Anatomical assessment of endodontic debridement challenges in severely diseased equine cheek teeth.

Abstract

BACKGROUND: There is a lack of knowledge on orthograde endodontic techniques in horses and endodontic case selection is mostly empirical currently. OBJECTIVES: To explore the efficacy of endodontic debridement in severely diseased cheek teeth that are currently deemed unsuitable for endodontic treatment, find where debris is left behind, compare intercanal communications with those described in healthy cheek teeth, explore the effects of endodontic repair mechanisms on endodontic debridement and to investigate the presence of accessory canals and apical deltas in infected parts of the pulp system. STUDY DESIGN: Ex vivo experimental study. METHODS: Nine severely infected, extracted, equine cheek teeth underwent a single stage, ex vivo orthograde endodontic treatment by one clinician. Micro computed tomography scans (μCT) were taken both before and after treatment and all samples were sectioned at 6 levels following treatment. All sections were evaluated through a stereo microscope for the presence of residual debris. Intercanal communications were evaluated based on μCT imaging. RESULTS: Varying amounts of residual contamination were present in eight of nine teeth in both physiological complexities of the root canal as well as inside altered canal morphology created by reparative dentine. No apical deltas were found in any of the infected canals of the samples. Intercanal communications differed in seven of nine samples from those described in healthy cheek teeth. MAIN LIMITATIONS: Limited sample size, ex vivo debridement, the use of severely diseased cheek teeth currently deemed unsuitable for endodontic treatment. CONCLUSIONS: A single stage endodontic protocol was unable to completely debride the endodontic cavity of severely infected equine cheek teeth. Literature on the anatomy of healthy cheek teeth was not accurate in predicting communications between pulp canals in infected cheek teeth. Apical deltas are likely not a cause of concern during equine endodontic procedures.