Filtración apical versus filtración coronal

Abstract

La filtración del conducto radicular es la principal causa de los fracasos en endodoncia (19). Esta recontaminación puede producirse a través de dos vías principales de filtración que son los orificios coronal y apical. En la actualidad hay controversia entre diferentes autores sobre cuál es la vía de filtración más importante, si la apical (9, 167) o la coronal (4, 76). Existen diversas técnicas de obturación y materiales de obturación, entre las que puede elegir el clínico en función de cada caso en particular. Un factor importante a la hora de decidir cuál puede ser más eficaz es saber si el comportamiento de una técnica en concreto es igual a nivel apical que coronal...

Recontamination of the root canal is the main cause of failure in endodontics. Such recontamination may occur by two main filtration routes – the coronal and the apical orifices. Owing to its complex anatomy, the apical third seems the most difficult area to be fully sealed. Additionally, the fact that an adequate apical sealing can be performed in the furthest area from the operator but not in the nearest and most accessible one is difficult to stand by. Currently, there is controversy among various authors as to which route is more important – the apical route (Orstavik 1996, Pommel 2001) or the coronal route (Ray 1995, Tronstad 2000). The clinician may choose from the various obturation techniques available according to each specific case. Knowing whether a given technique performs equally at the apical and the coronal level is important to determine which technique is most effective, since the orifice at the coronal level is more easily accessible and looks easier to treat, but its greater perimeter as compared to the diameter of the apical foramen and the absence of a stop to facilitate material condensation against it can offset this easier access...