Endodontic Techniques Research Articles

Comparative evaluation of efficacy of guided endodontic technique with and without sleeve for access cavity preparation: An In Vitro study

BackgroundCalcific metamorphosis in root canals is common and presents challenges in gaining access. Guided endodontics offers a solution to overcome these difficulties. The PriciGuide® system is a patented guided endodontic technique claiming superior precision compared to sleeve-based guides. This study aims to compare deviation between the PriciGuide® system and the guide with sleeve. MethodsA patient with calcified canal underwent CBCT scanning to obtain a DICOM file. Using the DICOM file, 3D models were printed. The patient's cast was scanned to obtain an STL file. Using DICOM and STL files, the guide with sleeve was designed using BlueSkyBio software and 3D printed. The PriciGuide® system was obtained from Roots to Cusps® Private Limited. Access opening was performed using conventional method, guide with sleeve and guide without sleeve (PriciGuide® system).Samples underwent radiograph scans to measure coronal, apical, and angular deviations, as well as procedural time. ResultsOne-Way ANOVA and Post Hoc Bonferroni's test revealed that coronal, apical, and angular deviations were lowest in the guide without sleeve group. However, access opening times were similar in both guided technique groups. ConclusionsThe PriciGuide® system offers precise access cavity preparation for calcified canals, showing minimal deviation compared to the sleeve-based guides. It facilitates accurate root canal access regardless of the dentist's experience level. This study utilized 3D-printed teeth that do not fully replicate the complexities of natural teeth, further research is needed to validate the PriciGuide® system's performance on natural teeth and assess deviation using CBCT for a more comprehensive evaluation.

Non-Surgical Endodontic Management of Teeth with Aberrant Anatomy: A Case Series

The root canal therapy aims to remove the necrotic and vital pulp tissue remnants from the root canal to treat the periradicular inflammation. The knowledge of the tooth anatomy is essential to ensure a successful treatment. However, the deviation of the tooth anatomy complicates the diagnostic and treatment processes. Effective management of such complexities requires a tailored approach, utilizing detailed imaging and precise endodontic techniques to achieve successful outcomes and restore patient function and comfort. This case series presents the endodontic management of three different anatomic variations of permanent teeth that include taurodontism in the mandibular molar, two rooted mandibular canine and dilacerated maxillary central incisor and underscores the importance of personalized treatment planning and advanced diagnostic tools in managing complex dental anomalies.

Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss: A 20-year longitudinal study.

To evaluate the long-term survival of immature traumatized incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA-apical plug) and to identify major factors affecting the survival of these teeth. Records of 2400 children and adolescents were screened for presence of traumatic dental injuries to immature incisors where endodontic treatment with the two apexification techniques was performed during January 2003 and December 2022, compared to a control group of mature teeth treated with conventional endodontic techniques. The studied variables were age; sex; apexification technique, presence of luxation and hard tissue injuries; preoperative root development stage (RDS), preoperative and postoperative periapical index (PAI), the time-point for tooth loss, and overall survival time in years. Kaplan-Meier estimates were used to graphically present the survival functions and Cox proportional hazard model to calculate hazard ratios (HR, 95% CI). The median survival time was 10 years for calcium hydroxide apexification, 16.1 for MTA-apexification, for luxation injuries other than intrusions and avulsions 15.5 years, for intrusions 12.5 years and for avulsions 6.8 years. The variables with significant negative impact on tooth survival were calcium hydroxide apexification, avulsion and postoperative PAI 3-5. No significant relationships were found for the variables MTA apexification, concussion; subluxation; lateral luxation; extrusion, intrusion, hard tissue injuries, preoperative RDS and PAI scores and postoperative PAI 1-2. After adjustment, the risk for premature tooth loss was 13.5 times higher in calcium hydroxide apexification, approximately 2 to 4 times higher in PAI 3-5, and 5.6 times higher in avulsions. Calcium hydroxide apexification, avulsion, and postoperative PAI 3-5 were identified as prognostic variables with significant negative impact on the risk for premature tooth loss.

