Cleaning and shaping of the root canal is a key procedure in root canal treatment. The task of root canal cleaning presents a greater challenge mainly due to the anatomical complexities; flat-oval canals, curved canals, C-shaped canals, lateral canals, immature teeth with open apices and in canal systems that contain an isthmus and apical cul-de-sac areas.
The apical portion of the root canal is very complex and challenging during endodontic treatment. Apical patency is considered as a way for maintaining the apical part free of debris by recapitulation, using a small K-file through the area of the apical foramen. However, using patency file in endodontic treatment is controversial. Maintenance of the apical patency has recently been associated with a lower degree of postoperative pain while there is possibility of over-instrumentation, which in turn would force materials and debris into the periradicular tissues or promote apical transportation.
Alternative concepts of root canal cleaning include minimally invasive approach by Self-adjusting File (SAF) with simultaneous irrigation, XP-Endo Shaper and laser disinfection.
Objectives
1. How to manage root canals with different anatomical variations?
2. Apical patency or not?
3. Alternative concepts of root canal cleaning.