The effectiveness of increased apical enlargement in reducing intracanal bacteria

Steven J. Card, Asgeir Sigurdsson, Dag Ørstavik, Martin Trope

Research output: Contribution to journalArticle

Abstract

It has been suggested that the apical portion of a root canal is not adequately disinfected by typical instrumentation regimens. The purpose of this study was to determine whether instrumentation to sizes larger than typically used would more effectively remove culturable bacteria from the canal. Forty patients with clinical and radiographic evidence of apical periodontitis were recruited from the endodontic clinic. Mandibular cuspids (n = 2), bicuspids (n = 11), and molars (mesial roots) (n = 27) were selected for the study. Bacterial sampling was performed upon access and after each of two consecutive instrumentations. The first instrumentation utilized 1% NaOCl and 0.04 taper ProFile® rotary files. The cuspid and bicuspid canals were instrumented to a #8 size and the molar canals to a #7 size. The second instrumentation utilized Light- Speed® files and 1% NaOCl irrigation for further enlargement of the apical third. Typically, molars were instrumented to size 60 and cuspid/bicuspid canals to size 80. Our findings show that 100% of the cuspid/bicuspid canals and 81.5% of the molar canals were rendered bacteria-free after the first instrumentation sizes. The molar results improved to 89% after the second instrumentation. Of the (59.3%) molar mesial canals without a clinically detectable communication, 93% were rendered bacteria-free with the first instrumentation. Using a Wilcoxon rank sum test, statistically significant differences (p < 0.0001) were found between the initial sample and the samples after the first and second instrumentations. The differences between the samples that followed the two instrumentation regimens were not significant (p = 0.0617). It is concluded that simple root canal systems (without multiple canal communications) may be rendered bacteria-free when preparation of this type is utilized.

Original languageEnglish (US)
Pages (from-to)779-783
Number of pages5
JournalJournal of Endodontics
Volume28
Issue number11
DOIs
StatePublished - Nov 2002

Fingerprint

Cuspid
Bicuspid
Bacteria
Dental Pulp Cavity
Nonparametric Statistics
Communication
Periapical Periodontitis
Endodontics
Light

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

The effectiveness of increased apical enlargement in reducing intracanal bacteria. / Card, Steven J.; Sigurdsson, Asgeir; Ørstavik, Dag; Trope, Martin.

In: Journal of Endodontics, Vol. 28, No. 11, 11.2002, p. 779-783.

Research output: Contribution to journalArticle

Card, Steven J. ; Sigurdsson, Asgeir ; Ørstavik, Dag ; Trope, Martin. / The effectiveness of increased apical enlargement in reducing intracanal bacteria. In: Journal of Endodontics. 2002 ; Vol. 28, No. 11. pp. 779-783.
@article{57bde402fd324252a22e6138a28af460,
title = "The effectiveness of increased apical enlargement in reducing intracanal bacteria",
abstract = "It has been suggested that the apical portion of a root canal is not adequately disinfected by typical instrumentation regimens. The purpose of this study was to determine whether instrumentation to sizes larger than typically used would more effectively remove culturable bacteria from the canal. Forty patients with clinical and radiographic evidence of apical periodontitis were recruited from the endodontic clinic. Mandibular cuspids (n = 2), bicuspids (n = 11), and molars (mesial roots) (n = 27) were selected for the study. Bacterial sampling was performed upon access and after each of two consecutive instrumentations. The first instrumentation utilized 1{\%} NaOCl and 0.04 taper ProFile{\circledR} rotary files. The cuspid and bicuspid canals were instrumented to a #8 size and the molar canals to a #7 size. The second instrumentation utilized Light- Speed{\circledR} files and 1{\%} NaOCl irrigation for further enlargement of the apical third. Typically, molars were instrumented to size 60 and cuspid/bicuspid canals to size 80. Our findings show that 100{\%} of the cuspid/bicuspid canals and 81.5{\%} of the molar canals were rendered bacteria-free after the first instrumentation sizes. The molar results improved to 89{\%} after the second instrumentation. Of the (59.3{\%}) molar mesial canals without a clinically detectable communication, 93{\%} were rendered bacteria-free with the first instrumentation. Using a Wilcoxon rank sum test, statistically significant differences (p < 0.0001) were found between the initial sample and the samples after the first and second instrumentations. The differences between the samples that followed the two instrumentation regimens were not significant (p = 0.0617). It is concluded that simple root canal systems (without multiple canal communications) may be rendered bacteria-free when preparation of this type is utilized.",
author = "Card, {Steven J.} and Asgeir Sigurdsson and Dag {\O}rstavik and Martin Trope",
year = "2002",
month = "11",
doi = "10.1097/00004770-200211000-00008",
language = "English (US)",
volume = "28",
pages = "779--783",
journal = "Journal of Endodontics",
issn = "0099-2399",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - The effectiveness of increased apical enlargement in reducing intracanal bacteria

AU - Card, Steven J.

