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Ginjeira A, Neto F, Behdad S, Farinha I, Gonçalves N, Martins JNR, Pires M, Rito Pereira M, Vasconcelos I, Duarte I. Influence of root shape on canal complexity at the mandibular molar apical surgical resection level: A micro-CT study. Arch Oral Biol 2024; 164:105983. [PMID: 38718467 DOI: 10.1016/j.archoralbio.2024.105983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This study aimed to investigate the relationship between the aspect ratios of mandibular molar roots at the apical 3-mm level and their root canal complexity. DESIGN This study used micro-CT imaging to analyze 163 two-rooted mandibular molars. The aspect ratios of the roots at the apical 3-mm level were categorized as "< 2.75" or "≥ 2.75" (mesial) and "< 1.75" or "≥ 1.75" (distal). A two-dimensional (2D) analysis focused on four apical axial cross-section levels to determine the presence of main and accessory canals and isthmus. Additionally, a three-dimensional (3D) assessment of the apical 4-mm of both roots examined main and accessory canals, apical foramina, apical deltas, and middle mesial canals. RESULTS Mesial roots with aspect ratios ≥ 2.75 showed a higher number of main canals at all levels compared to those with aspect ratios < 2.75 at the 3-mm level. Additionally, the ≥ 2.75 group exhibited more accessory canals and a higher average number of accessory canals. The 3D assessment confirmed significantly more accessory canals and apical foramina in the ≥ 2.75 group. The prevalence of roots with apical deltas was nearly double in the ≥ 2.75 group, and middle mesial canals were exclusively found in this group. In the distal root, the ≥ 1.75 group showed a significantly higher number of main canals at all axial levels. No significant differences were observed between groups in terms of accessory canals, apical foramina, or deltas. CONCLUSIONS A higher root aspect ratio is related to higher anatomical complexity.
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Affiliation(s)
- António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, 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, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Filipa Neto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Shirin Behdad
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Inês Farinha
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Nuno Gonçalves
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, 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, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Mariana Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal.
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Rua de Portugal, 2430-028 Marinha Grande, Portugal
| | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal; LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
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Zhu Q, Liu C, Bai B, Pei F, Tang Y, Song W, Chen X, Gu Y. Micro-computed tomographic evaluation of the shaping ability of three nickel-titanium rotary systems in the middle mesial canal of mandibular first molars: an ex vivo study based on 3D printed tooth replicas. BMC Oral Health 2024; 24:294. [PMID: 38431556 PMCID: PMC10909274 DOI: 10.1186/s12903-024-04024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The preparation of the middle mesial (MM) canal of mandibular molars represents a challenge because it is often curved, narrow, and close to the root concave. The purpose of this study was to evaluate the ex vivo shaping ability of 3 nickel-titanium (NiTi) rotary systems in the MM canal using 3D printed resin tooth replicas. METHODS A permanent mandibular first molar with a MM canal was acquired from a pool of extracted teeth and reproduced by a 3D printer. The resin tooth replicas (n = 18) were equally assigned to 3 groups for the evaluation of the shaping abilities of 3 NiTi rotary systems (OneShape [OS], Twisted Files [TF], and ProTaper Gold [PTG]) according to the manufacturer's recommendations. The tooth replicas were scanned by micro-computed tomography (micro-CT) twice before and after instrumentation of the mesiobuccal (MB), mesiolingual (ML), and MM root canals. After 3D reconstruction, the canal straightening, change of root canal volume and surface area, the mesial and distal canal wall thickness and canal transportation at the levels of 1, 2, and 3 mm below furcation were assessed. One-way variance analysis and Turkey's post hoc test were used for comparisons of the means among different groups, and paired-t test was used to compare the mesial and distal sides of the mesial roots. RESULTS As compared with OS and TF, the use of PTG in preparation of MM canals resulted in significantly more straightening of canal curvature (p < 0.05), greater post-instrumentation canal volume and surface area, and thinner mesial and distal remaining canal wall thickness at 1, 2 and 3 mm below furcation (all p < 0.05). Regarding the root canal transportation in the mesiodistal direction, there was no significant difference among the 3 instruments (all p > 0.05) after the preparation of the MB and ML canals. However, in the MM canal, more pronounced transportation was detected in the PTG group at 2 mm below furcation, and in the TF group at 3 mm below furcation as compared with the other 2 systems (both p < 0.05). CONCLUSIONS 3D printed tooth replicas have the advantages of consistency and can be an ideal model to evaluate the shaping ability of different instruments in the MM canal. OS and TF files performed similarly and both are appropriate for shaping the MM canal, while PTG may cause excessive and uneven resin removal, especially near the furcation, and may lead to root fragility and procedural errors.
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Affiliation(s)
- Qi Zhu
- Department of Dentistry and Central Laboratory, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China
| | - Chao Liu
- Department of Dentistry and Central Laboratory, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China
| | - Bingbing Bai
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Fan Pei
- Department of Dentistry and Central Laboratory, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China
| | - Ying Tang
- Department of Pathology, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China
| | - Weijian Song
- Department of Stomatology, Suzhou Municipal Hospital, Daoqian St. 26#, Gusu Dist, Suzhou, 215002, China
| | - Xiuchun Chen
- Department of Dentistry and Central Laboratory, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China.
| | - Yongchun Gu
- Department of Dentistry and Central Laboratory, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., Suzhou, 215200, China.
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China.
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Huang CS, Hsiao CH, Chang YC, Chang CH, Yang JC, Gutmann JL, Chang HC, Huang HM, Hsieh SC. A Novel Endodontic Approach in Removing Smear Layer Using Nano and Submicron Diamonds with Intracanal Oscillation Irrigation. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:nano13101646. [PMID: 37242062 DOI: 10.3390/nano13101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended for effectively removing organic and inorganic components in the smear layer. This layer is found on root canal walls after root canal instrumentation. However, high-concentration EDTA reduces the strength of dentin and the dissolution efficacy of organic substances in NaOCl solution. The objective of this study was to investigate the efficacy of applying nano and submicron diamonds in irrigation solutions with sonic and ultrasonic oscillation for removing the smear layer during endodontic treatment. Extracted single-rooted human teeth were instrumented with ProTaper® Gold (Dentsply Sirona) nickel-titanium rotary instruments. Subsequently, each canal was irrigated with 3% NaOCl, 17% EDTA, distilled water, and 10-1000 nm-sized nano and submicron diamond irrigation solutions, respectively. Sonic and ultrasonic instruments were compared for oscillating the irrigation solutions. The teeth were processed for scanning electron microscopy to observe the efficiency of smear layer removal on the canal walls. Our results indicated that diamond sizes of 50 nm and above irrigation solutions showed significant effectiveness in removing the smear layer following the oscillation of sonic instruments for 10 s. Ultrasonic assisted 500 nm and 1000 nm diamond solutions significantly differed from the other diamond-sized solution in their ability to remove the smear layer. These results suggest that sonic and ultrasonic oscillation with specific sizes of nano and submicron diamond irrigation solution can be used as an alternative approach to removing the smear layer during endodontic treatment. The potential clinical application of root canal treatments can be expected.
