Endodontic practice. Basic principles and new technologies.

Endodontic practice today is easier than in the past. In modern dentistry it is possible to perform predictable root canal treatments, in molars, with complex anatomies, in single visit, in most cases by using one single file, without stress for the clinician and the patient and an excellent ratio cost-benefit from a biological and economic point of view. Simplification in root canal shaping is due to the improvement of the nichel-titanium instruments. This revolution, started about twenty years ago, changed the procedures and the protocols of the instrumentation. Recently a new system, in gold alloy, with a revolutionary design, a quadrangular cross-section, a shorter handle, a smaller regressive taper, and a smaller wire have been created to shape with a more conservative approach. Minimally invasive philosophy is involving the medicine in general, but also dentistry, especially endodontics. The goal of this procedures is to preserve healthy dental tissues in order to reduce the structural weakening of the tooth, preventing cracks and fractures and improve the long-term success. The new technologies are mandatory also in solving difficult cases and saving natural teeth. CBCT, Operative Microscope, Bioceramics are essential to manage complex root canal retreatments, but only if the basic principles are respected. A complex root canal retreatment in presence of a large foramen, unusual anatomy, lesion, sinus tract in esthetic area of a young patient is finally described step by step. Experience, common sense, respect of clinical protocols and details are crucial factors to obtain predictable long-term results.