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Chamani A, Azizi V, Karimpour S. Endodontic management of taurodontic teeth: A case series. Clin Case Rep 2024; 12:e9101. [PMID: 38915932 PMCID: PMC11194297 DOI: 10.1002/ccr3.9101] [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: 03/31/2024] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 06/26/2024] Open
Abstract
This paper illustrated successful endodontic non-surgical (re)treatments of molars and premolar with different taurodontic classifications and accompanied anomalies like C-shape and extra root canals in otherwise healthy patients. Magnification with illumination besides active irrigation with NaOCl were the most helpful items in managing these cases.
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Affiliation(s)
- Ali Chamani
- Endodontics Resident, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
| | - Vahid Azizi
- Endodontics Resident, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
| | - Sahar Karimpour
- Endodontics Resident, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
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Xu M, Ren H, Liu C, Zhao X, Li X. Systematic review and meta-analysis of root morphology and canal configuration of permanent premolars using cone-beam computed tomography. BMC Oral Health 2024; 24:656. [PMID: 38835024 DOI: 10.1186/s12903-024-04419-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: 03/13/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
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Affiliation(s)
- Mengchen Xu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Huiying Ren
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Congrui Liu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Xinyu Zhao
- Department of stomatology, Jinan Hospital, Jinan, Shandong, 250013, China.
| | - Xiaoyan Li
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China.
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China.
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Rae O, Parashos P. Prevalence and morphology of different root canal systems in mandibular premolars: a cross-sectional observational study. Aust Dent J 2024; 69:112-123. [PMID: 37970986 DOI: 10.1111/adj.12994] [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] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND This study investigated the prevalence and morphology of C-shaped and non-C-shaped root canal systems in permanent mandibular first (PM1) and second (PM2) premolars using retrospective analysis of cone-beam computed tomography (CBCT) scans, and panoramic radiographs. METHODS CBCT scans from 2000 patients were screened for the presence of premolars with C-shaped canals and then assessed at three axial levels to determine the canal classification. The teeth were also assessed for Vertucci configuration, number of roots, and radicular grooves. Pre-existing panoramic radiographs were evaluated to identify features specific to PM1/2 with multiple canals or C-shaped anatomy. RESULTS A total of 1576 PM1 and 1424 PM2 from 880 patients were evaluated. The overall prevalence of C-shaped canals was 2.2% (3.3% PM1, 1.0% PM2), with 49 (5.6%) patients presenting with at least one C-shaped mandibular premolar. There were 2.3 ± 0.6 and 2.4 ± 0.5 different classifiable cross-sections per tooth for PM1 and PM2, respectively. The sudden disappearance or bifurcation of a canal on panoramic radiographs was associated with the presence of multiple canals (P < 0.001) or C-shaped anatomy (P = 0.03). CONCLUSIONS There was substantial variation in cross-sectional anatomy within and between C-shaped premolars, which will affect endodontic treatment planning. © 2023 Australian Dental Association.
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Affiliation(s)
- O Rae
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Burse A, Mahapatra J, Reche A, Awghad SS. Uncovering the Enigma of the C-shaped Root Canal Morphology. Cureus 2024; 16:e61883. [PMID: 38975401 PMCID: PMC11227744 DOI: 10.7759/cureus.61883] [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: 04/22/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024] Open
Abstract
A C-shaped canal describes an anatomical configuration of a tooth's root canal that resembles the alphabet C when viewed occlusally in a prepared access cavity. In the second molar of the maxillary arch, the root canals unite into a single, continuous, extensive root canal morphology to form a C-shaped canal. The natural crevices found in tooth roots where blood vessels and nerves are housed are called root canals. The frequently referred etiology resulting in the development of the C-shaped canal arrangement is the inability of Hertwig's epithelial root sheath to undergo fusion. The occurrence of the C-shaped canal anatomic variation varies among populations, with the majority of cases occurring in mandibular second molars. C-shaped canals pose several challenges in endodontic treatment such as in their diagnosis, biomechanical preparation, debridement, and obturation. Nevertheless, the desired result can be achieved with relative ease if one has a solid grasp of the different root canal configurations and uses the relevant clinical expertise. Therefore, three-dimensional radiography is utilized to help identify and negotiate C-shaped canals by enabling three-dimensional reconstruction of the root canal system. Efficient C-shaped canal configuration treatment may be attained using hand-driven and rotary instruments assisted by sonic or ultrasonic hand-pieces. Four alternative gutta-percha filling methods are used in C-shaped canals: core-carrier, ultrasonic compaction, cold lateral compaction, and single cone with injectable gutta-percha. The core-carrier technique is the most efficient obturation technique in the C-shaped canal. Calcium silicate materials (CSMs) are also used for the obturation of C-shaped canals. The most frequently used CSMs are mineral trioxide aggregate and biodentine.
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Affiliation(s)
- Ankita Burse
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Joyeeta Mahapatra
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Srushti S Awghad
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
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Park DM, Seok WH, Yoon JY. Factors Influencing Non-Surgical Root Canal Treatment Outcomes in Mandibular Second Molars: A Retrospective Cone-Beam Computed Tomography Analysis. J Clin Med 2024; 13:2931. [PMID: 38792472 PMCID: PMC11122081 DOI: 10.3390/jcm13102931] [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: 04/30/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: This study aimed to investigate the influence of the root canal morphology and various treatment variables on the outcomes of root canal treatments (RCTs) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 of previously treated root canals with normal apices in the mandibular second molars. CBCT was utilized to evaluate the root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore the correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p = 0.05). Factors influencing endodontic treatment outcomes included missing canals (p = 0.018), underfilling or overfilling (p = 0.045), and inadequate coronal restoration (p = 0.006). Missing a canal was identified as the variable most significantly associated with periapical lesions (OR = 3.103). Inhomogeneous root canal obturation was more commonly observed in C-shaped root canals (p < 0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.
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Affiliation(s)
- Da-Min Park
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
| | - Woo-Hyun Seok
- Department of Public Health Administration, Yanggugun Public Health Center, Yanggu-gun 24522, Republic of Korea;
| | - Ji-Young Yoon
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
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Martins JNR, Versiani MA. Worldwide Anatomic Characteristics of the Mandibular Canine-A Multicenter Cross-Sectional Study with Meta-Analysis. J Endod 2024; 50:456-471. [PMID: 38280512 DOI: 10.1016/j.joen.2024.01.016] [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: 12/28/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Abstract
INTRODUCTION This study aimed to examine the global prevalence of root and root canal morphologies in mandibular canines and analyze potential influences of region, ethnicity, sex, and age on the proportion of a second root and root canal configuration. METHODS Observers from 44 countries screened 13,200 canines using cone-beam computed tomographic exams and gathered data on the percentages of 2 root canal morphologies and 2-rooted configurations (primary outcomes), as well as the root canal configurations (secondary outcome). Demographic factors (ethnicity, sex, and age) were collected for each participant. Primary outcomes were represented as odds ratios and untransformed proportions accompanied by 95% confidence interval (CI) forest plots. Meta-analysis compared subgroups and identified sources of heterogeneity. Intra- and inter-rater tests were conducted. Statistical significance was set at 5%. RESULTS The worldwide prevalence of a second canal was 7.5% (95% CI, 6.3%-8.7%), ranging from 0.7% in Nigeria to 17.7% in Uruguay. The meta-analysis also revealed significant variations when comparing ethnicity, gender, and age (P < .05). The global prevalence of a second root was 1.9% (95% CI, 1.5%-2.3%), with the highest proportion observed in Spain (6.7%). Caucasian and Indian (south Asian) ethnic groups, females, and older patients exhibited higher proportions of 2 roots (P < .05). Meta-regression excluded side, voxel size, and field of view as sources of heterogeneity (P > .05). CONCLUSIONS The prevalence of 2 root canals and 2-rooted configurations in the mandibular canine exhibited variations based on geographic location, ethnicity, sex, and age. The global prevalence of 2 root canals and 2-root configuration was 7.5% and 1.9%, respectively.
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Affiliation(s)
- Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Grupo de Investigação em Bioquimica 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.
| | - Marco A Versiani
- Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
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Mehrjouei M, Jafarzadeh H, Esmaeelpour P, Khorasanchi M. Endodontic treatment of a C-shaped mandibular second molar with narrow dentinal thickness: A case report. Clin Case Rep 2024; 12:e8505. [PMID: 38356781 PMCID: PMC10866061 DOI: 10.1002/ccr3.8505] [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: 09/24/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Formulating an effective root canal treatment plan necessitates clinician awareness of the complexities of the root canal system and possible anatomic challenges. The C-shaped canal variation accompanying the radicular lingual groove makes the lingual dentinal wall so thin that cleaning and shaping of canals require accurate management. This report presents endodontic treatment of a C-shaped mandibular second molar diagnosed with pulpal necrosis and asymptomatic apical periodontitis, that initial radiographic assessment revealed extremely thin (0.3 mm) width of the lingual wall of the canals prone to perforation. Mechanical preparation was performed through the anti-curvature technique and basically by chemical irrigation rather than mechanical instrumentation. The C-shaped isthmus was prepared up to 25/02 rotary system without dentinal defect while maintaining adequate dentin thickness so as to not significantly reduce the strength of the root. Follow-up radiographs showed normal periodontal ligament and lamina dura indicating significant healing of the periapical lesion.