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Affiliation(s)
- Ching-Shuan Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Chih-Hsun Hsiao
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
| | - Yu-Chia Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
| | - Chih-Hsiang Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - James L Gutmann
- College of Dentistry, Texas A&M University, Dallas, TX 77843, USA
| | - Huan-Cheng Chang
- Institute of Atomic and Molecular Sciences, Academia Sinica Taiwan, Taipei 11529, Taiwan
| | - Haw-Ming Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Sung-Chih Hsieh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
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Al-Maswary AA, Almadhoon HW, Elkhateb A, Hamdallah A, Halboub E. The global prevalence of middle mesial canal in mandibular first and second molars assessed by cone beam computed tomography: A systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00236-4. [PMID: 37116828 DOI: 10.1016/j.joen.2023.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND This meta-analysis sought to identify the in vivo prevalence and influencing factors of middle mesial canal (MMC) in mandibular first and second molars based on cone-beam computed tomography (CBCT) scans. METHODS MEDLINE/PubMed, Web of Science, Scopus, SciELO, Google Scholar databases/search engines were searched in period between 15th and 21st November 2022, to retrieve the in vivo CBCT-based studies that assessed the prevalence of MMC in mandibular first and/or second molars. The studies were strictly assessed using pre-defined inclusion and exclusion criteria for relevancy and eligibility through screening the title and abstract, and then assessed through reading the full texts using the same criteria. Subsequently, the fulfilled studies were assessed qualitatively using the Newcastle-Ottawa Quality Assessment Scale, and quantitatively using meta-analysis to calculate the pooled prevalence rates of MMC. The publication bias was assessed using funnel plot and Egger's test. RESULTS Out of 1,122 studies, 33 studies comprised 13,349 and 7,624 mandibular first and second molars, respectively, were eligible for inclusion. Twenty studies scored high quality, while thirteen scored moderate quality. The global prevalence of MMC in the first molar was 4.4% (95% CI = 0.035-0.053, P<0.001), significantly higher than that of the second molar which was 1.3% (95%, CI = 0.008-0.018, P<0.001). Gender, molar side, and age were not influencing factors of MMC prevalence. CONCLUSION The prevalence of MMC is not uncommon, being higher in the mandibular first molar compared to the mandibular second molar. The prevalence of MMC is not influenced by age, molar's side, and gender.
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Affiliation(s)
- Arwa A Al-Maswary
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen; Faculty of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sana'a, Yemen.
| | | | | | | | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
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Robberecht L, Delattre J, Meire M. Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high-speed imaging. Int Endod J 2023; 56:118-127. [PMID: 36148855 PMCID: PMC10092478 DOI: 10.1111/iej.13836] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 12/13/2022]
Abstract
AIM Little is known about the influence of isthmus morphology on the debridement efficacy of activated irrigation. The aim of this study was to investigate the influence of isthmus morphology on the debridement efficacy of laser-activated irrigation (LAI), EDDY and needle irrigation (NI), and to explain the methods of isthmus cleaning by LAI and EDDY. METHODOLOGY Four root canal models (apical diameter: 0.30 mm, taper: 0.06, curvature: 23°, length: 20 mm) were produced by CAD-CAM with different isthmus morphologies: long-wide (4 mm; 0.4 mm), long-narrow (4 mm; 0.15 mm), short-wide (2 mm; 0.4 mm) and short-narrow (2 mm; 0.15 mm). The isthmuses were filled with a hydrogel containing dentine debris. The canals were filled with irrigant and models were assigned to the following irrigation protocols (n = 240): needle irrigation (NI) with a 30G needle, Eddy, and LAI (2940 nm Er:YAG-laser, 15 Hz, 40 mJ, SWEEPS, tip at the canal entrance). Standardized images of the isthmuses were taken before and after irrigation, and the amount of removed hydrogel was determined using image analysis software and compared across groups using Kruskal-Wallis test followed by Dunn's multiple comparison. Visualization of the isthmus during activation was achieved using a high-speed camera. The pattern and speed of the flow in the isthmus as well as transient and stable cavitation were analysed using imaging software. RESULTS Laser-activated irrigation, EDDY and NI removed more hydrogel in short-wide isthmuses than in narrow isthmuses (p < .001). LAI and EDDY removed more hydrogel than NI in every isthmus configuration (p < .001). EDDY showed eddies and stable cavitation, and LAI showed transient cavitation at each pulse, and pulsed horizontal flow with the highest particle speed in closed short isthmuses. CONCLUSIONS Isthmus morphology influences debridement in all irrigation groups. Short-wide isthmuses were the easiest to clean while narrow isthmuses were the most challenging to clean. Width seems to be a more critical anatomical parameter than length. LAI and EDDY resulted in the greatest biofilm removal and performed better than NI. EDDY produced eddies and stable cavitation in the isthmus, and LAI showed transient cavitation and pulsed horizontal flow.
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Affiliation(s)
- Lieven Robberecht
- Section of Endodontology, Department of Oral Health Sciences, Ghent University, Ghent, Belgium.,Department of Restorative Dentistry and Endodontics, Faculty of Odontology, Univ. Lille, Inserm, CHU Lille, U1008, Lille, France
| | | | - Maarten Meire
- Section of Endodontology, Department of Oral Health Sciences, Ghent University, Ghent, Belgium
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Berutti E, Alovisi M, Moccia E, Carossa M, De Caro G, Roccuzzo A, Pasqualini D, Scotti N. Micro-computed tomographic evaluation of endodontic ledge position in relation to canal curvatures. BMC Oral Health 2022; 22:482. [PMID: 36357901 PMCID: PMC9650826 DOI: 10.1186/s12903-022-02531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background Endodontic ledge (EL) formation is the most common complication of endodontic treatment. Although various etiological factors have been identified, canal curvature is the most significant variable correlated with EL formation. The aim of this micro-computed tomographic (micro-CT) study was to evaluate EL position in the mesial canals of the lower molars in relation to the degree of canal curvature. Methods Forty intact mandibular first molars with independent mesial canals with 20°–40° primary mesio-distal curvature, 10°–30° buccal-lingual canal curvature and 4 < r ≤ 8 mm main curvature radius were selected. Working length was measured with a K-File #10 and a high resolution pre-operative micro-CT analysis was performed. Ledges were created at the point of maximum canal curvature using stainless steel K-Files #30–35, alternating irrigation with 5% NaOCl and 10% EDTA. A post-operative high-resolution micro-CT analysis was then completed. Pre- and post-operative images were analyzed. The angle (α) formed between the vector passing through the geometric center of the EL and the center of the original canal lumen and the line joining the centers of the mesio-buccal and mesio-lingual canal orifices was calculated, and a descriptive statistical analysis was achieved. The α angle values were analyzed in relation to canal curvature using Kruskal-Wallis and post hoc Dunn’s tests. The level of significance was set at P < 0.05. Results The α angles appeared inversely proportional to canal curvatures in the buccal-lingual and mesio-distal projections. The mean α angle was 36.4° (standard deviation 10.64; 95% confidence interval 34.1–40.9). Conclusion Within the limitations of this study, endodontic ledges develop in the opposite direction to the three-dimensional canal curvature and their position is influenced by the degree of curvature. Clinically, the α angle values may be related to the recommended direction to manage endodontic ledges.
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Incidence of fracture of ProDesign Logic system instruments: A cross-sectional retrospective study. Sci Rep 2022; 12:7897. [PMID: 35551478 PMCID: PMC9098633 DOI: 10.1038/s41598-022-11605-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/22/2022] [Indexed: 11/09/2022] Open
Abstract
The aim of the present study was to analyze the incidence of fracture of ProDesign Logic system instruments in endodontic treatments performed by a specialist, in addition to identifying the dental group, arch, and the root canal thirds in which the fractures occurred more frequently. Digital radiographs and medical records were initially analyzed and resulted in the selection of 561 teeth (1302 canals) treated between 2018 and 2020, using the ProDesign Logic system instruments. These data were reassessed to determine the occurrence of fractures and identify the dental group and root canal thirds in which they occurred. Then, the data were statistically analyzed using the Fisher's Exact Test (p < 0.05). The general fracture rates were 8.5 and 3.69%, considering the number of teeth and canals treated, respectively. Mandibular first molars were the teeth most associated with the occurrence of fractures (19.1%). When the arches were compared, there was no statistical difference regarding the number of fractures in the different root canal thirds (p = 0.307). However, they were more frequent in the apical third in both arches (p = 0.000). The incidence of fracture of ProDesign Logic system instruments was relatively high and occurred more frequently in the apical third of molars.
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Karobari MI, Arshad S, Noorani TY, Ahmed N, Basheer SN, Peeran SW, Marya A, Marya CM, Messina P, Scardina GA. Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review. J Clin Med 2022; 11:jcm11092287. [PMID: 35566414 PMCID: PMC9099997 DOI: 10.3390/jcm11092287] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6).
