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Kaur K, Saini RS, Vaddamanu SK, Bavabeedu SS, Gurumurthy V, Sainudeen S, Mathew VB, Khateeb SU, Mokhlesi A, Mosaddad SA, Heboyan A. Exploring Technological Progress in Three-Dimensional Imaging for Root Canal Treatments: A Systematic Review. Int Dent J 2024:S0020-6539(24)00148-5. [PMID: 39030097 DOI: 10.1016/j.identj.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/10/2024] [Accepted: 05/18/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION AND AIMS Root canal therapy is a crucial aspect of endodontic treatment aimed at preserving natural dentition. Over the years, advancements in three-dimensional (3D) technology have revolutionized diagnosis and treatment planning. Different 3D technologies are used in dental care, such as cone-beam computed tomography (CBCT), which ensures 3D slice visualization, root canal microanatomy, and dynamic navigation throughout the pulp cavity. By exploring the latest technological progress in this field, we seek to understand how these innovations are enhancing precision, efficiency, and patient outcomes, shedding light on the benefits and potential impact of 3D imaging in improving root canal procedures. METHODS Literature was searched from different databases, including PubMed, ScienceDirect, The Cochrane Library, Scopus, and Google Scholar. Inclusion criteria involved studies on 3D technology in root canal therapy with comparison groups, including RCTs and non-RCTs. Excluded studies lacked 3D imaging advancements, a control group, or were review articles or case studies. Quality assessment utilized QUIN for in vitro studies and ROBINS-I for non-RCTs to evaluate the studies' validity. RESULTS According to the PRISMA guidelines, among 5015 initial articles, 16 were included. CBCT was the most used 3D imaging technique for root imaging followed by micro-computed tomography (MCT) and limited CBCT (LCBCT) imaging methods. 2D radiographs and 2D histological methods and clearing techniques were the most common comparative modalities. Overall, 3D imaging streamlined dental treatment as clinicians could visualize much clearer and higher-quality images. Different resolutions and voxel sizes were applied to improve imaging quality. CONCLUSION Three-dimensional imaging, especially CBCT, improves root canal treatments by providing superior image quality. CBCT outperforms other techniques like MCT and LCBCT, enhancing clarity. Varying resolutions and voxel sizes optimize the effectiveness of 3D imaging in root canal therapy. CLINICAL RELEVANCE The advancements in 3D imaging technology, particularly CBCT, have significantly enhanced the diagnosis and treatment planning for root canal therapy. CBCT provides detailed insights into intricate root canal anatomy, improving diagnostic accuracy.
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Affiliation(s)
- Kanwalpreet Kaur
- Rutgers School of Dental Medicine, Rutgers University, New Jersey, USA
| | - Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | - Shashit Shetty Bavabeedu
- Department of Restorative Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - Shan Sainudeen
- Department of Restorative Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Vinod Babu Mathew
- Department of Restorative Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Shafait Ullah Khateeb
- Department of Restorative Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Aida Mokhlesi
- Student Research Committee, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India; Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India; Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Choudhari S, Venkata Teja K, Ramesh S, Jose J, Cernera M, Soltani P, Nogueira Leal da Silva EJ, Spagnuolo G. Assessment of Anatomical Dentin Thickness in Mandibular First Molar: An In Vivo Cone-Beam Computed Tomographic Study. Int J Dent 2024; 2024:8823070. [PMID: 38938693 PMCID: PMC11208803 DOI: 10.1155/2024/8823070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 03/21/2024] [Accepted: 05/21/2024] [Indexed: 06/29/2024] Open
Abstract
Aim To determine the minimum dentin thickness in the mesial and distal walls of the mesiobuccal (MB) and mesiolingual (ML) canals of the mandibular first molars using cone-beam computed tomography (CBCT). Materials and Methods CBCT examinations of 624 mandibular first molars from an Indian subpopulation were analyzed. The mesial and distal minimum dentin thickness was evaluated in 1 mm intervals apical to the furcation area. Independent t-test was used to analyze the data (α = 0.05). Using Cohen's kappa coefficient, the interexaminer and intraexaminer reliability was evaluated. Results The mesial dentin thickness was significantly higher than the distal dentin thickness for MB and ML canals (P=0.01). The average dentin thickness in the distal and mesial plane of the MB canal was 1.15 ± 0.15 mm and 1.52 ± 0.19 mm at the 1 mm level and 0.83 ± 0.13 and 1.08 ± 0.18 at the 5 mm level, respectively. For the ML canal, the average dentin thickness in the distal plane and the mesial plane was 1.24 ± 0.18 mm and 1.44 ± 0.21 at the 1 mm level and 0.91 ± 0.16 and 1.01 ± 0.17 at the 5 mm level, respectively. Statistical analysis between the MB and ML canals showed significant differences in the dentin thickness at 4 and 5 mm levels in both the distal and the mesial planes (P=0.01). In more than 85% of the cases, the minimum dentin thickness was seen at the 5 mm level in both the distal and mesial planes in MB and ML canals. Conclusion The distal planes of the mesiolingual and mesiobuccal canals were thinner in most cases, making the distal surface more prone to iatrogenic perforations. Considerably, at 4 and 5 mm from the furcation, the distal wall was significantly thinner than the mesial walls. Understanding the anatomy of the danger zone in the mesial roots of the mandibular first molars may serve to minimize the risk of endodontic mishaps such as strip perforations.
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Affiliation(s)
- Sahil Choudhari
- Department of Conservative Dentistry and EndodonticsSaveetha Dental CollegeSaveetha Institute of Medical and Technical SciencesSaveetha University, Chennai, Tamil Nadu, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and EndodonticsSaveetha Dental CollegeSaveetha Institute of Medical and Technical SciencesSaveetha University, Chennai, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and EndodonticsSaveetha Dental CollegeSaveetha Institute of Medical and Technical SciencesSaveetha University, Chennai, Tamil Nadu, India
| | | | - Mariangela Cernera
- Department of NeuroscienceReproductive and Odontostomatological SciencesUniversity of Naples, Federico II, Via Pansini n°5, Naples 80131, Italy
| | - Parisa Soltani
- Department of NeuroscienceReproductive and Odontostomatological SciencesUniversity of Naples, Federico II, Via Pansini n°5, Naples 80131, Italy
| | - Emmanuel João Nogueira Leal da Silva
- Department of EndodonticsSchool of DentistryGrande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
- Department of EndodonticsSchool of DentistryRio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Gianrico Spagnuolo
- Department of NeuroscienceReproductive and Odontostomatological SciencesUniversity of Naples, Federico II, Via Pansini n°5, Naples 80131, Italy
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Motamedi MRK, Amirzade-Iranaq MH, Ha WN. A systematic review and meta-analysis of the prevalence and global distribution of middle mesial canals in mandibular molars identified by CBCT. Clin Oral Investig 2024; 28:310. [PMID: 38743355 PMCID: PMC11093850 DOI: 10.1007/s00784-024-05660-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and regions based on cone-beam computed tomography (CBCT) studies. MATERIALS AND METHODS PubMed, Scopus, Embase, Web of Science, and Open-Grey were searched up to October 2023 according to specific keywords. A hand search was conducted on the references of the included studies and articles from three peer-reviewed journals in endodontics. The main variable of interest was the prevalence of MMC. Additional data such as the total number of included cases, age and country of the population, CBCT device information, voxel size, and field of view details were also extracted. Extracted data were analyzed qualitatively with the JBI quality assessment checklist and quantitatively with STATA software. RESULTS Of 32,793 studied teeth, the cumulative prevalence of MMC in both mandibular 1st and 2nd molars was 3.11% (95% CI: 2.00-4.44%). The subgroup analysis reveals a prevalence of 4.15% (95% CI: 2.69-5.89%) for mandibular 1st molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2nd molars. The highest prevalence of MMC in 1st molar was attributed to South Asia (11.24%) and Africa (6.61%). CONCLUSIONS The prevalence of MMC varies among regions. Clinicians should be aware of the potential prevalence of MMC, particularly in mandibular first molars, as a missed MMC could result in endodontic failure. CLINICAL RELEVANCE The presence of MMCs varies in different geographic regions (0% to 29.7%). Clinicians should always look for MMC when doing an endodontic treatment on mandibular molars, as the presence of this canal is not uncommon. We suggest searching for this canal as if searching for the second mesiobuccal canal of maxillary 1st molars.
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Affiliation(s)
- Mahmood Reza Kalantar Motamedi
- Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - William N Ha
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills NSW, Sydney, 2010, Australia.
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Llacer-Martínez M, Martín-Biedma B, Sanz MT, Aura-Tormos JI, Fos-Galve P, Fernández-Muñiz Z, Vega JA, Jovani-Sancho M. Cone-Beam Computed Tomography for the Evaluation of Dental Pulp Chamber Volume: Implications for Clinics and Teaching. Dent J (Basel) 2024; 12:95. [PMID: 38668007 PMCID: PMC11049409 DOI: 10.3390/dj12040095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/26/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
The dental pulp chamber volume is a fundamental measurement in the field of endodontics, but also in forensic sciences, teaching and training, or tissue engineering. This study evaluates the precision of cone-beam computed tomography (CBCT) in comparison with computed micro-tomography (micro-CT) in evaluating the pulp chamber volume of the upper central incisors ex vivo. The intra-operator and inter-operator errors were evaluated, and the results for the two techniques were compared with those of a T-test for paired samples. The intra-operator and inter-operator errors were >0.05, indicating adequate reproducibility in each operator and no significant differences between their measurements. On the other hand, no significant differences between the two measurement techniques were found. The present results demonstrate that CBCT is a precise, feasible, and reproducible technique for the evaluation of the dental pulp chamber volume ex vivo. The results provided with this method are useful for different medical domains but also for the teaching and training of undergraduate and postgraduate students. Furthermore, the findings of this study carry significant clinical implications, as the accurate assessment of the pulp chamber volume is critical in the diagnosis and treatment of various endodontic conditions. The ability of CBCT to provide reliable 3D dental anatomy measurements can enhance the planning of endodontic treatments by allowing for a better understanding of the internal tooth morphology. Additionally, the precision and reproducibility of CBCT in assessing the pulp chamber volume can contribute to improved clinical outcomes and reduced complications during endodontic procedures. These findings further support the increasingly vital role of CBCT in modern clinical practice and underscore its value as an indispensable tool in the field of dentistry.