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Affiliation(s)
- Mina Mehrjouei
- Department of Endodontics, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
| | - Hamid Jafarzadeh
- Department of Endodontics, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
- Faculty of DentistryUniversity of TorontoTorontoOntarioCanada
| | - Pourya Esmaeelpour
- Department of Endodontics, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
| | - Maryam Khorasanchi
- Department of Endodontics, Faculty of DentistryMashhad University of Medical SciencesMashhadIran
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Shin B, Seo JH, Kim W, Ahn YJ, Kim HY, Shon WJ. The flow behavior and sealing ability of calcium silicate root canal cement containing dimethyl sulfoxide: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106156. [PMID: 38041883 DOI: 10.1016/j.jmbbm.2023.106156] [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: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION To develop a calcium silicate (CaSi)-based cement containing dimethyl sulfoxide (DMSO) and cement deliver device for new root canal filling technique, and to assess the flow behavior, leakage, and root canal filling quality of CaSi containing DMSO. METHODS CaSi containing DMSO (CSC-DMSO) and CaSi containing PEG (CSC-PEG) were prepared, and the flow characteristics of both cements were compared in gypsum and resin channels using a high-speed camera. Eight root canals were obturated by CSC-DMSO or CSC-PEG using a cement delivery device, and root canal filling quality was assessed in terms of filling length using periapical radiographs. The filling length was evaluated by 'apico-coronal extension,' measuring length in reference to apical constriction. Microleakage was measured for thirty human molars that were randomly filled with CSC-DMSO, CSC-PEG, or gutta-percha and AH plus. Preliminary obturation of CSC-DMSO with cement delivery device in human teeth was analyzed in terms of filling length and void, using periapical radiographs. Statistical analysis was performed with the Kruskal Wallis test for simulated root canal fillings and one-way ANOVA for leakage test. RESULTS The flow speed of CSC-DMSO reduced in gypsum channels compared to resin channels, but CSC-PEG did not exhibit significant differences in the channels. The median absolute value of apico-coronal extension was significantly lower in CSC-DMSO compared to CSC-PEG (p < 0.05). Microleakage did not statistically differ between the groups (p > 0.05). In the preliminary obturation, the mean apico-coronal extension of CSC-DMSO was -0.297 ± 0.724 mm, while CSC-PEG was not feasible due to excess apical extrusions. CONCLUSIONS CSC-DMSO could be considered as an alternative filling material for root canal obturation.
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Affiliation(s)
- Bokyung Shin
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ji-Hwan Seo
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Wonjung Kim
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Yu Jin Ahn
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ho-Young Kim
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea.
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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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Molina MAV, Silva GO, Candemil AP, Camargo RVD, Pauwels R, Jacobs R, Sousa-Neto MD, Mazzi-Chaves JF. Evaluation of 2- and 3-dimensional anatomic parameters of C-shaped root canals with cone beam computed tomography, microcomputed tomography, and nanocomputed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:759-768. [PMID: 37580223 DOI: 10.1016/j.oooo.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate 2-dimensional (2D) and 3D morphometric parameters of C-shaped root canals on cone beam computed tomography (CBCT) and microcomputed tomography (microCT) images using nanocomputed tomography (nanoCT) as the reference standard. STUDY DESIGN Sixty mandibular molars with C-shaped canals were individually scanned using nanoCT and microCT. Cone beam computed tomography acquisitions were then performed with 4 CBCT systems, using high and standard resolutions. The 2D parameters of roundness and major and minor diameters were obtained in the cross sections of the root canals at 1, 2, and 3 mm from the root apex. The 3D parameters of surface area, volume, and structure model index were measured considering the entire extension of the root canals. Absolute error (AE) in measurement was calculated against the nanoCT values. Data were statistically analyzed with the Shapiro-Wilk test and analysis of variance (α = 0.05). RESULTS No significant differences in AE were discovered for the 2D parameters among microCT and the CBCT scans. The AE values for the 3D parameters of volume and surface area were significantly smaller in microCT compared to all CBCT units (P < .05). Significantly lower AE values for surface area were observed in high resolution compared to standard resolution for all CBCT units (P < .05). Structure model index did not differ significantly among microCT and all CBCT protocols. CONCLUSIONS Cone beam computed tomography images showed accuracy for evaluating 2D parameters and over- and underestimation for 3D parameters.
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Affiliation(s)
- Miguel Angel Ventura Molina
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Giovane Oliveira Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Rafael Verardino de Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Ruben Pauwels
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
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Candemil AP, Mazzi-Chaves JF, Oliveira ML, Ambrosano GB, Vasconcelos KF, Pauwels R, Jacobs R, Sousa-Neto MD. Assessment of the root filling volume in C-shaped root canal on cone-beam CT and micro-CT in relation to nano-CT. Clin Oral Investig 2023; 27:6413-6420. [PMID: 37704914 DOI: 10.1007/s00784-023-05244-3] [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: 04/18/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
AIM To assess the observed volume of filled C-shaped root canals from different CBCT and micro-CT having nano-CT as a reference. MATERIALS AND METHODS Twelve extracted mandibular molars with C-shaped root canals were endodontically treated using Reciproc Blue R25 (VDW GMBH, Munich, Germany) in a reciprocating system and filled with gutta-percha (Dentsply Maillefer) and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). CBCT scans were performed using 3 units-3D Accuitomo 170 (J. Morita, Kyoto, Japan), ProMax 3D Max (Planmeca, Helsinki, Finland), and NewTom VGi EVO (Cefla QR, Verona, Italy)-at two resolution modes: standard and high. Micro-CT and nano-CT scans were also obtained. The volume of all filled C-shaped root canals was obtained using CTAn software (Bruker, Kontich, Belgium), and the blooming artifact, in relation to nano-CT volume, was calculated. The data were evaluated by the Bland-Altman plots and ANOVA two-way for repeated measures (α = 0.05). RESULTS All CBCT units and micro-CT showed significantly larger observed volume of root canal filling when compared to nano-CT. The blooming artifact of root canal filling in standard resolution was significantly larger than that in high resolution (p < 0.05) in all CBCT units. CONCLUSIONS Endodontic filling material with AH Plus sealer causes blooming artifacts in CBCT units and micro-CT. CLINICAL RELEVANCE Considering the anatomical complexity of C-shaped root canals and the challenges associated with endodontic treatment, CBCT is frequently recommended for follow-up evaluations. However, the presence of endodontic filling material can result in blooming artifacts that may potentially impact the accurate diagnosis of endodontic complications.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Guilherme Bovi Ambrosano
- Department of Statistical Genetics, Luiz de Queiroz College of Agriculture, University of São Paulo, São Paulo, Brazil
| | | | - Ruben Pauwels
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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Shekarian M, Majlesi M, Zare Jahromi M. Prevalence of C-shaped canals and three-rooted mandibular molars in the Iranian population by using cone-beam computed tomography. Clin Exp Dent Res 2023; 9:906-912. [PMID: 37786348 PMCID: PMC10582229 DOI: 10.1002/cre2.787] [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: 03/13/2023] [Revised: 08/20/2023] [Accepted: 09/01/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the prevalence of C-shaped canals and three-rooted mandibular molars in the Iranian population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS This study evaluated mandibular teeth on 292 CBCT scans of patients referred to the Department of Radiology, Faculty of Dentistry, Islamic Azad University, Isfahan, Iran. All CBCT scans were obtained with the same three-dimensional CBCT scanner, and sections were reconstructed in all three planes (sagittal, axial, and coronal) with 1 mm slice thickness. A total of 291,402, and 200 first, second, and third molars, respectively, were evaluated. Data were analyzed using SPSS software (version 26.0). RESULTS Of 291 mandibular first molars, 0.7% were single-rooted, 96.6% were two-rooted, and 2.7% were three-rooted. The prevalence of C-shaped canals was 1.7% in mandibular first molars. Of 402 mandibular second molars, 8.5% were single-rooted, 90.5% were two-rooted, and 1% were three-rooted. The prevalence of C-shaped canals was 2% in mandibular second molars. Of 200 mandibular third molars, 21.5% were single-rooted, 77.5% were two-rooted, and 1% were three-rooted. The prevalence of C-shaped canals was 2% in mandibular third molars. CONCLUSION In the present study, the majority of mandibular molars were two-rooted, and three-rooted mandibular molars were less common. The third and second mandibular molars both had an increased prevalence of C-shaped canals. Mandibular first molars had the highest prevalence of three-rooted molars.
