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Keratiotis G, Spineli L, De Bruyne MAA, De Moor RJG, Meire MA. A 22-year follow-up cross-sectional study on periapical health in relation to the quality of root canal treatment in a Belgian population. Int Endod J 2024; 57:533-548. [PMID: 38314902 DOI: 10.1111/iej.14032] [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: 10/26/2023] [Revised: 12/12/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
AIM To investigate the prevalence of apical periodontitis (AP) and the technical standard of root canal treatment in a Belgian population, assess the association of different variables with periapical status, and compare the results to a similar study conducted 22 years previously. METHODOLOGY In this cross-sectional study, 614 panoramic radiographs of first-time adult attendees at the Dental School of the University Hospital of Ghent were examined. Recorded patient-level parameters included gender, age, number of teeth, number of root filled teeth, presence of any AP lesion, and number of implants. The following tooth-level data were collected: tooth presence, coronal status, quality of coronal restoration, post presence, type of root-filling material, length and density of root filling, root-end filling material, presence of AP, and adjacent implant. Multivariable multilevel binary logistic regression was used to explore the association between patient and tooth characteristics and AP prevalence. Risk differences and confidence intervals were calculated to compare the present with the previous study. RESULTS The prevalence of AP at patient and tooth level was 46.9% and 5.6%, respectively. Fifty-one per cent of the 614 patients had at least one root filled tooth, and 5.9% of the 14 655 teeth studied were root filled. AP was found in 45% of root filled teeth. Fifty-four per cent of the root-filled teeth were rated as inadequate. Multivariable multilevel logistic regression revealed that more teeth, more implants, fewer root-filled teeth, adequate density, adequate coronal restoration, and no caries reduced the likelihood of AP. There were no statistically significant differences between the two studies regarding the prevalence of root-filled teeth or AP and the technical quality of root canal treatment. CONCLUSIONS The prevalence of AP and the technical quality of root canal treatment in Belgium have not substantially changed over the last 22 years, despite the technological advancements and continuing education in the field.
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Affiliation(s)
- Georgios Keratiotis
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Loukia Spineli
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Mieke A A De Bruyne
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Roeland J G De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Maarten A Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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Calazans MAA, Pontual ADA, Pontual MLDA, Ferreira FABS, Santos A, Alcoforado MDLMG, Ramos-Perez FMDM, Madeiro F. A system for automatic classification of endodontic treatment quality in CBCT. Clin Oral Investig 2024; 28:223. [PMID: 38507031 DOI: 10.1007/s00784-024-05599-1] [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: 05/15/2023] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES An evaluation of the effectiveness of a new computational system proposed for automatic classification, developed based on a Siamese network combined with Convolutional Neural Networks (CNNs), is presented. It aims to identify endodontic technical errors using Cone Beam Computed Tomography (CBCT). The study also aims to compare the performance of the automatic classification system with that of dentists. METHODS One thousand endodontically treated maxillary molars sagittal and coronal reconstructions were evaluated for the quality of the endodontic treatment and the presence of periapical hypodensities by three board-certified dentists and by an oral and maxillofacial radiologist. The proposed classification system was based on a Siamese network combined with EfficientNet B1 or EfficientNet B7 networks. Accuracy, sensivity, precision, specificity, and F1-score values were calculated for automated artificial systems and dentists. Chi-square tests were performed. RESULTS The performances were obtained for EfficienteNet B1, EfficientNet B7 and dentists. Regarding accuracy, sensivity and specificity, the best results were obtained with EfficientNet B1. Concerning precision and F1-score, the best results were obtained with EfficientNet B7. The presence of periapical hypodensity lesions was associated with endodontic technical errors. In contrast, the absence of endodontic technical errors was associated with the absence of hypodensity. CONCLUSIONS Quality evaluation of the endodontic treatment performed by dentists and by Siamese Network combined with EfficientNet B7 or EfficientNet B1 networks was comparable with a slight superiority for the Siamese Network. CLINICAL RELEVANCE CNNs have the potential to be used as a support and standardization tool in assessing endodontic treatment quality in clinical practice.
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Affiliation(s)
| | - Andréa Dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | - Maria Luíza Dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | - Felipe Alberto B S Ferreira
- Unidade Acadêmica do Cabo de Santo Agostinho, Universidade Federal Rural de Pernambuco, Cabo de Santo Agostinho, 54518-430, Pernambuco, Brasil
| | - Andrezza Santos
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, 50670-420, Pernambuco, Brasil
| | | | | | - Francisco Madeiro
- Escola Politécnica de Pernambuco, Universidade de Pernambuco, Recife, 50720-001, Pernambuco, Brasil
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Srivastava S, Aldakhail NS, Javed MQ. Morphometric relationships in mesio-buccal roots of maxillary first molars in Saudi subpopulation: A CBCT study. AUST ENDOD J 2023; 49:614-622. [PMID: 37665125 DOI: 10.1111/aej.12793] [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: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
This CBCT-based study analysed morphometric relationships in Mesio-Buccal (MB) roots of maxillary first molars (MFM). 133 MFM with two MB canals were assessed and classified using Vertucci's classification. MB roots' length and MB1-MB2 canals inter-orifice distances (IOD) were noted. The data were analysed using SPSS software. The most frequently present canal was type IV (59.4%) followed by type II (40.6%). Mean MB roots' length for canals exhibiting type IV was 9.26 ± 0.21 mm and of those exhibiting type II was 12.8 ± 0.42 mm. Statistically significant relationship was found between MB root length and canal type. Mean IOD for type II and type IV canals was 2.4 ± 0.47 and 3.8 ± 0.21 mm, respectively. Statistically significant relationship was found between IOD and canal type. Length of MB root and IOD had a significant association with canal type present in MFM. This knowledge can enhance clinicians' understanding of canal morphology which can increase predictability and success rate of endodontic treatment.