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Affiliation(s)
- Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Sohaib Arshad
- Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Syed Wali Peeran
- Department of Periodontics, Armed Forces Hospital Jizan, Jazan 82722, Saudi Arabia;
| | - Anand Marya
- Department of Orthodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India;
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India;
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
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10
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Neelakantan P, Vishwanath V, Taschieri S, Corbella S. Present status and future directions ‐ Minimally invasive root canal preparation and periradicular surgery. Int Endod J 2022; 55 Suppl 4:845-871. [DOI: 10.1111/iej.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - V. Vishwanath
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - S. Taschieri
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - S. Corbella
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
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11
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Mashyakhy M, Awawdeh M, Abu-Melha A, Alotaibi B, AlTuwaijri N, Alazzam N, Almutairi R, Alessa R. Anatomical Evaluation of Root and Root Canal Configuration of Permanent Maxillary Dentition in the Population of the Kingdom of Saudi Arabia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3428229. [PMID: 35075425 PMCID: PMC8783711 DOI: 10.1155/2022/3428229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/17/2022]
Abstract
AIM This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to obtain a large sample size that represents the population of the KSA. The outcome of these combined studies is compared with international studies in terms of the number of roots, number of canals, and canal configurations on the basis of Vertucci's classification. Methodology. The studies were systematically reviewed using the Preferred Reporting Items for Systematic Review and Meta-analysis chart. Studies were included in the analysis if they were conducted in the KSA, involved permanent human maxillary teeth, and had a sample of more than 10 teeth (power). By contrast, studies were excluded if they involved deciduous teeth in the sample size, investigated nonhuman teeth, were not conducted in the KSA, and were case reports, case series, review studies, and anomalies. Relevant literature was searched from PubMed, Scopus, Web of Science, Embase, Cochrane, and Direct Science by two calibrated teams, starting in August 2020, without time limits or language restrictions. RESULTS The database searches and cross-referencing identified a total of 19 relevant studies. All maxillary canines (N = 1,018) had one root, whereas 98.4% had one canal and 98.3% had Vertucci type I. Moreover, 63.2% of the maxillary first premolars had two roots, and 91.4% had two canals. The most common Vertucci root canal configuration was type IV (64.6%). The maxillary second premolars mostly had one root (84.4%) and one canal (50.4%). The most common canal configuration was Vertucci type I (47.1%). The majority of maxillary first molars had three roots (98.9%), 48.7% of which had three canals, and 46.4% had four canals. The most prevalent feature of the canal morphology of mesiobuccal roots was Vertucci type II (35.3%). The investigated maxillary second molars had three roots, 88.0% of which had three canals. CONCLUSION This systematic review represents the Saudi population since samples were combined from different studies from different regions of the country. Variations in findings were observed in the same group of teeth from different regions and the same region, while the overall combined samples results fell within the range of other international studies.
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Affiliation(s)
- Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Mohammed Awawdeh
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulaziz Abu-Melha
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - Nada AlTuwaijri
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nouf Alazzam
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rahaf Almutairi
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Reuof Alessa
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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12
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Altan Şallı G, Egil E. Evaluation of mesial root canal configuration of mandibular first molars using micro-computed tomography. Imaging Sci Dent 2022; 51:383-388. [PMID: 34987998 PMCID: PMC8695466 DOI: 10.5624/isd.20210038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. Materials and Methods Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. Results The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant (P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. Conclusion Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.
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Affiliation(s)
- Gülay Altan Şallı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Beykent University, Istanbul, Turkey
| | - Edibe Egil
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Gelişim University, Istanbul, Turkey
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13
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Hassan H, Zaher M, Rabie M. Root canal morphology and incidence of isthmus in the mesial root canal of the mandibular first molar using cone-beam computed tomography of two different scanning modes. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_54_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Suguro H, Nishihara A, Tamura T, Nakamura T, Toyama Y, Takeichi O. The use of micro-computed tomography to determine the accuracy of electronic working length with two apex locators. J Oral Sci 2021; 63:167-169. [PMID: 33731504 DOI: 10.2334/josnusd.20-0466] [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] [Indexed: 11/01/2022]
Abstract
PURPOSE This study evaluated the precision of electronic working length by microcomputed tomography using two electronic apex locators (EALs). METHODS Twenty single-rooted permanent teeth without caries or restorations were selected as the subject teeth. The positions of the minor apical constriction (AC) and major apical foramen (AF) were measured by electronic root canal length, and microcomputed tomography was performed with the file inserted and fixed in the root canal. All teeth were measured individually and independently by two operators. The Mann-Whitney U-test was used to statistically test the AC and AF values using two EALs; P < 0.05 was defined as statistically significant. RESULTS This was 65.0% within 1.5 mm in the case of two EALs on AC. This was more than 90.0% within 1.0 mm in the case of two EALs on AF. Comparison of the differences between the respective AC and AF of the measurements obtained using the two EALs revealed no significant difference. CONCLUSION The two EALs are devices that can greatly improve the accuracy of WL control.
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Affiliation(s)
- Hisashi Suguro
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Anna Nishihara
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Takahito Tamura
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Takeshi Nakamura
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Yurika Toyama
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Osamu Takeichi
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
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15
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Tolentino EDS, Amoroso-Silva PA, Alcalde MP, Yamashita FC, Iwaki LCV, Rubira-Bullen IRF, Duarte MAH. Comparison of limited- and large-volume cone-beam computed tomography using a small voxel size for detecting isthmuses in mandibular molars. Imaging Sci Dent 2021; 51:27-34. [PMID: 33828958 PMCID: PMC8007390 DOI: 10.5624/isd.20200144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/03/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. Materials and Methods Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). Results The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat (P<0.05). Conclusion Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.
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Affiliation(s)
| | | | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil, Brazil
| | | | | | | | - Marco Antônio Húngaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil, Brazil
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16
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Nayak A, Jain PK, Kankar PK, Jain N. Effect of volumetric shrinkage of restorative materials on tooth structure: A finite element analysis. Proc Inst Mech Eng H 2021; 235:493-499. [PMID: 33482709 DOI: 10.1177/0954411921990138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Post-treatment coronal hermetic seal of the root canal opening prevents the food or saliva which assist to achieve successful endodontic treatment. Gutta-percha is filled in the inner canal, that is, from cervical third to apical third. Gutta-percha does not provide the hermetic seal because it does not bound with dentine walls. Various new restorative materials have been developed in the last 6-7 decade but drawback related to the polymerization shrinkage of the composite resin remains a clinical problem. In general, dental composites having volumetric shrinkage of the material depends on its formulation and curing conditions. In this article, the effect of this polymerization shrinkage on the tooth structure has been studied.
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Affiliation(s)
- Ankit Nayak
- Discipline of Mechanical Engineering, Pt. Dwarka Prasad Mishra Indian Institute of Information Technology, Design & Manufacturing Jabalpur, Jabalpur, Madhya Pradesh, India
| | - Prashant K Jain
- Discipline of Mechanical Engineering, Pt. Dwarka Prasad Mishra Indian Institute of Information Technology, Design & Manufacturing Jabalpur, Jabalpur, Madhya Pradesh, India
| | - Pavan K Kankar
- Discipline of Mechanical Engineering, Indian Institute of Technology Indore, Madhya Pradesh, India
| | - Niharika Jain
- Department of Conservative Dentistry and Endodontics, Triveni Institute of Dental Science, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
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17
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Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac Radiol 2021; 50:20200503. [PMID: 33400563 DOI: 10.1259/dmfr.20200503] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. METHODS 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. RESULTS For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. CONCLUSIONS Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla Faria Vasconcelos
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Biomaterials-BIOMAT, Leuven, Belgium
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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Drukteinis S, Peciuliene V, Bendinskaite R, Brukiene V, Maneliene R, Rutkunas V. Shaping and Centering Ability, Cyclic Fatigue Resistance and Fractographic Analysis of Three Thermally Treated NiTi Endodontic Instrument Systems. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5823. [PMID: 33371244 PMCID: PMC7766619 DOI: 10.3390/ma13245823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel-titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey's test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.
