The Role of Apical Size Determination and Enlargement in the Reduction of Intracanal Bacteria
André K. Mickel, DDS, MSD, Sami Chogle, BDS, DDS, MSD, Justin Liddle, Kirk Huffaker, DDS, Jefferson J. Jones, DDS
published online 20 October 2006. Corrected Proof
Abstract : Journal of Endodontics
The master apical preparation size in root canal therapy is debatable despite considerable research. The present study compared file sizes that bind at the apex before and during crown-down preparation and assessed the relation between apical size and extent of intracanal bacterial load. There were 100 single-rooted teeth biomechanically prepared after inoculation with Enterococcus faecalis. Canals were preflared, and apical size was ascertained by the first file to bind (FAB) at the working length (WL). During crown-down preparation, the first crown-down file to reach the apex during instrumentation was noted (CDF). Teeth were then divided into three master apical file size groups of CDF + 1, CDF + 2, and CDF + 3. Positive controls were inoculated postinstrumentation, whereas negative controls were instrumented without inoculation (n = 5). The samples were then cultured for intracanal bacterial counts. Fifteen samples and four controls were analyzed under SEM. The data were analyzed using ANOVA, Student's t-test, and χ2 tests. The CDF was demonstrated to be an average of four file sizes larger than the FAB (p < title="Search for this keyword within this periodical." href="http://www.jendodon.com/search/quick?search_area=journal&search_text1=Apex">Apex size, apical binding, apical enlargement, apical size, bacteria, canal culturing, crown down, dentinal tubules, Enterococcus faecalis, intracanal, master apical file, SEM, scanning electron microscopy
Case School of Dental Medicine, Graduate Endodontics, Cleveland, Ohio
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