Morphotypes of the apical constriction of maxillary molars: a micro-computed tomographic evaluation

Chang, Jeffrey Wen-Wei; Kuzhanchinathan, Manigandan; Samaranayake, LP; NandhaKumar, Chellapandian; Adhityavasun, Pazhamalai; Diji, Johny; PradeepKumar, Angambakkam Rajasekharan

doi:10.5395/rde.2022.47.e19

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Endodontic therapy is more challenging for practitioners since root canal structural patterns differ by ethnicity [ [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] ]. The effective management of periapical infections is crucial for the successful outcome of endodontic therapy.…”

Section: Introductionmentioning

confidence: 99%

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

Madfa,

Almansour,

Al-Zubaidi

et al. 2023

Heliyon

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Section: Introductionmentioning

confidence: 99%

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

Madfa,

Almansour,

Al-Zubaidi

et al. 2023

Heliyon

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“…The process of normalization was examined in prior investigations undertaken by Vanni et al [ 21 ] and Sharma et al [ 18 ]. Since the apical constriction denotes the boundary between periodontal and pulp tissue, it is the optimal location to terminate root canal instrumentation and obturation [ 22 , 23 ]. It was recommended that the canal preparation stop 1 mm before reaching the radiographic apex and apical constriction, which is the designated endpoint for the canal preparation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Coronal Flaring on Initial Apical File Size Estimation in Curved Canals Using Three Distinct Rotary Instruments: A Comparative In Vitro Study

Varatharajan,

Rahman Thazhathveedan,

Salman Kuttikkodan

et al. 2024

Cureus

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Background and objectives: The initial size of a root canal is established by progressively introducing K-files according to the increase in the International Organization for Standardization (ISO) size in the apical region. The initial file-fit sensation is caused by coronal interferences rather than always occurring at the apex, as is commonly believed. Flaring the canal at its earliest stages enables the practitioner to accurately assess the size of the canal approaching the apex. This enables more informed judgments on the selection of the master apical file required for shaping and cleaning the apex. The aim of this in vitro study is to examine the impact of cervical flaring on the first estimation of apical file size using three distinct rotary instruments. Materials and methods: Sixty-four extracted permanent maxillary first molars with a curvature of between 10⁰ and 20⁰ were chosen. Conventional access openings were made, and the precise length of the canal was determined, leaving it 1 mm short of the apex. The apical fit was deemed to have materialized when the largest file successfully reached the apex, and further progression beyond that depth was unattainable. An initial file that exhibited tactile resistance both before and following expansion at the designated working length (WL) was observed. The initial file that elicited a sensation of being securely attached was affixed using methacrylate into the root canal. A diamond sectioning disc was used to horizontally cut the apical 0.5 mm of the mesiobuccal root. This was done to expose the canal and the instrument at the WL. The uppermost portions were observed using a 3D optical profilometer, and digital photographs were captured for each sample. Results: The occurrence of coronal interferences and the choice of instruments for flaring had a notable impact on the estimation of the initial apical file (IAF) size. The file size frequency was augmented following flaring using various rotary instruments, namely ProTaper, HyFlex CM, and Endoflare. Group 1, which did not undergo preflaring, exhibited the highest disparity of 257.3 ± 54.4. The variation was substantially different (p<0.01) from all the groups that underwent flaring. The use of HyFlex CM (group 3) for preflaring resulted in the smallest average difference (124.4 ± 29.6) between the maximum diameter of the canal at the apex and the diameter of the initial file used. Endoflare (group 4) exhibited the second lowest mean disparity (178.7 ± 46) between the maximum width of the apical root canal and the diameter of the IAF, with the ProTaper group (211 ± 43.5) following closely behind. Nevertheless, there was no statistically significant discrepancy observed in the average differences between groups 2 and 4 (ProTaper and Endoflare groups, respectively). Conclusion: Coronal preflaring significantly contributes to minimizing the variation between the IAF and the diameter of the apical canal. Prior coronal expansion using rotary files enables a more precise ident...

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“…Nevertheless, it is generally accepted that root canal treatment must be carried out within the limits of the root canal [ 6 ], especially because the distance between AF and AC may vary from one tooth to another. In a small proportion, AF may coincide to AC [ 3 ] for some root canals, but the mean distance between AF and AC in the majority of the cases was reported to be of only 0.2 mm by El Ayouti et al [ 3 ], while other studies reported a mean of 0.5–0.6 mm between the two ending marks of root canals [ 7 ]. The extrusion of medication or filling materials, as well as instrumentation beyond the apical terminus, damages the periapical tissues, leading to a delay in tissue healing or causing treatment failure [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations

et al. 2023

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Background and Objectives: The aim of this study was to compare the accuracy of three types of electronic apex locators (EALs) when two different concentrations of NaOCl irrigation solutions are used by two operators. Materials and Methods: After creating the access cavities for 20 single rooted extracted teeth, the actual canal length (ACL) of each canal was determined visually using a #10 file and magnification. The teeth were subsequently inserted in plastic molds filled with alginate. The electronic measurement of root canal length (EWL) was performed using three different electronic apex locators: Root ZX II, Apex ID, and Dual Pex. Two independent operators, an endodontic specialist with 20 years practice and an undergraduate student in the final year of study, performed the irrigation procedures with two different concentrations of NaOCl (2% and 5.25%), and then measured the EWL using each of the EALs. The accuracy of all EALs, was determined in each case by subtracting the EWL from the ACL. Statistical analyses were performed using one-way ANOVA test. Results: In the presence of 2% NaOCl solution, for a margin error of ±0.5 mm, Root ZX II, Apex ID, and Dual Pex presented an accuracy of 90%, 80%, and 85% respectively. The increase in the concentration of the irrigation solution affected the accuracy of Root ZX II and Apex ID for both operators, diminishing it to 75% for the same margin error, but improved Dual Pex’s accuracy to 100%. Conclusions: The best accuracy in working length determination was obtained by Root ZX II for 2% NaOCl solution and by Dual Pex for 5.25% NaOCl solution with no significant statistical difference when compared.

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Morphotypes of the apical constriction of maxillary molars: a micro-computed tomographic evaluation

Cited by 3 publications

References 22 publications

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

Effect of Coronal Flaring on Initial Apical File Size Estimation in Curved Canals Using Three Distinct Rotary Instruments: A Comparative In Vitro Study

In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations

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