A comparison of canal preparations in

straight and curved root canals

Sam W. Schneider, D.D.S., Austin, Texas

Extracted human single-rooted permanent teeth mere classified according to degree

of root curvature. Following hand instrumentation of the root canals, an exami-
nation of cross sections revealed that straight canals were much more readily pre-
pared round than were curved canals.

A ccording to Ingle and Levine, 1 “The primary objective of operative

endodontics must be the development of a fluid-tight seal at the apical foramen
and total obliteration of the root canal space.” Therefore, the closer the relation-
ship between the prepared root canal and the filling material, the better. Im-
proving this relationship was the objective of the Second International Con-
ference on Endodontics. There, specifications for the standa.rdization of en-
dodontic instruments (files and reamers) and filling materials (silver and
gutta-percha points) were laid down1
The critical apical 6 mm. of the standardized instruments and points could
be characterized as round. This raises the question of whether a similar configu-
ration is produced by hand instrumentation of the root canal. Haga said : “The
percentages of inadequate preparations were surprisingly high in all categories
of canals except the maxillary central incisors.”
The purpose of the present study was to determine the frequency with
which round preparations could be produced by hand in&umcntation in the
apical third of straight and curved root canals. A pilot study established that
round preparations could be produced repeatedly in maxillary central incisors
with straight roots at a level 1 mm. from the apical foramen.

METHODS AND MATERIALS

The sample consisted of twenty-nine extracted, fully mature, single-rooted,
permanent teeth. Twenty-seven were maxillary and mandibular cuspids, one was
a maxillary lateral incisor, and one was a mandibular first premolar. Standard-

From a thesis submitted in partial fulfillment of the requirements for certification in

endodontics, University of Illinois College of Dentistry.

271
272 Schneider Oral Burg.
August, 1971

Fig. 2. Example of how degree of root curvature was determined.

ization of the sample was attempted in the following ways: First, it was thought
that all of the teeth had similar anatomic configurations in the apical third of
their roots. This is supported by a study by Mueller,3 who demonstrated that
such teeth could be expected to have a round-tapering anatomy in the apical
third at least 95 per cent of the time, with the exception of the mandibulas
cuspids (87 per cent of the time). Second, all anatomic crowns were removed
and the roots were reduced to a uniform length of approximately 15 mm. All
reductions in root length were made from the coronal aspect. In this manner,
access was removed as a variable in this study and differences in root length
were controlled. Third, the degree of root curvature, which was varied, was
determined. For this, the teeth were roentgenographed in both a buccolingual
plane and a mesiodistal plane. A line was scribed on the roentgenogram para~llel
to the long axis of the canal. A second line was drawn from the apical foramen
to intersect with the first at the point where the canal began to leave the long
axis of the tooth (Fig. 1) The acute angle thus formed was measured by means
of a protractor. A special view box which magnified the radiographic image was
used to simplify this procedure. This method was used to separate the sample of
twenty-nine teeth into three groups, based on degree of curvature, as follows:
Ten were classified as Straight (5 degrees or less) ; ten as moder&e (10 to 20
degrees) ; and nine as severe (25 to 70 degrees).
The canals were instrumented with Kerr style “B” files with a reaming ac-
tion only. Vessey4 concluded that a reaming action is more likely to produce
“a preparation uniformly circular in cross section” in the apical portion of the
c.anal than that of a filing action. Enlargement. of the canal was considered
adequate when done in the manner employed by Haga2: The canal was en-
larged two sizes la,rger than the first file that started to bite 5 to 6 mm. from the
apex if No. 35F or less and three sizes larger if over No. 35F. During this process
Number 2 Preparations in straight and wrved root canals 273
J’olume 32

Table I

Deree of root mrvature

Nature of canal preparation ( Straight Moderate Severe
Perfectly round (1 mm. level) 8/10 = 80% 4/10 = 40% 3/9 = 33$@7
Perfectly round (5 mm. level) 4/10 = 40% l/10 zx 10% O/9=0%

the file was carried apically until it could just be seen at the apical foramen.
Although not used as specific criteria as to when to stop enlarging the canal,
white dentinal filings were in evidence in all specimens at the completion of
instrumentation.
The canals were then filled with fitted silver cones and sealer.* One side of
the specimen was flattened to improve the perpendicular relationship between
the canal and the blade used to make the cross sections. Cross sections were then
made at 1 and 5 mm. from the apex with a Gillings-Hamco thin sectioning
machine. The resulting 4 mm. specimens were examined under a Spencer dis-
secting microscope at a magnification of x25. Both the 1 and 5 mm. levels were
evaluated by making two measurements perpendicular to each other by means
of a micrometer in the ocular eyepiece of the microscope. An attempt was
always made to make these measurements through what appeared to be the
largest and smallest aspects of the specimen. Representative samples were photo-
graphed with a photomicroscope (Fig. 2).

