Ledges – Causes, Prevention, Treatment

Endodontic ledges are among the most common challenges during the mechanical preparation of root canals. They can significantly complicate treatment, increasing the risk of instrument fracture, perforations, missed canals, inadequate or failed disinfection and obturation of the endodontic space, ultimately leading to treatment failure.
This lecture aims to present in detail:

the main causes of ledge formation – anatomical features, access errors, and mistakes during instrumentation;
potential complications following the creation of ledges;
preventive strategies, including modern techniques for isolation and access, as well as recommendations for proper instrument and protocol selection;
methods for identifying and managing already formed ledges in order to restore the canal’s anatomical patency and successfully complete the treatment.
The lecture is intended for general dental practitioners, residents, and specialists in endodontics who wish to enhance their skills and minimize the risk of complications during root canal treatment.

Dr. Dimitar Kosturkov

Dr. Dimitar Kosturkov graduated with honors from the Faculty of Dental Medicine in Sofia in 2014. In 2019, he obtained a PhD degree, and in 2020, he obtained a specialty in operative dentistry and endodontics. He is currently chief assistant professor at the Faculty of Dental Medicine – Sofia, in the Department of Conservative Dentistry. He practices at Uzunov Dental Clinic in Sofia, focusing on endodontics and direct restorations. He is author of numerous scientific articles on endodontics, caries treatment, dental diagnostics, microscopic and digital dentistry. Dr. Kosturkov is an international lecturer in endodontics for Kerr Endodontics, and in endodontics and restorative dentistry for Carl Zeiss. He is also a lecturer at Updent Training Center.