Comparative evaluation of Sapindus Mukorossi extract with 17% EDTA on smear layer removal in various parts of the tooth root.

OBJECTIVES: This study aimed to compare the effectiveness of an experimental root canal irrigant and 17% Ethylene-di-amine tetra acetic acid for removal of the smear layer in the coronal, middle and apical portions of the root canal. MATERIALS AND METHODS: Ninety human single rooted maxillary and mandibular teeth were selected for this study. The teeth were randomly divided into two experimental groups and one control group as follows: Group A (Ethanolic extract of Sapindus Mukorossi), Group B (17% EDTA), and Group C (Distilled water). The root canals of all three groups were prepared with stainless steel K-files by means of the standard step-back technique and irrigated with 5.25% sodium hypo chloride. The teeth were decoronated, following the irrigation and divided longitudinally into two-halves and visualized using scanning electron microscope (SEM) for the amount of smear layer present utilizing the three-point score system. The observations were noted both before and after the treatment. Nonparametric tests were applied for the comparison and p-value ⩽ 0.05 was considered as statistically significant. RESULTS: It was evident from that smear layer was completely removed in coronal portion of 27 out of 30 teeth in-group A. For middle and apical areas of group A, 24 and 19 teeth showed complete smear layer removal. In-group B it was found that there were 24, 21, and 3 teeth at coronal, middle and apical, areas respectively where smear layer were completely absent. Intra group comparison showed a significant difference (p = 0.002) in smear layer removal was found for group A at coronal, middle and apical thirds. Similarly, a significant difference (p = 0.001) was also found for group B; however heavy smear layer was found among the three parts of the canal for group C. CONCLUSIONS: Ethanolic extract of Sapindus Mukorossi have higher effectiveness in removing the smear layer from the root canal in comparison to 17% EDTA.

Long-term porosity and retreatability of oval-shaped canals obturated using two different methods with a novel tricalcium silicate sealer.

OBJECTIVE: To evaluate the percentage volume of voids and gaps in oval-shaped canals obturated using two different methods with a tricalcium silicate-based sealer after short- or long-term storage. The long-term effect of storage on the efficiency of removing filling material was also investigated. MATERIALS AND METHODS: Forty premolar teeth with oval-shaped canals were instrumented to Reciproc R25 and obturated using single cone obturation (SCO) or warm vertical compaction (WVC) techniques with gutta-percha and HiFlow sealer. The specimens were stored at 100% humidity and 37°C for 2 weeks or 6 months and scanned using micro-computed tomography. Initial retreatment was performed up to a Reciproc R40, and the operating time was recorded. The residual material in the canal received a supplementary procedure using XP-endo Finisher R (XPFR) files. After each retreatment procedure, the specimens were rescanned. RESULTS: The percentage volume of voids and gaps in the SCO group was higher than that of the WVC group at both 2 weeks and 6 months (P < 0.05). The percentage volume of the filling material removed after initial retreatment and XPFR cleaning was significantly higher in the 6-month group than in the 2-week groups (P < 0.05). The proportion of the residual material decreased significantly when XPFR files were used, compared to the initial retreatment group (P < 0.05) in both storage times. CONCLUSION: The efficiency of retreatment in the oval-shaped canal was closely related to the storage time rather than the filling technique using a tricalcium silicate sealer. The XPFR instrument proved effective in the removal of the remaining materials from the oval-shaped canal. CLINICAL RELEVANCE: Obturation of the oval-shaped canal with TSBS using the SCO technique in the coronal area needs to be optimized. The retreatment was less efficacious in freshly filled canals than aged filled canals.

Supplementary Steps for Removing Hard Tissue Debris from Isthmus-containing Canal Systems.

