The effect of endodontic procedures on apical crack initiation and propagation ex vivo.

By Adorno CG, Yoshioka T, Jindan P, Kobayashi C, Suda H.

Date: 01/2013
Journal: IEJ


Answer the research question: Can endo initiate or propagate apical cracks?


Subjects: Extracted max single-rooted PM with 2 canals

N= 40

Exclusion criteria: teeth with fracture lines, open apices and anatomical irregularities

Experimental Design:

Apical 1.5 mm was ground and polished for all groups

B canal prepared with GG and K-files to size 40/02 Groups A, B, and C

  • A filled with LC+ WVC without sealer
  • B filled with LC
  • C unfilled
  • Group D unprepared and unfilled

Criteria of evaluation:

  • Teeth inspected and photographed under microscope for presence of cracks at baseline, preparation,  obturation, and after 4 weeks of storage
  • Logistic regression and Fisher’s exact test statistical analysis


Logistic Regression- Crack Initiation

  • A significant effect of preparation/ instrumentation (P < 0.05)
  • No significant effect of filling or 4-week storage (P > 0.05)

Fisher’s exact test- Crack Progression

  • A significant effect of filling (P < 0.05)
  • No significant effect of 4-week storage (P > 0.05)

Clinical Significance:

Root canal procedures can potentially initiate and propagate cracks from within the root canal in the apical region