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Affiliation(s)
- Maria Llacer-Martínez
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (M.L.-M.); (J.I.A.-T.); (P.F.-G.)
| | - Benjamín Martín-Biedma
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, 15705 Santiago de Compostela, Spain;
| | - María T. Sanz
- Departamento de Didáctica Matemática, Universidad de Valencia, 46010 Valencia, Spain;
| | - Juan I. Aura-Tormos
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (M.L.-M.); (J.I.A.-T.); (P.F.-G.)
| | - Pablo Fos-Galve
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (M.L.-M.); (J.I.A.-T.); (P.F.-G.)
| | | | - José A. Vega
- Departamento de Morfología y Biología Celular, Universidad de Oviedo, 33003 Oviedo, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile 7500912, Chile
| | - Mar Jovani-Sancho
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (M.L.-M.); (J.I.A.-T.); (P.F.-G.)
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Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH. Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study. Odontology 2024; 112:570-587. [PMID: 37957521 DOI: 10.1007/s10266-023-00870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P < 0.05). Younger age groups showed a higher prevalence of Vertucci Type I configuration (P < 0.05). Bilateral symmetry was seen in more than half of the maxillary premolars. There is a considerable variation in the number of roots and root canal configurations of maxillary premolars in the studied Iraqi population, with a significant difference by gender and age groups. Ahmed et al. classification provided more accurate presentation of the root and canal anatomy in maxillary premolars compared to Vertucci's classification.
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Affiliation(s)
- Abdullah Mohammed Aljawhar
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Basrah, Basrah, Iraq
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Azwatee Abdul Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayati Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Pires M, Martins JNR, Pereira MR, Vasconcelos I, Costa RPD, Duarte I, Ginjeira A. Diagnostic value of cone beam computed tomography for root canal morphology assessment - a micro-CT based comparison. Clin Oral Investig 2024; 28:201. [PMID: 38453706 PMCID: PMC10920457 DOI: 10.1007/s00784-024-05580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The aim of this study was to assess cone beam computed tomography (CBCT) as a root canal anatomy diagnostic tool by comparison with micro-CT gold-standard. MATERIALS AND METHODS 216 two-rooted mandibular molars were first scanned in a CBCT device (200 μm voxel size) and posteriorly in a micro-CT scanner (19.61 μm). The volumes were sequentially screened to classify main root canal anatomy according to Vertucci classification, and for the presence of lateral canals and apical deltas, in both mesial and distal roots. RESULTS Both methods revealed a higher prevalence of Vertucci Type II and IV in the mesial root, and Vertucci Type I in the distal root. The percentage of agreement for main root canal anatomy classification between CBCT and micro-CT scores was high (85.2%). CONCLUSION Sensibility to detect both lateral canals and apical deltas with CBCT was low. These results attest to the fact that minor anatomical changes might be difficult to identify with CBCT imaging, hampering its diagnostic value.
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Affiliation(s)
- Mariana Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Marinha Grande, Portugal
| | | | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, Aveiro, 3810-193, Portugal
- LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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Karobari MI, Batul R, Khan M, Patil SR, Basheer SN, Rezallah NNF, Luke AM, Noorani TY. Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health 2024; 24:1. [PMID: 38167114 PMCID: PMC10763367 DOI: 10.1186/s12903-023-03624-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/05/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This systematic review and meta-analysis aim to study the characterization of root and canal morphology of the first mandibular premolar using micro-computed tomography. METHODOLOGY The literature search was conducted using electronic web databases like PubMed, Scopus, ScienceDirect and Cochrane with the chosen MeSH key words and data was retrieved until May 2023. Further to perform the statistical analysis, R v 4.3.1 software with "meta", 'metafor" "metaviz" " ggplot2" package was used, and results were represented by odds ratios (OR) and the percentage of forest plots along a 95 per cent confidence interval (CI). RESULTS The total number of studies meeting the inclusion criteria was 13; these studies were conducted on mandibular first premolar using Micro-CT; the total sample size was 1817. To scan the sample, an X-ray micro-focus CT system (Siemens Inveon CT, Erlangen, Germany) was used in four studies and seven different machines were used in the respective studies. Mimics 10.01 software (Materialize, Leuven, Belgium) and NRecon v.1.6.9 software (Bruker, Kontich, Belgium) were commonly operated. The minimum and maximum voxel size ranges between 11.94 and 50 μm. Vertucci's classification was frequently used (9), while one study applied Ahmed et al. and Vertucci's classification. CONCLUSION This systematic review provides essential information about the root and canal configurations, radicular grooves, accessory canals, and apical foramina through Micro-CT, aiming to improve the accuracy of endodontic treatment and help practitioners.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Dental Research Unit, Centre for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
| | - Mohammad Khan
- New Age Health Science Research Center, Muradpur, Chattogram, 4331, Bangladesh
| | - Santosh R Patil
- Department of Oral Medicine and Radiology, Chhattisgarh Dental College & Research Institute, Sundra, India
| | - Syed Nahid Basheer
- Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
- Center for Medical and Bio-Allied Health Sciences Research (CMBAHSR), Ajman University, Ajman, UAE
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
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Sevgi U, Johnsen GF, Hussain B, Piasecki L, Nogueira LP, Haugen HJ. Morphometric micro-CT study of contralateral mandibular incisors. Clin Oral Investig 2023; 28:20. [PMID: 38147175 PMCID: PMC10751267 DOI: 10.1007/s00784-023-05419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This study aimed to determine the degree of similarity and symmetry in the anatomy of contralateral mandibular incisors. Three-dimensional (3D) models of extracted teeth were obtained from microtomography (micro-CT) scans. Qualitative and quantitative assessments of the morphology and comparison of contralateral pairs were made. The null hypothesis was that contralateral mandibular incisors could not be considered identical in simple morphometric measurements. METHODS Sixty pairs of mandibular incisors were extracted from 30 patients and scanned with micro-CT. Virtual models of the cemento-enamel junction to the root apex were rendered. Parameters such as length, canal width, dentinal thicknesses, tortuosity, centerline length, accessory canals, root canal configurations, and root canal orifice cross-sections were used to compare the teeth. Width and thickness comparisons between paired teeth in the same individual were made by paired t-test (Wilcoxon signed-rank test for variables not normally distributed). An online randomization tool generated randomized pairs (independent of the individual/patient). Subsequently, an unpaired t-test (or Mann-Whitney U test for non-normally distributed parameters) and a correlation analysis were conducted. Canal configurations were classified according to preexisting classification schemes. The number and location of accessory canals and apical foramina were registered and compared. RESULTS Utilizing advanced imaging techniques and quantitative analyses, our study establishes that contralateral mandibular incisors exhibit a remarkable degree of symmetry in multiple morphological parameters, including length, canal width, and dentinal thicknesses. The apical third showed a high degree of inter-variability for the contralateral pairs. The rigorous statistical analysis of the normalized parameters by Z-score showed no statistically significant differences between the contralateral mandibular incisors. Comparisons between central and lateral teeth revealed differences in root length but no significant disparity in the distribution of accessory canals. Central teeth, on average, were longer, while accessory canals were distributed relatively evenly between central and lateral teeth. CONCLUSIONS The findings of this study further establish the significant similarities between contralateral mandibular incisors, reinforcing their suitability as a reliable substrate for root canal comparison studies. CLINICAL RELEVANCE The absence of statistically significant differences between contralateral pairs in normalized parameters underscores their potential as a reliable reference point for root canal comparison studies in clinical dentistry. Furthermore, our findings emphasize the importance of individualized treatment planning, considering the natural symmetry in mandibular incisors to enhance clinical decision-making. This research contributes valuable insights to the field of endodontics, offering a standardized approach to sample selection and enriching the understanding of dental anatomy.
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Affiliation(s)
- Usame Sevgi
- DF Dental Group, Istanbul, Turkey
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Gaute Floer Johnsen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Tanngarden AS, Sørumsand, Norway
| | - Badra Hussain
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, Buffalo, NY, USA
| | - Liebert Parreiras Nogueira
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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Marceliano-Alves MF, Amoroso-Silva P, Alves FRF, Soimu G, Provenzano JC, Campello AF, Duarte ML, Moreno JO, Sierra-Cristancho A, Calle JT, Rôças IN, Siqueira JF. Multipopulation evaluation of the internal morphology of mandibular first premolars from different South American countries. A micro-computed tomography study. Arch Oral Biol 2023; 156:105809. [PMID: 37832245 DOI: 10.1016/j.archoralbio.2023.105809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/14/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To evaluate and compare several anatomical parameters of mandibular first premolars from individuals from different Latin American countries using micro-computed tomography. DESIGN Five hundred extracted mandibular first premolars from Brazilian, Argentinian, Chilean, Colombian, and Ecuadorian individuals were scanned using micro-computed tomography (n = 100 teeth/country). Root canal configurations were classified according to established parameters. Analyses also included: canal volume and surface area, structure model index, distances from the apical foramen to the root apex or the cementoenamel junction, major/minor apical canal diameters, canal orifice shape, and prevalence of ramifications. RESULTS A single root was the most common anatomy in all countries (range, 97%-100%). Vertucci's type-I canal was the most frequent configuration (range, 36%-66%), followed by C-shaped and type-V canals. The oval-shaped canal orifice was the most predominant in all countries (range, 34%-58%), followed by the circular shape (range, 16%-47%). C-shaped canals occurred in all subpopulations (range, 14%-26%), always associated with radicular grooves. Ranges for canal ramifications were as follows: accessory canals, 36%-73%; lateral canals, 4%-12%; and apical delta, 4%-14% of the teeth. Many anatomic parameters differed significantly between countries (P < .05). CONCLUSIONS Vertucci's types-I and -V, and C-shaped canals were the most prevalent configurations in the subpopulations investigated. Accessory canals and several complex anatomies were found, with some significantly different frequencies between countries.
