Abstract
Introduction
The purpose of this study was to evaluate the effect of apical preparation size and
taper on postoperative pain and healing after primary endodontic treatment.
Methods
One hundred and twenty patients with asymptomatic mandibular first molars with radiographic
evidence of periapical pathology and with a periapical index (PAI) score ≥3 were randomly
assigned to 2 groups, group 1 and 2, based on apical enlargement to 2 and 3 sizes
larger than the initial apical binding file (IABF), respectively. Each group was further
divided into subgroups A and B depending on the apical enlargement taper of 4% and
6%, respectively. Endodontic treatment was performed, and the final apical enlargement
in all the groups was performed as follows: group 1A, 2 sizes larger than the IABF
with a 4% taper; group 1B, 2 sizes larger than the IABF with a 6% taper; group 2A,
3 sizes larger than the IABF with a 4% taper; and group 2B, 3 sizes larger than the
IABF with a 6% taper. Postoperative pain was assessed at 6, 12, 24, 48, and 72 hours.
Clinical evaluation and the change in the PAI score on radiographs were assessed at
the 3-, 6-, and 12-month follow-ups.
Results
No significant difference in postoperative pain was found. The success rate was lowest
(57.1%) in group 1 subgroup A as evidenced by the significant change in the PAI score
between group 1 subgroup A and the rest of the groups at the 6- and 12-month follow-ups.
Conclusions
Apical preparation to 2 sizes larger than the IABF with a 4% taper is insufficient
and results in significantly lower success rates compared with larger preparation
sizes and tapers.
Key Words:
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Article info
Publication history
Published online: May 28, 2021
Identification
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© 2021 American Association of Endodontists.
