Elka Radeva

Multi-visit treatment of endodontic infection – clinical aspects

Abstract
In long-standing root canal infection with the presence of sinus tract formation, preoperative swelling, pain, or large size of the periapical lesion, as well as patient factors, multi-visit treatment is indicated. During the first visit, instrumentation and irrigation of the root canals are performed due to the bacterial biofilm and smear layer being an obstruction to the efficacy of the following intracanal disinfection. After proper root canal cleaning and shaping, disinfecting medication is placed between visits to reduce microbial numbers and restrict bacterial growth. Pain relief, absence of percussion sensitivity, healing of a sinus tract, and absence of exudation are clinical signs of successful endodontic treatment, and the tooth can be filled and restored.
The literature lacks evidence of significant differences between a single-visit or multi-visit root canal treatment. Therefore, it is necessary to assess carefully the existing risk of exacerbation and prefer multi-visit treatment in teeth where the risk of complications is increased.
The lecture will focus on the present status of intracanal medicaments, their main characteristics, and clinical indications for their application during multi-visit treatment. Discussions related to the condition of the tissues in the apical area and the possibilities for healing processes will also be included.

Assoc. Prof. Elka Nikolaeva Radeva, DMD, PhD

Currently, Elka Radeva is an Associate Professor in the Department of Conservative Dentistry, Faculty of Dental Medicine (FDM)-Sofia, Bulgaria, Chairman of the General Assembly of the FDM-Sofia, President of the Bulgarian Scientific Association of Dental Medicine (BSADM), Vice president of the Bulgarian Dental Association (BgDA), President of the Communication Commission of BgDA.
Elka Radeva graduated from the Faculty of Dental Medicine - Sofia in 1993. In 1997, she acquired a specialty in Operative Dentistry and Endodontology and a specialty in General Dentistry in 2005. In 2017, she received a master's degree in Public Health and Health Management from the Faculty of Public Health, MU-Sofia.
Assoc. Prof. E. Radeva is a lecturer and researcher with 30 years of experience teaching undergraduate and postgraduate students courses. Author and co-author of 2 monographs in endodontics. Co-author in 4 books on pharmacology for medicine and dental medicine students. Author and co-author of 2 practical student books on endodontics in Bulgarian and English. Leading researcher of 14 scientific projects at MU-Sofia. Published over 95 articles in peer-reviewed journals. Reviewer of articles for Bulgarian and International Dental Journals and research projects.
Her research interests include endodontic microbiology, acute and chronic apical periodontitis, retreatment, instruments for shaping root canals, and operative dentistry.
Assoc. Prof. E. Radeva is a member of the Bulgarian Dental Association (BgDA), Bulgarian Scientific Association of Dental Medicine (BSADM), Balkan Stomatological Society (BaSS), European Society of Endodontology (ESE).