Root Canal Debridement and Disinfection in Minimally Invasive Preparation

As many other infections in the oral cavity, endodontic disease has a bacterial component that involves the presence of a mixed infection including facultative and anaerobic bacteria. These bacterial aggregations are able to attach to the root canal dentinal walls perpetuating an inflammatory condition known as apical periodontitis. Classically, hand and rotary instruments in conjunction with antimicrobial agents have been used to manage the infection at the apical root third. Whereas the removal of tooth structure is necessary to achieve biological goals, the uncontrolled dentin removal can present some side effects including the weakening of the tooth structure. One of the goals of minimally invasive endodontic procedures is to minimally modify the tooth architecture in order to avoid structural failures that may end in a tooth extraction; in this context, the main challenge is to improve the delivery of antimicrobials to the apical third modifying the technical endodontic triad process that has guided the contemporary practice of root canal treatment. Most specifically, decreasing the size of the access and the size of the preparation.