Salvaging the unsalvageable: A review on the management of severely decayed multi-rooted teeth

Abstract

Grossly decayed multirooted teeth often present a significant challenge in endodontic practice due to extensive structural loss, difficulty in isolation, compromised restorability, and the complexity of root canal anatomy. Successful management involves a comprehensive approach, starting from accurate case selection and diagnosis to meticulous treatment planning and execution. Advances in dental materials, magnification, and imaging technologies have significantly improved the prognosis of such cases. This review highlights the key considerations in the endodontic management of grossly decayed multi-rooted teeth, including pre-endodontic build-up, rubber dam isolation techniques, use of CBCT for anatomical assessment, conservative access cavity preparation, canal disinfection strategies, and post-endodontic restoration. Emphasis is placed on the importance of interdisciplinary collaboration when dealing with compromised teeth to ensure long-term functional and aesthetic success.