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Affiliation(s)
- Mina Shekarian
- School of Dentistry, Dental Research Center, Dental Research InstituteIsfahan University of Medical SciencesIsfahanIran
| | - Masih Majlesi
- School of Dentistry, Isfahan (Khorasgan) BranchIslamic Azad UniversityIsfahanIran
| | - Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) BranchIslamic Azad UniversityIsfahanIran
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Saber SM, Seoud MAE, Sadat SMAE, Nawar NN. Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study. BMC Oral Health 2023; 23:217. [PMID: 37061674 PMCID: PMC10105946 DOI: 10.1186/s12903-023-02939-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND This study was using Cone beam computed tomography (CBCT) to examine the anatomical variations in mandibular second molars in an Egyptian sub-population. METHODS A total of 350 CBCT images (215 females and 135 males, aged 15-65 years) of mandibular second molars were evaluated. Samples were evaluated in terms of: number of roots, number of root canals, roots' cross section as well as prevalence and configurations of C-shaped canals. Statistical analysis was done to highlight differences between different categories and their prevalence among genders (significance level was set at p < 0.05). Data were presented as frequency and percentage values and were analyzed using chi square test followed by pairwise comparisons utilizing multiple Fisher's exact tests with Bonferroni correction. The significance level was set at p < 0.05 within all tests. RESULTS Of the 350 mandibular second molars evaluated, 87.2% were non-C-shaped while 12.8% were C-shaped with no gender-based statistically significant differences (χ2 = 0.19, p = 0.656). Most samples had three root canals (80%) followed by two (16%), then one (3.2%), and finally four (0.8%) root canals. Among the non-C-shaped molars, presence of two roots was most common (83.4%) followed by presence of a single root (16.2%), and only one sample (0.2%) had three roots, and this had no correlation with gender (χ2 = 1.86, p = 0.431). In the mesial roots Type IV Vertucci was the most common configuration found (68.8%), while Type I was the most prevalent in the distal roots (91.8%). The long oval configuration was the most commonly found cross section in mesial roots while "oval" was the most prevalent in distal roots. CONCLUSION Egyptian sub-population shows highly variable morphological features in mandibular second molars, hence, CBCT is highly recommended on case-to-case conditions.
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Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
- Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mohammed Abou El Seoud
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt.
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Wahane KD, Bansod AV, Mattigatti S, Mahaparale R, Rote YB, Wanjari MB. Cone-Beam Computed Tomography (CBCT) Analysis of an Unusual Configuration of the Upper First Molar With a C-shaped Canal With Apically Fused Roots: A Case Report. Cureus 2023; 15:e36474. [PMID: 37090297 PMCID: PMC10115750 DOI: 10.7759/cureus.36474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Lack of identification of the root canal results in root canal treatment failure, one of the most frequent causes of root canal treatment failure. To successfully treat root canals, it is crucial to have a detailed understanding of root canal configuration, including distinguishing traits and anatomical differences. The root canal in the C form arrangement is among the most important anatomical variances. Because of its distinctive highlight, the existence of fins or webs linking the different root canals - the C-shaped form of root canal has proven challenging to detect and manage. Any molar region may have this root canal arrangement, including the mandibular first molar, first premolar, and maxillary molars. Above all, mandibular second molars are where it is most usually discovered. This report discusses the uncommon maxillary first molar with an apically merged root. The importance of comprehending canal variations, which are C-shaped root canals, should be critically evaluated in light of the rise in the root canal treatment failure rate for the upper molars.
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Affiliation(s)
- Kapil D Wahane
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Anand V Bansod
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Sudha Mattigatti
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Rushikesh Mahaparale
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Yuvraj B Rote
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Mayur B Wanjari
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Almansour MI, Al-Zubaidi SM, Enizy AS, Madfa AA. Comprehensive evaluation of root and root canal morphology of mandibular second molars in a Saudi subpopulation evaluated by cone-beam computed tomography. BMC Oral Health 2022; 22:267. [PMID: 35778729 PMCID: PMC9250273 DOI: 10.1186/s12903-022-02305-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study's goal was to use Cone Beam Computed Tomography (CBCT) to assess the root and root canal anatomy of mandibular second molars with C-shaped root canal configurations in residents of the Hail district. The impact of gender and side on the frequency of root canal morphology was considered. METHODS The sample size for this study was 304 untreated mandibular second molars with completely developed roots on the right and left sides. Using CBCT on the teeth, the root form and canal morphology for each root are based on Vertucci's classification. The occurrence of canals in the shape of a C. The prevalence and resemblance of the left and right sides or men and females were investigated. The Chi-square test was performed to evaluate the findings. RESULTS Of the 304 mandibular second molars studied, 286 teeth had two roots (94.1%), whilst 13 (4.3%) were C-shaped root canal systems. 77 molars (25.3%) had two canal orifices, 219 (72.0%) had three canal orifices, and six (2.0%) and one (0.3%) had four and five root canal orifices, respectively. Type IV was the most common for mesial root, accounting for 57.7% of the sample (n = 176). For distal root, the most common occurrence was type I, which occurred 282 times (96.60%). The most prevalent root canal morphology was the presence of two canals in the mesial root and one canal in the distal root of teeth with two distinct roots (variant 3). (69.4%). The overall prevalence of C-shaped root canal systems is (4.3%) (n = 13). CONCLUSIONS The patient's race is an undeniable factor that influences root canal anatomy. The root canal morphology of mandibular second molars revealed significant differences between Saudi subpopulations. The majority of mandibular second molars had two roots and three root canals. When treating these molars, the presence of a C-shaped root canal system must be taken into account.
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Affiliation(s)
- Moazzy I Almansour
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
| | - Saad M Al-Zubaidi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Abdulmjeed S Enizy
- Department of Dentistry, Prince Sultan Military Medical City, Riyadh, 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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Abdalrahman K, Talabani R, Kazzaz S, Babarasul D. Assessment of C-Shaped Canal Morphology in Mandibular and Maxillary Second Molars in an Iraqi Subpopulation Using Cone-Beam Computed Tomography. SCANNING 2022; 2022:4886993. [PMID: 35360525 PMCID: PMC8942670 DOI: 10.1155/2022/4886993] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/11/2022] [Accepted: 02/26/2022] [Indexed: 05/05/2023]
Abstract
Endodontic treatment is basically dependent on knowledge of the root canal anatomy. The goal of this study was to use cone-beam computed tomography (CBCT) imaging to examine the C-shaped canal configuration of mandibular and maxillary second molars in an Iraqi subpopulation. The prevalence and configurations of C-shaped canals were evaluated in 368 mandibular second molars and 369 maxillary second molars using CBCT scans. The effects of gender, age, and unilateral/bilateral on the presence of C-shaped canals were investigated. Chi-square and Fisher's exact tests were used to determine the level of significance (p ≤ 0.05), and kappa value was used to check reliability of results of the research. In mandibular second molars, the prevalence of C-shaped canals was 17.4%. The prevalence was significantly higher in females (23%) than males (10.4%) using the chi-square test. There is no significant difference in the prevalence of C-shaped canal depending on age and tooth position. The C2 type was the most common (56.3%). This prevalence did not differ with gender, age, or tooth position. In maxillary second molars, C-shaped canals were present in 7.9%. Type I (subtype C) (fusion of 2 root canals MB-DB) was the most common type of fused root (65.5%). There is no significant difference in the prevalence of C-shaped canal depending on the type of fused root, age, and tooth position. The majority of C-shaped canals in mandibular second molars were bilateral in both genders, but unilateral presence was more common in maxillary second molars in both genders. Within the limits of this study, C-shaped canals were found to be more common in mandibular second molars than in maxillary second molars in an Iraqi subpopulation.
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Affiliation(s)
- Kazhan Abdalrahman
- Conservative Department, College of Dentistry, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Iraq
| | - Ranjdar Talabani
- Conservative Department, College of Dentistry, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Iraq
| | - Sara Kazzaz
- Conservative Department, College of Dentistry, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Iraq
| | - Dlsoz Babarasul
- Conservative Department, College of Dentistry, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Iraq
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The C-shaped root canal systems in mandibular second molars in an Emirati population. Sci Rep 2021; 11:23863. [PMID: 34903785 PMCID: PMC8668958 DOI: 10.1038/s41598-021-03329-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/01/2021] [Indexed: 12/23/2022] Open
Abstract
Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.
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Thanaruengrong P, Kulvitit S, Navachinda M, Charoenlarp P. Prevalence of complex root canal morphology in the mandibular first and second premolars in Thai population: CBCT analysis. BMC Oral Health 2021; 21:449. [PMID: 34530811 PMCID: PMC8444426 DOI: 10.1186/s12903-021-01822-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Mandibular premolars demonstrate high variability in root canal morphology, especially mandibular first premolars. The purposes of this study were to determine the prevalence of root canal configurations of mandibular premolars according to Vertucci classification in a Thai population. Methods Total of 1159 CBCT images of Thai patients who received radiographic imaging at the Department of Radiology, Faculty of Dentistry, Chulalongkorn University in 2017–2018 was evaluated. The data were reported using descriptive statistics and the relationship between the prevalence of the root canal complexities and sex was analyzed using the chi-squared test. Results The most common root canal configuration was Vertucci type I, with a 63.1% and 98% prevalence in the mandibular first and second premolars, respectively. More than 98% of mandibular premolars had a single root. The prevalence of a bifurcation was 28.5% and 1.5% in the mandibular first and second premolars, respectively. The prevalence of a trifurcation was 3.2% in the mandibular first premolar. A C-shaped root canal was observed at 23.7% and 0.7% in the mandibular first and second premolars, respectively. The level of branching was mostly found at the middle 1/3 of the root. Bilateral appearance of the same root canal configuration was identified in 80.3% and 95.9% in the mandibular first and second premolars, respectively. There was no relationship between sex and the prevalence of a bifurcation, trifurcation, or C-shaped root canal. Conclusion Mandibular first premolars have more root canal complexities than mandibular second premolars. Horizontal tube shift x-ray technique, CBCT, dental operating microscope, and knowledge of root canal configurations have an important role in root canal identification in mandibular premolar with suspected complex root canal morphology. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01822-7.