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Affiliation(s)
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Flávio R F Alves
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
| | - Giuliana Soimu
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - José C Provenzano
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Andrea F Campello
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | | - Jaime O Moreno
- Dental School, Santo Tomás University, Bucaramanga, Colombia
| | | | | | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
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10
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Bukhary S, Alkahtany SM, Bukhari A, Aldosari A, Alanazi R. Prevalence of middle mesial canal using cone beam computed tomography: A systematic review and meta-analysis. Saudi Dent J 2023; 35:904-915. [PMID: 38107038 PMCID: PMC10724365 DOI: 10.1016/j.sdentj.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 12/19/2023] Open
Abstract
Background The presence of middle mesial canals in mandibular molars are not commonly encountered in daily practice. However, locating and debriding such anatomical variation during the endodontic therapy is essential to avoid endodontic failure. The aim of this systematic review was to identify the overall prevalence of middle mesial canals (MMC) in mandibular molars using cone-beam computed tomography (CBCT), to assess the influence of different gender on the prevalence of MMCs in mandibular molars and to describe the MMC configurations. Methods The review protocol was registered in the PROSPERO database (CRD42021238523). The main electronic databases were searched until February 2022 for prevalence studies on root/canal anatomy in mandibular molars using CBCT imaging, in addition to hand-searched scientific articles in peer-reviewed journals and grey literature. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. Egger's and Begg's tests and Pearson's chi-square test were used for statistical analysis. Results From 523 records, 488 studies were excluded after screening the title and abstract. 35 relevant studies were included for full-text assessment and 28 studies were included in the meta-analysis. The overall prevalence of MMC out of the 19,256 teeth was 5.09% (95% CI: 2.894 to 7.784). The prevalence of MMC was 9.79% (95% CI: 4.296 to 17.224) in males and 13.96% (95% CI: 0.541 to 40.737) in females with a statistically significant difference of 4.16% (95% CI: 2.29 to 6.01). The most MMC configuration found in this review to be confluent with the mesiobuccal canal. Conclusion The results showed an overall 5.09% prevalence of MMC in mandibular molars, with a significantly high prevalence in female subjects. Additionally, this canal was found to be confluent with the mesiobuccal canal.
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Affiliation(s)
- Sundus Bukhary
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sarah M. Alkahtany
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Areej Bukhari
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ahad Aldosari
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Rehab Alanazi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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11
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Liu YJ, Liu S, Liu T, Zhang J, Zhu YN. Root canal morphology and bifurcating/merging sites of permanent mandibular incisors in 9- to 12-year-old children: An in-vivo 3D visualization analysis in China. Arch Oral Biol 2023; 155:105781. [PMID: 37556979 DOI: 10.1016/j.archoralbio.2023.105781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE This retrospective study aims to analyze the root canal morphology of permanent mandibular incisors and the bifurcating/merging sites of root canal systems in children aged 9-12 in a Chinese subpopulation.Design Cone-beam computed tomography scans of 976 healthy, untreated and fully developed mandibular incisors were collected. Root canal morphology was identified by Vertucci's classification. Combined three-dimensional reconstruction and visualization techniques were used to locate bifurcating/merging sites in root canals. RESULTS Vertucci I was the most common classification of mandibular central incisors (42.3%) while Vertucci III was most common in mandibular lateral incisors (37.9%). Females more frequently showed Vertucci I classification (49.5% central incisors and 36.7% lateral incisors) while Vertucci III was most common among males (44.5% central incisors and 41.0% lateral incisors). The difference in canal classification by sex was statistically significant (p < 0.05). 58.7% of Vertucci V canals bifurcated in the apical third (AT) in central incisors, while 69.5% bifurcated in the middle third (MT) in lateral incisors. Bifurcating and merging in AT (44.3%) was the most common style of Vertucci III canals in central incisors, while bifurcating in MT and merging in AT (53.8%) was the most common in lateral incisors. CONCLUSION The root canal morphology of mandibular incisors in children aged 9-12 was different from that reported in previous studies on adults, and closely related to sex. Males had significantly greater canal variability than females. Lateral incisors had greater canal variability than central incisors. The bifurcating/merging sites were closely related to tooth type.
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Affiliation(s)
- Ya-Jing Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shu Liu
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ting Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jun Zhang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ya-Nan Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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12
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Eren İ, Sezer B. Comparison of the Effects of WaveOne Gold, TruNatomy, and Conventional Hand Files on Remaining Dentin Volume in the Coronal Part of the Root and Preparation Efficiency in Mandibular Molars. J Endod 2023:S0099-2399(23)00292-3. [PMID: 37269976 DOI: 10.1016/j.joen.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The use of file systems that work with different principles in root canal treatment is becoming widespread. The aim of this study was to evaluate the remaining dentine volume in the coronal region of the root and preparation efficiency after the use of conventional hand files, WaveOne Gold, which works with reciprocating motion, and TruNatomy, which works with rotational motion, in the root canal treatment of mandibular molar teeth. METHODS All canals of permanent mandibular molars (n = 36) were used. Root canals in each group (n = 12) were prepared with conventional hand files, WaveOne Gold, and TruNatomy. The three-dimensional images were evaluated for remaining dentine volume in the coronal two-millimeter region of the root and change in volume of the entire root canal space. RESULTS There was no statistically significant difference between the groups in terms of mean differences pre- and post-preparation (P >.05). The mean differences after preparation were observed the most in the WaveOne Gold group and the least in the TruNatomy group in the coronal two-millimeter region of the root and entire canal volume, but the differences were not significant (P>.05,P>.05, respectively). CONCLUSIONS Conventional hand files, WaveOne Gold working with reciprocating motion, and TruNatomy working with rotational motion, which are the file systems used in the study, are not superior to each other in terms of remaining dentin volume in the coronal two-millimeter region of the root and preparation efficiency in the entire root canal space in mandibular molars.
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Affiliation(s)
| | - Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
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13
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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14
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Root canal narrowing patterns of mandibular first premolars on panoramic radiographs according to the number of root canals diagnosed on cone beam computed tomographic images. Odontology 2023; 111:172-177. [PMID: 35554774 DOI: 10.1007/s10266-022-00713-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/20/2022] [Indexed: 01/06/2023]
Abstract
Understanding the variations in root canal morphology is important for successful endodontic treatment. Mandibular first premolars have a single root in 98% of cases, and multiple root canals are found in approximately 20% of cases. However, the details of these characteristic findings in panoramic radiography and their diagnostic accuracy are unknown. This study aimed to investigate the characteristic radiographic findings of mandibular first premolars possessing multiple root canals and determine the diagnostic accuracy using panoramic radiography. Four radiologists evaluated 347 mandibular first premolars in 186 patients who underwent panoramic radiography and dental cone beam computed tomography (CBCT). Two radiologists confirmed the existence of single or multiple root canals using CBCT. The remaining two radiologists evaluated the imaging findings of the root canal morphology and classified them into two patterns: gradual narrowing and sudden narrowing. In the case of the sudden narrowing pattern, the location of sudden narrowing was also evaluated. A gradual narrowing pattern was observed in 56% of teeth with a single root canal, and a sudden narrowing pattern was observed in 83% of teeth with multiple root canals. When sudden narrowing between the cervical and apical 1/4 of the root canal was used as the diagnostic criterion for multiple root canal teeth, the highest diagnostic performance was observed (sensitivity, 76.1%; specificity, 73.9%). The sudden narrowing between the cervical level and the apical 1/4 level of the root canal is a practical diagnostic criterion for mandibular first premolar with multiple root canals.
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15
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Chen C, Zhu T, Wu H, Zhao X, Leng D, Wang J, Yang L, Wu D. Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals. Sci Rep 2022; 12:19779. [PMID: 36396689 PMCID: PMC9671964 DOI: 10.1038/s41598-022-24381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).
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Affiliation(s)
- Cheng Chen
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Tingting Zhu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Lianfeng Yang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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16
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Lemos MC, Coutinho TM, Perez AR, Medeiros TC, Marceliano-Alves MF, Alves FR. Root canal morphology of 1316 premolars from Brazilian individuals: an in vivo analysis using cone-beam computed tomography. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2022; 35:105-110. [PMID: 36260941 DOI: 10.54589/aol.35/2/105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/01/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to investigate the internal root canal anatomy of maxillary and mandibular premolars in a Brazilian subpopulation, in order to establish the prevalence of the different configurations proposed by Vertucci. Three hundred and ninety-eight cone-beam computed tomography scans were collected from a private imaging clinic database in Rio de Janeiro, including 217 maxillary and 226 mandibular scans. A total 1316 premolars (594 maxillary and 722 mandibular) were evaluated using an image viewer, and classified according to Vertucci. Two calibrated examiners determined the frequency of each morphological Type. A third examiner reviewed discordant cases. The Kappa test was applied to verify inter-rater agreement, and Fisher's Exact Test to verify gender-related differences. The most frequent root canal configurations of maxillary first and second premolars were Type IV (73.86%) and Type I (47.18%), respectively. Type I was the most prevalent in mandibular first and second premolars (80.59% and 95.86%, respectively). Only Types I and VIII presented a statistically significant difference between sexes. Type I was more frequent in females and Type VIII in males. A highly significant frequency of Type I was found in both mandibular first and second premolars, whereas the most frequent maxillary premolar root canal configuration was Type IV for first premolars and Type I for second premolars.
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Affiliation(s)
- Marília C Lemos
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Estácio de Sá, Rio de Janeiro, Rio de Janeiro, Brasil.
| | - Thaïs Mc Coutinho
- Faculdade de Odontologia, Universidade Iguaçu, Nova Iguaçu, RJ, Brasil
- Grupo de Pesquisa em Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Alejandro R Perez
- Departamento de Endodontia, Universidade Rey Juan Carlos, Madrid, Espanha
- Grupo de Pesquisa Clínica e Experimental em Materiais para Odontologia e Engenharia de Tecidos, UCAM, Múrcia, Espanha
| | - Thamires C Medeiros
- Grupo de Pesquisa em Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Marília Fv Marceliano-Alves
- Faculdade de Odontologia, Universidade Iguaçu, Nova Iguaçu, RJ, Brasil
- Grupo de Pesquisa em Odontologia, Universidade Iguaçu, Nova Iguaçu, RJ, Brasil
| | - Flávio Rf Alves
- Grupo de Pesquisa em Odontologia, Universidade Iguaçu, Nova Iguaçu, RJ, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade do Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brasil
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Endodontic Management of Mandibular Second Premolar with Vertucci Root Canal Configuration Type V. Case Rep Dent 2022; 2022:3197393. [PMID: 35399794 PMCID: PMC8993574 DOI: 10.1155/2022/3197393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
The diversity of root canal anatomy in permanent dentition is quite common. Understanding the basic anatomy of the root canal morphology and its variations is particularly important for successful root canal treatment. Mandibular second premolar usually consists of a single root with a single root canal. The presence of split roots in the apical third of the root with two separate root canals is quite rare. The major cause of endodontic failure in missed canals is that it harbors bacteria and other microorganisms. Careful radiographic interpretation and clinical examination of the pulp chamber will be helpful in locating canal orifices. The mandibular premolars with Vertucci type V canal configuration pose a challenge in clinical management. Identifying them early is important to aid appropriate modification in treatment protocol. In this case report, important modifications of clinical steps and application of magnification for successful management with access chamber modification are explained.
