An Update on Root Canal Preparation Techniques and How to Avoid Procedural Errors in Endodontics

Mohamed El-Kishawi,Khaled Khalaf

doi:10.2174/1874210602115010318

Abstract

Background:Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors.Methods:A comprehensive search was carried out using multiple databases, PubMed, Medline, Google scholar, and Scopus, to identify relevant studies addressing the objective of this study and to summarize the current evidence to readers. Keywords,i.e., endodontics, root canal preparation, hand instrumentation, techniques and procedural errors, as well as, MeSH terms,i.e. “endodontics”, “instrumentation”, “root canal preparation” were used to conduct our comprehensive search.Results:The hybrid technique is a commonly-used approach that combines the benefits of both the crown-down and step-back techniques and was reported to be one of the best techniques to produce an optimal root canal preparation outcome. Hand-instrument manipulation using the balanced forced technique is also favoured as it rapidly and safely permits removal of canal contents allowing irrigants and medications to reach deep inside canal spaces.Conclusion:The use of hand files is still recommended for initial canal negotiation and preparation and is essential for the correction of procedural errors. This study provided an update on several hand instrumentation techniques commonly used in endodontics. The correct and safe application of these techniques can prevent iatrogenic procedural errors from occurring which optimizes the quality of treatment outcome.

Highlights

Dental students learn the required skills as depicted in their BDS program in two stages, namely, pre-clinical simulated clinical activities followed later by the clinical activities carried out on patients
The purpose of this review was to provide an update on root canal hand instrumentation techniques commonly used in endodontics, including how to overcome iatrogenic errors and optimize the quality of endodontic treatment outcomes
The following keywords were used to conduct a comprehensive search so that no key studies were missed during the search: hand files, root canal preparation, techniques, hand instrumentation, procedural errors, performance, and endodontics, as well as, MeSH terms, i.e. “endodontics,” “instrumentation,” and“root canal preparation”

Summary

Introduction

Dental students learn the required skills as depicted in their BDS program in two stages, namely, pre-clinical simulated clinical activities followed later by the clinical activities carried out on patients. The inaccurate or incorrect manipulation of endodontic hand instruments during canal instrumentation can result in a number of iatrogenic procedural errors [7]. These may include straightening of the root canal, the development of ledges, apical zipping, canal transportation, perforations, and instrument separation [8]. Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors

Objectives

Methods

Results

Conclusion