Abstract

The ability to navigate the primary canal system channels to their endpoints using a root canal instrument, referred to as technical patency and glidepath creation, is recognized as the most crucial factor influencing a favourable periapical healing outcome in teeth with apical periodontitis. This might not hold true for teeth without apical periodontitis, where reaching canal endpoints is not essential and could compromise periapical health. While a natural anatomical glide pathway is generally present in most human roots, its dimensions, content, geometry, and topography can pose challenges. Factors such as root canal curvatures, canal splitting, and calcifications introduce complexities that increase the risk of procedural accidents during the establishment of patency and the creation of a consistent glidepath.

Common procedural issues, such as the inability to achieve patency to the apical third and asymmetrical dentine removal leading to transportation, ledging, perforation, and instrument fracture, can jeopardize the management of intraradicular infection, resulting in poor treatment outcomes in cases with apical periodontitis. In fact, curved, splitting, ledged, and constricted canals introduce such complexity that specialized instrumentation concepts have been introduced, and instruments have been designed specifically to address these challenges. 

The lectures on root canal blockages will focus on the re-establishment of the lost glide path in cases of curvature/separation blockages, calcification blockages and ledge blockages.

Learning Objectives

• Understand the importance of technical patency and glidepath creation in root canal treatment, particularly in cases with apical periodontitis.
• Describe the challenges posed by curved, splitting, ledged, and constricted canals in root canal treatment.
• Explore specialized instrumentation concepts and instruments designed to address blockages and navigate complex root canal anatomy effectively.
• Learn techniques for re-establishing lost glide paths in cases of blockages to optimize treatment outcomes.
• Discuss the principles and techniques for different clinical scenarios through case-based discussions.

Agenda