Master of Science in Dentistry
Garry L. Myers, DDS, FACD, FICD
Objective: Previous authors have attempted to identify the ideal apical preparation size needed to achieve endodontic treatment objectives. Despite vast literature on the topic, there exists a lack of consensus on ideal apical enlargement, with few studies discussing the effect of apical prep enlargement on clinical outcomes. The purpose of this retrospective study was to evaluate the effect of final apical preparation size on endodontic outcomes in maxillary and mandibular molars treated in both a graduate endodontic clinic and a private practice.
Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic as well as a private practice. A total of 200 cases were included from each location. Eligible cases included maxillary and mandibular first and second molars that were treated by primary root canal therapy and had at least an 11 month recall available. Healing outcomes by individual root were evaluated radiographically by three board certified endodontists. Patient charts were reviewed by the author for each case, and the ending apical prep size among other variables were recorded. Statistical analysis was performed to assess the correlation of apical prep size with radiographic healing outcomes.
Results: When accounting for each individual root, there were no statistically significant differences in healing outcomes between any of the apical preparation sizes reviewed. While not statistically significant, there was a trend noted wherein the not healing group was prepared to larger apical preparation sizes than the healing group.
Conclusion: While previous studies have shown the debridement and disinfection benefits of larger apical preparation sizes, the present study found no direct correlation between apical preparation size and radiographic healing outcomes.
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Available for download on Tuesday, April 30, 2024