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Week 03 2017

Root canal treatment: Where does the apex end?

Allan S. Deutsch, DMD

Some dental schools still teach that the root canal should be obturated to the radiographic apex, and anything short of that is unacceptable. The reality of the situation is a little more complex.

Knowing where the root canal ends is a very important fact to be aware of during the course of endodontic procedures. It determines how far we instrument the canal and where we place the root canal filling material. In turn, this will often affect the success of the root canal treatment. Currently, there seems to be some difference of opinion on this subject. Some dental schools still teach that the root canal should be obturated to the radiographic apex, and anything short of that is unacceptable. The reality of the situation is a little more complex.

We start to get a clue about what is going on with the publication by Imura et al. in 2001, in which the authors show in 2,000 endodontically treated teeth that those with short filling levels had a higher success rate than teeth with filling material to or in excess of the apex. 

This begs the question that if short is better, how short of the radiographic apex do you want to be? Luckily there is a lot of published literature to guide us.

In all of these studies and quite a few more, the key number for a higher success rate seems to be a root canal filling ending between 0 mm to 2 mm short of the radiographic apex.

More information:

Where does the apex end?

Bron: DentistryIQ /January 4, 2017 /By Allan S. Deutsch, DMD

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