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Affiliation(s)
- Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
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Rosado LPL, Freitas DQ, Rovaris K, Oliveira ML, Neves FS. Can maxillary molar dimensions predict the presence of the second mesiobuccal canal? Oral Radiol 2023; 39:482-490. [PMID: 36266556 DOI: 10.1007/s11282-022-00661-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/09/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the potential of maxillary molar dimensions as predictors of the presence of the second mesiobuccal (MB2) canal. METHODS Micro-computed tomography scans were obtained from 47 maxillary molars, out of which 26 had the MB2 canal. The distance between root canals, extension of the canals, and thickness of surrounding dentin were obtained from axial images at the furcation level, 3 mm from the apex, and 5 mm from the apex. The association between the measurements and the presence of the MB2 canal was assessed using multiple logistic regression and odds ratio. RESULTS At the furcation level, the bucco-palatal extension of the MB1 canal significantly decreased the chance of the presence of the MB2 canal. Regarding the thickness of surrounding dentin measurements, the mesial and distal aspects of the MB1 canal at 3 mm from the apex were statistically significant to decrease and increase the chance of presence of the MB2 canal, respectively. Regarding the extension of the canals, only buccal-palatal extension seems to decrease the chance of the presence of the MB2 canal. CONCLUSION The presence of the MB2 canal in the mesiobuccal root of maxillary molars is associated with the bucco-palatal extension and surrounding dentin thickness of the first mesiobuccal canal, and seems to be unrelated to the dimensions of the distobuccal and palatal roots.
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Affiliation(s)
- Lucas P Lopes Rosado
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Karla Rovaris
- Department of Pathology and Dentistry Clinic, School of Dentistry, Federal University of Piauí (UFPI), Teresina, Piauí, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
- Division of Oral Radiology, School of Dentistry, Department of Propedeutics and Integrated Clinic, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Wang FM, Rudman J, Walsh RM, Jalali P. A retrospective study of initial root canal treatment failure in maxillary premolars via using cone-beam computed tomography. J Am Dent Assoc 2023; 154:471-478. [PMID: 37236705 DOI: 10.1016/j.adaj.2023.02.012] [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: 11/04/2022] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND This case-series study examined canal morphology and common factors for endodontic failure in maxillary first and second premolars that were referred for retreatment owing to clinical symptoms or radiographic signs. METHODS Records were retrospectively searched using Current Dental Terminology codes to identify maxillary first and second premolars with endodontic failure. Periapical and cone-beam computed tomographic images were examined to determine Vertucci classifications and suspected factors related to treatment failure. RESULTS A total of 235 teeth from 213 patients were included for evaluation. The following Vertucci classification of canal configurations were observed for maxillary first and second premolars: type I (1-1) (4.6% and 32.0%, respectively), type II (2-1) (15.9% and 27.9%, respectively), type III (2-2) (76.1% and 36.1%, respectively), type IV (1-2) (0% and 2%, respectively), and type V (3) (3.4% and 2%, respectively). More treatment failures were noticed in maxillary second premolars than first premolars and in females than in males. The 4 most common factors related to failure were inadequate filling, restorative failure, vertical root fracture, and missed canals. Missed canals were more frequently identified in maxillary second premolars (21.8%) than first premolars (11.4%) (P = .044). CONCLUSIONS Multiple factors are associated with primary root canal treatment failures in maxillary premolars. Variations in canal morphology appear to be underappreciated in maxillary second premolars. PRACTICAL IMPLICATIONS Maxillary second premolars have more complicated canal configurations than first premolars. Besides adequate filling, clinicians should give extra attention to anatomic variability in second premolars owing to higher failure incidence.
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Rosado LPL, Freitas DQ, Rovaris K, Oliveira ML, Neves FS. Can the detection of second mesiobuccal canals be enhanced based on the volume of adjacent canals? Arch Oral Biol 2023; 146:105604. [PMID: 36543039 DOI: 10.1016/j.archoralbio.2022.105604] [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: 09/11/2022] [Revised: 11/14/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate whether the presence of the second mesiobuccal (MB2) canal is related to volumetric differences on the adjacent canals of maxillary molars. DESIGN Forty-seven maxillary first and second molars with and without the MB2 canal were individually scanned using microcomputed tomography (micro-CT). The volume of each canal was measured by an evaluator with experience in micro-CT analysis. The intraclass correlation coefficient (ICC) was obtained. Multiple logistic regression and odds ratio was calculated. To compare the volume of canals in molars with and without MB2, the Mann-Whitney test was applied (α = 0.05). RESULTS The intra-examiner reproducibility was almost perfect (ICC=0.97). Multiple logistic regression demonstrated that the volume of the mesiobuccal (MB1) canal can possibly act as a predictor of the presence of the MB2 canal. It was also found that the MB1 canal volume is larger in molars without the MB2 canal (p = 0.01). No statistically significant difference was observed in the adjacent canals (p > 0.05). CONCLUSIONS Despite the challenging detection of the presence of MB2 canals, clinicians should be aware that MB1 canals of reduced volume are highly suggestive of their presence.
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Affiliation(s)
- Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, Espírito Santo, Brazil.