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Sierra-Cristancho A, González-Osuna L, Balanta-Melo J, Cafferata EA, Rojas C, Melgar-Rodríguez S, Carvajal P, Vernal R. A micro-CT analysis of radicular dentine thickness in mandibular first premolars presenting C-shaped root canals: Identification of potential danger zones. Int Endod J 2022; 55:672-684. [PMID: 35344612 DOI: 10.1111/iej.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
AIM To describe the radicular dentine thickness in mandibular first premolars presenting C-shaped root canals, in order to identify the canal walls with less thickness as potential danger zones. In addition, to describe the internal and external anatomical characteristics of these teeth and to associate them to the dentine thickness. METHODOLOGY A total of 70 mandibular first premolars presenting C-shaped root canals were examined. Their internal morphology was analyzed using Vertucci´s and Fan´s criteria, and their external morphology was analyzed using the ASUDAS score. Besides, the dentine thickness around the root canals was two/three-dimensionally determined at five root planes and quantified in the distal and the mesial aspects. RESULTS According to Fan´s, ASUDAS, and Vertucci´s classifications, the most common canal configurations were category C3, grade 3, and type V, respectively. In Vertucci's type III anatomy, the mesial root wall of the lingual canal showed significantly less dentine thickness than the distal wall in the middle plane (p = 0.031). Similarly, in Vertucci's type V anatomy, significantly less dentine thickness was observed in the mesial root wall of the buccal and lingual canals in the middle plane (p < 0.001) and the buccal canal in the middle-apical plane (p = 0.014) than the distal root wall of these canals. In teeth with ASUDAS grade 3 and 4 scores, significantly less dentine thickness was observed in the mesial in comparison with the distal root wall of these canals. These differences were demonstrated in the middle and middle-apical planes (p < 0.001) of grade 3 teeth and the middle-apical plane (p < 0.001) of grade 4 teeth. In these root planes, the Ver1-AS3 and VerV-AS3 combinations presented a 4-times greater risk of presenting walls with a critical dentine thickness of 0.6 mm (OR=4, p = 0.025) than the combinations Ver1-AS2, VerV-AS2, VerV-AS4, and VerIII-AS3. CONCLUSIONS The root canal system configuration of mandibular first premolars with C-shaped canals showed a wide range of anatomical variations. The lowest dentine thickness was located in the mesial wall of the canals in the middle and apical root thirds of Vertucci´s type III and V anatomies and in teeth with deep radicular grooves scored as ASUDAS grade 3 and 4. In the middle and middle-apical planes, the presence of the combinations Ver1-AS3 and VerV-AS3 showed a high risk of presenting a critical dentine thickness of 0.6 mm. Therefore, these root canal walls with less dentine thickness represent potential instrumentation danger zones in mandibular first premolars with C-shaped canals.
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Affiliation(s)
- A Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - L González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - J Balanta-Melo
- School of Dentistry, Faculty of Health, Universidad del Valle, Cali, Colombia
| | - E A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima
| | - C Rojas
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - S Melgar-Rodríguez
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - P Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Three-dimensional analysis of coronal root canal morphology of 136 permanent mandibular first molars by micro-computed tomography. J Dent Sci 2022; 17:482-489. [PMID: 35028074 PMCID: PMC8740396 DOI: 10.1016/j.jds.2021.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background/purpose Minimally invasive endodontic approach become a research hotspot and may prevent the fracture of endodontically-treated teeth. This research aims to measure the coronal root canal morphology of permanent mandibular first molars in 3D and propose a new minimally invasive endodontic approach based on this measurement. Materials and methods Data of 136 permanent mandibular first molars were involved and reconstructed in 3D models with canals. Then, the morphology characteristics of the coronal root canal were measured. Results Overall, the distribution of root canal orifices was more centralized than other landmarks. The landmarks were located more mesiobuccally to the center of the occlusal plane of molars. Specifically, the measurements of the maximum curvature of coronal root canals in the axial direction were: in 3-canals 2-rooted teeth, the average angles of curvatures were 23°,25°,11° for mesiobuccal (MB), mesiolingual (ML) and distobuccal (DB) canals, respectively; in 4-canals 2-rooted teeth were 23°,25°,12°,16°for MB, ML, DB, and distolingual (DL) canals, respectively; in 4-canals 3-rooted teeth were 25°,27°,17°,39° for MB, ML, DB, and DL canals, respectively. The degrees of coronal root canal curvatures in the horizontal direction were: in 3-canals teeth, the average angles of curvatures were −1°,47°,-2° for MB, ML and DB canals, respectively; in 4-canals 2-rooted teeth were −4°,41°,-25°,48° for MB, ML, DB, and DL canals, respectively; in 4-canals 3-rooted teeth were −3°,33°,-43°,79° for MB, ML, DB, and DL canals, respectively. Conclusion The results of this study are similar to those previously obtained using CBCT and can help us design endodontic approaches.
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Yu YH, Kim M, Kratchman S, Karabucak B. Surgical management of lateral lesions with intentional replantation in single-rooted mandibular first premolars with radicular groove. J Am Dent Assoc 2022; 153:371-381. [DOI: 10.1016/j.adaj.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
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Rincón Rodriguez ML, Martínez-Vega RA, Duarte Monsalve ML, Moreno Monsalve JO. Reproducibilidad y validez de criterio de dos técnicas radiográficas para variaciones de premolares mandibulares comparadas con CBCT. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La existencia de variaciones anatómicas ocasiona fracasos en tratamientos endodónticos, por lo que es importante diagnosticarlas. El objetivo fue determinar la reproducibilidad y la validez de criterio de las radiografías con placa de fósforo y la radiovisografía con sensor para identificar las variaciones anatómicas detectadas por tomografía computarizada de haz cónico (CBCT) en premolares inferiores. Métodos: En 140 premolares se obtuvieron imágenes por CBCT, radiografía y radiovisografía. Se realizó lectura independiente por dos endodocistas, evaluándose la clasificación de Vertucci y las ramificaciones. Se determinó la reproducibilidad intraobservador e interobservador. Se calcularon sensibilidad, especificidad y áreas bajo la curva operador-receptor (AUC) utilizando como estándar de oro la CBCT. Resultados: La reproducibilidad intraobservador e interobservador fue mayor para radiografía. Para la Clase I de Vertucci, la radiografía presentó mayor sensibilidad (94,7%), especificidad (64,9%) y AUC (0,795) que la radiovisiografía (89,3%, 62,2% y 0,757, respectivamente), al igual que para la Clase V (Radiografía 69,2%, 93% y 0,811; Radiovisiografía 50%, 84,2% y 0,671, respectivamente). Ninguna de las técnicas aportó al diagnóstico de la Clase III (AUC <0,5). Las ramificaciones fueron infrecuentes (2,9%) y su detección fue baja (Sensibilidad 25% para radiografía y 0% para radiovisiografía). Discusión: Este es el primer estudio que evalúa la reproducibilidad y validez de estas dos técnicas radiográficas comparadas con la CBCT para la detección de variaciones anatómicas en dientes. Conclusiones: La radiografía con placa de fósforo presentó mayor reproducibilidad y validez para el diagnóstico de las Clase I y V de Vertucci, que fueron las variaciones más frecuentes.
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Choi YJ, Lee C, Jeon KJ, Jang JT, Han SS. Canal configuration and root morphology of mandibular premolars using cone-beam computed tomography in a Korean population. Clin Oral Investig 2021; 26:3325-3332. [PMID: 34846559 DOI: 10.1007/s00784-021-04313-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate the anatomy of mandibular premolars from two perspectives-the canal configuration and radicular grooves-using cone-beam computed tomography (CBCT) in a large Korean population. MATERIALS AND METHODS CBCT images of mandibles acquired from March 2018 to December 2019 for dental treatment were randomly selected. In each image, the root canal of premolars was classified into 8 types according to the canal merging or diverging pattern and the number of apical foramens. The presence and the location of radicular grooves were also assessed. Statistical analysis was performed. RESULTS A total of 1463 first and 1448 s premolars from 732 patients (390 males, 342 females, mean age of 36.1 years) were evaluated. A single canal with one foramen predominated in both first (85.7%) and second (99.5%) premolars, while complete or partial multi-canals accounted for 14.3% and 0.5% of first and second premolars, respectively. The prevalence of radicular grooves was significantly higher in first premolars (13.2%) than in second premolars (0.5%) and in males (4.3%, n = 119) than in females (2.5%, n = 73). CONCLUSIONS Although most premolars were complete single canals, the first premolars showed a relatively higher number of complex canals compared to the second premolar. In addition, radicular grooves in mandibular premolars were significantly more common in male patients. CLINICAL RELEVANCE When planning the endodontic treatment of mandibular premolars, clinicians should be aware of their morphologic complexity, especially in the first premolar of male patients.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Ji-Taek Jang
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
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3D-printed multisampling holder for microcomputed tomography applied to life and materials science research. Micron 2021; 150:103142. [PMID: 34509886 DOI: 10.1016/j.micron.2021.103142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/15/2021] [Accepted: 08/22/2021] [Indexed: 11/21/2022]
Abstract
The aim of this work was to design, fabricate, test and validate a 3D-printed multisampling holder for multi-analysis by microcomputed tomography. Different raw materials were scanned by microcomputed tomography. The raw material chosen was used to fabricate the holder by 3D printing. To validate the multisampling holder, five teeth were filled with a high density-material and scanned in two ways: a single and a multisampling scan mode. For each tooth, the root canal filling volume, porosity volume, closed pore volume, and open pore volume were calculated and compared when the same tooth was scanned in the two sampling scan mode. ABSplus P430™ allowed a high transmission value (84.3 %), and then it was the polymeric material selected to fabricate the holder. In a single sampling scan mode, the scan duration for scanning five teeth was 87.42 min, contrasting with 21.51 min for a multisampling scan mode, which scanned five teeth at the same time. The scan duration time and the cost using a multisampling holder represented a reduction of 75 % and the data volume generated represented a reduction of 60 %. Comparing the two scan modes, the results also showed that the difference of root canal filling volume, porosity volume, closed pore volume, and open pore volume was not statistically significant (p > .05). The multisampling holder was validated to do multi-analysis by microcomputed tomography without significant loss of quantitative accuracy data, allowing a reduction in scan duration time, imaging cost, and data storage.
