Fate of the Tissue in Lateral Canals and Apical Ramifications in Response to Pathologic Conditions and Treatment Procedures

Ricucci, Domenico; Siqueira, José F.

doi:10.1016/j.joen.2009.09.038

Cited by 265 publications

(250 citation statements)

References 57 publications

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“…23 Complex anatomy also creates further procedural difficulties, which can leave debris and bacteria behind inadvertently. 3 Research demonstrates that bacteria remaining after endodontic therapy typically resides in complex anatomical regions, such as the lateral canals and isthmi. 18,24,25 New endodontic technologies have emerged in the last few decades, which aimed at addressing current limitations.…”

Section: Resultsmentioning

confidence: 99%

“…3 The presence of untreated complex anatomy after the completion of endodontic therapy is generally believed to increase the risk of endodontic failure. [1][2][3] Due to the difficulty of detecting and endodontically managing complex root canal anatomy, its clinical significance to endodontic therapy success has been a subject of debate, yet clinicians agree it is preferable to debride and disinfect complex anatomy to mitigate the risk of recurrent infection.…”

Section: Aim and Backgroundmentioning

confidence: 99%

“…4 Dentin does not form where lateral canals are created but instead gives rise to a canal containing small blood vessels and nerves. 3 Therefore, these lateral canals comprise pathways through which bacteria, and their byproducts, might reach the periodontal ligament and cause disease. 3 Due to the natural anatomical configuration of lateral canals and other complex anatomies, appropriate endodontic therapies to effectively debride, disinfect, and obturate are required to close the pathways of infection to the periodontal ligament, and thus prevent the initiation or exacerbation of apical periodontitis.…”

Section: 5005/jp-journals-10024-2264mentioning

confidence: 99%

“…3 Therefore, these lateral canals comprise pathways through which bacteria, and their byproducts, might reach the periodontal ligament and cause disease. 3 Due to the natural anatomical configuration of lateral canals and other complex anatomies, appropriate endodontic therapies to effectively debride, disinfect, and obturate are required to close the pathways of infection to the periodontal ligament, and thus prevent the initiation or exacerbation of apical periodontitis. Complex anatomy is difficult to predict and detect preoperatively, thus making these naturally occurring morphologies and varying canal configurations a challenge for debridement, disinfection, and obturation.…”

Section: 5005/jp-journals-10024-2264mentioning

confidence: 99%

“…[10][11][12] This is primarily due to the limitations of standard techniques, such as film and digital radiography, which has demonstrated low diagnostic accuracy for such anatomies. Scarfe et al 13 3 Currently, an endodontic therapy has been reported to meet the demands for a more effective method of debridement and disinfection of the root canal system. This innovative endodontic therapy is the GentleWave Procedure.…”

Section: 5005/jp-journals-10024-2264mentioning

confidence: 99%

See 4 more Smart Citations

Utilizing the GentleWave® System for Debridement of Undetected Apical Anatomy

Ford¹

2018

The Journal of Contemporary Dental Practice

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Aim and background: Debriding and disinfecting complex anatomies within the root canal system pose a major challenge during root canal therapy. Even with current chemomechanical techniques, debris and bacterial remnants are commonly left behind, which are generally believed to increase the risk of endodontic failure. This case details the use of a new technique to debride complex apical anatomy in a maxillary molar. Case report:A 48-year-old female presented to the clinic with a chief complaint of increasing pain in her tooth. Clinical examination of the right first maxillary molar (#3) revealed moderate sensitivity to percussion and mild sensitivity to palpation. A pulpal diagnosis of symptomatic irreversible pulpitis and a periapical diagnosis of symptomatic apical periodontitis were made. Mechanical instrumentation was performed using rotary file size #25/.04 for the mesiobuccal and distobuccal canals and size #25/.06 for the palatal canal to create a fluid path and enable obturation of the root canal system following the GentleWave ® Procedure. The GentleWave Procedure was completed using Multisonic Ultracleaning™ for complete debridement and disinfection of the root canal system. The tooth was obturated using a warm vertical continuous wave obturation technique. Postoperative radiographs revealed complex anatomy within the apical third that was undetected both during pre-operative radiography and mechanical instrumentation. The palatal canal exhibited a complex apical delta with multiple points of exit, and the mesiobuccal canal revealed an undetected lateral canal within the apical third that had a separate and distinct egress. Conclusion and clinical significance:It is important for the clinician to debride and disinfect complex anatomy within the root canal system to reduce the risk of endodontic failure. This case report highlights the clinical significance of utilizing the GentleWave Procedure for detecting complex apical anatomy during endodontic therapy.

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