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Affiliation(s)
- Paramee Thanaruengrong
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Sirinya Kulvitit
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand.
| | - Mettachit Navachinda
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Pornkawee Charoenlarp
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
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Cetin MS, Simsek N. Evaluation of fracture strength of different restoration techniques applied to C-shaped 3D model teeth. Odontology 2021; 110:262-268. [PMID: 34495439 DOI: 10.1007/s10266-021-00655-8] [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: 04/09/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study is to investigate the effect of different restoration methods applied to model teeth with a C-shaped root canal configuration on fracture strength. A total of 76 artificial tooth models were made using images of a molar tooth with a C-shaped root canal anatomy. The teeth were randomly divided into seven groups and different restorations, such as resin composite (2), bundled fiber post and resin composite (3), vertical fiber post and resin composite (4), horizontal fiber post and resin composite (5), woven fiber post and resin composite (6) and composite endocrown (7) were applied to the different groups except control group (1). The artificial teeth were embedded in acrylic blocks and subjected to fracture tests. The data were analyzed using one-way analysis of variance, Monte Carlo Pearson Chi-square, Pearson Chi-square, and Fisher's exact test (P < 0.05). All groups differed in terms of fracture strength (P = 0.001). The highest fracture strength observed in group 6, and there was a significant difference between group 6 and group 4 based on a least significant difference pairwise comparison test. In terms of fracture type, the highest reparability percentage (100%) observed in group 7. The fracture strength values of endocrown restorations and woven fiber-reinforced resin composite restorations were found to be as high as those of the intact models. Considering also fracture restorability, endocrown restorations may be recommended for teeth with C-shaped root canal anatomy. The usage of the 3D tooth models in the studies offer a valuable opportunity in terms of the standardization of the samples, particularly in teeth with anatomical variations. This study shows that using of this technology, homogeneous groups can be created and experimental studies can be improved.
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Affiliation(s)
- Melis Sila Cetin
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Neslihan Simsek
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
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Saghiri MA, Dadvand S, Abdolmaleki A. The evaluation of physical properties of a polyurethane expandable endodontic sealer: a preliminary study. AUST ENDOD J 2021; 47:550-558. [PMID: 33988276 DOI: 10.1111/aej.12521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/19/2021] [Accepted: 04/11/2021] [Indexed: 11/28/2022]
Abstract
Endodontic sealers play a vital role in providing 3-dimensional (3D) filling of complex root canal system (RCS). This study intended to compare the physical properties of a Polyurethane Expandable Sealer (PES), AH Plus and EndoSequence. Three properties including setting time, radiopacity and flow (rheology) were evaluated based on ISO 6876 standard. For evaluation of each of these physical properties, five samples from experimental groups: AH Plus, EndoSequence, PES (controlled expansion) and PES (high expansion) were used (n = 5). Data were analysed by one-way ANOVA and Post Hoc Tukey tests (a = 0.05). EndoSequence showed the longest setting time (P < 0.000); AH Plus showed that highest radiopacity (P < 0.000); and PES (high expansion) showed the highest flow (diameter and surface area) (P < 0.000). EndoSequence and PES (controlled expansion) showed promising and comparable physical properties to the AH Plus sealer in terms of flow, setting time and radiopacity.
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Affiliation(s)
- Mohammad Ali Saghiri
- Director of Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA.,Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Sahar Dadvand
- Department of Preventive and Restorative Dental Sciences, San Francisco School of Dentistry, University of California, San Francisco, CA, USA
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Chaintiou Piorno R, Consoli Lizzi EP, Gualtieri AF, Rodríguez PA. C-Shaped canal system in mandibular premolars evaluated by cone-beam computed tomography in a population of the Autonomous City of Buenos Aires, Argentina. Arch Oral Biol 2021; 123:105040. [PMID: 33454421 DOI: 10.1016/j.archoralbio.2021.105040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/20/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate cone-beam computed tomography images in an Argentine population in order to determine the presence of mandibular premolars with C-shaped canal system and classify them. METHODS 697 images were observed, 170 of them fulfilling the selection criteria. Once established the presence of a C-shaped canal system, premolars were classified using Fan's criteria. Data description was made by frequencies and percentages rates, with a 95% confidence interval according to the score method. Comparisons were assessed by means of the Chi-square test with a significance level equal to 5%. RESULTS Of 269 first premolars, 27 teeth showed C-shaped canal system, i.e. 10%, and of 231 second premolars, 4 presented C-shaped canal system, i.e. 2%. Out of 17 patients presenting first premolars in both sides, 6 showed a bilateral C-shaped canal system pattern and 11 did not present this condition. When the condition was unilateral (n = 15), 7 patients showed C-shaped canal in the tooth 3.4 and 8 patients showed C-shaped canal in the tooth 4.4. The second premolars showed C-shaped canals unilaterally. Along the canal, configuration variations at the three-thirds have been observed for the first and second mandibular premolars. CONCLUSION The C-shaped canal system pattern prevalence in mandibular first and second premolars was estimated for the first time in an Argentine population, in vivo. The present report contributes to the epidemiological understanding of the anatomical variable of the inner dental configuration and its extrapolation to the clinical practice.
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Affiliation(s)
- Romina Chaintiou Piorno
- Department of Endodontics, School of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Eugenia Pilar Consoli Lizzi
- Department of Endodontics, School of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Ariel Félix Gualtieri
- Department of Biophysics and Biostatistics, School of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Pablo Alejandro Rodríguez
- Department of Endodontics, School of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
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Jeon SJ, Yun JP, Yeom HG, Shin WS, Lee JH, Jeong SH, Seo MS. Deep-learning for predicting C-shaped canals in mandibular second molars on panoramic radiographs. Dentomaxillofac Radiol 2021; 50:20200513. [PMID: 33405976 DOI: 10.1259/dmfr.20200513] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the use of a convolutional neural network (CNN) system for predicting C-shaped canals in mandibular second molars on panoramic radiographs. METHODS Panoramic and cone beam CT (CBCT) images obtained from June 2018 to May 2020 were screened and 1020 patients were selected. Our dataset of 2040 sound mandibular second molars comprised 887 C-shaped canals and 1153 non-C-shaped canals. To confirm the presence of a C-shaped canal, CBCT images were analyzed by a radiologist and set as the gold standard. A CNN-based deep-learning model for predicting C-shaped canals was built using Xception. The training and test sets were set to 80 to 20%, respectively. Diagnostic performance was evaluated using accuracy, sensitivity, specificity, and precision. Receiver-operating characteristics (ROC) curves were drawn, and the area under the curve (AUC) values were calculated. Further, gradient-weighted class activation maps (Grad-CAM) were generated to localize the anatomy that contributed to the predictions. RESULTS The accuracy, sensitivity, specificity, and precision of the CNN model were 95.1, 92.7, 97.0, and 95.9%, respectively. Grad-CAM analysis showed that the CNN model mainly identified root canal shapes converging into the apex to predict the C-shaped canals, while the root furcation was predominantly used for predicting the non-C-shaped canals. CONCLUSIONS The deep-learning system had significant accuracy in predicting C-shaped canals of mandibular second molars on panoramic radiographs.
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Affiliation(s)
- Su-Jin Jeon
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Daejeon, South Korea
| | - Jong-Pil Yun
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, South Korea
| | - Han-Gyeol Yeom
- Department of Oral and Maxillofacial Radiology, Wonkwang University Daejeon Dental Hospital, Daejeon, South Korea
| | - Woo-Sang Shin
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, South Korea.,School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, South Korea
| | - Jong-Hyun Lee
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, South Korea.,School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, South Korea
| | - Seung-Hyun Jeong
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, South Korea
| | - Min-Seock Seo
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Daejeon, South Korea
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Cone-beam computed tomography classification of the mandibular second molar root morphology and its relationship to panoramic radiographic appearance. Oral Radiol 2020; 37:494-501. [PMID: 33048311 DOI: 10.1007/s11282-020-00486-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aimed to clarify the relationship between the panoramic radiographic appearance and the longitudinal cone-beam computed tomography (CBCT) classification of root configurations of the mandibular second molar. METHODS Panoramic radiographs of 1058 mandibular second molars were classified into five types according to the number and configuration of the roots. These molars were also examined with CBCT at four levels between the pulp chamber and the root apex, and axial images perpendicular to the root axis were categorized into three patterns: single (fused root with small grooves on both buccal and lingual sides or a round root with one canal); double (two separate roots with a trabecular appearance between them); and C-shaped (root with a deep groove opening only on the lingual or buccal side relative to the opposite side). Based on these patterns and their scan levels, the CBCT root morphology appearance in each tooth unit was classified into seven groups. Relationships were investigated between these seven CBCT groups and the five panoramic root types. RESULTS In panoramic types 1 and 2 (with separate roots), 85% had roots with a double pattern (groups II and III) on the CBCT images. In panoramic types 3 and 4 (with fused roots), 85% had C-shaped CBCT patterns at the lower scan levels. CONCLUSIONS When panoramic images show fused root types, CBCT examinations should be planned to clarify the root canal configuration.