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Al-Zubaidi SM, Almansour MI, Al Mansour NN, Alshammari AS, Alshammari AF, Altamimi YS, Madfa AA. Assessment of root morphology and canal configuration of maxillary premolars in a Saudi subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2021; 21:397. [PMID: 34389013 PMCID: PMC8364052 DOI: 10.1186/s12903-021-01739-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to use CBCT to look into the root canal morphology of maxillary premolars in a Saudi Arabian subpopulation and associate the results to existing canal morphology classifications. METHODS The sample size for this analysis was 500 right and left untreated maxillary first and second premolars with fully formed roots from 250 Saudi residents (125 male and 125 female). The following observations were made using CBCT on the teeth related: (1) The number and morphology of roots; (2) The canal morphology for each root according to Vertucci's classification. The frequency and similarities between the right and left sides, as well as between females and males, were studied. The Chi-square test was used to assess the results. RESULTS Of the 500 maxillary first premolars studied, 199 teeth had one root (39.8%), whilst 293 (58.6%) were two-rooted. Three-rooted maxillary first premolars were found in 8 (1.6%). For maxillary second premolars, 416 premolars had one root (83.2%), whilst 79 (15.8%) had two roots and the rest 5 (1.0%) were three roots. There were significant differences of number of root were found between groups (p > 0.05). For maxillary first premolar, Type IV was the most frequent, accounting for 57.8% of the sample (n = 289), followed by type II (32.8%, n = 164). For maxillary second premolar, Type I was mainly occurrence 302 (60.4%), followed by Type II (16.4%, n = 82). CONCLUSIONS The majority of maxillary first premolars had two roots and two root canals, while one root and one root canal was the most common anatomical configuration for maxillary second premolars. Additional canal forms do occur on occasion, and clinicians should pay close attention to them.
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Affiliation(s)
- Saad M Al-Zubaidi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
| | - Moazzy I Almansour
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | | | | | - Ahad F Alshammari
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Yazeed S Altamimi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
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Micro-CT assessment of radicular pulp calcifications in extracted maxillary first molar teeth. Clin Oral Investig 2021; 26:1353-1360. [PMID: 34373955 DOI: 10.1007/s00784-021-04109-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the frequency, position, and length of radicular pulp calcifications in three-rooted maxillary first molars using micro-computed tomography. MATERIALS AND METHODS Two hundred three-rooted maxillary first molars were scanned at a pixel size of 10 µm and reconstructed using similar parameters. Three-dimensional models of the mesiobuccal (MB1, MB2, MB3), distobuccal (DB), and palatal (P) canals were qualitatively evaluated for discontinuity in the canal path. Transaxial and sagittal cross-sectional images of the roots were further screened, and the complete obliteration of the canal lumen by pulp calcification was identified when the canal had similar radiodensity to the surrounding dentine. Then, the number, position, and length of the calcifications were recorded for each root. Intra-observer agreement was performed using Cohen's kappa test, while one-way ANOVA and Duncan tests compared the lengths of calcifications among the canals, with α = 5%. RESULTS Intra-observer agreement was perfect for identification of pulp calcifications (ĸ = 1.0; p = 0.000). MB2 and MB3 canals accounted for the highest percentage frequency of calcifications distributed throughout the canal path. In the MB1, DB, and P canals, they occurred mainly at the apical third. Lengths of calcifications were greater in the MB3 (0.89 ± 0.81 mm) and MB2 (0.82 ± 0.93 mm) canals than in the MB1 (0.39 ± 0.32 mm), DB (0.34 ± 0.22 mm), and P (0.28 ± 0.22 mm) canals (p < 0.05). CONCLUSION MB2 and MB3 canals accounted for the highest frequency and length of radicular pulp calcifications. In the MB1, DB, and P canals, calcifications occurred mostly at the apical third, while in the MB2 and MB3, most of calcifications were observed at the orifice level and along the canal path. CLINICAL RELEVANCE In maxillary first molars, radicular pulp calcifications are mainly located at the apical third of the MB1, DB, and P canals, while in the MB2 and MB3 canals, most of them are at the orifice level or along the canal path.
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Aung NM, Myint KK. Diagnostic Accuracy of CBCT for Detection of Second Canal of Permanent Teeth: A Systematic Review and Meta-Analysis. Int J Dent 2021; 2021:1107471. [PMID: 34335767 PMCID: PMC8315866 DOI: 10.1155/2021/1107471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Missed canal is one of the common reasons for nonsurgical endodontic retreatments. The missed canals were frequently associated with periapical pathology. The aim of this systematic review was to find the diagnostic accuracy of CBCT for detection of the second canal of the root canal system of permanent teeth. MATERIALS AND METHODS The articles were selected from seven electronic databases according to selection criteria. All eligible studies were judged by the reviewers. The selected studies were checked with the QUADAS-2 tool for risk of bias and applicability concerns. Finally, 12 studies were selected for qualitative and quantitative analyses. The summary estimates of sensitivities and specificities and SROC curves were calculated and drawn by RevMan 5.3 and MetaDTA software. RESULTS Summary estimates of CBCT for detection of second canal anatomy in permanent teeth were 94% sensitivity and 93.1% specificity. 96.6% sensitivity of MB2 was followed by 88.8% sensitivity of maxillary and mandibular premolars and 81% that of mandibular molars. The specificity of 97.6% for premolars was trialed by 85% specificity of mandibular molars and MB2. For permanent mandibular canines, 67% sensitivity and 100% specificity were estimated. CBCT showed more agreement with detecting the second canal with micro-CT, estimating 100% sensitivity and 95.6% specificity. The highest prevalence of the second canal comprised the highest sensitivity of 99.1% and lowest specificity of 77.5%. After the exclusion of case-control studies, a 3% drop of sensitivity from the summary estimate was observed. Multiple spectrum of the second canal had 8.6% higher sensitivity and 4.4% lower specificity than single spectrum. CONCLUSION CBCT is informative for detecting the second canal. Clinicians should keep in mind that the accuracy can vary in different types of teeth, with the prevalence of second canal across different populations, and with the spectrum of second canal anatomy in spite of the reviewers having postulated overestimation of the findings.
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Affiliation(s)
- Nyan M. Aung
- Department of Oral Biological Science, University of Dental Medicine, Mandalay 05041, Myanmar
| | - Kyaw K. Myint
- Department of Oral Biological Science, University of Dental Medicine, Mandalay 05041, Myanmar
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Alghamdi FT, Khalil WA. Root canal morphology and symmetry of mandibular second premolars using cone-beam computed tomography. Oral Radiol 2021; 38:126-138. [PMID: 33963988 DOI: 10.1007/s11282-021-00534-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The current study aims to investigate the morphology and symmetry of root canals of mandibular second premolar teeth via Cone-Beam Computed Tomography (CBCT) among a sample of the Saudi population. METHODS A total of 1200 CBCT images were examined in the study. The number of roots in the mandibular second premolars was identified, and canal configurations were classified according to Vertucci classification. Bilateral symmetry and association between gender and number of roots and root canal configuration were investigated using a chi-square test was utilized for data analysis and p value was set at 0.05 for significance. RESULTS Of the total 2400 Mandibular second premolars, 98.33% were single rooted and 1.67% were double rooted. The prevalence of double roots in females on the right side was significantly higher than that on the left side (p = 0.017), but the opposite was found among males. Only Type I and II canal configurations showed significant differences regarding gender and sides. 98.0% of teeth showed the symmetrical number of roots in both genders. The symmetry in canal configuration was 96.7% in males and 97.3% in females and 99.1% was Type I in both sides, 0.5% Type III, and 0.3% Type IV in both sides. CONCLUSIONS The root morphology of mandibular second premolars in the Saudi population demonstrated a high degree of variability. The vast majority of mandibular premolars have a single root with one canal and a low prevalence of two rooted teeth. Contralateral mandibular second premolars exhibited great symmetry of roots and root canal configuration.
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Affiliation(s)
- Faisal T Alghamdi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, 80209, Jeddah, 21589, Saudi Arabia.
| | - Wafaa A Khalil
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Li X, Xu J, Yin Y, Liu T, Chang L, He S, Chen S. Notch signaling inhibition protects against root resorption in experimental immature tooth movement in rats. Am J Orthod Dentofacial Orthop 2021; 159:426-434.e5. [PMID: 33568273 DOI: 10.1016/j.ajodo.2020.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This study aimed to build an experimental immature tooth movement model and verify less resorption of incompletely developed roots than those fully developed during the same orthodontic treatment, followed by investigating the cellular and molecular mechanism. METHODS The development of Wistar rat tooth was investigated using in vivo microcomputed tomography and hematoxylin and eosin staining to decide the optimal ages of rats for immature tooth and mature tooth groups. The rats in the immature tooth and mature tooth groups were divided into experimental, sham control, and blank control groups. After orthodontic treatment for 3 weeks, the mesial root volume, crown movement distance, neck movement distance, root inclination, and apical distance were measured by microcomputed tomography. The expressions of TRAP, Jagged1, Notch2, IL-6, and RANKL were analyzed by immunohistochemical staining and real-time polymerase chain reaction. The repair of root resorption was also investigated after removing orthodontic force for 3 and 6 weeks. RESULTS The root achieved the development stage around 10 weeks, so 4-week-old rats and 10-week-old rats were used in the immature tooth group and mature tooth group, respectively. The volume of root resorption in the experimental immature tooth group was 0.0869 ± 0.0244 mm3, which was less than that in the mature tooth group (0.1218 ± 0.0123 mm3) (P <0.001). Immature tooth movement decreased TRAP-positive odontoclasts on the compression side while having no statistically significant effect on osteoclasts. The protein expression of Jagged1, Notch2, IL-6, and RANKL in the mature tooth group increased significantly compared with the immature tooth group, not only on the compression side but also on the tension sides. The mRNA expression of Jagged1, Notch2, and RANKL was significantly lower in the immature tooth group, whereas the expression of IL-6 had no significance but a strong tendency. The root volume after repairing for 3 weeks was still less than that of blank control, whereas after repairing for 6 weeks, the difference was not statistically significant. CONCLUSIONS The experimental immature tooth movement model for the Wistar rat was achieved for the first time. The immature tooth will suffer less root resorption than the mature tooth, which may be due to odontoclastogenesis inhibition by decreased expression of Jagged1/Notch2/IL-6/RANKL signaling.
