Micro-Computed Tomographic Analysis of Apical Foramen Enlargement of Mature Teeth: A Cadaveric Study

2020 • Volume 14 • Issue 2

Cristina Bucchi; Josep Maria de Anta & María Cristina Manzanares-Céspedes



Revitalization procedures have been extensively studied during the last decade and offers several advantages over root canal treatment, such as the recovery of the natural immune system. Mature teeth have a small apical foramen diameter (AFD), which could impair the ingrowth of tissue into the root canal. We analysed three methods for apical foramen enlargement by instrumentation in in situ human teeth and evaluated the damage over hard tissues produced by the techniques. Tooth length (TL), defined as the length from the most coronal part of the crown to the point at which the file abandons the root canal, was calculated. Forty-four in situ teeth were randomized: Group I: instrumentation 0.5 mm coronal to TL; Group II: at TL level; Group III: 0.5 mm beyond TL. Teeth were instrumented up to K-file #80. The mandibles were scanned in a micro-CT device before and after treatment. Group I: Only 20 % of teeth presented an enlarged AFD, with augmentation of 0.09 mm. No damage to hard tissues was observed. Group II: 71.4 % of the teeth presented an enlarged AFD with augmentation of 0.42 mm. 35.7 % presented damage to periapical tissues. Group III: 86.7 % presented an enlarged AFD with augmentation of 0.43 mm. 46.7 % presented damage to periapical tissues. All groups presented similar prevalence of teeth with dentine thickness less than 1mm. All mandibular incisors presented areas of thickness less than 1mm. Instrumentation 0.5 mm beyond TL is the most effective technique.

KEY WORDS: regenerative endodontics; revitalization; mature teeth; apical foramen enlargement.


How to cite this article

BUCCHI, C.; DE ANTA, J. M. & MANZANARES-CÉSPEDES, M. C. Micro-computed tomographic analysis of apical foramen enlargement of mature teeth: a cadaveric study. Int. J. Odontostomat., 14(2):177-182, 2020


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