturers are thinking about creating new vaccines. The technologies will remain the same (vector, mRNA vaccines), but the vaccines will target other components of the virus (which do not change with mutations).

Analogs

Dentists also use analogues of Forfenan in their work, which are not inferior in characteristics and properties to the material in question.

Resorcinol

White with a grayish or light yellow tint, crystalline powder. It has a specific faint odor and quickly dissolves in alcohol or water.

In light and air it changes its color to pink. It is a derivative of phenol, but is slightly inferior in antimicrobial activity.

Phenol is less toxic and less irritating to mucous membranes and tissues. It is characterized by keratoplastic (at low concentrations), keratolytic and cauterizing effects (at high concentrations).

In dentistry it is still applicable in the case of:

• treatment and sealing of root canals for complicated caries;
• cauterization of keratinized areas of the mucous membrane;
• treatment of periodontal disease.

The demand for the material is explained by several facts:

• ease of operation;
• quickly achieving the required result;
• low cost.

Important! Over time, a resorcinol-based filling turns the treated dental element pink.

Rezident

The material is used for antiseptic treatment and filling of root canals (including difficult to pass) with partial pulp expiration.

Set contains:

• medicinal liquid containing formaldehyde;
• hardening liquid;
• powder based on resorcinol and radiopaque filler.

Additionally, it exhibits an anti-inflammatory effect.

Foredent

It is used for closing canals after depulpation, in periodontal treatment, as well as during third-party interventions (for example, during resection, dissection of alveolar walls, periapical curettage). Has a pronounced disinfectant effect.

The material is based on resorcinol-formaldehyde, known for its toxicity and negative effects. Therefore, when working with it, doctors strictly adhere to the dosage and observe safety precautions.

Foreign vaccines

Foreign vaccines against coronavirus.
Photo: marcbruxelle / Depositphotos The most popular foreign vaccines are mRNA drugs from Pfizer/BioNTech and Moderna, a vector vaccine from AstraZeneca, as well as Chinese whole-virion drugs from Sinovac and Sinopharm.

Pfizer/BioNTech and Moderna are the world's first mRNA vaccines

Vaccine developers from Pfizer/BioNTech and Moderna have decided to take a different route in solving problems with coronavirus. The fundamental difference between mRNA vaccines is that viral proteins are synthesized in the human body. Messenger RNA (mRNA) is a kind of instruction, after reading which the cell begins to produce the encoded protein4. In this case, it is a fragment of the coronavirus S protein.

Today, mRNA vaccines against coronavirus are used in the USA, Great Britain, the European Union, Israel, Ukraine and many other countries. Preliminary results show good protection against hospitalizations and deaths. In particular, in the USA (where more than 55% of the population has been vaccinated) they are already talking about an epidemic of unvaccinated people. The vast majority of patients admitted to hospitals with Covid are people who have not been vaccinated.

Advantages and disadvantages of mRNA vaccines

Messenger RNA vaccines are highly effective because they penetrate cells. Imitating infection with a virus leads to the formation of full immunity. These drugs do not require adjuvants. In addition, mRNA vaccines can be developed quickly. If live or inactivated vaccines need to be grown in cell cultures, then mRNA drugs are “printed” on special synthesizers. In emergency situations, when it is necessary to vaccinate a large number of people in a short time, this is a rational approach.

The disadvantage of mRNA drugs is that they are not well studied. These are new vaccines that have never been used before. There is no data yet on the long-term effects of such vaccinations on human health.

Vector vaccine from AstraZeneca

This is a vaccine made according to the same principle as Sputnik V. In this case, a modified chimpanzee virus5 is used as a vector.

The AstraZeneca vector vaccine is 79% effective against symptomatic and 100% effective against severe COVID-19. This is the main vaccine used in EU countries. In the spring of 2021, some states temporarily suspended vaccination with this drug due to data on thrombosis and other serious consequences. However, European regulators soon allowed the vaccine again.

Figure 1. Types of COVID-19 vaccines. Sources: Rospotrebnadzor and WHO (WHO): https://www.rospotrebnadzor.ru/about/info/news/news_details.php?ELEMENT_ID=15468, https://www.who.int/ru/news-room/feature -stories/detail/the-race-for-a-covid-19-vaccine-explained

Whole virion vaccines from Sinopharm and Sinovac

Chinese biopharmaceutical companies Sinopharm and Sinovac have become major suppliers of coronavirus vaccines. They developed whole-virion anti-Covid vaccines similar to CoviVaca.

In addition to China, these vaccines are actively used in Turkey, Chile, the United Arab Emirates, Argentina and other countries. The results of the third phase of studies in different countries range from 50 to 84%6. Moreover, the vaccines are 100% effective in preventing severe forms and death.

Wrong? Admit it!

“Developing vaccines is difficult.
Failures are normal, the main thing is to admit them. EpiVacCorona does not work and cannot be injected, but it is available for vaccination. There have been several vaccines around the world that don't work. For example, SanoFi Institute Pasteur is a protein vaccine, somewhat similar to EpiVacCorona. It contains a spike protein expressed in the baculovirus system. The Germans tried to make an mRNA vaccine and it didn't work. An inactivated whole-virion vaccine was developed in Scotland, but it was decided not to put it into circulation. Inactivated vaccines are less effective against covid than gene-transferring ones. Chinese whole-virion inactivated vaccines have not shown themselves to be very effective; their effectiveness is low. Seychelles and Chile, which vaccinated the population with these vaccines, received a wave of Covid with hospitalizations and deaths and were forced to urgently re-vaccinate the population with the AstraZeneca vector vaccine.

The vector and mRNA vaccines used today are highly effective, leaving the inactivated variants behind by a wide margin. In terms of immunogenicity and effectiveness, the vaccines go like this: Pfizer/BioNTech, Moderna, then Sputnik V and AstraZeneca.”

Dudnakova Tatyana Valerievna

expert

Research Fellow at the University of Edinburgh, UK

Reviews

The root canal sealing procedure differs from a simple tooth filling. There are special requirements for materials for this process.

Materials are constantly being improved or replaced with new ones. Despite the variety, dentists still use formalin-based products in their work, one of which is Forfenan.

You can share your opinion regarding the effectiveness and feasibility of using this material for endodontic treatment by leaving a comment on this article.

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