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Affiliation(s)
- Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (V.P.); (R.B.); (V.B.); (R.M.); (V.R.)
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19
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Mandras N, Pasqualini D, Roana J, Tullio V, Banche G, Gianello E, Bonino F, Cuffini AM, Berutti E, Alovisi M. Influence of Photon-Induced Photoacoustic Streaming (PIPS) on Root Canal Disinfection and Post-Operative Pain: A Randomized Clinical Trial. J Clin Med 2020; 9:jcm9123915. [PMID: 33276670 PMCID: PMC7761631 DOI: 10.3390/jcm9123915] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to evaluate the ability of a PIPS (photon-induced photoacoustic streaming) Er:YAG laser to reduce the root canal system bacterial count in vivo in comparison to the traditional irrigation technique. The post-operative patients’ quality of life (QoL) after endodontic therapy was evaluated through a questionnaire. Fifty-four patients affected by pulp necrosis with or without apical periodontitis biofilm disease were selected for endodontic treatment and randomly assigned to Group A (n = 27) with traditional irrigation and Group B (n = 27), with PIPS irrigation applied according to the protocol. Shaping was performed with ProGlider and ProTaper Next, and irrigation was performed with 5% NaOCl and 10% EDTA. Intracanal samples for culture tests were collected before and after irrigation. The microbiological analysis was evaluated by the Kolmogorov–Smirnov normality and Mann–Whitney tests (p < 0.05). A self-assessment questionnaire was used to evaluate the QoL during the 7 days after treatment; differences were analysed with Student’s t-test. Irrigation with the PIPS device was significantly effective in reducing bacterial counts, which were higher for facultative than obligate anaerobic strains, particularly for Gram-negative bacteria, without statistical significance (p > 0.05). There were no significant differences among the QoL indicators, except for the maximum pain (p = 0.02), eating difficulty (p = 0.03) and difficulty performing daily functions (p = 0.02) in the first few days post-treatment. PIPS may represent an aid to root canal disinfection not affecting the patients’ QoL, particularly for the first day after treatment.
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Affiliation(s)
- Narcisa Mandras
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (J.R.); (V.T.); (G.B.); (A.M.C.)
- Correspondence:
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy; (D.P.); (E.G.); (F.B.); (E.B.); (M.A.)
| | - Janira Roana
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (J.R.); (V.T.); (G.B.); (A.M.C.)
| | - Vivian Tullio
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (J.R.); (V.T.); (G.B.); (A.M.C.)
| | - Giuliana Banche
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (J.R.); (V.T.); (G.B.); (A.M.C.)
| | - Elena Gianello
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy; (D.P.); (E.G.); (F.B.); (E.B.); (M.A.)
| | - Francesca Bonino
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy; (D.P.); (E.G.); (F.B.); (E.B.); (M.A.)
| | - Anna Maria Cuffini
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (J.R.); (V.T.); (G.B.); (A.M.C.)
| | - Elio Berutti
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy; (D.P.); (E.G.); (F.B.); (E.B.); (M.A.)
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy; (D.P.); (E.G.); (F.B.); (E.B.); (M.A.)
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20
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Kuzekanani M, Walsh LJ, Amiri M. Prevalence and Distribution of the Middle Mesial Canal in Mandibular First Molar Teeth of the Kerman Population: A CBCT Study. Int J Dent 2020; 2020:8851984. [PMID: 33178278 PMCID: PMC7648697 DOI: 10.1155/2020/8851984] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Missed additional canals are one of the most important reasons for RCT failures in molar teeth. This study aimed to determine the prevalence and distribution of middle mesial canals in mandibular first molars of the Kerman population. MATERIALS AND METHODS A retrospective study was performed on de-identified cone beam image sets from 3 private radiology centers in Kerman. A total of 100 mandibular first molars from 62 patients (mean age 32 years) were included. Information regarding the patient's age and gender, the location of teeth, and the presence or absence of a MMC and also a second distal canal in MMC cases was recorded in an Excel table. Data were analyzed using SPSS software (IBM-USA). RESULTS The overall prevalence of MMCs in the mandibular first molars was 8.1% (10.0% in females and 6.3% in males). More cases of MMCs were seen on the right side (12.2%) than the left side (3.4%). One case of bilateral MMCs combined with bilateral second distal canals in the mandibular first molars was seen in a 26-year-old female. A further case of bilateral MMCs was found in a 32-year-old male but with single-canal distal roots on both sides. CONCLUSION The overall prevalence of MMCs in the Kerman population (8.1%) is at the lower end of the reported range of the international literature (0.26% to 53.8%). In the cohort examined in this study, mid mesial canals were more prevalent in females and on the right side. There was no definite relationship between MMCs and second distal canals in the mandibular first molar teeth in the same subject. MMCs may be unilateral or bilateral. Careful exploration of the pulpal floor between canal orifices is essential to prevent missing the MMC, as this would cause undesirable clinical outcomes.
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Affiliation(s)
- Maryam Kuzekanani
- Endodontology Research Center, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Laurence J. Walsh
- The University of Queensland School of Dentistry, Brisbane, Australia
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21
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Loroño G, Zaldívar JMR, Jimenez-Octavio JR, Dorado S, Arias A, Cisneros R. CFD analysis on the effect of combining positive and negative pressure during the irrigation of artificial isthmuses. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3385. [PMID: 32639658 DOI: 10.1002/cnm.3385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 06/16/2020] [Accepted: 07/05/2020] [Indexed: 06/11/2023]
Abstract
Fluid dynamics generated by irrigation needles have not been deeply analyzed in root canal irregularities such as apical ramifications or isthmus where the cleaning capacity of irrigants might be compromised and hence the treatment outcome. The goal of this study was to compare the key irrigation parameters (flow pattern, irrigant velocity, apical pressure, and shear stress) between two irrigation needles and the additional effect of aspiration cannulas through computational fluid dynamics. A 3D-model consisting of two canals linked by an isthmus was modeled. The abovementioned needles irrigated the primary canal, whereas an aspiration cannula was located inside the secondary canal. Both the geometry definition and spatial discretization were carried out with ANSYS 16.2, through which six different simulations were performed: lateral exit (LE) needle, frontal exit (FE) needle, LE and cannula in crown (LEC), FE and cannula in crown (FEC), LE and cannula in middle third (LEM), FE and cannula in middle third (FEM). FE and FEM showed that the irrigation flow only passes through the isthmus in the most apical section (maximum irrigant velocity / shear stress = 8.44 m/s / 1628.44 Pa and 8.63 m/s / 1185.69 Pa, respectively). However, the remaining simulations showed the irrigation flow passing through the isthmus twice, through the most apical section first and through the upper part of the isthmus later (maximum irrigant velocity / shear stress = 8.48 m/s / 1298.24 Pa (LE), 8.61 m/s / 1261.36 Pa (LEM), 8.61 m/s / 1355.24 Pa (LEC), 8.59 m/s / 1256.87 Pa (FEC)). Furthermore, the highest velocity values were detected when aspiration cannulas were added.
