Abstract
To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy. The canals were divided in two groups depending on the presence or absence of periapical radiolucency. After preflaring of the root canal the size of the root canal terminus (apical canal dimension) was gauged with hand-held Light Speed LS1 files inserted at the estimated working length and established with the use of an electronic apex locator. The dimension recorded in the computer database was represented by the largest instrument able to reach the electronically established working length. The differences between the treatment groups were assessed using the Mann-Whitney U test and the significance level was set at P < 0.05. Teeth with lesions had a significantly greater diameter in the apical region than teeth without lesions (P < 0.001). The dimension of the apical portion of the root canal is larger in the case of periapical radiolucency. This involves verifying this parameter in order to use the correct sized instruments and to obtain an efficient cutting action at the apical level.
Highlights
The significance of cleaning and shaping root canals properly for successful endodontic therapy is well established
To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy
There are different opinions about the width to which the apical portion of root canals should be prepared in endodontics, accurate measurement of the apical dimension should provide a better basis for the debridement of the root canal space especially in cases of infected root canals [28]
Summary
The significance of cleaning and shaping root canals properly for successful endodontic therapy is well established. To achieve the desirable shape it is essential that the cross-sectional diameter of the finished canal preparation gradually decreases towards the root canal terminus [2, 3] This geometrical shape is necessary to ensure a correct action of the endodontic instruments, obtain the most effective cutting action against the canal walls and, at the same time, determine the conditions for a correct fit of the tapered master cone of gutta-percha. A complicating factor, not invariably recognized, is that in cases with apical periodontitis the apical portion of the root may have been resorbed to an extent that the apical canal dimension is enlarged These factors may reduce the potential to achieve effective shaping and cleaning for optimal control of root canal infection. Studies emphasize the need to instrument large sizes in order to attain this objective: increasing the size of the apical instrumentation significantly reduces the number of remaining bacteria [8, 12, 17,18,19,20,21,22,23,24,25]
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