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Influence of the length of instrumentation and canal obturation on the success of endodontic therapy. A 10-year clinical follow-up

Purpose: To clinically test the periapical healing of the method of recurrent electronic root canal measurement and the method of root canal obturation by the guttapercha-eucapercha method. Methods: During 10 years of endodontic practice of the first author, endodontic interventions were performed on approximately 4500 patients, aged 12-75 years. The success of therapy was followed-up in 257 teeth with diagnosis K04.0 to K04.5 (according to the X international classification of diseases) for whom a preoperative and control radiograph during the investigation period existed. Root canal preparation started with the “ crown-down pressureless technique” and proceeded with the method of recurrent electronic root canal measurement. Obturation was done by the guttapercha-eucapercha method up to the apical constriction. Results: The result of therapy success was approximately 95% overall (t-test, ANOVA) ; for the diagnosis: necrosis and pulp gangrene (K04.1): 64% ; for the acute apical periodontitis (K04.4): 88% ; for the inflamed pulp (K04.0) and pulp degeneration (K04.2) 95% ; chronic apical periodontitis (K04.5): 98%, and abnormally formed hard tissue in the pulp (K04.3):100%. CLINICAL SIGNIFICANCE: The results confirmed that every endodontic diagnosis needs a specific therapeutic approach that depends on the spread of tissue inflammation which influences the length of instrumentation. The length could be determined by the method of recurrent electronic root canal measurement.

endodontic therapy; periapical diseases; working length; instrumentation; obturation

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