title: Are referred inaccessible human primary molar teeth really inaccessible?
abstract: Despite a body of compelling evidence pertaining to the root canal accessibility of primary teeth, the number of referrals for inaccessibility of primary molars is considerable. The aim of the present study was to evaluate the prevalence of true and false primary molar inaccessibility among subjects who had been referred by general and pediatric dentists. We examined 199 primary molars in 156 patients (87 males, 69 females) aged 3-7 years who were referred by 215 general and 35 pediatric dentists. Problems related to inaccessibility were recorded for each tooth and any individual canal. One hundred seventy-five inaccessible teeth (87.9%) were successfully rehabilitated to accessible status (P < 0.001). The most frequent cause of inaccessibility was an inappropriate access cavity (42.3%), followed by difficult canals (32.6%) and orifice calcification (25.2%). The tooth most frequently reported as inaccessible was the maxillary first molar (40.2%), and that least frequently reported was the mandibular second molar (11.6%). The distobuccal canal of the maxillary first molar and the mesiolingual canal of the mandibular first molar were the most commonly inaccessible canals (P < 0.001). Only 1 out of 8 teeth referred as inaccessible was truly inaccessible. It seems that root canal inaccessibility is mostly attributable to lack of expertise among individual practitioners.
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran. aslaminabadi@gmail.com
authors.forename: Naser Asl
authors.initials: NA
authors.lastname: Aminabadi
authors.forename: Alireza
authors.initials: A
authors.lastname: Sighari Deljavan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Samiei
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jamali
mesh_terms: D000766:Anesthesia, Dental; D002648:Child; D002675:Child, Preschool; D003442:Crowns; D003731:Dental Caries / Q000628:therapy; D003737:Dental Cavity Preparation / Q000379:methods; D003784:Dental Pulp Calcification / Q000175:diagnosis / Q000473:pathology; D003786:Dental Pulp Cavity / Q000473:pathology*; D005260:Female; D005792:General Practice, Dental; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008963:Molar / Q000473:pathology*; D009407:Nerve Block; D010377:Pediatric Dentistry; D011670:Pulpectomy / Q000379:methods*; D016300:Radiography, Bitewing; D012017:Referral and Consultation; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D016733:Rubber Dams; D007507:Therapeutic Irrigation / Q000379:methods; D014094:Tooth, Deciduous / Q000473:pathology*; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
chemical_list: D005899:Glass Ionomer Cements; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement