Changes in compaction stress distributions in roots resulting from canal preparation

To examine if canal enlargement with instruments of controlled taper leads to more uniform stress distributions within a root, thereby reducing fracture susceptibility.

Finite element models of a mandibular incisor were constructed with round and oval canal profiles, based on measurements from extracted teeth. The shapes of rotary nickel-titanium instruments (ProTaper F1, F2, and F3 and ProFile size 30, 0.04 taper and size 30, 0.06 taper; Dentsply Maillefer) were superimposed on the canals. Equivalent stresses and circumferential stresses in the root were calculated for a compaction load.

The highest stresses were found at the canal wall. Round canals showed lower uniform distributions, whilst oval canals showed uneven distributions with high concentrations at the buccal and lingual canal extensions and greater stresses in the coronal and middle thirds than in the apical third. Preparation of round canals introduced only small circumferential stress increases in the apical half; preparation of oval canals produced substantial reductions where the canal was enlarged to a smooth round shape. Even where fins were not completely eliminated, the maximum stresses were still reduced by up to 15%. External distal and mesial surfaces of roots with oval canals showed moderate stress concentrations that were minimally affected by preparations, whilst stress concentrations emerged on roots with round canals when preparation sizes increased.

The potential for reducing fracture susceptibility exists as a result of round canal profiles achieved and smooth canal taper. Even when fins were not contacted by the instrument, stresses within the root were lower and more evenly distributed than before preparation.