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Are referred inaccessible human primary molar teeth really inaccessible?
Naser Asl Aminabadi1, Alireza Sighari Deljavan, Mohammad Samiei
1Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran. aslaminabadi@gmail.com
Journal of Oral Science
|June 11, 2013
Summary
Most primary molar root canal inaccessibility referrals are false alarms, often due to operator inexperience rather than true anatomical challenges. Improving practitioner skill can enhance primary molar root canal treatment success.
Area of Science:
- Pediatric Dentistry
- Endodontics
- Dental Public Health
Background:
- Referrals for inaccessible primary molars are frequent despite existing evidence.
- True inaccessibility of primary molar root canals is a significant clinical concern.
Purpose of the Study:
- To determine the prevalence of true versus false primary molar inaccessibility.
- To identify common causes and locations of reported inaccessibility.
Main Methods:
- Examined 199 primary molars in 156 pediatric patients (aged 3-7 years).
- Analyzed referral data from general and pediatric dentists.
- Recorded causes and locations of inaccessibility for each tooth and canal.
Main Results:
- 87.9% of referred "inaccessible" teeth were successfully treated.
- Inappropriate access cavity (42.3%) was the primary cause, followed by difficult canals (32.6%) and calcification (25.2%).
- Maxillary first molars were most frequently reported as inaccessible; only 1 in 8 referrals represented true inaccessibility.
Conclusions:
- Most primary molar root canal inaccessibility is not absolute but stems from operator limitations.
- Enhancing practitioner expertise in access cavity preparation and canal negotiation is crucial.
- The study highlights a need for improved training to reduce unnecessary referrals and improve treatment outcomes.
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