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The formation of dentinal microscopic on the external or internal surface of the tooth can become new bacterial colonization and MD, which can lead to successful endodontic treatment. In addition, these possible dental teeth, when present, can evolve into a vertical root fracture (VRF), which compromises the tooth's permanence in the oral environment (DE-DEUS et al., 2016). However, to achieve an effective cleaning of the SCR, additional care is necessary, especially if necrotic and bacterial debris are present in their irregularities, as well as if there is the presence of residual biofilm after instrumentation. These factors were of paramount importance in the recommendation of intensional foraminal enlargement (AFI), which, in turn, consists of going beyond the modeling instrument beyond the apical foramen during endodontic treatment (SUSILA; MINU, 2019). Over-instrumentation is commonly performed from 1 to 3 mm beyond the foramen and has become widely applied in cases of teeth with periapical lesions, since in these cases the mechanical chemical preparation must be intensified due to the high bacterial load (DE GOD et al., 2016). Although some endodontists may have concerns regarding postoperative pain within this approach, previous studies have shown that foraminal enlargement is not responsible for significantly increasing postoperative pain rates (CRUZ et al., 2016; YAYLALI et al., 2017). In recent years, nickel-titanium (NiTi) instruments have become indispensable items for endodontic treatment. These instruments have presented better performance and safety elements to make root canal preparation more efficient and, thus, obtain higher success rates in endodontic treatment (CAPAR et al., 2016). However, it is still unclear in the literature the real effect of instrumentation beyond the apex on the morphology of the foramen, as well as on the formation of dentin microcracks, since even the microtomography methodologies present divergent results regarding the evaluation of microcrack formation. dentinal changes and foraminal alterations (DEDeus et al., 2014, DEDeus et al., 2015, DEDeus et al., 2016, CEYHANLI et al., 2016, JAMLEH et al., 2016). Considering these points and the fact that the number of studies that address this topic at the moment is undoubtedly limited, this study aims at a scoping review on the morphological changes of the apical foramen and formation of dentinal microcracks after intentional foraminal enlargement with instruments of heat-treated mechanized NiTi and in their different kinematics. |