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Affiliation(s)
- Xinyi Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jingchen Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ting Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Le Chang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shushu He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Sierra-Cristancho A, González-Osuna L, Poblete D, Cafferata EA, Carvajal P, Lozano CP, Vernal R. Micro-tomographic characterization of the root and canal system morphology of mandibular first premolars in a Chilean population. Sci Rep 2021; 11:93. [PMID: 33420202 PMCID: PMC7794380 DOI: 10.1038/s41598-020-80046-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
This study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.
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Affiliation(s)
- Alfredo Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - Luis González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Daniela Poblete
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Emilio A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Paola Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Carla P Lozano
- Oral Biology and Biochemistry Laboratory, Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile. .,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
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Villa-Machado PA, Restrepo-Patiño DM, Calvo-Trejos JP, Restrepo-Restrepo FA, Tobón-Arroyave SI, Provenzano JC, Siqueira JF, Alves FRF. Cone-beam Computed Tomographic and Micro-computed Tomographic Evaluations of the Root Apexes of Teeth with Posttreatment Apical Periodontitis. J Endod 2020; 46:1695-1701. [PMID: 32682792 DOI: 10.1016/j.joen.2020.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/05/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This study evaluated the association of different variables that may influence the outcome of root canal treatment through cone-beam computed tomographic (CBCT) and micro-computed tomography (micro-CT) assessments of root apexes obtained by endodontic microsurgery of teeth with posttreatment apical periodontitis (AP), the agreement between CBCT and micro-CT findings, and the association of these variables with symptoms or lesion size. METHODS Clinical and CBCT records and root apexes obtained by endodontic microsurgery from 11 cases of symptomatic AP and 22 cases of asymptomatic AP were available. Apical root specimens were further scanned using micro-CT imaging. CBCT parameters included periapical radiolucency size, apical extent/density of root canal filling, and occurrence of procedural errors. Micro-CT images evaluated the same parameters plus the presence of filling material in lateral canals and ramifications, the volume of the filled/nonfilled apical root canal, and the percentage of the nonfilled canal space. The agreement between CBCT/micro-CT observations was evaluated. RESULTS Mandibular teeth, a lesion size <5 mm, a nonfilled volume <0.04 mm3, and the decreased percentage of the nonfilled canal volume were significantly associated with symptomatic AP. Maxillary teeth and inadequate apical filling density were significantly associated with larger lesions. Agreement between CBCT/micro-CT scores varied from fair (procedural errors) to satisfactory (extent/density of filling). CONCLUSIONS Tooth location, lesion size, the nonfilled apical canal volume, and the percentage of the nonfilled apical canal volume were associated with symptomatic AP. In addition, lesion size was significantly associated with tooth location and apical root canal filling density. CBCT imaging may not provide a reliable evaluation of procedural errors associated with posttreatment disease.
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Affiliation(s)
- Paula A Villa-Machado
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana M Restrepo-Patiño
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Juliana P Calvo-Trejos
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Felipe A Restrepo-Restrepo
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Sergio I Tobón-Arroyave
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | - José C Provenzano
- Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - José F Siqueira
- Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio, Duque de Caxias, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Department of Endodontics and Dental Research Group, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio, Duque de Caxias, Rio de Janeiro, Brazil
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Borges CC, Estrela C, Decurcio DDA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G. Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 2020; 34:e056. [PMID: 32578799 DOI: 10.1590/1807-3107bor-2020.vol34.0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022] Open
Abstract
This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.
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Affiliation(s)
- Caroline Cristina Borges
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Jesus Djalma PÉcora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Arayasantiparb R, Banomyong D. Prevalence and morphology of multiple roots, root canals and C-shaped canals in mandibular premolars from cone-beam computed tomography images in a Thai population. J Dent Sci 2020; 16:201-207. [PMID: 33384798 PMCID: PMC7770317 DOI: 10.1016/j.jds.2020.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/12/2020] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Variations in root and root canal morphology of mandibular premolars of Thais has not been reported, and understanding these variations enhances endodontic success. The purpose was to investigate prevalence and morphology of multiple roots, root canals and C-shaped canals in mandibular premolars in a Thai population from cone-bean computed tomography (CBCT) images. Materials and methods A total of 349 first mandibular premolars and 416 second premolars from CBCT images with 0.125-mm voxel size and 60 × 60 mm field of view were evaluated. Number of roots, root canals, and C-shaped canals were recorded and statistically analyzed using chi-square test. Root canal configurations were defined according to the Vertucci's classification. Levels and distances of separated multiple canals were reported. Results Multiple roots in mandibular first premolars were found at 5.73% while none of second premolars had. Multiple root canals were found in the first premolars at 19.48% and the second premolars at 3.85%. C-shaped canals (C1/C2) were found in the first premolars at 3.72% and the second premolars at 0.48%. All parameters in the first premolars were significantly higher than in the second premolars (p < 0.01). The majority of multiple root canals were defined as Vertucci's type V (1–2 canals). Multiple root canals were frequently separated at the middle level of roots about 6.5–7.0 mm from the cementoenamel junction. Conclusion Prevalence of multiple roots/root canals and C-shaped canals in mandibular first premolars were significantly higher than in mandibular second premolars. Level of separation in multiple root canals was frequently at the mid-root level.
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Affiliation(s)
- Raweewan Arayasantiparb
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Thailand
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Wolf TG, Kim P, Campus G, Stiebritz M, Siegrist M, Briseño-Marroquín B. 3-Dimensional Analysis and Systematic Review of Root Canal Morphology and Physiological Foramen Geometry of 109 Mandibular First Premolars by Micro-computed Tomography in a Mixed Swiss-German Population. J Endod 2020; 46:801-809. [PMID: 32303349 DOI: 10.1016/j.joen.2020.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/08/2020] [Accepted: 03/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aim of this study was to systematically revise the root canal configuration (RCC) literature and to investigate the root canal morphology of mandibular first premolars (Ma1Ps) of 2 populations by means of micro-computed tomographic imaging. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including RCC randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies. Furthermore, the RCC, physiological foramina, the frequency of accessory and connecting canals, and the physiological foramina morphology of 109 Ma1Ps were investigated by means of micro-computed tomographic imaging. The RCC results are described using a 4-digit system code. RESULTS The most frequent RCCs observed were 1-1-1/1 (70.6%), 1-1-2/2 (7.3%), 1-2-2/2 (7.3%), and 1-2-1/1 (5.5%). Accessory canals were observed in 31.2%. Connecting canals were observed in 1-1-2/2 (4.6%), 1-2-2/2 (4.6%), 1-1-2/1 (1.8%), and 1-2-1/1 (1.8%) RCCs. Accessory foramina were observed in 52.3%; 30.3% of the Ma1Ps had 1 accessory foramen, 12.8% had 2, 2.8% had 3, 2.8% had 4, 2.8% had 5, and 0.92% had 6. The narrow and wide diameter mean of 136 physiological foramina was 0.28 mm (±0.9) and 0.37 mm (±0.11) when only 1 physiological foramen was present. CONCLUSIONS This study provides detailed root canal morphology of Ma1Ps in a Swiss-German population. Within the limitations of the study, the authors recommend a final physiological foramen preparation size of instrument tip sizes 30-40; yet, such a decision should be carefully considered on an individual basis.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Paul Kim
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Guglielmo Campus
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Stiebritz
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mark Siegrist
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Liu YJ, Yang WD, Wang WM, Zhu YN, Lin ZT, Zhu M. Relationship between canal morphology and isthmus in mesio-buccal roots of maxillary first molars in 9- to 12-year-old children: An in-vivo cone-beam computed tomography analysis. Arch Oral Biol 2020; 112:104645. [PMID: 31991228 DOI: 10.1016/j.archoralbio.2019.104645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/23/2019] [Accepted: 12/23/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This study aims to analysis the distribution of root canal isthmuses (RCIs), and its relationship with canal morphology in the mesio-buccal roots of maxillary first molars in children aged 9-12 in a Chinese sub-population. METHODS 494 healthy, untreated maxillary first molars with fully developed mesio-buccal roots were examined. Cone-beam computed tomography (CBCT) scans were acquired as part of diagnosis and treatment plannings unrelated to the present study. The images were evaluated to identify the canal morphology of mesio-buccal roots according to Vertucci's classification. A map-reading strategy was used to identify RCIs. RESULTS In mesio-buccal roots, the most common canal morphology was type Ⅳ (38.5 %). The frequency of type I (1.6 %) was much lower than adults. RCIs were found in 92.5 % mesio-buccal roots. The RCIs which began in the cervical third and ended in the middle third (CT-MT) (31.0 %) had the highest frequency. In type III, the RCIs which began and ended in the middle third (MT-MT) (30.3 %) were most common. For type V, 30.8 % RCIs began in the cervical third and ended in the apical third (CT-AT). No significant differences were found between sexes and sides (P > 0.05). CONCLUSIONS For children aged 9-12, the frequency of type I canals was much lower in mesio-buccal roots of maxillary permanent first molars, while the frequency of RCIs was higher than adults, especially in the apical third. The distribution of RCIs had its own characteristics in each canal type, closely related to the structures.