INTRODUCTION: The purpose of this ex vivo study was to evaluate the percentage reduction of accumulated hard tissue debris (AHTD) in the mesial root canal system of mandibular molars under different final irrigation regimens by means of micro-computed tomographic imaging. METHODS: Sixty curved mesial roots of mandibular molars with 2 independent canals joint apically by an isthmus (Vertucci type II) were selected. Specimens were scanned at a resolution of 12.5 µm, anatomically matched, and distributed into 3 groups (n = 20) according to the preparation protocol: Self-Adjusting File (SAF; ReDent Nova, Ra'anana, Israel), Reciproc (VDW GmbH, Munich, Germany), and Revo-S (Micro-Mega, Besançon, France) systems. Then, each group was subdivided into 2 subgroups (n = 10) according to the final irrigation protocol with the SAF or EndoVac system (Discus Dental, Culver City, CA). The percentage volume and percentage reduction of AHTD after root canal preparation and final irrigation protocols were statistically compared using 1-way analysis of variance, the paired sample and the independent Student's t tests. The level of significance was set at 5%. RESULTS: Within groups, the mean percentage volume was significantly reduced after the final irrigation procedures in either the SAF (from 1.52%-1.78% to 1.01%-1.20%) or EndoVac (from 2.11%-2.23% to 1.31%-1.52%) subgroups (P < .05). In the experimental groups, the mean percentage reduction of AHTD ranged from 29.15%-39.90% after the irrigation protocols, with no statistical difference between groups (P > .05). CONCLUSIONS: None of the irrigation approaches succeeded in rendering the mesial root canal system free of AHTD. A similar percentage reduction of AHTD was achieved after final irrigation protocols using either the SAF or EndoVac system.

Sodium Thiosulfate for Recovery of Bond Strength to Dentin Treated with Sodium Hypochlorite.

INTRODUCTION: The aim of this study was to evaluate the efficacy of sodium thiosulfate (Na2S2O3) for restoring adhesion to pulp chamber dentin treated with sodium hypochlorite (NaOCl) and EDTA. METHODS: Sixty-three crowns of bovine incisors were cut to expose the dentin pulp chamber. The specimens were polished and randomly distributed into 9 groups (n = 7) according to the following protocols used: 0.9% sodium chloride for 30 minutes (negative control), 5.25% NaOCl for 30 minutes, 17% EDTA for 3 minutes, and 5.25% NaOCl for 1 minute (positive control). The other groups, after treatments with NaOCl and EDTA, were immersed in 0.5% or 5% Na2S2O3 for 1, 5, and 10 minutes or just immersed in an inert solution for 10 minutes (0.9% sodium chloride). After drying the specimens, Scotchbond Multi-Purpose (3M ESPE, St Paul, MN) was applied to the pulp chamber dentin followed by Filtek Z250 composite (3M ESPE). Six rectangular slabs were obtained from each specimen, and the dentin/resin interface was tested by using a universal testing machine. The resulting data were submitted to 1-way analysis of variance and the Duncan test (P = .05). RESULTS: There was a significant decrease in bond strength regarding NaOCl and EDTA (P < .05). When 5% Na2S2O3 was used for 10 minutes, the bond strength was found to be statistically equal to the negative control and higher than the positive control (P < .05). CONCLUSIONS: The use of Na2S2O3 can significantly increase the bond strength of composite resin to NaOCl/EDTA-treated dentin, allowing adhesive restorations to be immediately applied after endodontic treatment.

Efficacy of laser-driven irrigation versus ultrasonic in removing an airlock from the apical third of a narrow root canal.

The purpose of the study was to test the hypothesis that air entrapment occurs in the apical third of a root canal during irrigation. A second objective was to test the null hypothesis that there is no difference between laser-driven irrigation (an erbium, chromium:yttrium-scandium-gallium-garnet laser) and passive ultrasonic irrigation in removing an airlock from the apical third. One hundred twenty extracted human teeth with single narrow root canals were randomised into two experimental groups (n = 40) and two control groups (n = 20). The specimens were shaped using hand instruments up to a size 30/0.02 file. The teeth were irrigated with a mixture of saline, radiopaque contrast and ink in solution. In the passive ultrasonic irrigation group, the irrigant was activated with an ultrasonic device for 60 s. In the laser group, the irrigant was activated with a laser for 60 s. It was concluded that if the insertion of irrigation needle is shorter than the working length, air entrapment may develop in the apical third, but the use of laser-driven irrigation is completely effective in removing it.

Technical quality of root canal treatment of posterior teeth after rotary or hand preparation by fifth year undergraduate students, The University of Jordan.

