Micro-computed tomographic evaluation of dentinal microcracks in response to progressive taper enlargement in root canals of maxillary molars.

Abstract

To investigate the development of dentinal microcracks resulting from the progressive enlargement of the buccal canals of maxillary molars with and without the MB2 canal employing instruments with the same tip and four different tapers. Twenty maxillary molars with (n = 10) and without (n = 10) the MB2 canal underwent micro-CT scanning. Their mesiobuccal and distobuccal canals were sequentially enlarged using nickel-titanium instruments with sizes 25/.03, 25/.05, 25/.06 and 25/.08v. Subsequent scans were conducted after each canal enlargement. The preoperative scans were coregistered with their respective datasets, and the cross-sectional images were carefully examined to identify dentinal defects. This process, conducted twice at two-week intervals, involved two examiners. Intra- and inter-examiner calibrations were validated using the Kappa index. The incidence of microcracks was reported as a percentage frequency. The intra- and inter-examiner Kappa values were 0.85 and 0.88, respectively, indicating excellent agreement. Dentinal microcracks were detected in 1206 out of 42 975 cross-sectional image slices (2.8%). Molars with MB2 canal exhibited more slices (4.5%) than teeth without MB2 (0.9%). Every dentinal microcrack observed in the images after root canal preparation was already present in the corresponding images takenbefore root canal preparation. The progressive enlargement of root canals using instruments with different tapers did not induce the formation of new dentinal microcracks in maxillary molars, regardless of the presence of the MB2 canal.