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Affiliation(s)
- Gaizka Loroño
- Departamento de Endodoncia, Universidad Europea de Madrid, Madrid, Spain
| | - J M R Zaldívar
- Departamento de Endodoncia, Universidad Europea de Madrid, Madrid, Spain
| | - J R Jimenez-Octavio
- Universidad Pontificia Comillas, Escuela Técnica Superior de Ingeniería ICAI, Instituto de Investigación Tecnológica, Madrid, Spain
| | - Saul Dorado
- Universidad Pontificia Comillas, Escuela Técnica Superior de Ingeniería ICAI, Instituto de Investigación Tecnológica, Madrid, Spain
| | - Ana Arias
- Departamento de Odontología Conservadora, Facultad (Estomatologia II) de Odontología, Universidad Complutense de Madrid, Madrid, Spain
| | - Rafael Cisneros
- Departamento de Endodoncia, Universidad Europea de Madrid, Madrid, Spain
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Keleş A, Keskin C, Alqawasmi R, Versiani MA. Micro-computed tomographic analysis of the mesial root of mandibular first molars with bifid apex. Arch Oral Biol 2020; 117:104792. [DOI: 10.1016/j.archoralbio.2020.104792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
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Keles A, Keskin C, Alqawasmi R, Aydemir H. Accuracy of an endoscope to detect root canal anastomoses in mandibular molar teeth: a comparative study with micro-computed tomography. Acta Odontol Scand 2020; 78:433-437. [PMID: 32141355 DOI: 10.1080/00016357.2020.1735515] [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] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study was to investigate the accuracy of endoscopic visualization to detect root canal anastomoses at the coronal half of the mesial root canals of mandibular molars using micro-computed tomographic (micro-CT) images as reference.Material and methods: Seventy-four mesial roots of mandibular first molars with (n = 47) or without (n = 27) intercanal anastomosis were selected based on the micro-CT scans of 269 mandibular first molars at a pixel size of 10 µm. The specimens were mounted on the mannequins and their root canals were evaluated using dental operating microscope (DOM) and endoscope. The endoscopic probe was inserted into the main mesial root canals and 2 blinded observers evaluated the presence of a divergence point of anastomosis (where the branching occurs) as 'present' or 'absent'. The scorings were compared with the three-dimensional reconstructed images of the specimens and recorded as 'correct' or 'incorrect' evaluation. Degree of agreement between evaluators was assessed with Kappa test and the accuracy of endoscopic visualization according to the presence and location of anastomosis was compared using Fisher exact tests with a significance threshold at 5%.Results: High inter-examiner reliability was reported (0.91). None of the divergence points were identified using DOM whereas 11 divergence points were detected using endoscope, corresponding the 23.4% of the intercanal anastomoses. The endoscope also showed the absence of an intercanal anastomosis correctly in all of the specimens without an anastomosis. Detectability of a divergence point using endoscope was not affected by its location within the coronal half of root canal (p > .05).Conclusions: The endoscopes were able to visualize the divergence points of 23.4% of the intercanal anastomoses located at the coronal halves of root canals.
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Affiliation(s)
- Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Rawan Alqawasmi
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Hikmet Aydemir
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Assessment of Mechanical Root Canal Preparation with Centric Reciprocating or Eccentric Rotary Kinematics: A Micro-computed Tomographic Study. J Endod 2020; 46:1309-1316. [PMID: 32565335 DOI: 10.1016/j.joen.2020.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this study was to compare, using micro-computed tomographic imaging, the preparation of mesial canals of mandibular molars with the Reciproc (VDW GmbH, Munich, Germany) and XP-endo Shaper (FKG, La Chaux-de-Fonds, Switzerland) systems, evaluating changes in dentin and canal volume, the percentage of untouched walls, the volume of accumulated hard tissue debris, and root canal deviation in the apical third. METHODS Twenty-four mandibular molars with 2 mesial root canals and a single foramen were anatomically paired and divided into 2 experimental groups (n = 12) according to the system used. The specimens were scanned before and after preparation with the SkyScan 1176 microtomographic scanner (Bruker-microCT, Kontich, Belgium) at a resolution of 17.42 μm. The resulting data were statistically compared at a significance level of 5% using the Student t test and the Mann-Whitney test. RESULTS A significant difference was observed in the untouched surface area for the total canal and the cervical and middle thirds, with the lowest untouched surface area in the XP-endo Shaper group (P < .05). The volume of accumulated hard tissue debris was significantly higher in the Reciproc group in the total canal as well as in the middle and apical thirds. There was no significant difference between the groups regarding the volume of dentin removed or the increase in canal volume and surface area (P > .05). CONCLUSIONS The XP-endo Shaper touched more walls and left less accumulated hard tissue debris in the root canal system than the Reciproc group. Although the XP-endo Shaper showed superior results, neither system was able to fully prepare the root canal.
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Nagahara T, Takeda K, Wada K, Shirawachi S, Iwata T, Kurihara H, Shiba H. A mandibular second molar with a middle mesial root canal. Clin Case Rep 2020; 8:1015-1020. [PMID: 32577255 PMCID: PMC7303868 DOI: 10.1002/ccr3.2779] [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: 12/06/2019] [Revised: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 11/17/2022] Open
Abstract
The present case report describes the clinical detection and root canal management of a rare middle mesial canal of a Japanese mandibular second molar by troughing preparation using an operating microscope and cone-beam computed tomography.
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Affiliation(s)
| | - Katsuhiro Takeda
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Satomi Shirawachi
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tomoyuki Iwata
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hidemi Kurihara
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Shiba
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Xu S, Dao J, Liu Z, Zhang Z, Lu Y, Zeng X. Cone-beam computed tomography investigation of middle mesial canals and isthmuses in mandibular first molars in a Chinese population. BMC Oral Health 2020; 20:135. [PMID: 32384929 PMCID: PMC7206827 DOI: 10.1186/s12903-020-01126-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/29/2020] [Indexed: 11/20/2022] Open
Abstract
Background While there is ample research into the anatomy of mandibular molars, little is known regarding isthmuses and middle mesial (MM) canals in Chinese populations. The goal of this study was to determine the prevalence of MM canals and isthmuses in the mesial root of mandibular first molars using Cone-beam Computed Tomography. Methods Cone-beam Computed Tomography images of 357 mature mandibular first molars were retrospectively analyzed. Presence of isthmuses and MM canals, and the length of isthmuses in the mesial root were recorded. Meanwhile, we also recorded possible correlated factors such as demographics, side of mandible, presence of separated distal-lingual roots. Results Of these 357 teeth, 209 showed evidence of either complete or partial communication in the mesial root. Of these, 11(3.1%) exhibited true MM canals while 198(55.5%) exhibited isthmuses. Sex or side of mandible was not correlated with the prevalence of isthmuses (P > 0.05). However, there was a significant association between the presence of a distal-lingual root and the prevalence of such communication (P < 0.001). The average length of isthmuses was 4.3 ± 3.1 mm. Conclusions We detected high rate of isthmuses and low rate of MM canals in mesial roots of mandibular first molars, which is important as such areas should be identified and cleaned during root canal treatment.
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Affiliation(s)
- Shuaimei Xu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Junfeng Dao
- Department of Prosthodontics, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Zhongjun Liu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Zhiyong Zhang
- Department of Oral and Maxillofacial Radiology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yu Lu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Xiongqun Zeng
- Department of Endodontics, Stomatological Hospital, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China.
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Solomonov M, Kim HC, Hadad A, Levy DH, Ben Itzhak J, Levinson O, Azizi H. Age-dependent root canal instrumentation techniques: a comprehensive narrative review. Restor Dent Endod 2020; 45:e21. [PMID: 32483538 PMCID: PMC7239687 DOI: 10.5395/rde.2020.45.e21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 11/11/2022] Open
Abstract
The aim of this article was to review age-dependent clinical recommendations for appropriate root canal instrumentation techniques. A comprehensive narrative review of canal morphology, the structural characteristics of dentin, and endodontic outcomes at different ages was undertaken instead of a systematic review. An electronic literature search was carried out, including the Medline (Ovid), PubMed, and Web of Science databases. The searches used controlled vocabulary and free-text terms, as follows: 'age-related root canal treatment,' 'age-related instrumentation,' 'age-related chemo-mechanical preparation,' 'age-related endodontic clinical recommendations,' 'root canal instrumentation at different ages,' 'geriatric root canal treatment,' and 'pediatric root canal treatment.' Due to the lack of literature with practical age-based clinical recommendations for an appropriate root canal instrumentation technique, a narrative review was conducted to suggest a clinical algorithm for choosing the most appropriate instrumentation technique during root canal treatment. Based on the evidence found through the narrative review, an age-related clinical algorithm for choosing appropriate instrumentation during root canal treatment was proposed. Age affects the morphology of the root canal system and the structural characteristics of dentin. The clinician's awareness of root canal morphology and dentin characteristics can influence the choice of instruments for root canal treatment.