AU - Sigurdsson, Asgeir

AU - Ørstavik, Dag

AU - Trope, Martin

PY - 2002/11

Y1 - 2002/11

N2 - It has been suggested that the apical portion of a root canal is not adequately disinfected by typical instrumentation regimens. The purpose of this study was to determine whether instrumentation to sizes larger than typically used would more effectively remove culturable bacteria from the canal. Forty patients with clinical and radiographic evidence of apical periodontitis were recruited from the endodontic clinic. Mandibular cuspids (n = 2), bicuspids (n = 11), and molars (mesial roots) (n = 27) were selected for the study. Bacterial sampling was performed upon access and after each of two consecutive instrumentations. The first instrumentation utilized 1% NaOCl and 0.04 taper ProFile® rotary files. The cuspid and bicuspid canals were instrumented to a #8 size and the molar canals to a #7 size. The second instrumentation utilized Light- Speed® files and 1% NaOCl irrigation for further enlargement of the apical third. Typically, molars were instrumented to size 60 and cuspid/bicuspid canals to size 80. Our findings show that 100% of the cuspid/bicuspid canals and 81.5% of the molar canals were rendered bacteria-free after the first instrumentation sizes. The molar results improved to 89% after the second instrumentation. Of the (59.3%) molar mesial canals without a clinically detectable communication, 93% were rendered bacteria-free with the first instrumentation. Using a Wilcoxon rank sum test, statistically significant differences (p < 0.0001) were found between the initial sample and the samples after the first and second instrumentations. The differences between the samples that followed the two instrumentation regimens were not significant (p = 0.0617). It is concluded that simple root canal systems (without multiple canal communications) may be rendered bacteria-free when preparation of this type is utilized.

AB - It has been suggested that the apical portion of a root canal is not adequately disinfected by typical instrumentation regimens. The purpose of this study was to determine whether instrumentation to sizes larger than typically used would more effectively remove culturable bacteria from the canal. Forty patients with clinical and radiographic evidence of apical periodontitis were recruited from the endodontic clinic. Mandibular cuspids (n = 2), bicuspids (n = 11), and molars (mesial roots) (n = 27) were selected for the study. Bacterial sampling was performed upon access and after each of two consecutive instrumentations. The first instrumentation utilized 1% NaOCl and 0.04 taper ProFile® rotary files. The cuspid and bicuspid canals were instrumented to a #8 size and the molar canals to a #7 size. The second instrumentation utilized Light- Speed® files and 1% NaOCl irrigation for further enlargement of the apical third. Typically, molars were instrumented to size 60 and cuspid/bicuspid canals to size 80. Our findings show that 100% of the cuspid/bicuspid canals and 81.5% of the molar canals were rendered bacteria-free after the first instrumentation sizes. The molar results improved to 89% after the second instrumentation. Of the (59.3%) molar mesial canals without a clinically detectable communication, 93% were rendered bacteria-free with the first instrumentation. Using a Wilcoxon rank sum test, statistically significant differences (p < 0.0001) were found between the initial sample and the samples after the first and second instrumentations. The differences between the samples that followed the two instrumentation regimens were not significant (p = 0.0617). It is concluded that simple root canal systems (without multiple canal communications) may be rendered bacteria-free when preparation of this type is utilized.

UR - http://www.scopus.com/inward/record.url?scp=0036836277&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036836277&partnerID=8YFLogxK

U2 - 10.1097/00004770-200211000-00008

DO - 10.1097/00004770-200211000-00008

M3 - Article

VL - 28

SP - 779

EP - 783

JO - Journal of Endodontics

JF - Journal of Endodontics

SN - 0099-2399

IS - 11

ER -