Endodontic and prosthodontic management of a rhinectomy patient

This case report presents the endodontic and prosthodontic management of a rhinectomy patient who sustained iatrogenic damage to the apices of her anterior maxillary teeth during surgical resection of a nasal tumour. We discuss the issues with surgical and prosthodontic management of oncology patients who have undergone surgery and radiotherapy, in addition to the endodontic techniques employed to ensure success of treatment whilst noting important prognostic indicators. The case highlights the importance of routine radiographic review and post-surgical tooth assessment of patients who sustain trauma or have surgery in the midface, since clinicians may only radiograph anterior teeth when they are symptomatic and/or present with trauma. CPD/Clinical Relevance: Close monitoring of traumatized teeth or teeth in close proximity to surgical sites should be provided.

Understanding the Dynamics of Inflammatory Cytokines in Endodontic Diagnosis: A Systematic Review.

The primary aim of this literature review is to delineate the key inflammatory cytokines involved in the pathophysiology of pulp inflammation. By elucidating the roles of these cytokines, a deeper comprehension of the distinct stages of inflamed pulp can be attained, thereby facilitating more accurate diagnostic strategies in endodontics. The PRISMA statement and Cochrane handbook were used for the search strategy. The keywords were created based on the review question using the PICO framework. The relevant studies were meticulously assessed according to predefined inclusion and exclusion criteria for this systematic review. A rigorous quality checklist was implemented to evaluate each included study, ensuring scrutiny for both quality and risk-of-bias assessments. The initial pilot search conducted on PubMed, Scopus, Cochrane, and WoS databases yielded 9 pertinent articles. Within these articles, multiple cytokines were identified and discussed as potential candidates for use in endodontic diagnosis, notably including IL-8, IL-6, TNF-α, and IL-2. These cytokines have been highlighted due to their significant roles in the inflammatory processes associated with pulp pathology. The identification of specific inflammatory cytokines holds promise for enhancing endodontic diagnostic procedures and exploring diverse treatment modalities. However, the current body of research in this area remains limited. Further comprehensive studies are warranted to fully elucidate the potential of cytokines in refining diagnostic techniques in endodontics.

Comparative Morphology of the Carnassial Teeth Root Canals in Mixed-Breed Dogs and German Shepherds.

Root canal treatment of carnassial teeth in dogs is a common endodontic technique which aims to re-establish or maintain the health of the periapical tissues. In total, 43 dogs were used in this study. Root canal morphology was evaluated in 86 superior fourth premolars and 86 inferior first molars. Apical delta was present in 247 roots, while obliteration of the root canal was found in 11 roots. The most common type of apical delta of the roots of superior fourth premolars was type II, with up to 10 apical ramifications, while type IIIA, with 10-20 apical ramifications, was most commonly present in the roots of inferior first molars. Considering that knowledge of the morphology of root canals is essential for a successful endodontic procedure, the aim of this study was to analyze and compare the morphology of root canals in the carnassial teeth of German shepherds and mixed-breed dogs. Apical resection for the purpose of endodontic therapy of the superior fourth premolar and the inferior first molar is indicated at a length of 4 to 6 mm from the anatomical tip of the roots, which would completely remove the apical delta of these two teeth.

Effective Treatment of Recurrent Periapical Lesion Involving Multiple Teeth in a Pediatric Patient: A Rare Case Report with Review of Literature

Nonsurgical endodontic therapy is usually advised as primary approach to treat the nonvital teeth with pulpal or periapical infection. However, in certain clinical scenarios and also owing to various factors, surgical modality of endodontics is eventually adopted to manage the recurrent or persistent pulpal or periapical infection and also to treat the failed cases of previously endodontically-treated teeth with conventional approach. In existing literature, there is deficiency of published case report articles regarding successful surgical endodontic management of recurrent pulpal/priapical signs and symptoms and also of failed cases of nonsurgical modality of endodontic therapy in growing pediatric patients. Hence, the present article describes the case report of the effective and successful clinical management of recurrent and failed case of conventional nonsurgical orthograde endodontic therapy by employing the surgical endodontic modality in an adolescent pediatric patient aged 13 years. The whole clinical procedure in step-wise manner has been described, and furthermore, the relevant contemporary endodontic techniques have been elucidated in context of the present case.

Influence of Cavity Designs on Fracture Resistance: Analysis of the Role of Different Access Techniques to the Endodontic Cavity in the Onset of Fractures: Narrative Review.