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Affiliation(s)
- Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Dan Henry Levy
- 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
| | | | - Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
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Chuppani Dastgerdi A, Navabi M, Rakhshan V. Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study. Restor Dent Endod 2020; 45:e7. [PMID: 32110536 PMCID: PMC7030962 DOI: 10.5395/rde.2020.45.e7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/22/2019] [Accepted: 09/17/2019] [Indexed: 11/12/2022] Open
Abstract
Objectives This study was performed to assess the anatomy of mandibular first molars. Materials and Methods In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0–2, 2–4, and 4–6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ2 test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.
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Affiliation(s)
| | - Manizheh Navabi
- Department of Removable Prosthodontics, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Vahid Rakhshan
- Department of Dental Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
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Yang Q, Liu MW, Zhu LX, Peng B. Micro‐CT study on the removal of accumulated hard‐tissue debris from the root canal system of mandibular molars when using a novel laser‐activated irrigation approach. Int Endod J 2019; 53:529-538. [DOI: 10.1111/iej.13250] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Q. Yang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - M. W. Liu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - L. X. Zhu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - B. Peng
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
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Ziya M, Yüksel BN, Sarı Ş. ROOT CANAL MORPHOLOGY OF MANDIBULAR PRIMARY MOLARS: A MICRO-CT STUDY. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.615843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rödig T, Koberg C, Baxter S, Konietschke F, Wiegand A, Rizk M. Micro-CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard-tissue debris from isthmus-containing mesial root canal systems of mandibular molars. Int Endod J 2019; 52:1173-1181. [PMID: 30773661 DOI: 10.1111/iej.13100] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/13/2019] [Indexed: 01/23/2023]
Abstract
AIM To evaluate the efficacy of sonically and ultrasonically activated irrigation on removal of accumulated hard-tissue debris (AHTD) in mesial root canal systems of mandibular molars using micro-computed tomographic (micro-CT) analysis. METHODOLOGY Forty mesial roots of mandibular molars with two independent canals joined apically by an isthmus (Vertucci type II) were selected. The root canals were instrumented using Reciproc R25 instruments, and specimens were scanned at a resolution of 10.5 μm. Subsequently, n = 10 roots were assigned to each of the four final irrigation groups such that the group means and variances were almost identical: sonically activated irrigation with EndoActivator (EA) or EDDY (ED), ultrasonically activated irrigation (UAI) and manual irrigation without activation (MI). The final irrigation procedures were performed using a total of 5 mL 1% NaOCl and 5 mL 15% EDTA per canal over 5 min with activation time of 4 × 20 s. Reconstructed data sets were coregistered, and the mean percentage reduction of AHTD after final irrigation was compared statistically between groups using analysis of variance at a significance level set at 5%. RESULTS A significant reduction of AHTD was achieved after final irrigation in all groups (P < 0.05), ranging from 44.1% to 66.8%. The vol% of debris after irrigation was 3.7 ± 1.9% for EA, 3.3 ± 2.3% for ED, 2.1 ± 1.6% for UAI and 4.4 ± 2.3% for MI, with no significant difference between groups (P > 0.05). CONCLUSIONS None of the final irrigation protocols completely removed AHTD from mesial root canal systems in extracted human mandibular molars. Sonically and ultrasonically activated irrigation performed no better compared to manual irrigation.
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Affiliation(s)
- T Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - C Koberg
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - S Baxter
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - F Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité - University Medical Center Berlin, Berlin, Germany
| | - A Wiegand
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - M Rizk
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Piasecki L, José dos Reis P, Jussiani EI, Andrello AC. A Micro–computed Tomographic Evaluation of the Accuracy of 3 Electronic Apex Locators in Curved Canals of Mandibular Molars. J Endod 2018; 44:1872-1877. [DOI: 10.1016/j.joen.2018.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022]
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Accuracy of High-resolution Small-volume Cone-beam Computed Tomography in Detecting Complex Anatomy of the Apical Isthmi: Ex Vivo Analysis. J Endod 2018; 44:1862-1866. [DOI: 10.1016/j.joen.2018.08.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/20/2018] [Accepted: 08/26/2018] [Indexed: 11/24/2022]
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Sousa-Neto MDD, Silva-Sousa YC, Mazzi-Chaves JF, Carvalho KKT, Barbosa AFS, Versiani MA, Jacobs R, Leoni GB. Root canal preparation using micro-computed tomography analysis: a literature review. Braz Oral Res 2018; 32:e66. [DOI: 10.1590/1807-3107bor-2018.vol32.0066] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
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Incidence of ProTaper Universal System Instrument Fractures - A Retrospective Clinical Study. Eur Endod J 2018; 3:77-81. [PMID: 32161860 PMCID: PMC7006571 DOI: 10.14744/eej.2018.30592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/28/2018] [Accepted: 06/05/2018] [Indexed: 11/20/2022] Open
Abstract
Objective: The aim of this retrospective clinical study was to evaluate the incidence of ProTaper Universal System instrument fractures, associated with observation of the arch, group of teeth, and root thirds in which these fractures occurred. Methods: From analysis of charts, clinical record cards and radiographs of endodontic treatments performed by postgraduate students using the ProTaper Universal System at a reference center, a total of 1031 teeth and 2355 canals were analyzed. The general incidence of instrument fractures and their frequency, considering the group of teeth, arch and root thirds, were cataloged and the data obtained were statistically analyzed (Exact Fischer test, with level of significance of 1%). Results: The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. Instrument fractures occurred more frequently in the mandibular first (8.8%) and second (9.6%) molars, however, without statistically significant difference between them (P=0.81). In the first and second maxillary molars, the incidence of fracture was 4.7% and 5.1%, respectively, also without significant difference (P=0.81). Considering the dental arches (maxillary and mandibular), the fractures occurred with significantly higher frequency in the mandibular arch (66.7%), in comparison with the maxillary arch (33.3%) (P<0.01). A significantly higher percentage of fractures occurred in the apical third (84.4%) compared with the middle third (15.6%) (P<0.01). Conclusion: The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. However, the arch (mandibular) and root third (apical) had a significant effect on the incidence of instrument fractures.
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Both operator and heat treatment determine the centring ability of Reciproc® files in vitro. Clin Oral Investig 2018; 23:697-706. [DOI: 10.1007/s00784-018-2486-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/07/2018] [Indexed: 10/16/2022]
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Keles A, Keskin C. Deviations of Mesial Root Canals of Mandibular First Molar Teeth at the Apical Third: A Micro-computed Tomographic Study. J Endod 2018; 44:1030-1032. [PMID: 29681478 DOI: 10.1016/j.joen.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/21/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The present study aimed to quantitatively analyze apical foramen deviations of mesial root canals of mandibular first molar teeth by means of micro-computed tomographic (micro-CT) imaging. METHODS Micro-CT images of the mesial roots of 109 mandibular first molar teeth with independent mesiobuccal (MB) and mesiolingual (ML) root canals were analyzed. The deviations of the apical foramina of the MB, ML, and middle mesial root canals from the anatomic apex were measured. The vertical distance between the apical foramina of each mesial root canal in relation to each other was also calculated. RESULTS The distances from the apical foramina of the MB, ML, and middle mesial root canals to the anatomic apex of the mesial root were up to 2.51 mm, 3.21 mm, and 5.67 mm, respectively. There was no significant difference between the deviations of MB and ML root canals from each other (P > .05). The middle mesial root canal showed the greatest deviation compared with the MB and ML canals (P < .05). CONCLUSIONS The apical foramina of mesial root canals of mandibular first molar teeth showed greater variations from each other and anatomic apices than previously reported. Clinically, the use of electronic apex locators for the detection of minor apical foramen of each mesial root canal is of the utmost important.
