Krasner P, Rankow HJ. Anatomy of the pulp-chamber floor. J Endod. 2004; 30:(1)5-16
Vertucci F. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1984; 58:(5)589-599
Stock C, Nehammer C. Endodontics in practice.London
Kulid JC, Peters DD. Incidence and configuration of canal systems in the mesiobuccal root of maxillary first and second molars. J Endod. 1990; 16:(7)311-317
Abella F, Patel S, Durán-Sindreu F Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J. 2012; 45:(11)963-978
Goga R, Chandler N, Oginni A. Pulp stones: a review. Int Endod J. 2008; 41:(6)457-468
Robertson A, Andreasen FM, Bergenholtz G Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors. J Endod. 1996; 22:(10)557-560
Kuyk JK, Walton RE. Comparison of the radiographic appearance of root canal size to its actual diameter. J Endod. 1990; 16:(11)528-533
McCabe P, Dummer M. Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Int Endod J. 2012; 45:177-197
Oehlers F. Dens invaginatus (dilated composite odontome): I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol. 1957; 10:(11)1204-1218
Shifman A, Chanannel I. Prevalence of taurodontism found in radiographic dental examination of 1,200 young adult Israeli patients. Community Dent Oral Epidemiol. 1978; 6:(4)200-203
Sjögren U, Figdor D, Persson S Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997; 30:(5)297-306
De Deus QD, Horizonte B. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod. 1975; 1:(11)361-366
Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res. 1981; 89:321-328
Ørstavik D, Kerekes K, Molven O. Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study. Int Endod J. 1991; 24:(1)1-7
Trope M, Delano EO, Ørstavik D. Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. J Endod. 1999; 25:(5)345-350
Kvist T, Molander A, Dahlén G Microbiological evaluation of one- and two-visit endodontic treatment of teeth with apical periodontitis: a randomized, clinical trial. J Endod. 2004; 30:(8)572-576
Orstavik D, Pitt Ford T.Oxford: Blackwell Science Ltd; 2004
Wahl M. Myths of single-visit endodontics. Gen Dent. 1995; 44:(2)126-131
Field J, Gutmann J, Solomon E A clinical radiographic retrospective assessment of the success rate of single-visit root canal treatment. Int Endod J. 2004; 37:(1)70-82
Sathorn C, Parashos P, Messer H. Effectiveness of single-versus multiple-visit endodontic treatment of teeth with apical periodontitis: a systematic review and meta-analysis. Int Endod J. 2005; 38:(6)347-355
Chong B, Ford TP. The role of intracanal medication in root canal treatment. Int Endod J. 1992; 25:(2)97-106
Andersen M, Lund A, Andreasen J In vitro solubility of human pulp tissue in calcium hydroxide and sodium hypochlorite. Dent Traumatol. 1992; 8:(3)104-108
Siren EK, Haapasalo MP, Waltimo TM In vitro antibacterial effect of calcium hydroxide combined with chlorhexidine or iodine potassium iodide on Enterococcus faecalis. Eur J Oral Sci. 2004; 112:(4)326-331
Andreasen JO, Munksgaard EC, Bakland LK. Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dent Traumatol. 2006; 22:(3)154-156
Abbott PV. Factors associated with continuing pain in endodontics. Aust Dent J. 1994; 39:(3)157-161
Naoum H, Chandler N. Temporisation for Endodontics. Int Endod J. 2002; 35:964-978
Fox K, Gutterirdge L. An in vitro study of coronal microleakage in root-canal-treated teeth restored by the post and core technique. Int Endod J. 1997; 30:361-368
Modern endodontic planning part 2: access and strategy James Darcey Carly Taylor Reza Vahid Roudsari Sarra Jawad Mark Hunter Dental Update 2024 42:8, 707-709.
Authors
JamesDarcey
BDS, MSc, MDPH, MFGDP, MEndo, FDS(Rest Dent)
Consultant and Honorary Clinical Lecturer in Restorative Dentistry, University Dental Hospital of Manchester
Poor access and iatrogenic damage can result in failed root canal treatment. Understanding tooth anatomy improves access and ensures that the clinician is cleaning and shaping the whole root canal system. If a canal is missed treatment usually fails. This paper revisits tooth anatomy and discusses how to ensure that access is optimized, but not at the expense of precious tooth structure. The concept of multi-visit root canal treatment is also addressed with emphasis on the, often overlooked, aspect of temporization.
CPD/Clinical Relevance: Good anatomical knowledge of teeth is the cornerstone of endodontics. Once root treatment has begun the clinician must be logical about how many visits to take and how to temporize teeth between such visits.
Article
Root canal treatment is complex and time consuming. Good access facilitates placement of instruments, improves vision and limits iatrogenic damage. This makes the procedure more comfortable for both dentist and patient. Knowing what to expect after access removes surprises and helps support the biological goals of cleaning and shaping. This is only possible with a sound understanding of root canal anatomy and canal configurations. Finally, the clinician must give consideration to whether a multi-visit strategy is required and, if so, the importance of good temporization.
Accessing the root canal system can be one of the biggest challenges to successful root canal treatment. The ability to get instruments into the canal system unimpeded using a glide path without unnecessary damage to a tooth can facilitate endodontic treatment for the practitioner. Based on analysis of extracted teeth, a series of ‘laws’ have been developed to help dentists achieve these goals.1
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