In recent years, new endodontic access techniques have been proposed with the aim of preserving as much dental tissue as possible for subsequent prosthetic rehabilitation. It has indeed been demonstrated that the success of this therapy is essential and dependent on the proper execution of endodontic cavity access. The main objective is to provide a comprehensive and up-to-date overview of the new access techniques in endodontics in order to guide clinical practice toward a more precise and qualitative approach. As of today, there is still no universally standardized and recognized taxonomy for the different access cavity designs described in the literature. It has been observed that there are various nomenclatures in the literature. The cavity access designs described mainly in the literature can be categorized into six groups: Traditional Access Cavity (TradAC), Conservative Access Cavity (ConsAC), Ultra-Conservative Access Cavity (UltraAC), Truss Access Cavity (TrussAC), Caries-Guided Access Cavity (CariesAC), and Restoration-Guided Access Cavity (RestoAC). The drafting of this narrative review followed the indications of the SANRA (Scale for the Assessment of Narrative Review Articles). A search for scientific articles was conducted on the PubMed and SCOPUS databases, using the following search query: ((truss) OR (conservative) OR (ninja) OR (traditional)) AND access AND endodontic. The initial search yielded a total of 941 articles. After removing duplicates using EndNote X8 software, the number of articles decreased to 785. By applying the inclusion and exclusion criteria, a total of 64 articles were obtained. Among these, 20 articles were finally selected for the purposes of this review, 11 literature reviews and 9 ex-vivo studies. Studies on fracture resistance have yielded heterogeneous results. For anterior teeth, studies do not find a significant relationship between different endodontic access cavities and fracture resistance. However, in the posterior sector, there is more discrepancy and many positive results for minimally invasive access cavities seem to relate to molars. Therefore, it can be concluded that the evidence supporting the influence of endodontic preparations on dental fracture resistance is still limited. Research on new endodontic access techniques holds significant clinical relevance in contemporary endodontics. The evolution of dental technologies, including cone beam computed tomography (CBCT) and computer-guided cavity preparation, has ushered in the era of minimally invasive endodontics. This shift aims to enhance the precision and quality of endodontic treatments while preserving maximum healthy dental tissue for subsequent prosthetic rehabilitation. The success of endodontic therapy is closely tied to the proper execution of access to the endodontium, influencing all phases of endodontic treatment and playing a role in determining fracture resistance for subsequent rehabilitation phases. The dichotomy between traditional and minimally invasive approaches has spurred clinical investigations. Specifically, within the scientific community, doubts have been raised about the potential limitations of minimally invasive access cavities. Concerns include their impact on canal orifice localization and raise questions about their influence on the overall success of endodontic treatment. This review holds clinical significance as it sheds light on the evolving landscape of endodontic access techniques, analyzing the anatomical trajectory, carefully examines the transition to minimally invasive approaches, and critically assesses existing scientific evidence and concerns surrounding these developments, contributing to an informed decision-making process in clinical practice.

Pediatric endodontic considerations in the application of regenerative therapy for immature permanent teeth: a review article

For adult teeth with necrosis or apical periodontitis, regenerative endodontics provides a useful alternative to standard endodontic treatment. This review focuses on the pediatric endodontic considerations in the application of regenerative therapy for immature permanent teeth. A thorough literature search was conducted in the MEDLINE database using the keywords "pediatric, regenerative, therapy, endodontics, immature, permanent, and teeth" to find relevant publications published between 2017 and 2024. Additionally, Google Scholar was used to find and access pertinent scientific publications using the appropriate search terms. Various inclusion criteria were applied to select the articles for review. The selected articles were published between 2020 and 2024 and included discussions on several specific elements. Topics covered include the criteria for case selection for regenerative endodontics. Overall, the existing evidence indicates that using regenerative endodontic techniques to treat adult permanent teeth with apical periodontitis or necrosis may successfully lead to the resolution of apical translucencies and the absence of clinical signs and symptoms. With slight modifications to the clinical procedure, regenerative dentistry methods can be effectively applied to specific cases, such as those involving a small apical foramen, decreased blood supply, and a lack of growth factors. However, additional research is required to determine the optimal conditions for achieving successful treatment outcomes.