| | - Deborah Q Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Karla Rovaris
- Department of Pathology and Dentistry Clinic, School of Dentistry, Federal University of Piauí (UFPI), Teresina, Piauí, Brazil
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Frederico S Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Al Yahya RS, Al Attas MH, Javed MQ, Khan KI, Atique S, Abulhamael AM, Bahammam HA. Root Canal Configuration and Its Relationship with Endodontic Technical Errors and Periapical Status in Premolar Teeth of a Saudi Sub-Population: A Cross-Sectional Observational CBCT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1142. [PMID: 36673896 PMCID: PMC9859327 DOI: 10.3390/ijerph20021142] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 06/13/2023]
Abstract
Endodontic technical errors are the foremost cause of treatment failure. A thorough understanding of root canal configuration (RCC) is essential to prevent these iatrogenic errors. This study used CBCT images to determine the association between root canal configuration, endodontic technical errors, and periapical status. CBCT images of 101 patients, including total of 212 obturated premolars (256 canals) were assessed. RCCs were classified according to the Vertucci system. The presence of endodontic errors and periapical lesions associated with each RCC was noted. Presence or absence of coronal restoration and its association with periapical radiolucency was recorded. The most frequent RCC was Type I (199 cases; 77.73%), followed by Type II (26 cases; 10.15%), Type IV (22 cases; 8.59%), Type V (4 cases; 1.56%), Type III (4 cases; 1.56%), and Type VI (1 case; 0.39%). Under-filling and non-homogeneous filling were the most common technical errors. Prevalence of periapical radiolucency was 81% in the presence of technical errors. The absence of coronal restoration caused apical lesions in 93% of cases. The frequency of endodontic technical errors increased as the root canal configurations became more complex. Periapical lesions occurred more often in teeth with endodontic errors and/or absent coronal restoration.
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Affiliation(s)
- Rayan Suliman Al Yahya
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Mustafa Hussein Al Attas
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Kiran Imtiaz Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad 22030, KPK, Pakistan
| | - Sundus Atique
- College of Dental Medicine, Qatar University, Doha 2713, Qatar
| | - Ayman M. Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
| | - Hammam Ahmed Bahammam
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
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Almeida JC, Candemil AP, Bertolini GR, Souza-Gabriel AE, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Cone-beam computed tomographic evaluation of the root canal anatomy of the lower premolars and molars in a Brazilian sub-population. Imaging Sci Dent 2023; 53:77-82. [PMID: 37006788 PMCID: PMC10060753 DOI: 10.5624/isd.20220204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose This study evaluated anatomical variations in the root canals of the lower premolars and molars in a Brazilian sub-population using cone-beam computed tomography (CBCT). Materials and Methods In total, 121 CBCT images of patients were selected from a database. All images contained lower first and second premolars and molars on both sides of the arch, fully developed roots, and no treatment, resorption, or calcifications. In each image, the root canals of the lower premolars and molars were evaluated according to the Vertucci classification in On-Demand 3D software in the multiplanar reconstruction with dynamic navigation. Twenty-five percent of the images were re-assessed to analyze intraobserver confidence with the kappa test. Data were statistically evaluated with linear regression to evaluate the correlations of anatomic variations with age and sex, and the Wilcoxon test to analyze the laterality of variations, with a significance level of 5%. Results The intraobserver agreement (0.94) was excellent. In general, the root canals of lower premolars and molars showed a higher prevalence of type I than other Vertucci classification types, followed by type V in premolars and type II in molars. When the molar roots were evaluated separately, type II was more frequent in mesial roots and type I in distal roots. Although age showed no correlations with the results, sex and laterality showed correlations with tooth 45 and the lower second premolars, respectively. Conclusion The lower premolars and molars of a Brazilian sub-population showed a wide range of root canal anatomic variations.
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Affiliation(s)
- Jessica Cecilia Almeida
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Gunther Ricardo Bertolini
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio Miranda Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Gariba Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Barros-Costa M, Ferreira MD, Costa FF, Freitas DQ. Middle mesial root canals in mandibular molars: prevalence and correlation to anatomical aspects based on CBCT imaging. Dentomaxillofac Radiol 2022; 51:20220156. [PMID: 35926079 PMCID: PMC9717399 DOI: 10.1259/dmfr.20220156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/13/2022] [Accepted: 07/22/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To determine the prevalence of middle mesial root canal (MMC) in a Brazilian subpopulation, verify whether its presence is related to anatomical characteristics of the tooth, and propose a classification using cone-beam computed tomography (CBCT). METHODS CBCT scans of 284 patients were evaluated by 2 radiologists to determine the presence of the MMC in mandibular first and second molars. Subsequently, the mesiodistal and buccolingual measurements of the mesial roots were obtained; the measurements between the root canals, and from MMC to the mesiobuccal canal and to the mesiolingual canal were also obtained. The MMC was classified according to its relationship with mesiobuccal and mesiolingual canals. The data were analyzed using χ2 and Fisher's exact test, multiple logistic regression analysis, Student's t-test, κ and intraclass correlation coefficient (p < 0.05). RESULTS The intraexaminer agreements for the presence of the MMC and the measurements were considered almost perfect (0.953 and 0.999, respectively). Of 216 mandibular first molars, 11.1% had the MMC, and of 228 mandibular second molars, only 1.75% had the MMC. The presence was significant higher in the mandibular first molar (p < 0.0001). The buccolingual measurement and the measurement between mesiobuccal and mesiolingual canals were higher in teeth with MMC (p = 0.024 and p = 0.005, respectively). It was possible to classify the configuration of MCC into four types: independent (60.7%), confluent (14.3%), mesiolingual confluent (14.3%), and mesiobuccal confluent (10.7%). CONCLUSIONS The prevalence of MMC is more pronounced in mandibular first molars and anatomical measurements, such as greater measurement between mesiobuccal and mesiolingual canals, may alert clinicians to its presence. It was found four types of configurations of MMC.
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Affiliation(s)
- Matheus Barros-Costa
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Matheus Diniz Ferreira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Felipe Ferreira Costa
- Department of Oral Diagnosis, São Paulo Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Calazans MAA, Ferreira FABS, Alcoforado MDLMG, dos Santos A, Pontual ADA, Madeiro F. Automatic Classification System for Periapical Lesions in Cone-Beam Computed Tomography. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176481. [PMID: 36080940 PMCID: PMC9459969 DOI: 10.3390/s22176481] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 05/29/2023]
Abstract
Imaging examinations are of remarkable importance for diagnostic support in Dentistry. Imaging techniques allow analysis of dental and maxillofacial tissues (e.g., bone, dentine, and enamel) that are inaccessible through clinical examination, which aids in the diagnosis of diseases as well as treatment planning. The analysis of imaging exams is not trivial; so, it is usually performed by oral and maxillofacial radiologists. The increasing demand for imaging examinations motivates the development of an automatic classification system for diagnostic support, as proposed in this paper, in which we aim to classify teeth as healthy or with endodontic lesion. The classification system was developed based on a Siamese Network combined with the use of convolutional neural networks with transfer learning for VGG-16 and DenseNet-121 networks. For this purpose, a database with 1000 sagittal and coronal sections of cone-beam CT scans was used. The results in terms of accuracy, recall, precision, specificity, and F1-score show that the proposed system has a satisfactory classification performance. The innovative automatic classification system led to an accuracy of about 70%. The work is pioneer since, to the authors knowledge, no other previous work has used a Siamese Network for the purpose of classifying teeth as healthy or with endodontic lesion, based on cone-beam computed tomography images.
