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Does Low-Taper Root Canal Shaping Decrease the Risk of Root Fracture? A Systematic Review.

Francesco Puleio1, Giuseppe Lo Giudice1, Angela Militi1

  • 1Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy.

Dentistry Journal
|June 23, 2022
PubMed
Summary

Root canal shaping with low-taper instruments may not significantly reduce root fracture risk compared to high-conicity shaping. Current evidence is inconclusive, highlighting the need for more robust clinical trials on root fracture resistance.

Keywords:
endodontic instrumentfracture resistanceinstrument tapermicrocracksroot canal preparationroot canal shapingroot fracture

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Area of Science:

  • Endodontics
  • Dental Materials Science
  • Biomechanical Engineering

Background:

  • Minimal root canal preparation may reduce root fracture risk but compromise cleaning.
  • Large taper instrumentation aids infected tissue removal but can weaken tooth structure.

Purpose of the Study:

  • To systematically review if low-taper root canal shaping decreases root fracture risk compared to high-conicity shaping.
  • To evaluate existing human and in vitro studies on root fracture resistance after endodontic treatment.

Main Methods:

  • Systematic review of studies comparing low- and high-conicity taper instruments for root canal shaping.
  • Searched Ovid MEDLINE, PubMed, and Web of Science databases.
  • Included human trials and in vitro studies assessing root fracture resistance.

Main Results:

  • Analysis of 20 selected studies from 328 initial results.
  • Current evidence is insufficient to determine if taper differences impact root fracture resistance.
  • No long-term randomized controlled trials (RCTs) were found.

Conclusions:

  • The impact of root canal instrument taper on root fracture resistance remains unclear.
  • In vitro study limitations in simulating clinical conditions were noted.
  • Further high-quality clinical research is required to establish definitive conclusions.