SP-27 - Minimally Invasive Apical Preparation Size in the New Era of Modern Irrigation

Presentation Description/Abstract: The goal of root canal treatment is to prevent or reverse apical periodontitis by removal of necrotic/infected or irreversibly inflamed tissues, followed by obturation of the root canal space. Mechanical instrumentation and irrigation play a key role in the removal of pulp tissue, contaminants, debris, and microorganisms from the root canal system. Different adjunctive agitation techniques have been developed to help irrigating solutions penetrate the complexities of the root canal system. Passive ultrasonic irrigation, apical negative pressure irrigation systems, sonic activation, multisonic agitation, and laser activation have been reported to be superior to conventional positive pressure needle irrigation in regards to smear layer removal, antimicrobial effect, and decreased post-operative pain. Minimally invasive canal preparation has been promoted with the activated irrigation approaches. However, what is not known is the effect of minimally invasive instrumentation, in conjunction with an activated irrigation approach on clinical outcomes (retention/longevity, healing of apical periodontitis). Can infected root canals be predictably disinfected following conservative root canal preparation? Based on a review of the current literature and personal clinical experience, appropriate preparation sizes for root canal treatment will be explored.