Single-Visit Endodontics Under Dental Operating Microscopy: A Retrospective Observational Study

Area of Science:

• Endodontics
• Dental Anatomy
• Retreatment Procedures

Background:

• Missed lingual canals in mandibular incisors can lead to persistent endodontic pain and treatment failure.
• Identifying and treating these untreated canals during retreatment is crucial for improving clinical success.
• This study investigates the prevalence of untreated lingual canals in symptomatic, previously treated mandibular incisors.

Purpose of the Study:

• To evaluate the occurrence of previously untreated lingual canals in symptomatic, previously treated mandibular incisors.
• To assess symptom resolution after single-visit nonsurgical retreatment of these teeth.
• To determine the effectiveness of access cavity refinement and microscope-assisted examination in detecting additional canals.

Main Methods:

• Retrospective observational study of 129 previously treated mandibular incisors.
• Thirty symptomatic teeth underwent single-visit nonsurgical retreatment.
• Access cavities were refined, and canal detection used unaided vision and dental operating microscope (DOM)-assisted magnification.
• Pain intensity was recorded preoperatively and up to 7 days postoperatively using a visual analog scale.

Main Results:

• Previously missed lingual canals were identified in all 30 (100%) symptomatic mandibular incisors studied.
• Thirteen canals (43.3%) were found with unaided vision, while 17 (56.7%) required DOM-assisted evaluation.
• Pain intensity significantly decreased, with complete or near-complete symptom resolution by day 7 post-retreatment.

Conclusions:

• Previously untreated lingual canals are frequently found in symptomatic mandibular incisors requiring retreatment.
• Single-visit nonsurgical retreatment addressing these canals leads to substantial symptom resolution.
• Access cavity refinement combined with sequential unaided and DOM-assisted examination aids in identifying additional lingual canals.