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Affiliation(s)
- Ya-Jing Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Wei-Dong Yang
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China.
| | - Wen-Mei Wang
- Department of Oral Mucosa Diseases, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Ya-Nan Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Zi-Tong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Min Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
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Jang YE, Kim Y, Kim B, Kim SY, Kim HJ. Frequency of non-single canals in mandibular premolars and correlations with other anatomical variants: an in vivo cone beam computed tomography study. BMC Oral Health 2019; 19:272. [PMID: 31801495 PMCID: PMC6894311 DOI: 10.1186/s12903-019-0972-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background A knowledge regarding anatomical variants is important to achieve success in endodontic treatment. Root canal treatment of mandibular first premolars (PM1 s) is challenging due to the existence of numerous variations in canal configurations, including a C-shaped variant. We aim to determine the frequency and morphologic characteristics of non-single canals of mandibular first (PM1 s) and second (PM2 s) premolars in a Korean population using cone beam computed tomography (CBCT) and to evaluate correlations between non-single canals of PM1 s and other anatomical variants, such as distolingual roots (DLRs) in mandibular first molars (M1 s) and C-shaped canals in mandibular second molars (M2 s). Methods A total of 971 PM1 s and 997 PM2 s from 500 patients were examined in vivo by CBCT. Root canal configurations and C-shaped canals were determined in accordance with the Vertucci classification and Fan classification, respectively. The correlation between non-single canals in PM1 s and DLRs in M1 s was evaluated using logistic regression analysis. Results PM2 s typically had one root (99.89%) with one canal (98.4%). Among PM1 s with non-single canals (21.2%), Vertucci type V (10.9%) and C-shaped (3.7%) canals were prevalent. Among C-shaped PM1 canals, the majority were Vertucci type V (77.8%); a C-shaped configuration (C2) was predominant mostly at the middle and/or apical third of the root. After adjusting for other variables (i.e., sex, age, and side), C-shaped canals in PM1 s was significantly correlated with the presence of DLRs in M1 s (odds ratio = 2.616; 95% confidence interval, 1.257–5.443; p = 0.010). Conclusions The presence of C-shaped PM1 canals was positively related to the presence of DLRs in M1 s. Although C-shaped canals in PM1 s are difficult to distinguish, this finding could aid clinicians in predicting C-shaped canal configurations in PM1 s of patients who exhibit DLRs in M1 s.
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Affiliation(s)
- Young-Eun Jang
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, South Korea
| | - Yemi Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, South Korea.
| | - BomSahn Kim
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyung-Jong Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, South Korea
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Corbella S, Baruffaldi M, Perondi I, Taschieri S. Surgically-oriented anatomical study of mandibular premolars: A CBCT study. J Clin Exp Dent 2019; 11:e877-e882. [PMID: 31636856 PMCID: PMC6797462 DOI: 10.4317/jced.55848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
Background The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to investigate the anatomical features of mandibular premolars, evaluating their relationship with mental nerve. Material and Methods CBCT scans were evaluated recording the number of roots, root canal configuration and the relationship with mental nerve of 100 mandibular premolars. After simulating a resection of 3 mm of the root, the shape and the number of canals, and the distance to the buccal and lingual bone plate and to the mental foramen was evaluated. Results The one root - one canal configuration was the most common configuration. The mental foramen was located at the level of MSPs in 40% cases, and it was between MSP and MFP in 46% of cases. The distance between the apex and the vestibular plate was lower than the distance to the lingual one. Conclusions We found a significant heterogeneity in the anatomy of mandibular premolars. CBCT could be considered important when planning surgical endodontics in this region. Key words:Cone-Beam Computed Tomography, bicuspid, root canal, root canal therapy, apicoectomy, mandibular nerve.
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Affiliation(s)
- Stefano Corbella
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
| | - Martino Baruffaldi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Isabella Perondi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Silvio Taschieri
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
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Mashyakhy M, Gambarini G. Root and Root Canal Morphology Differences Between Genders: A Comprehensive in-vivo CBCT Study in a Saudi Population. Acta Stomatol Croat 2019; 53:213-246. [PMID: 31749454 PMCID: PMC6820446 DOI: 10.15644/asc53/3/5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/27/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To comprehensively explore the differences of all maxillary and mandibular permanent teeth in relation to number of roots, number of root canals, and root canal configuration between both genders in a Saudi Arabian population. METHODS This retrospective radiographic study comprised 208 subjects (48% males and 52% females) with a mean age 28.74±9.56 years. The CBCT images of the recruited subjects were evaluated for all permanent teeth. A careful examination was obtained by optimal visualization using all the software features. The data were analyzed using SPSS software program. Cohen's Kappa test was used for reliability and the Chi-squared test of association was used for the differences between both genders in relation to the study variables. A P-value < 0.05 was considered significant. RESULTS A total of 5254 maxillary and mandibular permanent teeth were evaluated. In relation to number of roots, there were no significant differences between both genders for all maxillary and mandibular teeth together (P= 0.064) as well as for maxillary and mandibular teeth separately (P= 0.315 and P= 0.100, respectively). A significant difference was found between males and females in relation to the number of canals of maxillary teeth (P= 0.014). For mandibular teeth, the significant level of difference was at the cut-off point (P= 0.050). For all maxillary and mandibular teeth together, the distribution among both genders was not significant (P= 0.082). The difference between both genders with regard to canal configuration of maxillary roots was highly statistically significant (P< 0.001). For mandibular teeth, the difference between males and females in relation canal configuration of anterior and premolar teeth was significant (P= 0.016) while, the difference was not significant when related to mesial roots of 1st and 2nd molars (P= 0.205). However, the difference was highly significant when related to distal roots of 1st and 2nd molars (P< 0.001). CONCLUSION No significant differences between both genders in relation to number of roots were found. Regarding the number of canals, significant differences were found only in three groups out of 14 groups of teeth with females who had a smaller number of canals than males. For canal configuration, two groups of maxillary teeth and three groups of mandibular teeth showed statistically significant differences between both genders.
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Affiliation(s)
- Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Gianluca Gambarini
- Department of Restorative Dentistry and Endodontics, Sapienza University of Rome, Rome, Italy
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Kaya Büyükbayram I, Sübay RK, Çolakoğlu G, Elçin MA, Ordulu Sübay M. Investigation using cone beam computed tomography analysis, of radicular grooves and canal configurations of mandibular premolars in a Turkish subpopulation. Arch Oral Biol 2019; 107:104517. [PMID: 31442932 DOI: 10.1016/j.archoralbio.2019.104517] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To conduct an in vivo evaluation of prevalence of root canal configurations, lengths of C-shaped canals, prevalence and depths of radicular grooves (RGs), in mandibular first and second premolars in a Turkish subpopulation using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT images of 327 first and 264 second premolars were included. Canal configurations, locations, lengths, and types of C-shaped canals, and RGs were evaluated on CBCT images. Data were statistically analyzed (P < 0.05). RESULTS First and second premolars were classified as follows: type I, (83.8%, 97.72%); type V, (12.22%, 0.76%); type III, (3.06%, 0.76%); and other types. RGs were exhibited by 14.68% of first and 2.27% of second premolars (P < 0.05). Incidence of complex canals (types III, V and other types, 89.8%) in first premolars with RGs was significantly higher versuswithout RGs (P < 0.05). C-shaped configuration was exhibited by 4.58% of first (80% semilunar-type), and 1.13% of second premolars (P < 0.05). All first premolars with C-shaped canals showed RGs and complex canals. CONCLUSIONS Complex canals and RGs frequently co-exist in mandibular premolars. C-shaped canals are not common in mandibular premolars, and mostly located in middle thirds. Type V is the most prevalent complex canal configuration in first premolars, and frequently associated with a C-shaped semilunar-type anatomy.
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Affiliation(s)
- Işıl Kaya Büyükbayram
- Department of Endodontics, Faculty of Dentistry, İstanbul Aydın University, Küçükçekmece, İstanbul, 34295, Turkey.
| | - Rüstem Kemal Sübay
- Department of Endodontics, Faculty of Dentistry, İstanbul Aydın University, Küçükçekmece, İstanbul, 34295, Turkey
| | - Gizem Çolakoğlu
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, İstanbul Aydın University, Küçükçekmece, 34295, İstanbul, Turkey
| | - Mehmet Ali Elçin
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, İstanbul Aydın University, Küçükçekmece, 34295, İstanbul, Turkey
| | - Melike Ordulu Sübay
- Department of Oral Surgery, Faculty of Dentistry, İstanbul University, Çapa, Fatih, 34093, İstanbul, Turkey
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Biz MT, Cucco C, Cavalcanti BN. Incorporation of AuNP-PLL nanocomplexes in DPSC: a new tool for 3D analysis in pulp regeneration. Clin Oral Investig 2019; 24:1761-1767. [PMID: 31375901 DOI: 10.1007/s00784-019-03037-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/18/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To assess the viability of dental pulp stem cells loaded with gold nanoparticles complexed with poly (L-lysine) (AuNP-PLL) and to track the cellular behavior in a 3D analysis by micro-CT. MATERIALS AND METHODS DPSC (dental pulp stem cells) were cultured and incorporated with AuNP-PLL (0.2 mg/ml) and assessed for cell viability (24 h, 48 h, and 72 h) using MTS assay. Apoptosis/cell death index and cell cycle were analyzed by propidium iodide. AuNP-PLL-RITC were used for observation in confocal microscopy and quantification of the incorporation rates. Cells were also suspended in agarose and analyzed three-dimensionally in μCT, assessing their radiopacity. Quantitative data (cell viability and apoptosis) were analyzed by t test (p < 0.05). RESULTS AuNP-PLL labeling did not affect cellular viability in any of the periods analyzed nor interfered with the apoptosis index of DPSC. AuNP-PLL nanocomplexes were identified in the cytoplasm of cells by immunofluorescence, mainly in the perinuclear region. The observed incorporation rate was 98%. Micro-CT analysis has shown that incorporated cells are now visible using x-ray, with a clear increase in radiopacity when compared to the control group (non-incorporated cells). CONCLUSION These results indicate that it is possible to incorporate AuNP-PLL complex into DPSC and track the cells by using μCT; furthermore, this incorporation of 0.2 mg/ml of AuNP-PLL does not interfere in the DPSC basic behavior. CLINICAL RELEVANCE This methodology can be a useful tool for cellular labeling to observe cell behavior and their interaction with scaffolds in a 3D manner, opening an array of new approaches in regenerative endodontics.
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Affiliation(s)
- Michelle Tillmann Biz
- Departamento de Ciências Morfológicas, Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil
| | - Carolina Cucco
- Department of Endodontics, University of Iowa College of Dentistry and Dental Clinics, W344 DSB, 801 Newton Rd, Iowa City, IA, 52242, USA
| | - Bruno Neves Cavalcanti
- Department of Endodontics, University of Iowa College of Dentistry and Dental Clinics, W344 DSB, 801 Newton Rd, Iowa City, IA, 52242, USA.