Periapical Pathologies Treated with Conservative Approach

Periapical pathologies are encountered routinely on an endodontically compromised tooth which may or may not be painful. The lesions resulting from few millimeters to centimeters can be a cyst, granuloma or an abscess combinedly comprising up to more than 90% of all periapical lesions. Various methods can be used for the treatment of the periapical lesions using modern endodontic techniques including endodontic microscopes, ultrasonic irrigation tips, intra canal calcium hydroxide medicaments, advanced cleaning and shaping endodontic files and advanced obturation techniques. The goal of the endodontic treatment is to provide a complete aseptic environment with complete sealing of root canal and coronal restoration with absolute eradication of any microbial growth for successful resolution of the lesions. We are reporting here multiple cases where we used calcium hydroxide as an intra-canal medicament for its antibacterial properties and intra-canal medicament for the treatment of periapical lesions.

Three-dimensional accuracy of endodontic access preparations using novel nonrestrictive static guides: A laboratory study.

This study compared the accuracy of traditional endodontic access to conservative access cavities prepared with or without novel nonrestrictive endodontic access guides by operators with different levels of clinical experience without visual aids, using a three-dimensional volumetric accuracy analysis method. The accuracy of the preparations was analysed using a novel 3D volumetric analysis by calculating the intersection and volume of the actual cavities to the planned model cavities. The experienced operator significantly outperformed the inexperienced operator in the free hand groups, while accuracy of conservative access cavities prepared using the novel guides were comparable and significantly higher than the other groups (p < 0.05). The results demonstrated clinical experience enhanced endodontic preparations accuracy and that nonrestrictive guides achieve accurate conservative access cavities which are independent of the operator skill level. Additionally, the three-dimensional volumetric analysis is a consistent and objective method to judge the accuracy of guided endodontic techniques.

Histologic and radiological observations of a human immature premolar with pulp necrosis treated with regenerative endodontic procedure – A case report of a four-year follow-up

BackgroundReports are found on long-term radiographic follow-up of teeth treated with regenerative endodontic techniques, but scarce literature is observed regarding the tissue formed in the root canal. A four-year radiographic follow-up with histologic findings in an immature mandibular premolar with dens evaginatus that underwent a regenerative endodontic procedure (REP) is presented here. After four years following REP, the tooth was extracted for orthodontic purposes thereby presenting an opportunity to report the histologic findings. SummaryTheradiographic changes included a slight root lengthening and thickening and apex closure. Histologic evaluation revealed a fibrous connective tissue with an inflammatory infiltrate in the canal space. In the apical region, cementum-like irregular mineralization developed toward the center, giving the appearance of a closed apex. Root thickening, increase in length, and radiographic closure of the apex occurred due to cemental hyperplasia. ConclusionAfter 4 years following REP in an immature mandibular premolar with apical periodontitis, granulation tissue had formed in the root canal, indicating repair and not regeneration.

Does single-visit root canal treatment of permanent teeth provide more benefit than a multiple-visit approach?

Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Ovid, Embase Ovid. Randomised controlled trials and quasi-randomised controlled trials were included. Participants aged ≥ 10 with a permanent tooth possessing a completely formed apex and without resorption; Intervention: Root canal treatment (RoCT) carried out in a single visit; Comparison: RoCT carried out over multiple visits; Outcome: Primary outcome was treatment success (retention of tooth or radiographic evidence of healing), with secondary outcomes investigating post-operative symptoms (pain, swelling, sinus tract formation). Standard Cochrane methods to assess internal validity were used. The Robins 1 tool (for quasi randomised controlled trials) or risk of bias (RoB) 1 tool (for randomised controlled trials) were used to assess RoB whereby a judgement was assigned as 'low', 'high' or 'unclear'. GRADE (GRADEpro GDT software) was used to assess certainty of evidence for each outcome. The certainty of evidence was defined as high, moderate, low or very low, having no downgrade, downgrade of one level, downgrade of two levels and downgrade of three or more levels, respectively. Of the various subgroups investigated to determine their relevance, only pretreatment conditions (vital teeth versus necrotic teeth) and endodontic technique (manual versus mechanical instrumentation) were available for subgroup analysis. The Cochrane's test for heterogeneity and I2 test were used to assess the variation in treatment effects. A random-effects model was used to combine risk ratio (RR) for dichotomous data and mean difference (MD) for continuous data. Sensitivity analysis was performed for each outcome, excluding studies at overall high or unclear RoB. Forty-seven studies were included in the meta-analysis and internal validity assessment, with 5693 teeth analysed. Ten studies were found to have a low RoB, 17 with a high RoB and 20 with an unclear RoB. No evidence was identified suggesting a difference between treatment carried out in a single visit compared to a multiple visits approach for the primary outcome measure, but there was very low certainty about the findings (RR 0.46, 95% confidence interval (CI) 0.09 to 2.50; I 2 = 0%; 2 studies, 402 teeth). No evidence was identified suggesting a difference between treatment carried out in a single visit compared to multiple visits with regards to radiological failure (RR 0.93, 95% CI: 0.81 to 1.07; I 2 = 0%; 13 studies, 1505 teeth; moderate-certainty evidence), participants reporting pain up to 72 h post obturation (RR 0.97, 95% CI: 0.81 to 1.16; I 2 = 70%; 12 studies, 1329 teeth; low-certainty evidence), pain for 72 h post obturation (MD 0.26, 95% CI: -4.76 to 5.29; I 2 = 98%; 12 studies, 1258 teeth; low-certainty evidence) or pain at 1 week post obturation (RR 1.05, 95% CI: 0.67 to 1.67; I2 = 61%; 9 studies, 1139 teeth; very low-certainty evidence). Similarly, no evidence was identified to prove that there was a difference between treatment carried out in a single visit compared to multiple visits with regards to swelling or flare-up (RR 0.56 95% CI: 0.16-1.92; I 2 = 0%; 6 studies; 605 teeth; very low-certainty evidence), analgesic use (RR 1.25 95% CI: 0.75-2.09; I 2 = 36%; 6 studies, 540 teeth; very low-certainty evidence) and sinus tract or fistula presence (RR 1.00, 95% CI: 0.24-4.28; I 2 = 0%; 5 studies, 650 teeth; very low-certainty evidence). Interestingly, however, there was evidence to show that more participants reported pain after 1 week following RoCT completed in a single visit, compared to those in multiple visit groups (RR 1.55, 95% CI: 1.14-2.09; I 2 = 18%; 5 studies, 638 teeth; moderate-certainty evidence). Subgroup analysis showed there was an increase in post-treatment pain after 1 week for RoCT carried out in a single visit on vital teeth (RR 2.16, 95% CI: 1.39-3.36; I 2 = 0%; 2 studies, 316 teeth), and with the use of mechanical instrumentation (RR 1.80, 95% CI: 1.10-2.92; I 2 = 56%; 2 studies, 278 teeth). The current evidence shows that RoCT carried out in a single visit is no more effective than RoCT carried out over multiple visits; after 12 months, there is no difference in pain or complications with either approach. However, single visit RoCT has been shown to have increased post-operative pain after 1 week compared to RoCT completed over multiple visits.

Endodontic surgery. Part 2: surgical root canal re-treatment

Surgical root canal re-treatment (SRCReT), or root-end surgery, is the most commonly undertaken surgical endodontic technique. Approaches to SRCReT differ, with a variety of different protocols described and varied success rates reported. In the second part of this two-part series, the current scientific literature is examined and clinical examples are given to offer guidance for the optimal protocol for SRCReT. CPD/Clinical Relevance: SRCReT is a procedure which may facilitate the treatment of disease of endodontic origin which is not amenable to management with orthograde non-surgical root canal treatment.

Endodontic surgery. Part 1: an overview

Surgical root canal re-treatment (SRCReT) or root-end surgery is the surgical endodontic technique most commonly studied and undertaken in clinical practice. A range of diagnostic, emergency and corrective surgical procedures may be included under the umbrella of endodontic surgery. The first article in this two-part series uses the best available evidence and clinical examples to provide the clinician with an overview of endodontic surgery. CPD/Clinical Relevance: An updated review of endodontic surgical techniques is of relevance to clinicians.