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Baghbani A, Bagherpour A, Ahmadis Z, Dehban A, Shahmohammadi R, Jafarzadeh H. The efficacy of five different techniques in identifying C-shaped canals in mandibular molars. AUST ENDOD J 2020; 47:170-177. [PMID: 33030295 DOI: 10.1111/aej.12445] [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] [Accepted: 09/02/2020] [Indexed: 12/24/2022]
Abstract
Information regarding the canal anatomy especially in complex cases such as C-shaped canals is essential for a successful treatment. In this study, five different methods for identification of C-shaped canal configuration were compared. 108 extracted mandibular molars with fused roots were studied. Radiographic evaluation was carried out using periapical radiography and CBCT. After access cavity preparation, all specimens were evaluated by direct visual examination and then under dental operating microscope. Finally, the actual anatomy of each sample was determined by preparing horizontal cross sections of the roots (1 mm thick) and examining them under stereomicroscope as the gold standard. Among the techniques used, high-resolution CBCT manifested the highest accuracy, whereas periapical radiography had the lowest. All approaches can be useful in reaching a correct diagnosis. CBCT, especially the low-resolution modality, is an effective technique in the diagnosis of C-shaped anatomy.
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Affiliation(s)
- Atefeh Baghbani
- Department of Prosthodontics, Faculty of Dentistry, Bojnurd University of Medical Sciences, Bojnurd, Iran
| | - Ali Bagherpour
- Department of Oral and Maxillofacial Radiology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Ahmadis
- Department of Prosthodontics, Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
| | - Arezou Dehban
- Department of Prosthodontics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Shahmohammadi
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Jafarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Taurodontism and C-shaped anatomy: is there an association? Oral Radiol 2020; 37:443-451. [PMID: 32803678 DOI: 10.1007/s11282-020-00476-5] [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: 06/19/2020] [Accepted: 08/08/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate the relation between taurodontism and C-shaped configuration, as well as the prevalence and classification according to sex, left/right position, and arc length in the mandibular premolar and molar teeth using cone beam computed tomography (CBCT). METHODS The presence of taurodontism and C-shaped configuration were evaluated using CBCT scans and classified by two independent radiologists. The sex, location in the jaw (left-right), and mandibular arc length measurements were recorded. The Chi-square test was used to determine the presence of taurodontism and C-shape configuration according to sex, left/right location, and independent-sample t tests were used to assess the relation between the arc length. RESULTS The prevalence of taurodontism was significantly higher in the female population, whereas the C-shaped configuration was more frequent in males (p < 0.05). In both sexes, the most common type was hypotaurodont (7.5%). In the molars, the prevalence was significantly higher in second molars, and the most common C-shaped configuration type was C3 (39.3%). The prevalence was significantly higher in the first premolar, with C2 (22.4%) being the most frequent type in the premolars (p < 0.05). The arc length and location in the jaw were not significantly affected (p > 0.05). CONCLUSIONS A high correlation was revealed between taurodontism and complicated C-shape canal configurations. Practitioners should be very careful about the presence of C-shape morphology in taurodontism treatment, and various types of C-shaped morphology ranging from coronal to the apical direction.
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Ren HY, Zhao YS, Yoo YJ, Zhang XW, Fang H, Wang F, Perinpanayagam H, Kum KY, Gu Y. Mandibular molar C-shaped root canals in 5th millennium BC China. Arch Oral Biol 2020; 117:104773. [PMID: 32512259 DOI: 10.1016/j.archoralbio.2020.104773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the occurrence and variations in C-shaped canals in ancient Chinese teeth and compare the differences of these features between ancient and age-matched modern populations. DESIGN Approximately 5000-year-old craniofacial bone remains were collected from the fossils of 38 individuals (total: 68 mandibular second molars) excavated from the Jiaojia site. The control group comprised of an equal number of randomly selected modern samples. We used cone-beam computed tomography to scan the mandible along the apex-crown axis and analyzed the canal morphology, based on Fan's categorization criterion, at 2 mm, 5 mm, and 8 mm to the apical level. Grooves on the lingual and buccal sides were also recorded. RESULTS The proportion of C-shaped roots among ancient samples on the left and right sides were 48.57 % (17/35 teeth) and 54.55 % (18/33 teeth), respectively, and 51.47 % (35/68 teeth) in the total sample. Conversely, in the control group, 44.12 % (15/34) and 38.24 % (13/34) occurred on the left and right sides, respectively, and 41.18 % (28/68) in the total sample. Among the C-shaped canals from the Jiaojia site samples, the classification type changed between two adjacent levels in 84.31 % of samples. Approximately 35 (51.5 %) teeth had a fused root, 20 (29.41 %) had one shallow buccal and one deep lingual groove. The occurrence of C-shape variation was not significantly correlated with time (p>0.05). CONCLUSIONS This study identified a high rate of C-shaped root canals among individuals of Jiaojia who lived approximately 5000 years ago.
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Affiliation(s)
- Hui Ying Ren
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - Yong Sheng Zhao
- Institute of Cultural and Heritage, Shandong University, Qingdao, PR China
| | - Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Xiao Wen Zhang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Hui Fang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Fen Wang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Hiran Perinpanayagam
- Division of Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Yu Gu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China.
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C-shaped canals in mandibular molars of a Brazilian subpopulation: prevalence and root canal configuration using cone-beam computed tomography. Clin Oral Investig 2020; 24:3299-3305. [PMID: 31965283 DOI: 10.1007/s00784-020-03207-6] [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: 10/03/2019] [Accepted: 01/07/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To assess C-shaped root canal configuration by identifying its prevalence and each configuration type proportion, according to tooth (mandibular first or second molar) and demographic characteristics in a Brazilian population, using cone-beam computed tomography (CBCT). Moreover, it was verified if there is a relationship between root canal configuration observed in two-dimensional reconstructions of CBCT and presence of C-shape. METHODS Mandibular jaw CBCT scans (184 males and 220 females, aged 15 to 80 years), which presented 1464 mandibular molars (710 first molars and 754 second molars), were assessed. Teeth were evaluated for the presence and type of C-shaped root canals by observing the roots at five levels in CBCT axial reconstructions. Root canal configuration was assessed in panoramic reconstructions. Data were statistically analyzed at a significance level of 5%. RESULTS Of the 1464 mandibular molars, 125 (8.5%) were classified as C-shaped. This variation was more prevalent in females (n = 107, 85.6%) and in second molars (n = 108, 86.4%). C1 (uninterrupted C-shaped canal) was the most prevalent type of C-shaped configuration (41.76%), while C5 (no canal lumen) was the least prevalent type (0.96%). Single root with single canal in panoramic reconstructions was the most predominant configuration for C-shaped teeth (n = 54, 43.2%). Fused roots presented 17.2 higher odds of being associated with C-shaped root canals than non-fused roots. CONCLUSIONS C-shaped root canals were more prevalent in mandibular second molars and in females. Additionally, clinicians should bear in mind the greater possibility of C-shaped configuration in mandibular molars with fused roots. CLINICAL RELEVANCE Mandibular molars with C-shaped canals present a clinical challenge. A higher C-shaped proportion was noted in radiographic fused root types, which had 17.2 higher odds of presenting such anatomy when compared to radiographic non-fused roots. Root radiographic features may help in diagnosis of complex C-shaped morphologies.
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Unusual Maxillary First Molars with C-Shaped Morphology on the Same Patient: Variation in Root Canal Anatomy. Case Rep Dent 2019; 2019:1857289. [PMID: 31772783 PMCID: PMC6854219 DOI: 10.1155/2019/1857289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 11/18/2022] Open
Abstract
A maxillary first molar should be considered a four-canal tooth until proved otherwise; however, a clinician should also be aware of the possibility of the presence of C-shaped root canal configuration with or without possibility of splitting into two or three canals. The two clinical cases reported in this paper describe the endodontic treatment of two maxillary first molars, on the same patient, with uncommon anatomy: the first case is about a maxillary first molar with only one C-shaped root and one oval canal with a large buccolingual diameter, a C1 type according to Fan's classification; the second case, about the contralateral maxillary first molar, is probably the first case documented of a maxillary first molar with a C-shaped root canal and C-shaped root with complete fusion of the three roots, having a C3 configuration.
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Evaluation of the internal anatomy of paramolar tubercles using cone-beam computed tomography. Surg Radiol Anat 2019; 42:15-21. [PMID: 31659406 DOI: 10.1007/s00276-019-02361-1] [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: 03/20/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the internal anatomy of paramolar tubercles (PTs) on molars, determine the existence of root canals in these structures that either communicate with or are isolated from the main root canals of teeth, and analyze the prevalence of root fusion and a C-shaped canal configuration using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Twenty-six molars with PTs from the study group and 664 molars without PTs from the control group were evaluated using CBCT. The locations and sizes of tubercles were noted. The existence of root canals in PTs was detected. All teeth were evaluated according to the presence or absence of root fusion and a C-shaped canal configuration. Statistical analyses were performed with Pearson Chi square and Fisher's exact tests (p < 0.05). RESULTS Eleven (42.3%) PTs with their own canals communicated with the main root canals of teeth, and 10 of 11 PTs (90.9%) were larger than 4 mm in size. No PT possessed its own canal independent from the other canals. Teeth with PTs tended to have more root fusions than teeth without PTs. A statistically significant correlation was observed between PTs and the C-shaped canal configuration (p < 0.01). Maxillary second molars with PTs were the major teeth showing variations in the internal morphology. CONCLUSIONS PTs are an uncommon anatomical variation that is specific to the coronal and radicular morphology. Therefore, clinicians should be aware of its unpredictable and complex internal anatomy, particularly in cases requiring endodontic treatment. CBCT is recommended for teeth with PTs, particularly maxillary second molars, to improve the prognosis of the teeth.
