What Size apical diameter ?

Question:

When a tooth with tenderness on percussion is being treated endodontically, even after
obturation the tenderness remains for several months(in a gradual decreasing manner), though the acuteness of pain is being relieved. Analgesics, warm saline mouth wash, nothing
works except time. I generally use to relieve the occlusion.

Answer:
The factors that may be involved in continued tenderness are:

- Most important reason is inadequate cleaning of apical area (infection remains). Commonly we have seen most dentists prepare apical area to a 25 or maximum 30 size. Please see a paper published recently in Nov 2006 issue of triple O, to read open the attached pdf article.

- The instruments going beyond the apical constriction (use apex locater for length determination)
- The irrigant solution going beyond the foramen ( irrigate without forcing the solution)
- Obturating material extending beyond the apex, even though the Xray may show that it is within the canal. (use apex locater)
- Relieving the occlusion in cases with acute tenderness is s good policy.

For full understanding of issues related to Endodontics see the material on this WEBPAGE

Prof Beena Rani