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Affiliation(s)
- Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Marceliano-Alves MF, Lima CO, Bastos LGDPMN, Bruno AMV, Vidaurre F, Coutinho TM, Fidel SR, Lopes RT. Mandibular mesial root canal morphology using micro-computed tomography in a Brazilian population. AUST ENDOD J 2018; 45:51-56. [PMID: 29611889 DOI: 10.1111/aej.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 12/15/2022]
Abstract
To assess the root canal system morphology of mandibular molars by means of micro-computed tomography, one hundred and four mandibular first molars were investigated and the following were evaluated: Vertucci's classification, the presence of lateral canals and the number of apical foramina. Mesial root canal surface area and volume were obtained by the CTAn and CTvol software. The type of root canal isthmi was classified applying the Hsu & Kim and Fan criteria. The most frequent root canal configuration was Vertucci type IV (46.2%). Lateral canals were observed in all root canal thirds and the average number of apical foramina was 3.15 ± 1.77. Regarding the presence of isthmus, Types I and II were the most prevalent, according to Hsu & Kim and Fan et al. criteria, respectively. Mesial root canals of mandibular molars showed high morphology variability.
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Affiliation(s)
| | | | | | | | - Fernanda Vidaurre
- Department of Endodontics, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Sandra Rivera Fidel
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Tadeu Lopes
- Metallurgical and Materials Engineering, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
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Maung Maung Kyaw Moe, Ha JH, Jin MU, Kim YK, Kim SK. Anatomical profile of the mesial root of the Burmese mandibular first molar with Vertucci's type IV canal configuration. J Oral Sci 2017; 59:469-474. [PMID: 29151457 DOI: 10.2334/josnusd.16-0604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study evaluated the anatomical profile of the mesial root canals of the Burmese mandibular first molar with Vertucci's type IV canal configuration (VT4) using microcomputed tomography analysis. Seventy-five mesial roots of extracted mandibular first molars were scanned and evaluated. Fourteen middle mesial canals (MMCs) were observed in the specimens; each specimen had an average of 1.63 lateral canals and 3.77 apical foramina. The lateral canals arising from the mesiobuccal canal, mesiolingual canal, MMC, and isthmus terminated at an average distance of 0.92, 0.73, 2.11, and 1.89 mm, respectively, from the apex. The mean distance between the centers of the mesiobuccal and mesiolingual canals at 1.5 mm coronal to the furcation was 2.60 mm. A higher incidence of isthmus was observed in the apical 2-6-mm region compared with the apical 0-2-mm region (P < 0.05). The incidence of lateral canals in the isthmus was similar to that of the mesiobuccal and mesiolingual canals (P > 0.05). This study shows that the mesial root of the Burmese mandibular first molar with VT4 has complex anatomical profiles comprising MMCs and isthmus and their lateral canals.
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Affiliation(s)
- Maung Maung Kyaw Moe
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University.,Department of Conservative Dentistry, University of Dental Medicine
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University
| | - Myoung-Uk Jin
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University
| | - Young-Kyung Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University
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Ring J, Ring KC. Rare Root Canal Configuration of Mandibular Second Premolar Using Cone-beam Computed Tomographic Scanning. J Endod 2017; 43:1897-1900. [DOI: 10.1016/j.joen.2017.04.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
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Suman S, Verma P, Prakash-Tikku A, Bains R, Kumar-Shakya V. A Comparative Evaluation of Smear Layer Removal Using Apical Negative Pressure (EndoVac), Sonic Irrigation (EndoActivator) and Er:YAG laser -An In vitro SEM Study. J Clin Exp Dent 2017; 9:e981-e987. [PMID: 28936288 PMCID: PMC5601115 DOI: 10.4317/jced.53881] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/02/2017] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy. Material and Methods 40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test. Results The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups. Conclusions None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal. Key words:EndoVac, EndoActivator, Er:YAG laser, smear layer, scanning electron microscopy.
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Affiliation(s)
- Sanghamitra Suman
- Post Graduate Student, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Promila Verma
- Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aseem Prakash-Tikku
- Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rhythm Bains
- Associate Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar-Shakya
- Assistant Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Gambarini G, Ropini P, Piasecki L, Costantini R, Carneiro E, Testarelli L, Dummer PMH. A preliminary assessment of a new dedicated endodontic software for use with CBCT images to evaluate the canal complexity of mandibular molars. Int Endod J 2017; 51:259-268. [DOI: 10.1111/iej.12845] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023]
Affiliation(s)
- G. Gambarini
- Department of Oral and Maxillo-Facial Sciences; La Sapienza University; Rome Italy
| | - P. Ropini
- Department of Oral and Maxillo-Facial Sciences; La Sapienza University; Rome Italy
| | - L. Piasecki
- Division of Endodontics; University at Buffalo; Buffalo NY USA
| | - R. Costantini
- Department of Oral and Maxillo-Facial Sciences; La Sapienza University; Rome Italy
| | - E. Carneiro
- Pontifical Catholic University of Paraná; Curitiba Brazil
| | - L. Testarelli
- Department of Oral and Maxillo-Facial Sciences; La Sapienza University; Rome Italy
| | - P. M. H. Dummer
- School of Dentistry; College of Biomedical and Life Sciences; Cardiff University; Cardiff UK
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Keleş A, Keskin C. A micro-computed tomographic study of band-shaped root canal isthmuses, having their floor in the apical third of mesial roots of mandibular first molars. Int Endod J 2017; 51:240-246. [DOI: 10.1111/iej.12842] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/22/2017] [Indexed: 10/19/2022]
Affiliation(s)
- A. Keleş
- Faculty of Dentistry; Department of Endodontics; Ondokuz Mayıs University; Samsun Turkey
| | - C. Keskin
- Faculty of Dentistry; Department of Endodontics; Ondokuz Mayıs University; Samsun Turkey
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Nevares G, de Albuquerque DS, Freire LG, Romeiro K, Fogel HM, Dos Santos M, Cunha RS. Efficacy of ProTaper NEXT Compared with Reciproc in Removing Obturation Material from Severely Curved Root Canals: A Micro-Computed Tomography Study. J Endod 2017; 42:803-8. [PMID: 27117757 DOI: 10.1016/j.joen.2016.02.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to compare the remaining root canal obturation, volume of dentin removed, and apical transportation after retreatment of severely curved root canals by using Reciproc (REC) or ProTaper NEXT (PTN) systems. METHODS Twenty-eight mesial canals of mandibular molars were instrumented and then obturated with gutta-percha and sealer and allocated into 2 balanced groups (n = 14), the REC group (R25 file) and the PTN group (X3 and X2 files). Micro-computed tomography analysis was performed to assess the percentage of residual obturation material, the amount of dentin removed, and apical transportation. The effective time for the removal of obturation and procedural errors were recorded. RESULTS Obturation was effectively removed from the root canal in the REC and PTN groups (P ≤ .001), and the percentages of remaining obturation material were similar between both groups (84.8% PTN vs 86.5% REC) (P > .05). The amount of dentin removed (3.17 ± 2.64 mm(3) PTN versus 3.50 ± 2.82 mm(3) REC), apical transportation (at 1 mm: 0.096 ± 0.189 mm PTN versus 0.093 ± 0.186 mm REC; at 3 mm: 0.059 ± 0.069 mm PTN versus 0.082 ± 0.080 mm REC; at 5 mm: 0.097 ± 0.093 mm PTN versus 0.133 ± 0.138 mm REC), and the working time (269.69 ± 19.25 seconds PTN versus 268.62 ± 16.37 seconds REC) were also similar in both groups (P > .05). One file fractured in the REC group. CONCLUSIONS Both systems were equally effective in the removal of obturation from severely curved canals and can be used for retreatment. Neither system could completely remove the obturation material; therefore, additional techniques are needed to improve cleaning of the root canal.