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30
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Martins JNR, Mata A, Marques D, Caramês J. Prevalence of C-shaped mandibular molars in the Portuguese population evaluated by cone-beam computed tomography. Eur J Dent 2019; 10:529-535. [PMID: 28042270 PMCID: PMC5166311 DOI: 10.4103/1305-7456.195175] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: The purpose of this study was to evaluate the prevalence of first and second C-shaped mandibular molars in a Western European population of Portuguese Caucasians. Materials and Methods: Patients having both routine panoramic radiograph and presurgical cone-beam computed tomography (CBCT) exams were selected. The CBCT examination was performed at five different axial levels and the mandibular molars were classified as C-shape according to the Fan criteria. Differences between genders, age groups, left and right side, type of tooth, and root concavity side were determined. The molars were classified as nonfused roots (NFRI–II), FRI–III, or single root with single canal (SS) groups, using the panoramic radiograph. The prevalence of C-shaped anatomy was calculated to each group. Results: A total of 1783 teeth (695 first molars and 1088 second molars) from 792 patients were included in the study. The prevalence of C-shaped configurations was 0.6% and 8.5% to mandibular first and second molars, respectively. The differences between gender, teeth, and root concavity direction were considered statistically significant (P < 0.05). The FR had a significantly higher rate of C-shapes when compared to NFR (P < 0.05). Intrarater reliability was 93.6%. Conclusions: The FR radiographic appearance may be considered a predictor of this anatomy. Second mandibular molars and females had a higher incidence ratio. Apparently, the mandibular C-shaped anatomy is more common in the population of this study than that has been previously reported for the European population.
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Affiliation(s)
| | - António Mata
- Department of Biology, New York University, New York, USA.,Department of Oral Biology, School of Dental Medicine, Lisbon University, Lisbon, Portugal.,Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062)- Evidence Based Dentistry Center, Lisbon University, Lisbon, Portugal
| | - Duarte Marques
- Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062)- Evidence Based Dentistry Center, Lisbon University, Lisbon, Portugal.,Department of Anatomy and Physiology, School of Dental Medicine, Lisbon University, Lisbon, Portugal
| | - João Caramês
- Department of Implantology, School of Dental Medicine, Lisbon University, Lisbon, Portugal
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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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Marcano-Caldera M, Mejia-Cardona JL, Blanco-Uribe MDP, Chaverra-Mesa EC, Rodríguez-Lezama D, Parra-Sánchez JH. Fused roots of maxillary molars: characterization and prevalence in a Latin American sub-population: a cone beam computed tomography study. Restor Dent Endod 2019; 44:e16. [PMID: 31149614 PMCID: PMC6529798 DOI: 10.5395/rde.2019.44.e16] [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: 11/12/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population. Materials and Methods A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion. Results Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped. Conclusion Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.
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Affiliation(s)
- Maytté Marcano-Caldera
- Postgraduate Endodontics Program. Autonomous University of Manizales, Manizales, Colombia
| | | | | | | | | | - Jose Hernán Parra-Sánchez
- Math and Statistics Department. National University of Colombia, Campus Palogrande, Manizales, Colombia
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Roy A, Astekar M, Bansal R, Gurtu A, Kumar M, Agarwal LK. Racial predilection of C-shaped canal configuration in the mandibular second molar. J Conserv Dent 2019; 22:133-138. [PMID: 31142981 PMCID: PMC6519192 DOI: 10.4103/jcd.jcd_369_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The purpose of this article is to determine the racial predilection of C-shaped canal configuration in a mandibular second molar. Background: Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of root canal treatment outcome. C-shaped canal configuration is such an aberrant morphology of molar teeth that vary in different population and is commonly seen in a mandibular second molar. Thus, knowledge of racial predilection of C-shaped canal configuration in different population for early diagnosis is obligatory. Materials and Methods: An exhaustive search was undertaken to identify published research articles related to C-shaped canal configuration in mandibular second molars. Forty-three research articles were analyzed which included 12,481 mandibular second molars. Chi-square test using value of P < 0.05 was performed to assess the statistical significance of this anomalous anatomic variation among the different population. Results: Statistical test revealed a significant variation between the Asian and nonAsian population. The highest incidence of racial predilection was observed in China (Asia) with 93.1%, and the minimum was observed in America with 2.7%. Conclusion: This research reported that racial predilection of C-shaped canal configuration in mandibular second molar varies significantly.
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Affiliation(s)
- Aishwarya Roy
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rashmi Bansal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Anuraag Gurtu
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Mrityunjay Kumar
- Department of Anaesthesiology, Critical Care and Pain Management, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Lalit Kumar Agarwal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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A cone-beam computed tomography study of C-shaped root canal systems in mandibular second premolars in a Taiwan Chinese subpopulation. J Formos Med Assoc 2018; 117:1086-1092. [DOI: 10.1016/j.jfma.2017.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 10/17/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022] Open
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35
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Kim HS, Jung D, Lee H, Han YS, Oh S, Sim HY. C-shaped root canals of mandibular second molars in a Korean population: a CBCT analysis. Restor Dent Endod 2018; 43:e42. [PMID: 30483466 PMCID: PMC6237723 DOI: 10.5395/rde.2018.43.e42] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/22/2018] [Indexed: 01/03/2023] Open
Abstract
Objectives The purpose of this study was to investigate the C-shaped root canal anatomy of mandibular second molars in a Korean population. Materials and Methods A total of 542 teeth were evaluated using cone-beam computed tomography (CBCT). The canal shapes were classified according to a modified version of Melton's method at the level where the pulp chamber floor became discernible. Results Of the 542 mandibular second molars, 215 (39.8%) had C-shaped canals, 330 (53%) had 3 canals, 17 (3.3%) had 2 canals, 12 (2.2%) had 4 canals, and 8 (1.7%) had 1 canal. The prevalence of C-shaped canals was 47.8% in females and 28.4% in males. Seventy-seven percent of the C-shaped canals showed a bilateral appearance. The prevalence of C-shaped canals showed no difference according to age or tooth position. Most teeth with a C-shaped canal system presented Melton's type II (45.6%) and type III (32.1%) configurations. Conclusions There was a high prevalence of C-shaped canals in the mandibular second molars of the Korean population studied. CBCT is expected to be useful for endodontic diagnosis and treatment planning of mandibular second molars.
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Affiliation(s)
- Hee-Sun Kim
- Department of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
| | - Daun Jung
- Department of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
| | - Ho Lee
- Department of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
| | - Yoon-Sic Han
- Department of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
| | - Sohee Oh
- Department of Biostatics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
| | - Hye-Young Sim
- Department of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU BMC), Seoul, Korea
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Ilayaraja V, Ganapathy N, Jisha G, Keerthipriyadharshini T, Maheswaran T, Yoithapprabhunath TR. Digitized Morphometric Analysis using Maxillary Canine and Mandibular First Molar for Age Estimation in South Indian Population. Open Dent J 2018; 12:762-769. [PMID: 30369986 PMCID: PMC6182877 DOI: 10.2174/1745017901814010762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/18/2018] [Accepted: 09/11/2018] [Indexed: 11/23/2022] Open
Abstract
Background: In recent years, the estimation of age in living individuals have become important to solve judicial or civil problems. Secondary dentin deposition occurs as the age advances and can be measured by calculating the reduction in pulp chamber through Noninvasive radiograph techniques. Aim: The aim is to derive precise population specific formulae for age estimation. Materials and Methods: Digitalized Orthopantomography of 150 subjects, was retrieved. The subjects were divided into study and test group. Pulp tooth area ratio was recorded from the maxillary canine and pulp chamber crown root trunk height ratio was recorded from a mandibular first molar. Statistical Analysis: Regression equation was derived from study group subjects and this equation was used to estimate the age of subjects in the test group. Results: No significant differences were seen between mean chronological age and mean estimated age (p-value- 0.157). Mean Absolute Error (MAE) was estimated to be 2.76 years. The percentage of estimated ages in test sample < ± MAE was 72%. The difference was higher in the group I and II (p-value- 0.001 and 0.002) Conclusion: The equation derived from the anterior and posterior teeth together gave more accurate results in the present study. The prediction accuracy can further be enhanced by using multiple teeth or by utilizing other linear measurements in the same teeth.