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Affiliation(s)
| | - Felipe Alberto B. S. Ferreira
- Unidade Acadêmica do Cabo de Santo Agostinho, Universidade Federal Rural de Pernambuco (UFRPE), Cabo de Santo Agostinho 54518-430, Brazil
| | | | - Andrezza dos Santos
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco (UFPE), Recife 50670-420, Brazil
| | - Andréa dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco (UFPE), Recife 50670-420, Brazil
| | - Francisco Madeiro
- Escola Politécnica de Pernambuco, Universidade de Pernambuco (UPE), Recife 50720-001, Brazil
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Barbhai S, Shetty R, Joshi P, Mehta V, Mathur A, Sharma T, Chakraborty D, Porwal P, Meto A, Wahjuningrum DA, Luke AM, Pawar AM. Evaluation of Root Anatomy and Canal Configuration of Human Permanent Maxillary First Molar Using Cone-Beam Computed Tomography: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10160. [PMID: 36011794 PMCID: PMC9408299 DOI: 10.3390/ijerph191610160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to review the literature on root canal configuration (RCC) and the frequency of occurrence of a second mesiobuccal canal (MB) in human permanent maxillary first molars where cone-beam computed tomography (CBCT) is used. Online electronic databases such as PubMed-Medline, Embase, Scopus and Cochrane Library were searched using appropriate keywords from the earliest available date until 12th June 2022, without restriction on language. In the mesiobuccal root, type I was the most frequent (33.29%), followed by types II and IV (27.18% and 26.36%, respectively). Moreover, 68.2% of maxillary first molars had a second MB canal. For both the distobuccal and palatal roots, type I was the most prevalent, with 99.08% and 97.83% occurrence, respectively. All other types were infrequent. Type I RCC is most frequent in all the roots of the maxillary first molars. Hence, care must be taken during biomechanical preparation of the MB roots.
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Affiliation(s)
- Sourabh Barbhai
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Rajesh Shetty
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Poonam Joshi
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Ankita Mathur
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Tanvi Sharma
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Damini Chakraborty
- Bhowal’s Dental and Implant Clinic, Bengal GreenField Heights, Galaxy-6FS, beside Apollo Pharmacy, DJ Block (Newtown), Newtown, Kolkata 700136, West Bengal, India
| | - Priyanka Porwal
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya 60132, East Java, Indonesia
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
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Mason J, Kirkpatrick T, Roberts HW. Dislodgement pushout resistance of five bioceramic root-end filling materials. Dent Mater J 2022; 41:843-849. [PMID: 35934803 DOI: 10.4012/dmj.2022-058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated the dislodgement push-out resistance of five bioceramic materials. One hundred single-rooted teeth with one canal had the apical 3 mm and crown resected to create a 14 mm standardized length. The canals were instrumented to an apical size 80 with a 3 mm root-end preparation made with ultrasonic diamonds. The prepared roots were randomly divided into 5 root-end restorative groups (n=20). ProRoot MTA, Biodentine, EndoSequence Root Repair Material, EndoSequence Fast Set Putty, and EndoSequence BC Sealer with each material placed following manufacturer's instructions and stored at 100% humidity for 2 weeks. An apical-to-coronal static testing load with the identified dislodgement force converted into MPa with mean results analyzed with Kruskal-Wallis and Dunn's post hoc tests (α=0.05). ProRoot MTA and Biodentine displayed similar push-out stress resistance and exhibited significantly greater stress resistance than the similar Endosequence materials. However, all materials failed cohesively and were not dislodged from the root canal surface.
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Affiliation(s)
| | - Timothy Kirkpatrick
- Department of Endodontics, University of Texas Health Science Center at Houston
| | - Howard W Roberts
- Dental Biomaterials Research, University of Kentucky College of Dentistry
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Colakoglu G, Kaya Buyukbayram I, Elcin MA, Garip Berker Y, Ercalik Yalcinkaya S. Association between second mesiobuccal canal and apical periodontitis in retrospective cone‐beam computed tomographic images. AUST ENDOD J 2022; 49:20-26. [PMID: 35908285 DOI: 10.1111/aej.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
This retrospective cone-beam computed tomography study aimed to investigate the possible associations of apical periodontitis (AP) with missed/unmissed second mesiobuccal (MB2) canals. MB2 canals and AP were investigated in 257 endodontically treated and 673 untreated maxillary molars, and the former were analyzed regarding missed/unmissed MB2 canals. The chi-squared test and odds ratio (OR) were used for statistics. The prevalence of MB2 canals in maxillary first molars was higher than that in second molars (p = 0.001). MB2 canals were 1.751 times more common in males than in females (OR: 1.751; 95% CI: 1.334-2.297), with a significant difference in the 18-39 age groups (p = 0.005). The risk for AP was 5.5 times greater in endodontically treated maxillary molars with missed MB2 canals than in those with unmissed MB2 canals (p = 0.012) (OR: 5.5, 95% CI: 1.549-19.527). The findings of this study reveal that the likelihood of the MB2 canal is higher in the maxillary first molars of young adult males.
