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Working length variation during multiple-visit endodontic treatment: An observational study.

Mario Alovisi1, Davide Mirra1, Elio Berutti1

  • 1Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy.

Australian Endodontic Journal : the Journal of the Australian Society of Endodontology Inc
|October 25, 2022
PubMed
Summary

Working length often varies during multi-visit root canal therapy. Re-checking working length before filling is crucial, especially when apical periodontitis is present, to prevent procedural errors in endodontic treatment.

Keywords:
acute apical periodontitisapex locatorelectronic working lengthendodontic treatmentmultiple-visit

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Area of Science:

  • Dentistry
  • Endodontics
  • Dental Anatomy

Background:

  • Accurate working length determination is critical for successful endodontic treatment outcomes.
  • Multiple-visit endodontic procedures may introduce variability in working length measurements.
  • Understanding factors influencing working length changes is essential for clinical practice.

Purpose of the Study:

  • To investigate the variation in working length between initial preparation and final filling in multiple-visit endodontic treatments.
  • To identify clinical factors associated with working length variation during endodontic procedures.

Main Methods:

  • A cohort of 106 patients with pulpitis or pulp necrosis underwent endodontic treatment.
  • Working length was assessed multiple times during the first visit and re-measured before canal filling in the second visit.
  • A 0.5 mm threshold defined clinically significant working length variation.
  • Logistic regression analysis evaluated the influence of tooth anatomy, pulp status, and apical periodontitis on working length variation.

Main Results:

  • Working length varied between appointments in 34% of the patients.
  • The presence of apical periodontitis was the only statistically significant factor associated with working length variation (p=0.011).
  • No significant association was found between tooth anatomy or preoperative pulp status and working length variation.

Conclusions:

  • Working length can significantly vary between endodontic treatment appointments.
  • Apical periodontitis is a key predictor of working length variation in endodontic treatment.
  • Re-checking working length prior to root canal filling is recommended to minimize procedural errors.