Location of the apical foramen and its relationship with foraminal file size

Abstract

Aim: This article analyzed the location of the apical foramen and its relationship with foraminal file size in maxillary central incisors. Methods: Eighty four human maxillary central incisors were used in this study. K-files of progressively increasing diameters were inserted into the root canal until it got snugly fit and the tip was visible at the apical foramen. The files were removed and teeth were crosssectioned 10 mm from the root apex. The files were then reinserted, fixed with a cyanoacrylate-based adhesive, and sectioned at the same level as the root. The root apices were examined using a scanning electron microscope set at 140x magnification, the images were captured digitally and the results were subjected to Chi-square test. Results: It was observed that 63 (75%) of the apical foramen emerged laterally to the root apex and 21 (25%) coincided with the apex. The results presented statistically significant differences ‫ג(‬ 2 =22.1; p=0.00). Conclusions: Lateral emergence of the apical foramen is more common than coincidence of the foramen with the apex in maxillary central incisors. This anatomical characteristic may have influence on determination of the foraminal file size.

Influence of apical foramen lateral opening and file size on cemental canal instrumentation

“…Maxillary central incisors usually have wide canals, requiring the use of large files. On the other hand, analysis of the apical anatomy of these teeth show that the apical foramen frequently emerges laterally to the apex (13)(14)(15)(16).…”

Relationship between files that bind at the apical foramen and foramen openings in maxillary central incisors - a SEM study

“…According to Butler (21), the apical foramen should be instrumented with a file that fits closely the constriction of the canal and be followed by the next two of its type in series and size. However, as in dentinal canal, instrumentation of the cemental canal should not follow rigid pre-established principles, but rather, each clinical situation should be individually examined (22). The results of this study suggest that it would require 4 files of greater size beyond the one that bound to the foramen in order to allow a better relationship between files and apical openings of maxillary central incisors.…”

Incidence of postoperative pain after instrumentation of the cemental canal in teeth with necrotic pulp

“…3 At the end of canal preparation, a file fitted to its diameter cleaned the cemental canal by applying a watch-winding filing motion. 3,4 After instrumentation, the canals were irrigated with 4 mL of sterile saline solution and dried with absorbent paper points. The smear layer was removed by irrigation with 1 mL of 17% EDTA (INODONPorto Alegre, Rio Grande do Sul, Brazil) which was agitated with a Lentulo spiral and remained in the canal for 3 minutes.…”

“…[1][2][3][4][5] However, it is believed that this procedure may cause severe damage to periapical tissues, which would result in postoperative pain. 6,7,8 Postoperative pain is a frequently recurring topic in endodontic literature.…”