Background/Objectives: the present narrative review article endeavors to expose the updated principles of improved clinical approach dedicated to root canal isthmuses cleaning. Methods: the recent literature analysis is focused on both conventional comprehensive and innovative endodontic procedures aiming to come up to a better removal of tissue remnants and biofilms harbored in morphologic tooth niches of the endodontic system such as root canal isthmuses. Preoperative imagistic investigations are discussed related to their value in disclosing these morphologies. Results: findings emphasize the enhanced contribution of ultrasonic and laser activated antimicrobial irrigation accompanying the chemomechanical treatment of the infected root canals. Conclusion: given the impossibility of using in patients the microCT as gold standard imagistic diagnose, in clinical setting the current endodontic treatment of mesial roots in first permanent lower molars as well as of mesiobuccal roots in first permanent upper molars should consider the presence of isthmuses and the appropriate therapeutic strategy.
Earar et al. (Wed,) studied this question.