Abstract
Since instrumentation of the apical foramen has been suggested for cleaning and disinfection of the cemental canal, selection of the file size and position of the apical foramen have challenging steps. This study analyzed the influence of apical foramen lateral opening and file size can exert on cemental canal instrumentation. Thirty-four human maxillary central incisors were divided in two groups: Group 1 (n=17), without flaring, and Group 2 (n=17), with flaring with LA Axxess burs. K-files of increasing diameters were progressively inserted into the canal until binding at the apical foramen was achieved and tips were visible and bonded with ethyl cyanoacrylate adhesive. Roots/files set were cross-sectioned 5 mm from the apex. Apices were examined by scanning electron microscopy at ×140 and digital images were captured. Data were analyzed statistically by Student's t test and Fisher's exact test at 5% significance level. SEM micrographs showed that 19 (56%) apical foramina emerged laterally to the root apex, whereas 15 (44%) coincided with it. Significantly more difficulty to reach the apical foramen was noted in Group 2. Results suggest that the larger the foraminal file size, the more difficult the apical foramen instrumentation may be in laterally emerged cemental canals.
Highlights
Loss of 1 mm of the working length increases the failure rate by 14% in teeth with periapical lesions [1]
Apical foramen widening has been demonstrated to be more favorable to the healing of chronic periapical lesions [11] and it should be performed with a file which fits closely the constriction of the canal and be followed by the two of its type in series and size [12]
The aim of the present work was to evaluate the influence of apical foramen lateral opening and file size can exert on cemental canal instrumentation in maxillary central incisors
Summary
Loss of 1 mm of the working length increases the failure rate by 14% in teeth with periapical lesions [1]. A working length more than 2 mm short of the apex represents a 20% reduction in the success rates when periapical lesions are present [2] This may be explained by the presence of microorganisms at the apical portions of the canal and their participation in the development of periapical lesions [3,4]. The success of endodontic treatment depends on the eradication of microorganisms from the root canal system and prevention of reinfection [5] For such purpose, it seems reasonable to suppose that instrumentation should be carried out in the entire length of the canal, including the cementum portion, beyond the apical constriction [6,7,8]. Apical foramen widening has been demonstrated to be more favorable to the healing of chronic periapical lesions [11] and it should be performed with a file which fits closely the constriction of the canal and be followed by the two of its type in series and size [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
