Effect of different apical preparation sizes on outcome of primary endodontic treatment: a randomized controlled trial

By Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A

Date: 01/2012
Journal: JOE


To evaluate the effect of apical preparation size in relation to first apical binding file (FABF) on outcome of primary endo treatment in mandibular first molar.


  • n=167 pts
  • inclusion: mature teeth, md M1, pulpal necrosis via cold/EPT, PARL >2x2mm, >18 y/o, non-contributory med hx
  • 5 tx groups (A,B,C,D,E) in which canals enlarged to 2,3,4,5,6 files sizes larger than FABF respectively
  • 129 pts at 1 yr f/u (77% recall)
  • outcome measure was change in PARL size via PAI score
  • clinical findings were secondary outcome measure


  • PAI scores were reduced in all groups (P< .001)
  • proportion of successfully healed cases increased with an increased apical size by 48%, 71.43%, 80%, 84.61%, and 92% respectively (A-E)
  • only group A showed significantly less improvement vs. other groups (P< .05)
  • as increased MAF size, saw decreased PAI score (P= .001)

Clinical Significance:

Enlargement of canal to >3 sizes than FABF is adequate.