Analysis of Instrumentation Protocols Regarding the Quality of Mesial Canal Preparation in Mandibular Molars: A Micro-computed Tomographic Study

Introduction: This study aimed to use micro-computed tomographic imaging to analyze the quality of the endodontic preparation of mesial canals in mandibular molars provided by 3 instrumentation protocols. Methods: Forty-five extracted mandibular molars with 2 independent mesial canals were selected, and the initial micro-computed tomographic imaging was performed. The initial volume values of the canals were submitted to statistical analysis for paired division. The groups were determined according to the final enlargement of the canal and the working length adopted (ie, G25.06/+1 mm, G35.05/foramen, and G50.01/-1 mm). At the end of each instrumentation sequence, the root canals were scanned and analyzed with regard to the increase in the total and apical volume, centralization, and preparation transportation and the percentage of the total and apical uninstrumented walls. Results: For the intragroup comparison, the Wilcoxon test was used, and for the intergroup analysis, the Kruskal-Wallis and Dunn tests were used (P < .05). In the analysis of the canal total volume, a statistical difference was found between G25.06/+1 mm and the remaining groups (P < .05). In the apical third, a statistical difference was observed between G25.06/ +1 mm and G50.01/-1 mm (P < .05). No statistical difference was found between the groups in terms of centralization and transportation of the preparation or in terms of the percentage of the total or apical uninstrumented walls. Conclusions: The preparation of the mesial canals of mandibular molars up to larger tip files but with a lower taper at 1 mm before the foramen resulted in a larger volume of apical preparation, kept the preparation centralized, and provided safe apical dentin wear without excessive cervical wear.

Automated summary

This study used micro-computed tomographic imaging to analyze the quality of endodontic preparation of mesial canals in mandibular molars provided by 3 instrumentation protocols. The results showed that using larger tip files with lower taper 1mm before the foramen resulted in a larger volume of apical preparation, centralization of the preparation, and safe apical dentin wear.