PARTICULAR FEATURES OF ROOT CANAL FILLING IN TEETH WITH RESORBED APICAL OPENING NEAR THE MANDIBULAR CANAL

When filling root canals of teeth with apical resorption near the mandibular canal, there is a risk that the material will go beyond the apex into the region of mandibular canal, which can lead to serious damage to the innervation of this area. In most cases, modern approaches and technologies in endodontics allow to achieve the formation of dentinal plug in the resorption area, thus minimizing the risk of traumatization of the patient.&#x0D; Background. Improving efficiency of endodontic treatment of teeth with apical resorption in the region of mandibular canal.&#x0D; Materials and methods. 56 patients aged between 18 and 45 years were examined. All patients had clinical signs of mandibular endodontic treatment failure with a dark radiolucent focus in the region of the apex, which bordered the mandibular canal. Radiological indicators and quality of obturation were assessed on the basis of CBCT, the presence of dentinal bridge was assessed visually using a dental microscope and an apical hermetic test. The results were evaluated after 4, 6, 12, and 24 months.&#x0D; Results. After 16 weeks of treatment, more than 70% of apical barrier formation occurred in groups 1 and 2, which allowed us to perform a quality permanent obturation without excessive risks of complications.&#x0D; Conclusion. The use of a dental microscope in conjunction with modern endodontic techniques in the treatment of teeth with apical resorption can significantly reduce the treatment time, thereby improving the quality of treatment of patients with this pathology.

Assessment of bone quality of apical periodontitis treated with MTA plug and regenerative endodontic techniques.

Fractal analysis (FA) is a quantitative, objective and non-invasive method that facilitates the characterisation of the tissue architecture. This study aims to compare the periapical healing at 1-year follow-up by evaluating newly generated trabecular bone with FA after Mineral trioxide aggregate (MTA) plug and regenerative endodontic treatment (RET). A total of 55 asymptomatic teeth with a single-canal, open apex and periapical lesion, treated with MTA plug or RET, were evaluated retrospectively. After considering the inclusion/exclusion criteria, FA was conducted on 30 periapical images using the box-counting method. In both groups, a significant decrease was observed in the periapical lesion size at 1-year follow-up (p < 0.01). However, there was no significant difference between the MTA plug and RET (p > 0.01). Significantly higher fractal dimension values were detected at 1-year follow-up in both MTA plug and RET cases (p < 0.01). However, the difference was not significant between the groups (p > 0.01). Both procedures seem to improve periapical healing with a new resistant bone of similar density and complexity.

Recent Progress on the Applications of Nanomaterials and Nano-Characterization Techniques in Endodontics: A Review.

The impact of nano-based technologies in endodontics for the identification and treatment of various dental infections is showing fast progress. Studies show that nanoparticles could serve as useful agents with many beneficial results and continue to be promising in the field of endodontics. To ensure progress and improvements on novel nanomaterials in relation to their physicochemical and biological properties, nano-identification methods for the detection and evaluation of diseases need to be further highlighted. This study aims to review the current technological progress and recent research outcomes as well as possible prospective applications of nano-based technologies in endodontics. A comprehensive literature survey has been carried out on the utilizations of nanomaterials and nano-characterization techniques in endodontics. The current status and recent applications in endodontics are discussed with illustrative examples. The results have shown that the progress and improved accuracy of nano-identification techniques enabled a better characterization, evaluation and selection of appropriate treatment plans for endodontics-related diseases. The results have been inspiring for further clinical investigations. Nano-endodontics is still a developing field with a strong potential for revolutions of novel materials and techniques in the diagnosis and treatment of dental diseases. Further improvements in nanoparticles properties will pave the way for the development of many beneficial endodontic therapeutic agents. The future looks encouraging for sustainable products and testing methods for clinical endodontic applications.

Alternative endodontic technique in pediatric dentistry: lesion sterilization and tissue repair

Alternative endodontic technique in pediatric dentistry: lesion sterilization and tissue repair

Minimal Invasive Endodontics: A Comprehensive Narrative Review.

It is the aim of any surgical procedure to restore the tooth to its normal form and function, as well as to restore the tooth's appearance when it is appropriate to do so. One of the primary purposes of endodontic therapy is to clear out the root canal system of germs, pulpal remains, and other foreign matter. A tooth's biomechanical properties have to be compromised in order to achieve this goal; hence the tooth has a poor prognosis for restorative success. The remaining dental structure and restorations have a significant impact on the long-term viability of an endodontically treated tooth. Minimally invasive endodontics (MIE) is an endodontic technique that aims to maintain as much of the healthy coronal, cervical, and radicular tooth structure as possible. Access opening, root canal cleaning and shaping, and surgical endodontics are all possible applications for MIE in endodontic treatment. The objective of new-age endodontics is minimum intervention, and this review article examines a variety of methods that may be combined at each level of endodontics to reach this goal. A favorable outcome with minimally invasive treatment may be achieved while preserving the tooth's natural structure with careful case selection.