Chamberless Endodontic Access for Treatment of Calcified Anterior Central Incisors. 2021

Paul A Falcon, and Carla Y Falcon, and Farnoosh Abbasi, and Craig S Hirschberg
Department of Endodontics, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ. Electronic address: pafalcon539@gmail.com.

BACKGROUND Modern techniques for treating maxillary anterior central incisors with calcified canals emphasize maintaining coronal dentin with small crown access. Alternatively, traditional retrograde surgical procedures are focused on creating an apical seal predominately limited to the remaining resected apical one third of the root canal space. A treatment option for calcified anterior teeth, with avoidance of traditional orthograde access, is presented. Chamberless endodontic access (CEA) to the canal is chosen in this case, leveraging a previous surgical treatment and osseous defect to create straight line canal access. METHODS A tooth presenting with a chronic apical abscess and an apparent previous apical surgery was instrumented and obturated using a CEA avoiding the traditional orthograde approach to the root canal system. Straight line approach was achieved retrograde and canal instrumentation was performed using ultrasonic activated U-files. Canal obturation was accomplished with warm vertical condensation technique followed by placement of an apical retroseal. RESULTS A successful 52-month outcome demonstrated the viability of CEA facilitating retrograde instrumentation and obturation. CONCLUSIONS Use of CEA simultaneously protected the clinical crown and provided a successful clinical outcome. A viable option for treatment of an anterior calcified canal and abscess due to dental trauma, CEA mitigates many of the risks associated with the treatment of calcified root anatomy.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D010485 Periapical Periodontitis Inflammation of the PERIAPICAL TISSUE. It includes general, unspecified, or acute nonsuppurative inflammation. Chronic nonsuppurative inflammation is PERIAPICAL GRANULOMA. Suppurative inflammation is PERIAPICAL ABSCESS. Periodontitis, Acute Nonsuppurative,Periodontitis, Apical,Acute Nonsuppurative Periodontitides,Acute Nonsuppurative Periodontitis,Apical Periodontitides,Apical Periodontitis,Nonsuppurative Periodontitides, Acute,Nonsuppurative Periodontitis, Acute,Periapical Periodontitides,Periodontitides, Acute Nonsuppurative,Periodontitides, Apical,Periodontitides, Periapical,Periodontitis, Periapical
D003786 Dental Pulp Cavity The space in a tooth bounded by the dentin and containing the dental pulp. The portion of the cavity within the crown of the tooth is the pulp chamber; the portion within the root is the pulp canal or root canal. Pulp Canal,Pulp Chamber,Root Canal,Cavities, Dental Pulp,Cavity, Dental Pulp,Dental Pulp Cavities,Pulp Cavities, Dental,Pulp Cavity, Dental,Canal, Pulp,Canal, Root,Canals, Pulp,Canals, Root,Chamber, Pulp,Chambers, Pulp,Pulp Canals,Pulp Chambers,Root Canals
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012387 Root Canal Filling Materials Materials placed inside a root canal for the purpose of obturating or sealing it. The materials may be gutta-percha, silver cones, paste mixtures, or other substances. (Dorland, 28th ed, p631 & Boucher's Clinical Dental Terminology, 4th ed, p187) Root Canal Filling Material,Root Canal Sealants,Sealants, Root Canal,Canal Sealant, Root,Canal Sealants, Root,Root Canal Sealant,Sealant, Root Canal
D012389 Root Canal Obturation Phase of endodontic treatment in which a root canal system that has been cleaned is filled through use of special materials and techniques in order to prevent reinfection. Endodontic Obturation,Canal Obturation, Root,Canal Obturations, Root,Endodontic Obturations,Obturation, Endodontic,Obturation, Root Canal,Obturations, Endodontic,Obturations, Root Canal,Root Canal Obturations
D012390 Root Canal Therapy A treatment modality in endodontics concerned with the therapy of diseases of the dental pulp. For preparatory procedures, ROOT CANAL PREPARATION is available. Therapy, Root Canal,Canal Therapies, Root,Canal Therapy, Root,Root Canal Therapies,Therapies, Root Canal
D018915 Root Canal Preparation Various preparatory steps prior to ROOT CANAL THERAPY by extirpation of diseased pulp and preparation of access cavity to receive the sealing material. Access Cavity Preparation,Endodontics Access Cavity Preparation,Access Cavity Preparations,Preparation, Access Cavity,Preparation, Root Canal,Root Canal Preparations

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