Abstract
The aim of this study was to evaluate apical transportation and apical root canal sealing after root canal filling in human teeth prepared with MTwo® Rotary System with and without apical foramen enlargement. Twenty mandibular premolars were divided into two groups (n=10). Group 1 had root canals prepared 1mm beyond the apical foramen. Group 2 had root canals prepared 1mm below the root canal length. After chemo-mechanical preparation, samples were submitted to scanning electronic microscopy. Apical foramen images had 75x magnification at standardized positions, allowing measurements from the apical foramen area before and after root canal preparation, and after root canal filling. Apical foramen shape and apical transportation, as well as its level of circumferential filling after root canal preparation were accessed using the Image Subtraction System. Scanning electronic microscopy analysis demonstrated that samples of Group 1 showed larger foraminal diameter than samples of Group 2 (p<0.05). Apical foramen transportation was statistically different between Groups 1 and 2 (p=0.0108). Furthermore, the apical foramen sealing also differed statistically between groups 1 and 2 (p=0.0007) and 100% of samples of Group 1 showed apical root canal sealing. Apical root canal sealing was more effective when the root canal was prepared with apical foramen enlargement, even when the apical transportation was detected.
Highlights
The apical limit of root canal instrumentation and filling is one of the major controversial issues in Endodontics (Negishi et al 2005)
There was no statistically significant difference between groups before root canal preparation (p>0.05), but statistically significant difference was observed between groups after root canal preparation (p
The present study suggests root canal preparation 1mm from the apical foramen, from the moment in which this procedure provides enlargement of the apical foramen, improving the apical sealing and providing better conditions to perform adequate and tridimensional root canal filling
Summary
The apical limit of root canal instrumentation and filling is one of the major controversial issues in Endodontics (Negishi et al 2005). The maintenance of the pulp stump in teeth with vital pulp and the possibility of injury to apical and periapical tissues have supported the principle of the working length to remain up to 1-2 mm from the radiographic apex (Ricucci and Langeland 1998; Holland et al 2005). It is known that this area has physical space enough to host significant amount of microorganisms. The apical third of root canals associated to the periapical lesion, including cemental canal, shows high infection percentage, with predominance of anaerobic bacteria (Brandão et al 2019)
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