Saturday, January 27, 2024

Tooth requires RCT with bone resorption. Terminate RCT.. 0.5-1 mm short of radiographic apex

Tooth requires RCT with bone resorption. Terminate RCT at:

  • A. Radiographic apex
  • B. 0.5-1 mm short of radiographic apex.
  • C. 0.5-1 mm beyond radiographic apex

The recommended termination point for an RCT with bone resorption is: B. 0.5-1 mm short of the radiographic apex.

Here's why:

A. Radiographic apex:

Terminating exactly at the apex might not adequately clean and disinfect the entire canal, especially in cases with resorption where the anatomical landmarks might be obscured. This could lead to incomplete treatment and potential failure.

B. 0.5-1 mm short of the apex:

This is the ideal balance between thorough cleaning and minimizing the risk of complications. It allows you to reach the dentin-cementum junction while avoiding overinstrumentation, perforation, and apical extrusion of debris.

C. 0.5-1 mm beyond the apex:

Going beyond the apex significantly increases the risk of:
  • Overinstrumentation: This can damage the surrounding bone and potentially lead to fractures or cysts.
  • Perforation: Pushing beyond the apical foramen can create a hole through the root tip, potentially requiring surgical intervention.
  • Apical extrusion of debris: Pushing infected material beyond the apex can worsen inflammation and compromise treatment success.

Therefore, while reaching the dentin-cementum junction is crucial, stopping 0.5-1 mm short of the radiographic apex offers the best balance between effective cleaning and avoiding complications in teeth with bone resorption.

Remember, this is a general recommendation, and the specific termination point may vary depending on the individual case's anatomy, radiographic findings, and other factors. Always consult with an experienced endodontist to determine the optimal approach for your situation.