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Affiliation(s)
- Vadivel Ilayaraja
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | - Nalliapan Ganapathy
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | - Georgebabu Jisha
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | | | - Thangadurai Maheswaran
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
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Relationship of the Incidence of C-shaped Root Canal Configurations of Mandibular First Premolars with Distolingual Roots in Mandibular First Molars in a Taiwanese Population: A Cone-beam Computed Tomographic Study. J Endod 2018; 44:1492-1499.e1. [DOI: 10.1016/j.joen.2018.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/16/2018] [Accepted: 05/29/2018] [Indexed: 11/22/2022]
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Lim A, Le Clerc J. Endodontic treatment of a hypertaurodontic mandibular left second molar in a patient with many taurodonts combined with multiple pulp stones. AUST ENDOD J 2018; 45:414-419. [DOI: 10.1111/aej.12291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Adrian Lim
- UFR Odontologie Univ Rennes 1 Rennes France
- Pôle Odontologie CHU Rennes Rennes France
| | - Justine Le Clerc
- UFR Odontologie Univ Rennes 1 Rennes France
- Pôle Odontologie CHU Rennes Rennes France
- ISCR – UMR CNRS 6226 Univ Rennes 1 Rennes France
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Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: a retrospective study. Clin Oral Investig 2018. [PMID: 29536188 DOI: 10.1007/s00784-018-2415-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the prevalence of the C-shaped root canal configuration, location of the longitudinal groove, sex differences, and unilateral/bilateral presence in mandibular first and second molars in a Saudi population using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT images for the mandibular first and second molars of 487 patients (a total of 529 first molars and 681 s molars) were evaluated. The teeth were assessed for the presence of C-shaped root canals according to Fan criteria. Subdivisions were also made according to sex, direction of the longitudinal groove, and unilateral/bilateral presence. RESULTS Only one C-shaped mandibular first molar was observed (0.19%), whereas 62 second molars (9.1%) exhibited C-shaped anatomy. Unilateral presence of the C-shaped root canal system was more common (53.85%). Female patients had a higher prevalence than males. Longitudinal grooves were most commonly found on the root lingual surface (58.1%). CONCLUSIONS The prevalence of the C-shaped canal configuration in a Saudi Arabian population was 0.19% in the mandibular first molar and 9.1% in the mandibular second molar. Longitudinal groove prevalence was highest on the lingual surface. Women had a significantly higher prevalence of the C-shaped canal configuration than men. Patients with unilateral presence of the C-shaped canal configuration were more common than those with bilateral presence. CLINICAL RELEVANCE Tooth type, patient sex, and ethnicity can help clinicians predict the prevalence of the C-shaped canal system in mandibular molars.
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Gharechahi M, Dastmalchi P. Cutaneous Sinus Tract from Mandibular Second Molar with C-shaped Canal System and Improper Former Root Canal Treatment: A Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 57:183-7. [PMID: 27665696 DOI: 10.2209/tdcpublication.2015-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Here, we report the diagnosis and treatment of an extraoral cutaneous sinus tract originating in a mandibular second molar with a C-shaped root canal system. The patient was referred to our department by a dermatologist after a series of unsuccessful treatments, including antibiotics. Diffuse radiolucency on a preoperative radiograph revealed that earlier root canal treatment had been only partially successful. Consequently, we performed retreatment of the root canal comprising removal of the former restoration and gutta-percha, cleaning and shaping, and passive irrigation with sodium hypochlorite. The patient responded well, and the cutaneous lesion completely resolved uneventfully within 1 month postoperatively. Preoperative recognition and thorough knowledge of the root canal anatomy and conventional methods of obturation are necessary in performing successful endodontic treatment.
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Affiliation(s)
- Maryam Gharechahi
- Department of Endodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences
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Janani M, Rahimi S, Jafari F, Johari M, Nikniaz S, Ghasemi N. Anatomic Features of C-shaped Mandibular Second Molars in a Selected Iranian Population Using CBCT. IRANIAN ENDODONTIC JOURNAL 2018; 13:120-125. [PMID: 29692847 PMCID: PMC5800453 DOI: 10.22037/iej.v13i1.17286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/17/2017] [Accepted: 10/28/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this retrospective study was to analyze the frequency of C-shaped root canal configuration and characterize mandibular root canal morphology using cone-beam computed tomography (CBCT) with 3D images in an Iranian population. METHODS AND MATERIALS This study consisted of retrospective evaluation of CBCT images from 231 adult patients (153 with bilateral second mandibular molars). Two endodontists examined 384 mandibular second molars of a population in Tabriz, Iran to determine the presence of C-shaped canals and their anatomical characteristics. Root canal configurations were categorized at three different levels. Bilateral or unilateral occurrence of C-shaped canals and their relationship to gender, age and tooth position were examined and statistically analyzed using chi squared test and Fisher's exact test in SPSS 17. The significance level was set at 0.05. RESULTS Of 384 mandibular second molars examined, 82 (21.4%) molars from 58 patients had a C-shaped root canal configuration. The prevalence of bilateral C-shaped canals was 15.6% amongst 153 patients with bilateral mandibular second molars. There were no significant differences in the distribution of C-shaped canals with respect to gender or age (P=0.06 and P=0.86, respectively). Only 4 teeth (4.9%) had the same root canal configuration from the orifice to the apex. In the remainder of the teeth, the cross-sectional root canal configuration changed at different levels of the root. CONCLUSION There were significant variations in the number of roots and canal morphology in mandibular second molars, which should be considered during debridement and obturation of the root canal system.
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Affiliation(s)
- Maryam Janani
- Endodontics Department, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Farnaz Jafari
- Department of Endodontics, Dental School, Tabriz Branch, Islamic Azad University, Tabriz, Iran;
| | - Masoomeh Johari
- Department of Oral and Maxillofacial Radiology, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Shabnam Nikniaz
- Department of Periodontology, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Negin Ghasemi
- Endodontics Department, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran;
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Worldwide Prevalence of Mandibular Second Molar C-Shaped Morphologies Evaluated by Cone-Beam Computed Tomography. J Endod 2017; 43:1442-1447. [DOI: 10.1016/j.joen.2017.04.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 01/02/2023]
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43
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Root and canal morphology of mandibular premolars using cone-beam computed tomography in a Chilean and Belgian subpopulation: a cross-sectional study. Oral Radiol 2017; 34:143-150. [PMID: 30484131 DOI: 10.1007/s11282-017-0297-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/19/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe mandibular premolar root and canal morphology and its variability in Chilean and Belgian samples using cone-beam computed tomography. METHODS A cross-sectional and descriptive study was conducted. A total of 402 mandibular premolars were examined using cone-beam computed tomography images of Chilean and Belgian patients. Premolars that met the inclusion criteria were studied in relation to the number of roots, number of canals, root canal configuration, presence of C-shaped configuration, tooth length, and root length. RESULTS The mandibular first premolar frequently presented with one root (94% Chilean; 100% Belgian), as did the mandibular second premolar (99% Chilean; 98% Belgian). One canal was present in 69% of Chilean, and 83% of Belgian mandibular first premolars, and in 95% of Chilean and 91% of Belgian second premolars. A type I root canal configuration was found in 69% of Chilean and 83% of Belgian first premolars and in 95% of Chilean and 92% of Belgian second premolars. CONCLUSIONS The anatomical parameters analyzed in the Chilean and Belgian samples are similar. However, it should be noted that there are anatomical variations in mandibular premolars.
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Bansal A, Parihar AS, Sethi A, Majety KK, Panjabi J, Choudhury BK. Retrospective Assessment of Healing Outcome of Endodontic Treatment for Mandibular Molars with C-shaped Root Canal. J Contemp Dent Pract 2017; 18:591-595. [PMID: 28713114 DOI: 10.5005/jp-journals-10024-2090] [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
INTRODUCTION A thorough knowledge of the anatomic morphology of the root canal system is necessary for the long-term success of the root canal therapy. The occurrence of C-shaped root canal configuration is one such variation. Achievement of favorable prognosis after commencing root canal therapy in such teeth is one of the challenges imposed on the endodontist. Hence, we evaluated the healing occurring after endodontic therapy in patients with C-shaped root canals in mandibular molars. MATERIALS AND METHODS The present study was conducted in the Department of Conservative Dentistry of the institution and included assessment of all the patients who underwent root canal treatment of the mandibular first and second molars. Endodontic therapy was performed in all the cases by experienced endodontist. Final postoperative radiographs were taken. Recording of the data of the personal and clinical details of a total of 250 patients was done. All the clinical and radiographic details of the patients, such as tooth location in the jaw, presence or absence of C-shaped canals, status of the pulp tissue, presence or absence of the fractures, and other details of the patients were recorded. Radiographic and clinical examination of the tooth of the patients was done during the baseline visit and further during the follow-up visits. The presence of C-shaped root canals was confirmed using the radiographs. Periapical index (PI) scoring system was used. Categories defined for enlisting the healing after the root canal treatment with the assessment of the PI score. All the results were analyzed by Statistical Package for the Social Sciences software. RESULTS Vital pulp tissue was encountered in majority of the cases. C-shaped root canal configuration was observed in 40% of the cases included in the present study. After completion of the endodontic therapy, complete crown placement was done in only 22% of the cases. In cases of vital teeth with C-shaped root canals configuration, most of the teeth showed complete healing. Significant results were obtained while comparing the complete coverage crown parameter in relation to the healing process in teeth with C-shaped root canals. CONCLUSION In the present study, no significant effect of the C-shaped root canal configuration was found on the healing rate of the endodontic therapy in mandibular molars. CLINICAL SIGNIFICANCE Meticulous endodontic therapy with special techniques should be done while preparing teeth with C-shaped root canals.
