In endodontics, root canal preparation is a crucial stage that directly affects the success of disinfection and obturation. Particularly in maxillary molars with frequently curved canals, the risk of procedural errors such as canal transportation is higher. Accurate evaluation of changes in canal shape and dimensions after preparation is therefore essential to achieve optimal endodontic outcomes. Advanced imaging technology such as Cone Beam Computed Tomography (CBCT) provides a more comprehensive three-dimensional (3D) visualization compared to conventional two-dimensional radiography.
Study and Methodology
A study conducted by FKG UGM student Tedi Pramayanto under the supervision of Dr. drg. Wignyo Hadriyanto, M.S., Sp.KG(K) and Dr. drg. Raphael Tri Endra Untara, M.Kes., Sp.KG(K) examined the effect of different single-file system designs and motions on canal transportation in the curved apical third, using CBCT as the evaluation tool. The specimens consisted of mandibular premolars with curved root canals, prepared using two types of single-file designs (parallelogram cross-section with 7% taper and S-shaped cross-section with 8% taper) and two modes of motion (continuous rotation and reciprocating motion). Changes in mesial and distal dentin wall thickness at 3 mm from the apex were measured using CBCT after preparation.
Related Findings
Thirty-two mandibular premolars underwent CBCT imaging to determine sample inclusion criteria, as well as baseline mesial and distal dentin wall thickness at 3 mm from the apex. The specimens were prepared with access cavities and working length determination, then divided into two groups. Post-preparation CBCT images were taken to measure changes in dentin wall thickness. The data were analyzed using two-way ANOVA.
Statistical analysis showed no significant effect of different single-file designs and motions on canal transportation in the curved apical third (p > 0.05). The study concluded that variations in design and motion of single-file systems did not significantly influence canal transportation in the curved apical third based on CBCT assessment.
Findings and Clinical Significance
- Based on CBCT results, no significant differences in canal transportation were found between single-file systems with different designs and motion modes in the curved apical third.
- This indicates that, under the tested conditions, both design (parallelogram vs. S-shape cross-section) and motion (continuous rotation vs. reciprocating) did not cause substantial deformation in the critical apical region.
- Clinically, this suggests that endodontic practitioners may choose single-file systems based on other factors such as efficiency, comfort, cost, or operator experience, without concern that the choice will cause major damage to the curved apical portion—provided that proper technique is used.
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CBCT has proven to be an effective evaluation tool for assessing canal transportation in curved apical regions. This study demonstrates that, in the tested specimens, differences in single-file design and motion did not result in significant transportation. Therefore, system selection can be based on considerations other than the risk of canal shape alteration. In clinical practice, this offers flexibility to choose systems that balance efficiency, safety, and clinical outcomes.
References
MKGI, TEDI PRAMAYANTO, Dr. drg. Wignyo Hadriyanto, M.S, Sp.KG (K), Dr. drg. Raphael Tri Endra Untara, M.Kes., Sp.KG(K), PENGARUH DESAIN DAN GERAKAN SINGLE FILE SYSTEM YANG BERBEDA TERHADAP TRANSPORTASI SALURAN AKAR DI SEPERTIGA APIKAL BENGKOK (KAJIAN CONE BEAM COMPUTED TOMOGRAPHY), https://etd.repository.ugm.ac.id/penelitian/detail/183299
Author: Rizky B. Hendrawan | Photo: Freepik
