A new radiographic technique was used to compare apical transportation in four Ni-Ti rotary instrumentation sequences. Mesiobuccal canals of 60 extracted mandibular molars were randomly divided into four groups. Groups 1 and 3 were instrumented by crown-down and groups 2 and 4 by step-back technique with 0.06 ProFiles series 29 to size 6. In groups 3 and 4 Greater Taper files were first used in a crown-down manner. The central axes of initial and final instruments were radiographically superimposed to measure loss of working length (WL) and transportation at 0, 0.5, 1, 3, and 5 mm from WL. ANOVA test showed no significant differences among groups regarding degree of transportation or loss of WL. Transportation was negatively correlated with radius of curvature at 0.5 and 5 mm from WL. The results indicate that the operational sequence of ProFiles or preinstrumentation with GT files has no effect on degree of transportation and loss of WL.
It should be assumed that all molar teeth have more than the traditionally expected three canals. The location of root canals should be identified at high magnification under the microscope. Careful radiographic re-examination of the fillings should be done in order to identify possibly missed canals.
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