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Martins JNR, Marques D, Silva EJNL, Caramês J, Mata A, Versiani MA. Prevalence of C‐shaped canal morphology using cone beam computed tomography – a systematic review with meta‐analysis. Int Endod J 2019; 52:1556-1572. [DOI: 10.1111/iej.13169] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- J. N. R. Martins
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
| | - D. Marques
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry Grande Rio University Rio de JaneiroBrazil
| | - J. Caramês
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - A. Mata
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - M. A. Versiani
- Dental Specialty Center Brazilian Military Police Minas Gerais Brazil
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Prevalence Studies on Root Canal Anatomy Using Cone-beam Computed Tomographic Imaging: A Systematic Review. J Endod 2019; 45:372-386.e4. [DOI: 10.1016/j.joen.2018.12.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 12/12/2018] [Accepted: 12/16/2018] [Indexed: 01/20/2023]
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Canal transportation and centering ratio after preparation in severely curved canals: analysis by micro-computed tomography and double-digital radiography. Clin Oral Investig 2019; 23:4255-4262. [PMID: 30834991 DOI: 10.1007/s00784-019-02870-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/19/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation. MATERIALS AND METHODS Mesial root canals of mandibular molars with severe curvature (25-70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%). RESULTS The micro-CT method showed that XPS's shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023). CONCLUSIONS Micro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups. CLINICAL RELEVANCE Root canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.
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Heney CM, Arzi B, Kass PH, Hatcher DC, Verstraete FJM. The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats. Front Vet Sci 2019; 6:42. [PMID: 30847347 PMCID: PMC6393352 DOI: 10.3389/fvets.2019.00042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) software modules for the identification of 32 pre-defined dentoalveolar lesions in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, 32 predefined dentoalveolar lesions were evaluated separately and scored by use of dental radiography and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views]. A qualitative scoring system was used. Dentoalveolar lesions were grouped into 14 categories for statistical analysis. Point of reference for presence or absence of a dentoalveolar lesion was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ2 test of marginal homogeneity of paired data. When all 3 CBCT software modules were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 14 categories (missing teeth, horizontal bone loss, loss of tooth integrity, feline resorptive lesions), and higher, although not significantly so, for 9 categories (supernumerary teeth, supernumerary roots, abnormally shaped roots, vertical bone loss, buccal bone expansion, periapical disease, inflammatory root resorption, and external replacement root resorption). In conclusion, we found that CBCT provided more clinically relevant detailed information as compared to dental radiography. Therefore, CBCT should be considered better suited for use in diagnosing dentoalveolar lesions in cats.
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Affiliation(s)
- Colleen M. Heney
- Dentistry and Oral Surgery Service, School of Veterinary Medicine, William Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Philip H. Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - David C. Hatcher
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Diagnostic Dental Imaging Center, Sacramento, CA, United States
| | - Frank J. M. Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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Dąbrowski P, Grzelak J, Kulus M, Staniowski T. Diagnodent and VistaCam may be unsuitable for the evaluation of dental caries in archeological teeth. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 168:797-808. [PMID: 30693947 DOI: 10.1002/ajpa.23785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The aim of the study was to compare the usefulness of fluorescence-based caries detection systems (Diagnodent and VistaCam) for the assessment of carious lesions on archeological molars. MATERIALS AND METHODS The study material consisted of teeth from the Cemetery of St. Mary Magdalene (Cmentarz św. Marii Magdaleny) in Wrocław, Poland. A sample of 178 permanent molars from 38 skulls were examined. Five surfaces of teeth (occlusal, mesial, distal, buccal, and lingual) were assessed on either basically cleaned or sandblasted teeth. Six diagnostic methods were used to detect carious lesions: the visual classification of the International Caries Detection and Assessment System (ICDAS II), fluorescent methods (Diagnodent and VistaCam), X-ray, cone beam computed tomography and histological sections. The sensitivity and specificity of the methods were determined using receiver operating characteristic (ROC) curves and the correlation between the severity of dental caries and the readouts obtained with each method. RESULTS In most cases, Diagnodent and VistaCam yielded unsatisfactory specificity and sensitivity values. The area under curve (AUC) values in ROC curves for Diagnodent and Vistacam were lower than the AUC values obtained for the ICDAS II visual classification. CONCLUSIONS According to our results, in the case of archeological teeth, neither Diagnodent nor VistaCam can be regarded as a better diagnostic method than the ICDAS II visual classification of caries.
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Affiliation(s)
- Paweł Dąbrowski
- Division of Normal Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Joanna Grzelak
- Department of Oral Anatomy, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Kulus
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Staniowski
- Department of Conservative Dentistry and Pedodontics, Wroclaw Medical University, Wroclaw, Poland
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Celikten B, Jacobs R, de Faria Vasconcelos K, Huang Y, Shaheen E, Nicolielo LFP, Orhan K. Comparative evaluation of cone beam CT and micro-CT on blooming artifacts in human teeth filled with bioceramic sealers. Clin Oral Investig 2018; 23:3267-3273. [DOI: 10.1007/s00784-018-2748-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/19/2018] [Indexed: 12/01/2022]
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Zhou J, Yang F, Xu X, Feng G, Chen J, Song J, Dai H. Dynamic Evaluation of Orthodontically-Induced Tooth Movement, Root Resorption, and Alveolar Bone Remodeling in Rats by in Vivo Micro-Computed Tomography. Med Sci Monit 2018; 24:8306-8314. [PMID: 30448850 PMCID: PMC6253985 DOI: 10.12659/msm.912470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background The aim of this study was to dynamically evaluate tooth movement, root resorption, and remodeling of alveolar bone using different forces to cause tooth movement in rats. Material/Methods 12-week-old male Sprague-Dawley rats were selected. Nickel-titanium (Ni-Ti) coil springs (20 g, 50 g, and 100 g forces) were placed for mesial movement of the left first maxillary molar teeth. Tooth movement, root resorption, and microarchitectural parameters of the trabecular bone were evaluated by in vivo micro-CT. Histological examination was used to observe the root resorption, alveolar bone remodeling, and changes in osteoclasts from day 0 to day 14. Results The tooth movement distance increased significantly over the initial 3 days in the 3 groups. The 20 g force group showed more tooth movement than in the 50 and 100 g force groups after 14 days (P<0.05). From days 7 to 10, root resorption lacunae appeared in the 3 groups and then stabilized, and the 100 g force group produced more lacunar resorption than in the anther 2 groups (P<0.05). Compared to day 0, the trabecular thickness and bone volume fraction on the pressure side gradually decreased from day 7 to day 14. The structure model index increased significantly from day 3 to day 14. Histological examination showed remarkable root resorption craters and osteoclasts positive for tartrate-resistant acid phosphatase in the root resorption lacunae in the 50 g and 100 g groups from day 7 to day 14. Conclusions A 100 g heavy force can be used to establish a root resorption model in rats.
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Affiliation(s)
- Jianping Zhou
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Fengxue Yang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Xiaolin Xu
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Gang Feng
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Jun Chen
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Jinglin Song
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Hongwei Dai
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
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Christodoulou A, Mikrogeorgis G, Vouzara T, Papachristou K, Angelopoulos C, Nikolaidis N, Pitas I, Lyroudia K. A new methodology for the measurement of the root canal curvature and its 3D modification after instrumentation. Acta Odontol Scand 2018; 76:488-492. [PMID: 29448877 DOI: 10.1080/00016357.2018.1440321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE In this study, the three-dimensional (3D) modification of root canal curvature was measured, after the application of Reciproc instrumentation technique, by using cone beam computed tomography (CBCT) imaging and a special algorithm developed for the 3D measurement of the curvature of the root canal. MATERIALS AND METHODS Thirty extracted upper molars were selected. Digital radiographs for each tooth were taken. Root curvature was measured by using Schneider method and they were divided into three groups, each one consisting of 10 roots, according to their curvature: Group 1 (0°-20°), Group 2 (21°-40°), Group 3 (41°-60°). CBCT imaging was applied to each tooth before and after its instrumentation, and the data were examined by using a specially developed CBCT image analysis algorithm. RESULTS The instrumentation with Reciproc led to a decrease of the curvature by 30.23% (on average) in all groups. CONCLUSIONS The proposed methodology proved to be able to measure the curvature of the root canal and its 3D modification after the instrumentation.
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Affiliation(s)
- Asterios Christodoulou
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Mikrogeorgis
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Triantafillia Vouzara
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Papachristou
- Artificial Intelligence and Information Analysis Laboratory, Department of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Angelopoulos
- Department of Oral Surgery, Implantology and Dental Radiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Nikolaidis
- Artificial Intelligence and Information Analysis Laboratory, Department of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Pitas
- Artificial Intelligence and Information Analysis Laboratory, Department of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kleoniki Lyroudia
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Cone-Beam Computed Tomographic Evaluation of Root Canal Morphology of Maxillary Premolars in a Saudi Population. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8170620. [PMID: 30186867 PMCID: PMC6114071 DOI: 10.1155/2018/8170620] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/09/2018] [Indexed: 11/17/2022]
Abstract
Objective The aim of the study was to investigate the root canal morphology of maxillary first and second premolars in a Saudi population using Cone-Beam Computed Tomography (CBCT). Methods This retrospective cross-sectional study assessed CBCT images of 707 Saudi patients. The number of roots and canal configuration were identified based on Vertucci's classification. Fisher's exact Chi-square tests were performed to analyze the association between sex and number of roots and sex and root canal configuration. Results Most teeth had two roots in maxillary first premolars (75.1%) and one root in maxillary second premolars (85.2%). Type IV was the most prevalent canal configuration in maxillary first premolars (69.1%), while Type I was the most in maxillary second premolars (49.4%). All types of canal configurations were observed in maxillary premolars except Type VII for the maxillary second premolar. Chi-square tests showed no significant association between gender and number of roots and sex and root canal configuration in both maxillary first and second premolars although higher number of roots was seen in men (P > 0.05). Conclusion Most maxillary first premolars had two roots with Type IV being the most predominant canal configuration, while a single root with Type I canal configuration was the most frequently observed morphology in maxillary second premolars. In maxillary first premolars, 21.3% had one canal apically, 75.4% had two canals apically, and 3.3% had three canals apically. In maxillary second premolars, 80.2% had one canal apically, 18.9% had two canals apically, and 0.9% had three canals apically.
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Differences on the Root and Root Canal Morphologies between Asian and White Ethnic Groups Analyzed by Cone-beam Computed Tomography. J Endod 2018; 44:1096-1104. [DOI: 10.1016/j.joen.2018.04.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/18/2018] [Accepted: 04/02/2018] [Indexed: 12/25/2022]
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