Dec 17, 2009

Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures

Journal of Endodontics
D Ricucci, J F Siqueira

Abstract

This article reviews and reports on the histopathologic and histobacteriologic status of the tissue in lateral canals and apical ramifications (LC/AR) in diverse clinical conditions as well as in response to endodontic treatment. In total, serial sections from 493 human tooth specimens obtained by extraction or apical surgery were screened for the presence of LC/AR. LC/AR were observed in about 75% of the teeth. In clinically vital teeth, vital tissue was consistently found in LC/AR. In teeth with periodontal disease, the whole pulp became necrotic only when the subgingival biofilm reached the main apical foramen. In teeth with pulp exposure by caries, the tissue in LC/AR remained vital as far as the pulp tissue in the main canal did so. When pulp necrosis reached the level of the LC/AR, the tissue therein was either partially or completely necrotic. Chemomechanical preparation partially removed necrotic tissue from the entrance of LC/AR, whereas the adjacent tissue remained inflamed, sometimes infected, and associated with periradicular disease. Vital tissue in LC/AR was not removed by preparation. In cases in which lateral canals appeared radiographically "filled," they were actually not obturated, and the remaining tissue in...Continue Reading

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Mentioned in this Paper

Necrosis
Root Canal Therapy
Exertion
Entire Lumen of Body System
Periapical Periodontitis
Maxilla
Bulla
Dental Pulp
Pulp Chamber
Blood Vessel

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