Manual versus reciprocating endodontic debridement of equine cheek teeth: Micro-computed tomography findings.
Authors: Korsós Szabolcs A, Kibleur Pierre, Josipovic Iván, Boone Matthieu, Vlaminck Lieven
Journal: Equine veterinary journal
Summary
# Editorial Summary Orthograde endodontic treatment in equine cheek teeth requires effective pulp canal debridement, yet little evidence compares the clinical efficacy of different instrumentation techniques. Researchers used micro-computed tomography to analyse 22 extracted healthy cheek teeth randomly assigned to manual Ni-Ti H-file or reciprocating Ni-Ti K-file debridement, measuring changes in pulp volume, material loss, percentage of instrumented canal wall at three levels, and instrumentation time. Reciprocating files achieved significantly better instrumentation coverage at the apical third (12% versus 3% of canal wall surface), though both methods left substantial portions of the pulp system untouched—particularly intercanal communications, lateral branches, narrow canal corners and pulp horn ramifications. Instrumentation mishaps occurred equally with both techniques, highlighting that neither method provides complete debridement of the equine cheek tooth pulp anatomy. These findings suggest practitioners should view endodontic debridement in equine cheek teeth with realistic expectations: whilst reciprocating files offer modest apical advantages, neither manual nor reciprocating techniques alone achieve comprehensive canal system instrumentation given the anatomical complexity of equine pulp morphology. This has implications for treatment planning, prognosis counselling, and consideration of adjunctive measures such as irrigation or medicament placement to address regions that mechanical instrumentation fails to reach.
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Practical Takeaways
- •Reciprocating instruments offer a modest advantage at the apical third of equine cheek teeth canals, but overall debridement remains challenging with both manual and reciprocating techniques
- •Clinicians should recognize that significant portions of the pulp canal system (intercanal communications, branches, narrow corners) will likely remain uninstrumented regardless of filing technique used
- •Instrumentation mishaps occur with both techniques at similar rates, so careful technique and awareness of canal anatomy are essential during equine endodontic procedures
Key Findings
- •Reciprocating files achieved significantly better instrumentation at apical levels (12% ± 6) compared to manual files (3% ± 3, p < 0.01)
- •Overall debridement efficacy is poor with both techniques, with no significant differences found between methods except at the apical third
- •Instrumentation mishaps were equally distributed between both groups and included intercanal communications, canal branches, and narrow corners remaining uninstrumented
- •Frequently uninstrumented regions included root canal branches, narrow corners of pulp canals, and branches of pulp horns regardless of technique used