Endodontic treatment in geriatric patients - expectations, challenges, obstacles, results

Objective: With increasing life expectancy, the demand for preserving natural dentition in older adults has risen. Endodontic treatment in geriatric patients presents unique challenges due to age –related changes in dental and systemic health. The objective of these case reports is to highlight the unique clinical challenges and considerations countered in the geriatric population.
Case Reports: Case 1: A 71- year – old, medically compromised male patient presented with exacerbated chronic periapical lesion and a fractured file in the root canal of a mandibular canine. The broken file was successfully retrieved using a dental operating microscope and ultrasound, allowing proper instrumentation, disinfection and sealing of the canals. Case2: A70-year-old female patient with calcified canals in her maxillary molar was managed using advanced endodontic techniques, including magnification, ultrasound, instrumentation and chelating agents, achieving predictable outcomes despite the calcifications. Case3: A 76-year-old female required retreatment of a maxillary premolar with a previous metal post and significant calcification in the middle radicular third. The crown and post were removed, and the calcified canals were successfully negotiated, allowing healing of the persisting periapical lesion.
Conclusions: Advanced endodontic treatment with correct instrumentation, magnification, irrigation and biocompatibility of materials used in endodontics play significant role in overcoming obstacles such as calcified canals, reduced healing capacity related to coexisting systemic conditions.
Keywords: Endodontic treatment, Geriatric patients, Calcified canals, Magnification, Instrumentation