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Published on: May 24, 2022
A preliminary study on the technical feasibility and outcome of retrograde root canal treatment
1Clinic of Endodontology, Gothenburg Public Dental Health Service, Gothenburg, Sweden. Peter.S.Jonasson@vgregion.se
Aim:
To investigate the technical feasibility and outcome of retrograde root canal treatment.
Summary:
Endodontic access cavity preparation in abutment teeth may jeopardize the retention of the coronal restoration leading to prosthodontic failure. In such cases leaving the crown intact and performing retrograde root canal treatment might be an alternative approach. The potential to promote healing with retrograde endodontic treatment, and the technical feasibility to shape, clean and fill the canal was evaluated retrospectively. The study consisted of 21 incisors, canines and premolar teeth followed-up clinically and radiographically from 6 to 48 months. In 14 teeth the canals were completely negotiated. These cases were all judged as completely healed. In five cases no canal could be explored by files and a conventional ultrasonic root-end preparation and filling was performed. Two of these were classified as completely healed and three as 'uncertain'. In 2 two-rooted premolars a combination was performed with complete instrumentation of the buccal canal and the ultrasonic root-end preparation of the palatal root. One case was judged as a failure and the other was classified as completely healed. The results from this preliminary evaluation of retrograde root canal treatment are promising and merit a randomized clinical trial.
Key Learning Points:
Abutment teeth with vital pulps may develop pulp necrosis and apical periodontitis in 10% of cases. Endodontic access preparation through an artificial crown may weaken its retention and jeopardize the longevity of a bridgework. Retrograde root canal treatment is often feasible in maxillary teeth. Results from this preliminary study suggest that treatment outcome for retrograde and orthograde root canal treatment is similar.