The aim of this study was to investigate the technical quality of root canal treatment provided by the undergraduate students as their first experience in molar endodontics using nickel-titanium (NiTi) files in a crown-down approach compared with stainless steel standard technique. This study was carried out by the fifth year undergraduate students attending peer review sessions as a part of their training programme, using two different questionnaires to assess the overall technical quality and potential problems regarding endodontic complications after root canal preparation with these two techniques. The overall results indicated a statistically significant difference in the performance of the two instrument techniques in difficult cases showing better performance of the NiTi system and mean rotary preparation time (P < 0.001). Under the conditions of this study, novice dental students, using NiTi ProTaper rotary files, were able to prepare root canals faster with more preparation accuracy compared with canals of same teeth prepared with hand instruments.

Accuracy of electronic apex locator in enlarged root canals with different root canal irrigants: an in vitro study.

AIM: To evaluate the accuracy of Root ZX-II (J Morita Corp) apex locator in enlarged root canals with different root canal irrigants. MATERIALS AND METHODS: 48 freshly extracted single rooted mandibular premolar teeth were used. The apical enlargement was done up to #45 K-file as the master apical file (MAF). The teeth were randomly divided into 4 groups and mounted in an experimental apparatus. The following irrigants were used during electronic canal measurements: group 1: saline; group 2: 3% NaOCl; group 3: 2% chlorhexidine; group 4: 17% EDTA. The canal measurement was done with Root ZX-II apex locator using #10 and #45 K-file. Data were analyzed by two way ANOVA and Bonferroni multiple comparison test. RESULTS: Statistical analysis showed that there was statistically significant difference between #10 and #45 K-file for group 1 (p < 0.01). CONCLUSION: Root ZX-II was accurate in the presence of 3% NaOCl and 17% EDTA when measured with smaller and larger files. However, it was accurate in the presence of saline and 2% CHX when larger files were used.

Comparison of orange oil and chloroform as gutta- percha solvents in endodontic retreatment.

OBJECTIVE: To compare the efficacy of gutta-percha removal achieved with simple mechanical technique using two different solvents. MATERIALS AND METHODS: It was an in vitro experimental study conducted at the Aga Khan University Hospital, Karachi, Pakistan on 27 extracted human molars divided into two groups by alternate sampling technique. The teeth were prepared by manual filing and obturated with gutta-percha and calcium hydroxide sealer. Two drops of the assigned solvent were placed on the orifice of the obturated canal and Gates Glidden drills #1, 2 and 3 were used for removal of coronal gutta-percha. Manual filing was done for removal of remaining gutta-percha and the solvent was used in drops until needed. Postoperative periapical radiographs were taken to visualize the remaining gutta-percha left in the canals. Descriptive statistics (mean and SD) of the variables such as tooth type, obturation length and canal curvatures were determined. Chi-square and independent sample t-tests were applied and level of significance was set at 0.05. RESULTS: There was 5.19 (3.8) mm of remaining gutta-percha in the orange oil group and 5.37 (4.2) mm in the chloroform group (p=0.90). CONCLUSION: There is no statistically significant difference between the orange oil and chloroform when used as solvent for removing gutta-percha.

Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: a randomized controlled trial.

INTRODUCTION: The aim of this study was to compare the outcome of a root canal treatment with and without additional ultrasonic activation of the irrigant. METHODS: Single-rooted teeth with radiographic evidence of periapical bone loss were randomly assigned to 2 treatment groups. In both groups syringe irrigation was performed, and in one group the irrigant was also activated by ultrasound. Ten to 19 months after treatment, the teeth were examined by using periapical radiography (PA) and cone-beam computed tomography (CBCT). Area and volume of the periapical lesions were measured, and the outcome was presented in 4 categories: absence, reduction or enlargement of the radiolucency, or uncertain. Lesions were classified as reduced or enlarged when the change in size of the radiolucency was 20% or more. RESULTS: The recall rate was 82%, and 84 teeth were analyzed. CBCT detected significantly more post-treatment lesions than PA (P = .038), but the percentages of absence and reduction of the radiolucency together revealed by CBCT and PA were similar (P = .383). The CBCT results showed that absence of the radiolucency was observed in 16 of 84 teeth (19%) and reduction of the radiolucency in 61 of 84 teeth (72.6%), but there was no significant difference between the results of the 2 groups (P = .470). Absence and reduction of the radiolucency together were observed in the ultrasonic group in 39 of 41 teeth (95.1%) and in the syringe group in 38 of 43 teeth (88.4%). CONCLUSIONS: Root canal treatments with and without additional ultrasonic activation of the irrigant contributed equally to periapical healing.