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Affiliation(s)
- Anika Bansal
- Department of Conservative Dentistry and Endodontics, Sudha Rastogi College of Dental Sciences and Research, Faridabad Haryana, India Phone: +919501544877, e-mail:
| | - Anuj Singh Parihar
- Department of Periodontology, RKDF Dental College & Research Centre, Bhopal, Madhya Pradesh, India
| | - Achla Sethi
- onservative Dentistry and Endodontics, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
| | - Kishore Kumar Majety
- Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India
| | | | - Basanta Kumar Choudhury
- Department of Oral Medicine & Radiology, Institute of Dental Science & Sum Hospital, Bhubaneswar, Orrisa, India
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Martins JN, Francisco H, Ordinola-Zapata R. Prevalence of C-shaped Configurations in the Mandibular First and Second Premolars: A Cone-beam Computed Tomographic In Vivo Study. J Endod 2017; 43:890-895. [DOI: 10.1016/j.joen.2017.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/31/2016] [Accepted: 01/08/2017] [Indexed: 01/05/2023]
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Johnsen GF, Dara S, Asjad S, Sunde PT, Haugen HJ. Anatomic Comparison of Contralateral Premolars. J Endod 2017; 43:956-963. [DOI: 10.1016/j.joen.2017.01.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/04/2017] [Accepted: 01/09/2017] [Indexed: 11/29/2022]
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47
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Dou L, Li D, Xu T, Tang Y, Yang D. Root anatomy and canal morphology of mandibular first premolars in a Chinese population. Sci Rep 2017; 7:750. [PMID: 28389648 PMCID: PMC5429691 DOI: 10.1038/s41598-017-00871-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/20/2017] [Indexed: 11/12/2022] Open
Abstract
This study was to investigate root anatomy and root canal morphology of mandibular first premolars in a Chinese population. 178 human permanent mandibular first premolars extracted from a native Chinese population were collected, scanned using micro-computed tomography and reconstructed three-dimensionally. The number of roots and canals, canal configuration and radicular grooves were investigated. The root canal morphology was categorized according to Vertucci’s criteria. The radicular grooves were scored according to the Arizona State University dental anthropology scoring system (ASUDAS), and the correlation between scores for radicular grooves and root canal morphology was analyzed. Almost all the samples were single-rooted (99.4%). 64.04% of teeth possessed type I canal systems, whilst 34.27% had two canals and 1.69% had three canals. According to ASUDAS, the scores of radicualr grooves were 56.74%, 16.85%, 12.36%, 10.11%, 3.37% and 0.56% respectively from grade 0 to grade 5. The roots with radicular grooves (grade 3 or 4) were defined as Tome’s anomalous root and these roots have a high incidence of C-shape configurations (66.67%) and multiple-canal systems (100%). There is complicated variation of the root anatomy and canal morphology of mandibular first premolars in southwestern Chinese population, which needs special attention and careful assessment for endodontic treatment.
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Affiliation(s)
- Lei Dou
- Department of Conservative dentistry and Endodontics, Stomatological hospital of Chongqing medical university, Chongqing, China.,Chongqing key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Duojiao Li
- Department of Conservative dentistry and Endodontics, Stomatological hospital of Chongqing medical university, Chongqing, China.,Zunyi Medical College, Zunyi, Guizhou, China
| | - Tingting Xu
- Department of Conservative dentistry and Endodontics, Stomatological hospital of Chongqing medical university, Chongqing, China.,Chongqing key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yin Tang
- University of Southern California Herman Ostrow School of Dentistry, Los Angeles, CA, USA
| | - Deqin Yang
- Department of Conservative dentistry and Endodontics, Stomatological hospital of Chongqing medical university, Chongqing, China. .,Chongqing key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Lopes DS, Câmara AC, Aguiar CM, do Nascimento MDCC, Farias de Araújo L. A C-Shaped Canal in a Maxillary Second Molar: Prexion 3D Cone-Beam Computed Tomography Analysis. Acta Stomatol Croat 2017; 50:354-358. [PMID: 28275283 DOI: 10.15644/asc50/4/9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to present an atypical case of a C-shaped root canal that was present in the vestibular root of a permanent maxillary second molar using PreXion 3-D cone-beam computed tomography (CBCT) as a diagnostic device. MATERIALS AND METHODS A 50-year-old female patient was referred for routine examination to a private diagnostic imaging clinic in Recife-Pernambuco. During the physical examination, the presence of an unusual C-shaped anatomy in the vestibular canal with a mesiodistal interconnection that extended from the apical to the cervical third was detected in axial slices acquired with a PreXion 3-D scanner. RESULTS Although C-shaped root canals are most frequently observed in the mandibular second molar, this case presented a rare finding in the permanent maxillary second molar. CONCLUSIONS PreXion 3-D CBCT has emerged as a new high-resolution imaging test technology, thus assisting with the diagnosis of anatomical variations such as C-shaped root canals. However, such imaging technology is not recommended for routine use.
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Affiliation(s)
- Daniela Siqueira Lopes
- - PhD student Integrated Clinic. Substitute Professor in the Department of Dental Prosthodontics and Oral Maxillofacial Surgery, Federal University of Pernambuco, Recife - PE - Brazil
| | - Andréa Cruz Câmara
- - Adjunct Professor in the Department of Dental Prosthodontics and Oral Maxillofacial Surgery, Federal University of Pernambuco, Recife - PE - Brazil
| | - Carlos Menezes Aguiar
- - Adjunct Professor in the Department of Dental Prosthodontics and Oral Maxillofacial Surgery, Federal University of Pernambuco, Recife - PE - Brazil
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Jafarzadeh H, Beyrami M, Forghani M. Evaluation of Conventional Radiography and an Electronic Apex Locator in Determining the Working Length in C-shaped Canals. IRANIAN ENDODONTIC JOURNAL 2017; 12:60-63. [PMID: 28179926 PMCID: PMC5282381 DOI: 10.22037/iej.2017.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction: The purpose of this in vitro study was to compare the accuracy of working length determination using the apex locator versus conventional radiography in C-shaped canals. Methods and Materials: After confirming the actual C-shaped anatomy using cone-beam computed tomography (CBCT), 22 extracted C-shaped mandibular second molars were selected and decoronated at the cemento-enamel junction. The actual working length of these canals were determined by inserting a #15 K-file until the tip could be seen through the apical foramen and the working length was established by subtracting 0.5 mm from this length. The working length was also determined using conventional analog radiography and electronic apex locator (EAL) that were both compared with the actual working length. The data was statistically analyzed using paired t-test and marginal homogeneity test. Results: There was no significant differences between the working length obtained with apex locator and that achieved through conventional radiography in terms of measuring the mesiolingual and distal canals (P>0.05); while, significant differences were observed in measurements of the mesiobuccal canals (P=0.036). Within ±0.5 mm of tolerance margin there was no significant difference between EAL and conventional radiography. Conclusion: The apex locator was more accurate in determination of the working length of C-shaped canals compared with the conventional radiography.
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Affiliation(s)
- Hamid Jafarzadeh
- Dental Research Center and Department of Endodontics, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Forghani
- Dental Materials Research Center and Department of Endodontics, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Shemesh A, Levin A, Katzenell V, Itzhak JB, Levinson O, Avraham Z, Solomonov M. C-shaped canals-prevalence and root canal configuration by cone beam computed tomography evaluation in first and second mandibular molars-a cross-sectional study. Clin Oral Investig 2016; 21:2039-2044. [PMID: 27844150 DOI: 10.1007/s00784-016-1993-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES C-shaped root canal configuration is an unusual root canal morphology and one of the most often anatomical variations in root canal systems of second mandibular molars. The purpose of this study was to assess the prevalence, symmetry and configuration of C-shaped canals in first and second mandibular molars in an Israeli population using cone beam computed tomography (CBCT). MATERIALS AND METHODS One thousand twenty Israel patients' CBCT scans were screened and evaluated. First and second mandibular molars with C-shaped canals were identified. Prevalence configuration along the root and symmetry were analyzed, and new radicular groove classification was proposed. RESULTS Total of 1465 mandibular second molars and 1229 mandibular first molars were evaluated. The overall prevalence of C-shaped canals in first and second mandibular molars was 0.16 and 4.6%, respectively. No significant difference was found by gender or side of occurrence. The unilateral prevalence of C-shaped canals in mandibular second molars was 55%. C-shaped canal configuration changed along the root in 63% of the cases. CONCLUSIONS The prevalence of C-shaped canals in first and second mandibular molars in the Israeli population is low in comparison to other subpopulations. Clinicians should be aware of the possible asymmetry, different configuration along the root, and the location of danger zone of this anatomic variation during clinical work. CLINICAL RELEVANCE CBCT is an efficient three dimensional radiographic examination for evaluation of C-shape root canal configuration. CBCT may help the clinicians during clinical work for considering appropriate cleaning, shaping, and obturation technique according to the characteristic of C-shape root canal configuration.
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Affiliation(s)
- Avi Shemesh
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.
| | - Avi Levin
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Vered Katzenell
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | | | - Zini Avraham
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
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