Endodontic Challenges: Understanding the Effects of Root Canal Treatment on Dentinal Cracks - A Narrative Review

Abstract

Background: Root canal treatment (RCT) is essential for managing infected or damaged dental pulp. However, the procedures involved may compromise the integrity of the tooth structure, potentially leading to the formation of cracks and fractures. This narrative review aims to explore the relationship between various stages of RCT and the occurrence of dentinal cracks, highlighting the implications for tooth preservation. Methods and Results: A thorough literature search was conducted using several databases, including PubMed, Scopus, and Google Scholar. The inclusion criteria involved studies published in the last twenty years, peer-reviewed articles, and clinical and laboratory studies. Studies were selected based on relevance to the impact of RCT on tooth integrity, particularly concerning cracks and fractures. Emphasis was placed on the relationship between endodontic procedures and the occurrence of cracks. Findings indicate that each stage of RCT can contribute to dentinal microcracks and cracks. Techniques such as minimally invasive access cavity preparation and the use of specific instrumentation (e.g., reciprocating systems) showed reduced incidence of cracks compared to traditional methods. Additionally, the type of obturation technique employed significantly influenced the development of dentinal defects. Conclusion: Understanding the relationship between RCT procedures and the integrity of tooth structure is crucial for improving clinical outcomes. Future research should focus on refining endodontic techniques and materials to minimize crack formation, ultimately enhancing treatment success and patient satisfaction.

Keywords

• cracked tooth
• vertical root fracture
• endodontic treatment
• dentinal microcracks