Impact of three radiographic methods in the outcome of nonsurgical endodontic treatment: a five-year follow-up.

INTRODUCTION: The periapical film radiograph (PFR) and digital periapical radiograph (DPR) techniques have some limitations in the visualization of small periapical lesions (PLs) when compared with cone-beam computed tomography (CBCT). However, the evidence supporting their effectiveness is very limited. This retrospective longitudinal cohort study evaluated the outcome of endodontic treatments measured/monitored by PFR, DPR, and CBCT during a 5-year follow-up and also determined the prognostic factors that influenced treatment success. METHODS: A total of 132 teeth (208 roots) with vital pulps received endodontic treatment. The periapical indexes with scores ≥2 for PFR and DPR and ≥1 for CBCT indicated the presence of PLs. Prognostic factors were determined by bivariate and multivariate analyses. Statistical significance was defined at a P level <.05. RESULTS: CBCT detected a higher number of PLs (18.7%, n = 39 roots), followed by DPR (7.7%, n = 16 roots) and PFR (5.7%, n = 12 roots). Likewise, CBCT was more sensitive than PFR and DPR in detecting deficiencies in extension and density of the root canal filling (P ≤ .001). Of the 17 prognostic factors evaluated, 4 were significantly associated with poor outcome to the treatment (P < .05): root canal curvature, disinfection of gutta-percha, presence of missed canals, and the quality of definitive coronal restoration. CONCLUSIONS: The success outcome of endodontic treatment after 5 years in teeth with vital pulps varied with each radiographic method: 94.3%/PFR, 92.3%/DPR, and 81.3%/CBCT.

Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts.

AIM: To investigate the benefits of pulpotomy (to the level of the floor of the pulp chamber) as an endodontic treatment for teeth with vital pulps. METHODOLOGY: Seventeen patients, aged 7-54 years (mean of 37.2 year), were treated by pulpotomy and filling with ProRoot MTA(®) in premolar or molar teeth with vital pulps and without clinical evidence of irreversible pulpitis. The patients were then followed up for 12 to 24 months and the teeth then assessed by clinical and radiographic examination. Statistical analysis was performed with Kaplan-Meier survival probability statistics to estimate the survival of the treated teeth. RESULTS: At 24 months, the survival rate without any complementary treatment was estimated to be 82%. Two of the 17 treated teeth required root canal treatment for pain control and one for prosthetic reasons. CONCLUSIONS: Under the conditions of this study, pulpotomy offered a viable alternative to root canal treatment for teeth with vital pulps in the short term. However, there is insufficient clinical evidence to consider this technique for the treatment of every permanent tooth. Nevertheless, it should be considered as a potential alternative approach to be further developed for future applications.

Apical periodontium response to enamel matrix derivative as an intracanal medication in rat immature teeth with pulp necrosis: radiographic and histologic findings.

INTRODUCTION: The aim of this study was to evaluate the enamel matrix derivative (EMD) biomaterial in nonvital immature teeth. METHODS: To arrest root development, pulpectomies were performed in the lower first molars of 36 4-week-old rats; the cavities were left exposed to the oral environment for 3 weeks. Then, chemical disinfection was performed, and triple antibiotic paste (TAP) or EMD was applied in the root canals. A control group did not receive any treatment. Radiographic and histological data were evaluated after 3 and 6 weeks. RESULTS: At 3 weeks, TAP promoted a milder inflammatory response and increased root lengths compared with the control group. At 6 weeks, root development and reduced periapical lesions could be observed in both test groups, mainly because of the deposition of a cementum-like tissue. EMD promoted narrower canals compared with TAP (P < .05). CONCLUSIONS: EMD deserves attention as a potential tool in the treatment of nonvital immature teeth. The ingrowth of cementum-like tissues into canal spaces favored dental wall thickness and may contribute to tooth resistance and support.

