Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies

Foraminal enlargement has been recommended to optimize the disinfection of infected root canals, although some authors still claim that the foramen should be kept in its original shape and position. This study aimed to evaluate morphological alterations of apical foramen after foraminal enlargement...

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Main Authors: Isabella Figueiredo Assis Macedo, Alexandre Henrique dos Reis-Prado, Gabriela da Costa Ferreira, Gustavo Oliveira Campos, Isabella da Costa Ferreira, Francine Benetti, Isabella Faria da Cunha Peixoto, Warley Luciano Fonseca Tavares, Ana Cecília Diniz Viana
Format: Article
Language:English
Published: Universidade Estadual Paulista 2023-12-01
Series:Brazilian Dental Science
Online Access:https://ojs.ict.unesp.br/index.php/cob/article/view/4065
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author Isabella Figueiredo Assis Macedo
Alexandre Henrique dos Reis-Prado
Gabriela da Costa Ferreira
Gustavo Oliveira Campos
Isabella da Costa Ferreira
Francine Benetti
Isabella Faria da Cunha Peixoto
Warley Luciano Fonseca Tavares
Ana Cecília Diniz Viana
author_facet Isabella Figueiredo Assis Macedo
Alexandre Henrique dos Reis-Prado
Gabriela da Costa Ferreira
Gustavo Oliveira Campos
Isabella da Costa Ferreira
Francine Benetti
Isabella Faria da Cunha Peixoto
Warley Luciano Fonseca Tavares
Ana Cecília Diniz Viana
author_sort Isabella Figueiredo Assis Macedo
collection DOAJ
description Foraminal enlargement has been recommended to optimize the disinfection of infected root canals, although some authors still claim that the foramen should be kept in its original shape and position. This study aimed to evaluate morphological alterations of apical foramen after foraminal enlargement through a systematic review. An electronic search was conducted until April 2022. Ex vivo studies evaluating influence of foraminal enlargement in the morphologic changes of apical foramen were included. Studies without a control group or available full text were excluded. Foraminal deformation and area increase were considered as primary outcomes. Risk-of-bias assessment was performed according to a modified Joanna Briggs Institute’s Checklist. From 702 studies retrieved, five were eligible. Most studies used single-rooted teeth, and rotary systems for instrumentation ranging from – 2 mm to + 1 mm to the apex. All studies found increased major foramen deformation after foraminal enlargement. Among four studies that evaluated foraminal area, all found increased area after foraminal enlargement. Insufficient data for touched/untouched walls by instruments and dentinal microcrack formation was observed. A low risk of bias was found. Foraminal enlargement during root canal preparation seems to increase deformation and major apical foramen area. Future investigations with standardized methodologies are encouraged. KEYWORDS Apical foramen; Endodontics; Root canal preparation; Root canal therapy; Tooth apex.
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spelling doaj-art-3b46aa95c7f74becaef15549a1b03dd32025-08-22T14:53:01ZengUniversidade Estadual PaulistaBrazilian Dental Science2178-60112023-12-0126410.4322/bds.2023.e4065Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studiesIsabella Figueiredo Assis Macedo0https://orcid.org/0000-0001-9891-5935Alexandre Henrique dos Reis-Prado1https://orcid.org/0000-0002-5866-7137Gabriela da Costa Ferreira2https://orcid.org/0000-0002-5184-6415Gustavo Oliveira Campos3https://orcid.org/0000-0002-0584-3176Isabella da Costa Ferreira4https://orcid.org/0000-0001-5477-5942Francine Benetti5https://orcid.org/0000-0002-5459-353XIsabella Faria da Cunha Peixoto6https://orcid.org/0000-0002-2261-8333Warley Luciano Fonseca Tavares7https://orcid.org/0000-0003-2077-927XAna Cecília Diniz Viana8https://orcid.org/0000-0002-5987-0540Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora. Belo Horizonte, MG, Brazil. Foraminal enlargement has been recommended to optimize the disinfection of infected root canals, although some authors still claim that the foramen should be kept in its original shape and position. This study aimed to evaluate morphological alterations of apical foramen after foraminal enlargement through a systematic review. An electronic search was conducted until April 2022. Ex vivo studies evaluating influence of foraminal enlargement in the morphologic changes of apical foramen were included. Studies without a control group or available full text were excluded. Foraminal deformation and area increase were considered as primary outcomes. Risk-of-bias assessment was performed according to a modified Joanna Briggs Institute’s Checklist. From 702 studies retrieved, five were eligible. Most studies used single-rooted teeth, and rotary systems for instrumentation ranging from – 2 mm to + 1 mm to the apex. All studies found increased major foramen deformation after foraminal enlargement. Among four studies that evaluated foraminal area, all found increased area after foraminal enlargement. Insufficient data for touched/untouched walls by instruments and dentinal microcrack formation was observed. A low risk of bias was found. Foraminal enlargement during root canal preparation seems to increase deformation and major apical foramen area. Future investigations with standardized methodologies are encouraged. KEYWORDS Apical foramen; Endodontics; Root canal preparation; Root canal therapy; Tooth apex. https://ojs.ict.unesp.br/index.php/cob/article/view/4065
spellingShingle Isabella Figueiredo Assis Macedo
Alexandre Henrique dos Reis-Prado
Gabriela da Costa Ferreira
Gustavo Oliveira Campos
Isabella da Costa Ferreira
Francine Benetti
Isabella Faria da Cunha Peixoto
Warley Luciano Fonseca Tavares
Ana Cecília Diniz Viana
Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
Brazilian Dental Science
title Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
title_full Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
title_fullStr Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
title_full_unstemmed Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
title_short Morphological alterations of the apical foramen after foraminal enlargement: a systematic review of ex vivo studies
title_sort morphological alterations of the apical foramen after foraminal enlargement a systematic review of ex vivo studies
url https://ojs.ict.unesp.br/index.php/cob/article/view/4065
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