OR17 - Impact of Final Apical Size Preparation on Root Canal Treatment Success: A Clinical and Volumetric Evaluation

Wednesday, April 2, 2025

1:00 PM – 1:15 PM EST

Location: Hynes Convention Center, Floor 3, Room 310

Presenter(s)

Clayton J. Travis, D.M.D.

Postgraduate Resident
Rutgers School of Dental Medicine
Jersey City, New Jersey

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Co-Author(s)

Craig S. Hirschberg, D.D.S.

Professor and Chair, Dept. of Endodontics
Rutgers School of Dental Medicine
Newark, New Jersey, United States, New Jersey

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Carla Y. Falcon, D.M.D., M.D.S.

Associate Professor & Pre-Doctoral Endodontics Program Director
Rutgers School of Dental Medicine
Newark, New Jersey

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Paul A. Falcon, D.M.D., M.S. (he/him/his)

Director Advanced Specialty Program in Endodontics
Rutgers School of Dental Medicine
Newark, New Jersey

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Vanessa Chrepa, D.D.S., M.S., Ph.D.

Associate Professor/Director of Clinical and Translational Research
Rutgers School of Dental Medicine
West New York, New Jersey

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Apical preparation size is currently a controversy among practitioners as limited studies have evaluated treatment success after different apical size preparations. Treatment success following minimal versus conventional apical preparation is largely unknown. This study is a randomized, double-blinded clinical trial to investigate the effect of small (#25) versus conventional apical sizes (#35) on root canal treatment success and tooth survival. Treatment outcome was assessed with cone-beam computed tomography (CBCT) volumetric analysis using AMIRA software from pre-operative and 2-year postoperative recall CBCT volumes as well as traditional outcome analysis with periapical radiographs and clinical examination. Fifty-five patients (small group n=29, large/conventional group n=26) returned for evaluation after root canal treatment, with a mean follow-up of 21 months (12-38 months). Pain levels were significantly reduced in both groups between the two visits (p < 0.05), with no differences between the groups. Both groups experienced a significant reduction in mesial root lesion volume, with a median reduction of 88% for the small group (p < 0.001) and 92% reduction for the large/conventional group (p=0.01). The treatment success rate was 86% for the small group and 96% for the large group, without statistical significance.

Conclusion: There was no statistical difference in healing outcomes between a #25 or #35 apical size preparation of mesial roots of necrotic mandibular molars.