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Establishing Apical Patency: To be or not to be?
Zahed Mohammadi1, Hamid Jafarzadeh2, Sousan Shalavi3
1Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shaheed Beheshti University of Medical Sciences, Iranian National Elite Foundation, Tehran, Islamic Republic of Iran.
The Journal of Contemporary Dental Practice
|March 29, 2017
Summary
Apical patency, a technique using a small file, helps clear debris in root canals. While it may improve apical seal, its effect on periapical tissue healing remains controversial and requires further research.
Area of Science:
- Endodontics
- Dental Anatomy
- Restorative Dentistry
Background:
- The apical root canal presents challenges in endodontic treatment, with incomplete debridement and inadequate apical seal leading to failure.
- Apical patency, involving recapitulation with a small K-file, aims to maintain apical cleanliness and prevent debris packing.
- Existing research on apical patency's impact on periapical tissue healing is limited, with some animal studies suggesting detrimental effects.
Purpose of the Study:
- To review the effects of apical patency on root canal treatment outcomes.
- To evaluate the influence of apical patency on extrusion of root canal contents, apical seal, and postoperative pain.
- To discuss the impact of apical patency on irrigation efficacy and periapical tissue healing.
Main Methods:
- Literature review of studies investigating apical patency in endodontic treatment.
- Analysis of data concerning apical patency's effect on debris extrusion, apical seal, and pain.
- Examination of evidence regarding apical patency's influence on periapical tissue healing and prognosis.
Main Results:
- Apical patency has been linked to improved apical seal and reduced leakage when combined with specific preparation and obturation techniques.
- The effect of apical patency on periapical tissue healing is debated, with conflicting findings from animal studies.
- Data on the influence of apical patency on postoperative pain and irrigation efficacy is scarce.
Conclusions:
- Apical patency may enhance the apical seal but its overall benefit requires further investigation due to controversial findings on periapical tissue healing.
- The technique's role in preventing debris extrusion and improving prognosis needs more extensive research.
- Further clinical studies are essential to clarify the controversial aspects of apical patency in endodontics.