Endodontic application of cone-beam computed tomography in South Korea.

INTRODUCTION: This study aimed to investigate the incidence of cone-beam computed tomography (CBCT) associated with endodontic procedures during 2009 in South Korea and to retrospectively evaluate information from CBCT with large field of view (FOV), which is popular in South Korea. METHODS: The Health Insurance Review and Assessment agency, which reviews all medical and dental expenses covered under the Korean National Health Insurance (NHI) system, was queried for data on the nationwide number of CBCTs associated with some treatment procedures. To compare digital periapical radiography and CBCT retrospectively, 470 roots of 257 root canal-infected teeth were enrolled. RESULTS: In total, 13,209 cases of NHI-covered CBCT were performed in South Korea during 2009, excluding cases for implant restoration and orthodontics. In total, 1253 and 95 CBCT cases were combined with root canal length measuring and apicoectomy, respectively. In a retrospective comparison, CBCT with large FOV provided more information about the presence of apical periodontitis, distortion of cortical bone, and identification of root compared with digital periapical radiography. CONCLUSIONS: CBCT with large FOV is useful in nonsurgical endodontic treatment and provides more information compared with digital periapical radiography.

Is endodontic treatment performed under general anaesthesia technically acceptable?

OBJECTIVES: Undertaking endodontic treatment under general anaesthesia (GA) is often described as difficult and hazardous, but no study reports on safe and efficacious conditions for endodontic treatment under GA. This study aims to evaluate whether compromises made for the endodontic treatment of permanent teeth under GA are acceptable. It describes the quality of endodontic treatment undertaken in two series of consecutive patients treated either under GA or local anaesthesia (LA). MATERIALS AND METHODS: Post-operative data sheets and periapical radiographs were collected for 255 permanent teeth treated under GA during a 4-year period (GA group, 125 patients with special needs) and for 246 permanent teeth treated under local anaesthesia over 7 months (LA group, 180 healthy patients). The radiographic criteria for quality of endodontic treatment (RCQET) were considered satisfactory when (1) the root filling was within 2 mm of the apex; (2) the filling displayed no voids or defects; and (3) all the visible canals had been obturated. The type of tooth, pulpal status and periapical status were considered independent variables for RCQET. RESULTS: The proportion of satisfactory RCQET reached 63% in both groups and differed by type of tooth, being significantly lower for molars than for other teeth. CONCLUSION: From a technical point of view, compromises made for the endodontic treatment of permanent teeth under GA are acceptable. Further studies should be conducted to evaluate the long-term success of endodontic treatment performed under GA. CLINICAL RELEVANCE: This study supports the feasibility of endodontic treatment for patients treated under GA.

Evaluation of interference of calcium hydroxide-based intracanal medication in filling root canal systems.

AIM: To evaluate the interference of the intracanal medication Calen® (SSWhite, Sao Paulo, Brazil) on the filling of simulated lateral canals. MATERIALS AND METHODS: Twenty human anterior teeth were used. Before the endodontic filling procedures the access of cavity was made, and after this root canals were made in all the teeth to simulate the presence of lateral canals. After preparation, the teeth were randomly divided into two groups (n=10). In group I, the root canal system was filled directly after chemicalmechanical preparation; in group II, endodontic treatment was performed in multiple sessions, and after preparation the calcium hydroxide-based intracanal medication Calen® was inserted. After the period of 7 days, the root canals were vigorously irrigated and then they were filled. Next, the teeth were radiographed to verify the quality of the filling. RESULTS: The results demonstrated that the teeth treated in a single session, without calcium hydroxide medication, presented 47 canals out of 60 with radiographic evidence of filling, whereas the teeth in which intracanal medication was used, only 07 presented a radiographic image compatible with filling (p < 0.05). CONCLUSION: The use of the calcium hydroxide-based medication Calen made it difficult to obtain a hermetic filling of the root canal system. CLINICAL SIGNIFICANCE: The clinical significance of this work basing on the fact that once the dentist knowing that property obliteration of calcium hydroxide can be taken care when they are used in the presence of lateral canals.