RESULTS
The results of this investigation appear in Table I.

DISCUSSION
There appears to be a trend established between the straight and curved
groups. At the 1 mm. level there was almost a 100 per cent better chance of
making a round preparation in the straight group as opposed to the two
curved groups. There was also a poorer chance of making a round preparation
at the 5 mm. level as compared to the 1. mm. level for all groups. It is interesting
that, once a definite curve existed, little difference was noticed in the incidence
of round preparations. This was true of this sample at both the 1 and 5 mm.
levels.
Because cross sections were made, there was the possibility that the observed
specimen might be elliptical if the cut was not made exactly perpendicular to
the long axis of the prepared canal. To offset, this possible error, known round
shapes (silver points) were sealed in the canals. Therefore, a specimen was
considered round as long as the relationship between the silver point and the
canal remained exact, even if the two perpendicular measurements were not
exactly the same.
Of the four known variables in this study-access, root curvature, canal
instrumentation, and root canal anatomy-the two most subject to lack of

*Roth Drug Company, Chicngo, 111.

274 Schneide, Oral Surg.
August, 197 1

Pig. 8. A, Straight canal. Left: Perfect preparation, 1 mm. level. Right: Higher-power
view. B, Straight canal. Left: Imperfect preparation, 1 mm. level. Right: Imperfect prepar-
ation, 5 mm. level. C, Moderate curve. Left: Perfect preparation, 1 mm. level. Right: Perfect
preparation, 5’ mm. level.
Volume 32 Preparations in straight and curved root canals 275
Xumber 2

control were canal instrumentation and root canal anatomy. Any study that
utilizes hand instrumentation in its experimental design is open to’ criticism
because of the innate variability from one operator to another. Unfortunately,
this same situation exists clinically, and a more reliable means of determining
when a canal is properly prepared is needed. The variable of root canal anatomy
is difficult to control in a study in which natural teeth are used. Further study
utilizing an artificial model is suggested as a possibly better approach to the
problem. In such a study, all the above variables except hand instrumentation
could be controlled.

SUMMARY
Twenty-nine single-rooted teeth were classified, on the basis of degree of
root curvature, into three groups: straight, moderate, and severe. The canals
were enlarged by hand instrumentation. Cross sections were made at 1 and
5 mm. from the apical foramen. The specimens were then evaluated under a
dissecting microscope to determine whether round or irregular preparations had
been made.

CONCLUSIONS
1. Straight canals were much more readily prepared round than were curved
canals.
2. Round preparations were obtained 51 per cent of the time at the 1 mm.
level, as compared to 17 per cent at the 5 mm. level.
3. Further study is needed to determine when a canal has been properly
prepa,red.
The author would like to thank Dr. Clarence Erebs and Dr. Richard Walton for their
suggestions concerning the experimental design of this study, Dr. Eric Hars for his assist-
ance in the use of the photomicroscope, and Dr. William H. Clem for reviewing the paper.

REFERENCES
1. Ingle, John I., and Levine, M.: The Need for Uniformity of Endodontic Instruments,
Equipment, and Filling Materials. I?t Grossman, L. I. (editor) : Transactions of the Second
International Conference on Endodontics, Philadelphia, 1958, University of Pennsylvania,
pp. 125-126, 123-143.
2. Haga, C.: Microscopic Measurements of Root Canal Preparations Following Instrumenta-
tion, J. Brit. Endodont. Sot. 2: 41-46, 196%
3. Mueller, A. H.: Anatomy of the Root Canals of the Incisors, Cuspids, and Biscuspids of
the Permanent Teeth, J. Amer. Dent. Ass. 20: 1361-1386, 1933.
4. Vessey, R. A.: The Effect of Filing Versus Reaming on the Shape of the Prepared Root
Canal, ORAL SURG.27: 543-547, 1969.
Reprint requests to:
Dr. Sam W. Schneider
3203 Benbrook
Austin, Texas 78758