MANAGEMENT OF CALCIFIED ROOT CANALS: A NARRATIVE REVIEW

Calcified root canals are among the most demanding challenges in endodontics. Progressive deposition of secondary and tertiary dentin often leads to partial or complete obliteration of the pulp space, complicating access, negotiation, cleaning, and shaping. This review synthesizes current literature on diagnostic modalities and management strategies for calcified canals. Special emphasis is given to advanced imaging (cone beam computed tomography [CBCT], micro-computed tomography [micro-CT12), clinical techniques such as the use of chelating agents with flexible rotary instruments, Buckling Resistance Activation Test (BRAT), and guided endodontics. Modern imaging techniques provide three-dimensional information that surpasses conventional radiography, enabling precise diagnosis and canal mapping. The use of chelating agents, dynamic mechanical negotiation, and guided endodontic approaches has significantly reduced procedural errors such as ledging, perforation, and instrument fracture. Elderly patients benefit particularly from these technology-driven methods, where meticulous planning yields higher success rates. Management of calcified root canals requires a balance between conservative preparation and effective debridement. Incorporating advanced imaging, flexible instruments, and guided techniques improves clinical outcomes and reduces complications. Future perspectives44 emphasize minimally invasive, technology-assisted methods to enhance predictability and long-term success.