Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies

Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic...

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Bibliographic Details
Published in:Brazilian oral research 2018-10, Vol.32 (suppl 1), p.e65-e65
Main Authors: Siqueira Junior, José Freitas, Rôças, Isabela das Neves, Marceliano-Alves, Marília Fagury, Pérez, Alejandro Ron, Ricucci, Domenico
Format: Article
Language:English
Subjects:
Dental Instruments
Dental Pulp Cavity - anatomy & histology
Dental Pulp Cavity - diagnostic imaging
Dental Pulp Cavity - microbiology
Dentistry
DENTISTRY, ORAL SURGERY & MEDICINE
Humans
Periapical Periodontitis
Periapical Periodontitis - therapy
Root Canal Irrigants - therapeutic use
Root Canal Preparation
Root Canal Preparation - instrumentation
Root Canal Preparation - methods
Root Canal Therapy
Treatment Outcome
X-Ray Microtomography - methods
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Summary:Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
ISSN:1806-8324
1807-3107
1807-3107
DOI:10.1590/1807-3107bor-2018.vol32.0065