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Change in Working Length at Different Stages of Instrumentation as a Function of Canal Curvature

The aim of this study was to determine the change in working length (∆WL) before and after coronal flaring and after complete rotary instrumentation as a function of canal curvature. One mesiobuccal or mesiolingual canal from each of 43 extracted molars had coronal standardization and access performed. Once the access was completed, canal preparation was accomplished using Gates Glidden drills for coronal flaring and EndoSequence files for rotary instrumentation. WLs were obtained at 3 time points: pre-instrumentation (unflared), mid-instrumentation (flared) and post-instrumentation (concluded). Measurements were made via direct visualization (DV) and the CanalPro apex locator (EM) in triplicate by a single operator with blinding across the time points. Root curvature was measured using Schneider’s technique. The change in working length was assessed using repeated-measures ANCOVA. The direct visualization measurements were statistically larger than the electronic measurements (paired t-test difference = 0.20 mm, SE = 0.037, P < .0001), although a difference this large may not be clinically important. Overall, a greater change in working length was observed in straight canals than in curved canals. This unexpected finding was attributed to the limitations of the study, specifically the confounding factor of root length. This trend was more pronounced when measured electronically than via direct visualization, especially after complete instrumentation than after coronal flaring. The overall change in working length after complete instrumentation was found to be clinically insignificant in this study. A limited amount of change in working length may be expected prior to obturation.

Identiferoai:union.ndltd.org:vcu.edu/oai:scholarscompass.vcu.edu:etd-6441
Date01 January 2018
CreatorsTang, Mei
PublisherVCU Scholars Compass
Source SetsVirginia Commonwealth University
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceTheses and Dissertations
Rights© The Author

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