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Affiliation(s)
- Gizem Colakoglu
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Isil Kaya Buyukbayram
- Department of Endodontics, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Mehmet Ali Elcin
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | | | - Sebnem Ercalik Yalcinkaya
- Department of Dentomaxillofacial Radiology, Faculty of DentistryMarmara UniversityMaltepe, IstanbulTurkey
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Alves Dos Santos GN, Faria-E-Silva AL, Ribeiro VL, Pelozo LL, Candemil AP, Oliveira ML, Lopes-Olhê FC, Mazzi-Chaves JF, Sousa-Neto MD. Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis. Clin Oral Investig 2022; 26:5105-5116. [PMID: 35618962 DOI: 10.1007/s00784-022-04558-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the influence of root canal filling quality on periapical lesion status using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The bibliographic search was conducted in electronic databases of PubMed, Embase, Scopus, and Web of Science without restrictions related to the year of publication and language. Inclusion criteria were prospective or retrospective cohort studies that followed periapical pathosis for, at least, 1 year. Three reviewers independently evaluated the eligibility for inclusion, extracted data, and assessed the risk of bias. The quality of the studies was based on the Newcastle-Ottawa Scale. This meta-analysis was performed to evaluate the quality of treatment by the homogeneity and apical extension of the filling. RESULTS Of the 1179 studies initially recovered, six cohort studies were included, out of which four were considered with a low risk of bias. The results showed that the absence of gaps in the filling reduced the chance of unhealed periapical lesions by 2.39 times (RR = 2.39; 95% CI: 1.62-3.53; p < 0.00001; I2 = 55%). An apical filling extension of 0-2 mm below the apex also contributed significantly to the absence of unhealed periapical lesions (RR = 1.49; 95% CI: 1.15-1.94; p = 0.003; I2 = 2%). CONCLUSION The homogeneity and apical extension of the filling influenced the presence of unhealed periapical lesions in endodontically treated teeth evaluated using CBCT. CLINICAL RELEVANCE Apical extension of the filling ranging between 0 and 2 mm short of the apical foramen and the homogeneity of the filling without gaps are directly related to the success rate of root canal treatment.
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Affiliation(s)
- Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | | | - Vitor Luís Ribeiro
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil.
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Endodontic procedural errors: Analysis of images from cone beam computed tomography. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2022.200493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rosado LPL, Oliveira ML, Rovaris K, Freitas DQ, Neves FS. Morphological characteristics of the mesiobuccal root in the presence of a second mesiobuccal canal: a micro-CT study. Restor Dent Endod 2022; 47:e6. [PMID: 35284322 PMCID: PMC8891461 DOI: 10.5395/rde.2022.47.e6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/21/2021] [Accepted: 04/01/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal. Materials and Methods Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student’s t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05). Results In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001). Conclusions The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.
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Affiliation(s)
- Lucas P. Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Karla Rovaris
- Department of Pathology and Dentistry Clinic, School of Dentistry, Federal University of Piauí (UFPI), Teresina, Piauí, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Frederico Sampaio Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
- Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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ÇAKICI EB, ÇAKICI F. Periapikal sağlık üzerine koronal restorasyonun kalitesine karşı kök kanal tedavisinin kalitesinin etkisi: sistematik derleme ve meta-analiz. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.837948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ballikaya E, Koc N, Avcu N, Cehreli ZC. The quality of root canal treatment and periapical status of permanent teeth in Turkish children and teens: a retrospective CBCT study. Oral Radiol 2021; 38:405-415. [PMID: 34714509 DOI: 10.1007/s11282-021-00570-2] [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: 05/08/2021] [Accepted: 09/16/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study aimed to assess the quality of root canal fillings and the prevalence of periapical radiolucencies in the permanent teeth of 6-18 year-old Turkish children. METHODS CBCT images of 150 patients' 235 teeth with a mean age of 16.0 ± 2.06 years were included. Root development stage, quality of root canal filling, the presence and severity of periapical radiolucencies, and their relationship with anatomical structures were recorded. Correlations between the quality of root canal filling, periapical lesion, and lesion size were assessed using regression analyses. RESULTS A total of 235 teeth (528 root canals) were evaluated. 65.5% of root canals had periapical lesions. Immature roots and mandibular teeth had the highest prevalence and the largest size of periapical radiolucencies (p < 0.05). Overfilling (n = 52), underfilling (n = 93), unfilled (n = 46), inhomogeneously filled (n = 113) root canals and poor coronal restoration (n = 85 teeth) were observed in terms of technical failures of endodontic treatment. The quality of endodontic treatment was associated with the presence of periapical lesion and lesion size (p < 0.05). Teeth with under-filled, overfilled or inhomogeneously filled root canals and poor coronal restoration had a periapical lesion larger than 5 mm (p < 0.05). Immature teeth were most associated with the presence of lesion (OR = 4.07) and the lesion size > 5 mm (OR = 3.71). CONCLUSION The prevalence of periapical radiolucencies in young permanent teeth showed an increase when the tooth was an incisor, had incomplete root development, or the root filling had technical errors.
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Affiliation(s)
- Elif Ballikaya
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey.