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Affiliation(s)
- Giselle Nevares
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, Pernambuco, Brazil.
| | - Diana S de Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Laila G Freire
- School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Howard M Fogel
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marcelo Dos Santos
- Division of Endodontics, Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Rodrigo S Cunha
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
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Keleş A, Keskin C. Detectability of Middle Mesial Root Canal Orifices by Troughing Technique in Mandibular Molars: A Micro–computed Tomographic Study. J Endod 2017; 43:1329-1331. [PMID: 28606668 DOI: 10.1016/j.joen.2017.03.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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Mancini M, Cerroni L, Iorio L, Dall'Asta L, Cianconi L. FESEM evaluation of smear layer removal using different irrigant activation methods (EndoActivator, EndoVac, PUI and LAI). An in vitro study. Clin Oral Investig 2017; 22:993-999. [PMID: 28721527 DOI: 10.1007/s00784-017-2179-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/10/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study was to compare the efficacy of EndoActivator, EndoVac, PUI, and LAI methods in removing the smear layer from root canals. MATERIALS AND METHODS Eighty single-rooted mandibular premolars were decoronated to a standardized length of 15 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer) and irrigated with 5.25% NaOCl at 37 °C. Teeth were divided into six groups (two control groups [n = 10] and four test groups [n = 15]) according to the final irrigation activation/delivering technique (sonic irrigation [EndoActivator], passive ultrasonic irrigation [PUI], negative apical pressure [EndoVac], and laser activated irrigation [LAI]). Root canals were then split longitudinally and observed with field emission scanning electron microscopy to evaluate the presence of smear layer at 1, 3, 5, and 8 mm from the apex. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. RESULTS The EndoActivator was significantly more efficient than PUI, LAI, and control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System removed statistically significantly more smear layer than all groups at 1 mm from the apex. At 5 mm from the apex, EndoActivator and EndoVac removed more smear layer than LAI and control groups. At 5 and 8 mm from the apex, PUI and EndoVac did not differ statistically, but both performed statistically better than the control groups. CONCLUSION In our study, none of the activation/delivery systems completely removed the smear layer from the root canal walls; nevertheless, EV and EA showed, respectively, statistically significant better results at 1, 3, 5, and 8 mm and 3, 5, and 8 mm from the apex.
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Affiliation(s)
- Manuele Mancini
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
| | - Loredana Cerroni
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Iorio
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Dall'Asta
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Luigi Cianconi
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
- Restorative Dentistry and Endodontics, University of Rome "Tor Vergata", Rome, Italy
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Tahmasbi M, Jalali P, Nair MK, Barghan S, Nair UP. Prevalence of Middle Mesial Canals and Isthmi in the Mesial Root of Mandibular Molars: An In Vivo Cone-beam Computed Tomographic Study. J Endod 2017; 43:1080-1083. [PMID: 28527840 DOI: 10.1016/j.joen.2017.02.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/03/2017] [Accepted: 02/12/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Many studies have investigated the morphology of the mandibular molar, but the prevalence of the middle mesial (MM) canal in the mesial root of the mandibular molar is still the subject of controversy. In addition, in previous literature, a true MM canal has not been clearly distinguished from an isthmus between the mesiobuccal and mesiolingual canals. Therefore, the objectives of this study were 2-fold: METHODS: Ninety limited field of view cone-beam computed tomographic scans were observed. One hundred twenty-two mature mandibular first and second molars with no previous root canal treatment, no root resorption, and intact crowns were retrospectively evaluated. Data regarding the sex, age, presence of MM canals, and number of root canals in the mesial root were recorded. RESULT Of the 122 teeth, 20 (16.4%) had true MM canals. The prevalence of MM canals was 26% in first molars and 8% in second molars (P < .05). The frequency of isthmi in the mesial roots was 64.7%. The frequency of isthmi was higher in second molars, but the difference was not statistically significant (P > .05). CONCLUSIONS This study showed a high prevalence of mandibular molars with MM canals or isthmi. The detection and biomechanical cleaning of these areas during nonsurgical or surgical root canal treatment are critical.
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Affiliation(s)
- Mehrnaz Tahmasbi
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida Colleges of Dentistry and Medicine, Gainesville, Florida
| | - Poorya Jalali
- Department of Endodontics, Texas A&M University College of Dentistry, Dallas, Texas
| | - Madhu K Nair
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida Colleges of Dentistry and Medicine, Gainesville, Florida
| | - Sevin Barghan
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida Colleges of Dentistry and Medicine, Gainesville, Florida
| | - Umadevi P Nair
- Department of Endodontics, University of Florida, Gainesville, Florida.
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Effect of Canal Anastomosis on Periapical Fluid Pressure Build-up during Needle Irrigation in Single Roots with Double Canals using a Polycarbonate Model. Sci Rep 2017; 7:1582. [PMID: 28484231 PMCID: PMC5431501 DOI: 10.1038/s41598-017-01697-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/31/2017] [Indexed: 12/03/2022] Open
Abstract
Sodium hypochlorite is an effective irrigant for chemical debridement of root canals. However, increasing the intracanal pressure during irrigant delivery may result in irrigant extrusion into the bone and soft tissues surrounding the tooth. Because clinicians often encounter teeth with intracanal communications, the objective of the present study was to examine the effects of canal anastomosis on the generation of periapical fluid pressure at different fluid flow rates and insertion depths. Two similar polycarbonate models were used to simulate a single root with double canals, one containing, and the other without communicating channels between the canals. For both models, periapical pressure increased with increasing irrigant flow rates and insertion depths of a 30-gauge side-venting needle. In the presence of communicating channels, the magnitude of pressure build-up decreased by almost 90% irrespective of the fluid flow rate or needle insertion depth. Pressure reduction in anastomoses-containing roots provides an explanation why pressure generation in single roots is considerably higher. Nevertheless, it is still possible in teeth with canal anastomoses for pressure exceeding the intraosseous pressure to be generated when the fluid flow rate is sufficiently high and when the needle tip is close to the apical terminus.
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Arias MPC, Maliza AGA, Midena RZ, Graeff MSZ, Duarte MAH, Andrade FBD. Effect of ultrasonic streaming on intra-dentinal disinfection and penetration of calcium hydroxide paste in endodontic treatment. J Appl Oral Sci 2017; 24:575-581. [PMID: 28076462 PMCID: PMC5161256 DOI: 10.1590/1678-775720150553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/03/2016] [Indexed: 11/21/2022] Open
Abstract
Objective The antimicrobial effect of ultrasonic agitation of calcium hydroxide (CH) pastes in infected bovine dentin and their penetrability were evaluated using confocal laser scanning microscopy (CLSM) and microbiological culture. Material and Methods Fifty-two bovine teeth were infected with Enterococcus faecalis using a new contamination protocol; then they received CH paste and were divided into groups with or without ultrasound. Ultrasonic agitation was conducted for 1 min with a plain point insert. After 15 d, the CLSM analyzed the viable and dead bacteria with Live and Dead assay. The dentinal wall debris was collected by burs, and the colony forming units (CFU/mL) were counted. The penetrability of the paste inside dentinal tubules was tested using the B-rodamine dye. Results The calcium hydroxide paste showed better results with the use of ultrasonic agitation (p<0.05). Conclusion The ultrasonic agitation of CH paste increased its antimicrobial action and was responsible for intradentinal penetration with the fulfilment of the tubules.
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Affiliation(s)
- Marcela Paola Castro Arias
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Amanda Garcia Alves Maliza
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Raquel Zanin Midena
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | | | - Marco Antonio Húngaro Duarte
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Flaviana Bombarda de Andrade
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
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50
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Keleş A, Keskin C. Apical Root Canal Morphology of Mesial Roots of Mandibular First Molar Teeth with Vertucci Type II Configuration by Means of Micro–Computed Tomography. J Endod 2017; 43:481-485. [DOI: 10.1016/j.joen.2016.10.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/28/2016] [Accepted: 10/30/2016] [Indexed: 01/22/2023]
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