Hard-tissue debris accumulation analysis by high-resolution computed tomography scans.

INTRODUCTION: Hard-tissue debris accumulation is a potential side effect of root canal instrumentation that has not been systematically investigated. In the current communication, a method to assess this debris using high-resolution microcomputed tomography (microCT) is presented. METHODS: Based on prescans, mandibular molars with joining mesial root canals and isthmuses between these were selected (n = 6). The mean volume filled with apparent hard-tissue debris after instrumentation without irrigation was calculated over 2 mm of the mesial canal system by multiplying the voxel volume with the number of voxels representing acquired radiopaque material. Backscattered electron imaging was used to compare the calcium-phosphorus content of this material with that of the root dentin in the same specimen. RESULTS: Backscatter scans showed that the accumulated debris viewed in the microCT scans was consistent with root dentin. In the selected canal segments, 29.2% +/- 14.5% of the original canal volume was filled with accumulated debris, which represented a significant change from the preoperative scan (p < 0.01, one-sample t test against zero). Three-dimensional reconstructions of the microCT images visualized the accumulated hard-tissue debris in the whole canal system. CONCLUSIONS: The current method appears suitable to quantitatively compare different instrumenting/irrigating regimens on dentin debris accumulation.

Analysis of the gutta-percha filled area in C-shaped mandibular molars obturated with a modified MicroSeal technique.

AIM: To analyse the gutta-percha filled area of C-shaped molar teeth root filled with the modified MicroSeal technique with reference to the radiographic features and the C-shaped canal configuration. METHODOLOGY: Twenty-three mandibular second molar teeth with C-shaped roots were classified according to their radiographic features as: type I--merging, type II--symmetrical and type III--asymmetrical. The canals were root filled using a modified technique of the MicroSeal system. Horizontal sections at intervals of 600 mum were made 1 mm from the apex to the subpulpal floor level. The percentage of gutta-percha area from the apical, middle and coronal levels of the radiographic types was analysed using the Kruskal-Wallis test. Complementary analysis of the C-shaped canal configurations (C1, C2 and C3) determined from cross-sections from the apical third was performed in a similar way. RESULTS: No significant differences were found between the radiographic types in terms of the percentage of gutta-percha area at any level (P > 0.05): apical third, type I: 77.04%, II: 70.48% and III: 77.13%, middle third, type I: 95.72%, II: 93.17%, III: 91.13% and coronal level, type I: 98.30%, II: 98.25%, III: 97.14%. Overall, the percentage of the filling material was lower in the apical third (P < 0.05). No significant differences were found between the C-shaped canal configurations apically; C1: 72.64%, C2: 79.62%, C3: 73.51% (P > 0.05). CONCLUSIONS: The percentage of area filled with gutta-percha was similar in the three radiographic types and canal configuration categories of C-shaped molars. These results show the difficulty of achieving predictable filling of the root canal system when this anatomical variation exists. In general, the apical third was less completely filled.

Clinical and radiographic evaluation of one- and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial.

The present investigation recorded the 2-year clinical and radiographic outcome of one- and two visit endodontic treatment and studied the significance of the bacteriologic sampling results on the outcome. A randomization procedure allocated 53 teeth to one-visit treatment and 48 teeth to two-visit treatment. At the end of the study period, 32 teeth (65%) in the one-visit group and 30 teeth (75%) in the two-visit group were classified as healed. The statistical analysis of the healing results did not show any significant difference between the groups (p = 0.75). Forty-nine (80%) of the 61 teeth that were obturated after a negative micobiologic sample were classified as healed. Teeth sealed after positive samples healed in 44%. The present study gave evidence that similar healing results might be obtained through one- and two-visit antimicrobial treatment.

Radiographic prevalence of root canal ramifications in a sample of root canal treatments in a Brazilian Dental School.

The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP), SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13), followed by mandibular premolars (n = 10) and maxillary incisors (n = 10). Apical deltas were mostly found in mandibular molars (n = 14), followed by maxillary incisors (n = 9). Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.