| | - Nagihan Koc
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Nihal Avcu
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Zafer Cavit Cehreli
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
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Yan Y, Li J, Zhu H, Liu J, Ren J, Zou L. CBCT evaluation of root canal morphology and anatomical relationship of root of maxillary second premolar to maxillary sinus in a western Chinese population. BMC Oral Health 2021; 21:358. [PMID: 34284763 PMCID: PMC8290624 DOI: 10.1186/s12903-021-01714-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To evaluate the root anatomy, root canal morphology and the anatomical relationship between the roots and maxillary sinus of maxillary second premolars by CBCT in a western Chinese population. METHODS A total of 1118 CBCT scans of the maxillary second premolars were collected from West China Hospital of Stomatology, Sichuan University. Information below were measured on axial, coronal and sagittal sections, recorded and evaluated properly: the number of roots and canals, the morphology of canal system classified by Vertucci standard, the inter-orifice distance of canal orifices, the curvature of each canal and the distance from root tip to maxillary sinus floor. RESULTS Among the 1118 teeth, 94.2% (1053) are single-rooted and 55.1% (616) have one canal. Type I (55.1%) is the commonest root canal morphology followed by Type II (31.9%). The mean inter-orifice distance (IOD) for multi-canal teeth ranging from 2.72 ± 0.32 to 3.41 ± 0.11 mm. Of 1622 canals, 38.8% (630) curvature are mesiodistal and 30.9% (501) are straight canals. The distance from root tip to maxillary sinus floor increased with age and the mean distance of single-rooted ones is 2.47 ± 3.45 mm. CONCLUSIONS All kinds of canal morphology category can be detected in maxillary second premolars. The IOD might be a predictable factor for root canal morphology. Roots of maxillary second premolars are related to maxillary sinus which should be treated carefully.
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Affiliation(s)
- Yujia Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - JingLin Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Hualing Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jun 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, 610041 , China
| | - Jiayin Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Ling Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Al-Habib M, Howait M. Assessment of Mesiobuccal Canal Configuration, Prevalence and Inter-Orifice Distance at Different Root Thirds of Maxillary First Molars: A CBCT Study. Clin Cosmet Investig Dent 2021; 13:105-111. [PMID: 33790655 PMCID: PMC8005364 DOI: 10.2147/ccide.s300241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/05/2021] [Indexed: 11/23/2022] Open
Abstract
Aim The aims of this study were to assess the prevalence and configuration of the second mesiobuccal (MB2) canal in the mesiobuccal MB root of permanent maxillary first molars at different root levels in a Saudi sub-population using cone‑beam computed tomography (CBCT) and to measure the inter-orifice distance between MB & MB2 at the pulpal floor level. Materials and Methods This retrospective study was carried out on CBCT images of Saudi patients seen at King Abdul Aziz University. A total of 106 maxillary first molars were evaluated using a specialized software program (iCAT CBCT software). The prevalence of MB2, canal configuration and location of joining (apical-middle-coronal), if present was calculated. Also, the inter-orifice distance between both canals was measured at the level of the pulpal floor. Chi‑square and one-way analysis of variance (ANOVA) were used. Results The MB2 canal was found in 92 (86.8%) maxillary first molar teeth. The MB and MB2 canals were joined in 61 (58%) cases, where the location of joining was 14 (23%), 17 (27%), and 31 (50%) in the coronal, middle, and apical third, respectively. The mean inter-orifice distance between both canals at the level of the pulpal floor was 2.52±0.76 mm. Conclusion The prevalence of MB2 canal in this Saudi sub-population was high. The prevalence decreased as the root canal approached the apical third. There was no correlation between the average distance and occurrence of canal joining. CBCT is useful in detecting and mapping the mesiobuccal root canal system, with a likelihood of enhancing the quality of root canal treatment.
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Affiliation(s)
- Mey Al-Habib
- Department of Endodontics, Faculty of Dentistry King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry King Abdul Aziz University, Jeddah, Saudi Arabia
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Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation. BMC Oral Health 2021; 21:124. [PMID: 33731077 PMCID: PMC7968314 DOI: 10.1186/s12903-021-01491-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/07/2021] [Indexed: 12/16/2022] Open
Abstract
Background The present study aimed at investigating the prevalence of Apical periodontitis in a Moroccan Adult subpopulation with a non-surgical root canal treatment and to assess associated risk factors including endodontic treatment quality, periodontal health status, coronal restoration cavity design and quality.
Methods A total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan subpopulation according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression. Results The present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% CI 1.08–3.91, OR 2.05, p = 0.02), inadequate coronal restoration (95% CI 1.16–4.04, OR 2.16, p = 0.01), inadequate root canal filling length and homogeneity (95% CI 1.24–3.01, OR 1.93, P = 0.004), (95% CI 1.41–4.44, OR 2.50, p = 0.002) respectively. Conclusions The present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth. Prevalence of Apical periodontitis in the present study was 72.1%.
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do Carmo WD, Verner FS, Aguiar LM, Visconti MA, Ferreira MD, Lacerda MFLS, Junqueira RB. Missed canals in endodontically treated maxillary molars of a Brazilian subpopulation: prevalence and association with periapical lesion using cone-beam computed tomography. Clin Oral Investig 2020; 25:2317-2323. [PMID: 32875385 DOI: 10.1007/s00784-020-03554-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/26/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To evaluate the prevalence of missed canals in endodontically treated maxillary molars through cone-beam computed tomography (CBCT) images and to verify their association with the presence of periapical lesions. MATERIAL AND METHODS Three oral radiologists evaluated 633 maxillary molars in CBCT exams regarding number of roots, number of root canals, number of missed canals, anatomic identification of missed canals, presence of periapical lesions, and root location of the periapical lesions. Data were statistically analyzed at a 5% significance level. RESULTS Descriptive statistical analysis showed that among 395 first molars, 218 had at least one missed canal, and 186 (46.5%) had a missed canal and periapical lesion simultaneously. Of these, 72.4% (134) of the missed canals were only mesiobuccal 2 (MB2). Among 238 s molars evaluated, 121 presented at least one missed canal, and 104 (43.6%) had a missed canal and periapical lesion simultaneously. Of these, 81.7% (85) of the missed canals were only MB2. The chi-squared test showed an association between the presence of missed canals and periapical lesions for 1st and 2nd maxillary molars. Teeth that presented a missed canal showed an odds ratio (OR) of 2.57 (p < 0.0001) of being associated with a periapical lesion. Missed canal occurrence was positively related to the number of root canals (z = 13.06, p < 0.0001), meaning when the number of root canals is higher, there is a higher probability of missed canal occurrence. According to the model calculated prediction, for a one-unit increase in the number of canals, the probability of missed canals increases by 4.22%. CONCLUSIONS It was concluded that MB2 was the most frequently missed canal, associated with the presence of periapical lesions in endodontically treated maxillary molars. CLINICAL RELEVANCE Professionals' negligence of anatomical root variations has been contributed to the high prevalence of missed canals, leading to failures in endodontic treatment. Their association with periapical lesion occurrence emphasizes the importance of correct detection and instrumentation of these canals.
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Affiliation(s)
- Weslley Duarte do Carmo
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Francielle Silvestre Verner
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Larisse Martins Aguiar
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Maria Augusta Visconti
- School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Matheus Diniz Ferreira
- School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mariane Floriano Lopes Santos Lacerda
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil.
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Influence of the Intracanal Material and Metal Artifact Reduction Tool in the Detection of the Second Mesiobuccal Canal in Cone-beam Computed Tomographic Examinations. J Endod 2020; 46:1067-1073. [DOI: 10.1016/j.joen.2020.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 11/22/2022]
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Aristizabal-Elejalde D, Arriola-Guillén LE, Aliaga-Del Castillo A, Ruíz-Mora GA, Rodríguez-Cárdenas YA. Assessment of fractures in endodontically treated teeth restored with and without root canal posts using high-resolution cone beam computed tomography. J Clin Exp Dent 2020; 12:e547-e554. [PMID: 32665813 PMCID: PMC7335599 DOI: 10.4317/jced.56854] [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: 01/30/2020] [Accepted: 04/13/2020] [Indexed: 11/09/2022] Open
Abstract
Background Root fractures are a diagnostic challenge for dentists in endodontic treatment. This study aimed to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT).
Material and Methods Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 μm voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student’s t-test, and multiple linear regression (α <0.05) were used.
Results No association was found between the type of fracture and type of retention or between the type of fracture and its extent (P>0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results.
Conclusions The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency. Key words:Cone-Beam CT, Tooth Fracture, Root Canal Post.
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Affiliation(s)
- David Aristizabal-Elejalde
- Lecturer, Part-time, Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Luis-Ernesto Arriola-Guillén
- Associate Professor, Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Aron Aliaga-Del Castillo
- Lecturer, Part-time, Department of Orthodontics. Bauru Dental School. University of São Paulo, Brazil
| | - Gustavo-Armando Ruíz-Mora
- Associate Professor, Division of Orthodontics, Faculty of Dentistry, Universidad Nacional de Colombia, Bogotá D.C, Colombia
| | - Yalil-Augusto Rodríguez-Cárdenas
- Associate Professor, Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, Universidad Nacional de Colombia, Bogotá D.C, Colombia
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Hanafi A, Donnermeyer D, Schäfer E, Bürklein S. Perception of a modular 3D print model in undergraduate endodontic education. Int Endod J 2020; 53:1007-1016. [PMID: 32220071 DOI: 10.1111/iej.13299] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education. METHODOLOGY Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test. RESULTS A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2 mm from the radiographic apex. Readings more than 2 mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P < 0.05). CONCLUSIONS The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.
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Affiliation(s)
- A Hanafi
- Private Office, Gelsenkirchen, Germany
| | - D Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - E Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - S Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
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Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims. Clin Oral Investig 2020; 24:3683-3690. [PMID: 32140781 DOI: 10.1007/s00784-020-03246-z] [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: 04/22/2019] [Accepted: 02/14/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess occurrence and its variation over time of serious accidental perforations during endodontic treatment and the fate of perforated teeth by tooth type and characteristics of patients and dentists. MATERIALS AND METHODS Data, based on patient documents on healthcare malpractice claims, comprised all endodontic injuries (n = 970) verified by the Patient Insurance Centre in Finland in 2002-2006 and 2011-2013. Two specialists in endodontics scrutinized the documents. Accidental perforations were recorded by location (tooth type, chamber/canals) and dichotomized as avoidable (could have been avoided by following good clinical practice) or unavoidable (normal treatment-related risks). Fate of perforation cases was recorded as treatment discontinued, root canal(s) filled, or tooth extracted. Background information included patients' and dentists' sex and age and the service sector. Statistical evaluation used Chi-square tests. RESULTS Serious accidental perforations comprised 29% of all verified injuries. Most perforations were judged as avoidable: 93% in patients aged below 35 years, 87% when located in the pulp chamber or in molars (84%); 70% of all perforations and 75% of those in molars resulted in tooth extraction. The overall rate of serious accidental perforations was 17.6 cases per 100,000 endodontic patients per year. CONCLUSIONS The rate of serious accidental perforations increased over time. The majority was in molars and resulted in tooth extraction. CLINICAL RELEVANCE Accidental perforations comprise almost a third of serious injuries during root canal treatment. However, four of five perforations could be avoided by following good clinical practice. Therefore, training is needed before adopting new working equipment and methods.
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27
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Patnana AK, Chugh A, Chugh VK, Kumar P. The incidence of nickel-titanium endodontic hand file fractures: A 7-year retrospective study in a tertiary care hospital. J Conserv Dent 2020; 23:21-25. [PMID: 33223636 PMCID: PMC7657430 DOI: 10.4103/jcd.jcd_254_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/07/2020] [Accepted: 07/14/2020] [Indexed: 12/29/2022] Open
Abstract
Aim: The present retrospective cross-sectional study aims to evaluate the incidence and factors associated with nickel-titanium hand file fractures in root canal-treated teeth in a tertiary care hospital of western India. Methodology: The diagnostic records of intraoral periapical (IOPA) radiographs were analyzed to check for file fractures in the root canal-treated teeth. As a part of standardized departmental protocol, Hand ProTaper Universal file system (Dentsply, India) was used for chemomechanical preparation for root canal treatment. The file fractures were analyzed with reference to age group, type of teeth, curvature of the canal, site of file fracture in the canal, length of file fracture, level of file fracture, distance of the file fracture from the apex, and obturation status of the file-fractured tooth. Chi-square test was applied to assess the significance difference between the tested groups. Results: A total of 19,810 IOPA X-rays were screened and 2728 root canal-treated teeth were found and of these 2728 cases, 109 file-fractured teeth were observed. Conclusion: The total incidence of file fractures was 3.9/100 root canal-treated cases, and mandibular molars with severely curved canals (>25°) had shown the maximum incidence of file fractures.
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Affiliation(s)
- Arun Kumar Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ankita Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinay Kumar Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Gaêta-Araujo H, Fontenele RC, Nascimento EHL, Nascimento MDCC, Freitas DQ, de Oliveira-Santos C. Association between the Root Canal Configuration, Endodontic Treatment Technical Errors, and Periapical Hypodensities in Molar Teeth: A Cone-beam Computed Tomographic Study. J Endod 2019; 45:1465-1471. [DOI: 10.1016/j.joen.2019.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/28/2019] [Accepted: 08/11/2019] [Indexed: 01/26/2023]
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Szabó B, Garoushi S, Braunitzer G, Szabó P B, Baráth Z, Fráter M. Fracture behavior of root-amputated teeth at different amount of periodontal support - a preliminary in vitro study. BMC Oral Health 2019; 19:261. [PMID: 31775721 PMCID: PMC6882155 DOI: 10.1186/s12903-019-0958-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the effect of the amount of periodontal support on the fracture resistance of root-amputated maxillary molar teeth restored with either direct class. I. restorations or class II. mesio-occluso-distal (MOD) indirect overlay restorations with cuspal coverage. Methods Sixty sound maxillary first molars were collected and randomly divided into four groups. In Groups 1 and 2, MOD cavities were prepared and all cusps were reduced by 2 mm, whereas in Group 3 and 4, only a conservative Class I. cavity was prepared. Subsequently, root canal treatment was performed and the mesio-buccal roots were amputated. Groups 1 and 2 were restored with indirect composite overlay, while Groups 3 and 4 received direct composite fillings. After restoration, teeth were embedded as follows: Groups 1 and 3: normal bone level, Groups 2 and 4: furcation involvement. The specimens were submitted to static fracture resistance testing. Fracture thresholds and fracture patterns were measured and evaluated. Results Group 1 had the highest fracture resistance (2311,6 N) among the restored groups and showed statistically significant difference compared to Group 2 (p = 0.038) and Group 4 (p = 0.011). There was no statistically significant difference in terms of fracture resistance between the rest of the groups. In terms of the fracture patterns, Group 3 was characterized by the highest percentage (60%) of mostly favorable fractures, while the rest of the groups showed predominantly unfavorable ones. Conclusions The amount of periodontal support seems to influence the fracture resistance of root-amputated and restored maxillary molars.
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Affiliation(s)
- Balázs Szabó
- Department of Periodontology Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center -TCBC Institute of Dentistry, University of Turku, Turku, Finland
| | | | - Balázs Szabó P
- Department of Food Engineering Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Zoltán Baráth
- Department of Prosthodontics Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry Faculty of Dentistry, University of Szeged, Tisza Lajos Krt., 64-66, Szeged, H-6720, Hungary.
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Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis. Clin Oral Investig 2019; 24:1217-1227. [DOI: 10.1007/s00784-019-02985-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/20/2019] [Indexed: 12/18/2022]
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Restrepo‐Restrepo FA, Cañas‐Jiménez SJ, Romero‐Albarracín RD, Villa‐Machado PA, Pérez‐Cano MI, Tobón‐Arroyave SI. Prognosis of root canal treatment in teeth with preoperative apical periodontitis: a study with cone‐beam computed tomography and digital periapical radiography. Int Endod J 2019; 52:1533-1546. [DOI: 10.1111/iej.13168] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 06/13/2019] [Indexed: 01/15/2023]
Affiliation(s)
- F. A. Restrepo‐Restrepo
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. J. Cañas‐Jiménez
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - R. D. Romero‐Albarracín
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - P. A. Villa‐Machado
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - M. I. Pérez‐Cano
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. I. Tobón‐Arroyave
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
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Nascimento EHL, Nascimento MCC, Gaêta-Araujo H, Fontenele RC, Freitas DQ. Root canal configuration and its relation with endodontic technical errors in premolar teeth: a CBCT analysis. Int Endod J 2019; 52:1410-1416. [PMID: 31111507 DOI: 10.1111/iej.13158] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/17/2019] [Indexed: 01/26/2023]
Abstract
AIM To evaluate the association between endodontic technical errors and the root canal configuration (RCC) of human premolars, as well as their relationship with periapical lesions through cone-beam computed tomography (CBCT) images. METHODOLOGY The sample consisted of CBCT scans belonging to 136 patients, totalling 152 root filled premolars (185 roots). CBCT images were evaluated by two oral radiologists. RCC was recorded according to Vertucci's classification, and the endodontic treatment quality was judged on the presence and type of technical endodontic errors (underfilling, overfilling, nonhomogeneous filling, nonfilled canal, fractured instruments, root deviation and absence of coronal restoration). In addition, the presence of periapical lesions associated with each RCC was recorded. Data were expressed by frequencies and percentages, and intraobserver agreement was calculated using the Kappa test. RESULTS The most common RCC was type I (71%), followed by type IV (15%), type II (8%), type V (3%), type VI (1%) and type III (1%). Types VII and VIII were not observed in the sample. Underfilling was the most frequent endodontic technical error for most RCCs, except for types IV, V and 'other', whose most frequent error was a nonfilled canal. The presence of technical errors was greater with an increase in the proportion of the periapical lesions. The intraobserver agreement was excellent. CONCLUSIONS There was an increase in the prevalence of endodontic technical errors and in the presence of periapical lesions as the anatomical complexity of the root canals increased. Underfilled and nonfilled canal were the most frequent endodontic technical errors.
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Affiliation(s)
- E H L Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - M C C Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba.,Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - H Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - R C Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - D Q Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
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