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Motamedi MRK, Amirzade-Iranaq MH, Ha WN. A systematic review and meta-analysis of the prevalence and global distribution of middle mesial canals in mandibular molars identified by CBCT. Clin Oral Investig 2024; 28:310. [PMID: 38743355 PMCID: PMC11093850 DOI: 10.1007/s00784-024-05660-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and regions based on cone-beam computed tomography (CBCT) studies. MATERIALS AND METHODS PubMed, Scopus, Embase, Web of Science, and Open-Grey were searched up to October 2023 according to specific keywords. A hand search was conducted on the references of the included studies and articles from three peer-reviewed journals in endodontics. The main variable of interest was the prevalence of MMC. Additional data such as the total number of included cases, age and country of the population, CBCT device information, voxel size, and field of view details were also extracted. Extracted data were analyzed qualitatively with the JBI quality assessment checklist and quantitatively with STATA software. RESULTS Of 32,793 studied teeth, the cumulative prevalence of MMC in both mandibular 1st and 2nd molars was 3.11% (95% CI: 2.00-4.44%). The subgroup analysis reveals a prevalence of 4.15% (95% CI: 2.69-5.89%) for mandibular 1st molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2nd molars. The highest prevalence of MMC in 1st molar was attributed to South Asia (11.24%) and Africa (6.61%). CONCLUSIONS The prevalence of MMC varies among regions. Clinicians should be aware of the potential prevalence of MMC, particularly in mandibular first molars, as a missed MMC could result in endodontic failure. CLINICAL RELEVANCE The presence of MMCs varies in different geographic regions (0% to 29.7%). Clinicians should always look for MMC when doing an endodontic treatment on mandibular molars, as the presence of this canal is not uncommon. We suggest searching for this canal as if searching for the second mesiobuccal canal of maxillary 1st molars.
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Affiliation(s)
- Mahmood Reza Kalantar Motamedi
- Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - William N Ha
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills NSW, Sydney, 2010, Australia.
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Cai X, Tang R. Maxillary first molar with two distobuccal root canals and cervical deformity: A case report. Clin Case Rep 2024; 12:e8555. [PMID: 38410658 PMCID: PMC10895546 DOI: 10.1002/ccr3.8555] [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: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
The second distobuccal canal in the maxillary first molar is often missed because of the low prevalence rate (0%-4%). The article reports this kind of variation in one case. Promising outcomes have continued up to the present (2-year follow-up).
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Affiliation(s)
- Xue Cai
- Department of Cariology and EndodontologyPeking University School and Hospital of StomatologyBeijingChina
| | - Rentao Tang
- Department of Cariology and EndodontologyPeking University School and Hospital of StomatologyBeijingChina
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Perondi I, Taschieri S, Baruffaldi M, Fornara R, Francetti L, Corbella S. The Correlation between Intraorifice Distance and the Anatomical Characteristics of the Second Mesiobuccal Canal of Maxillary Molars: A CBCT Study. Int J Dent 2024; 2024:6636637. [PMID: 38318327 PMCID: PMC10843869 DOI: 10.1155/2024/6636637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/08/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Missing anatomy is one of the main causes of endodontic failures, and accurate knowledge of teeth anatomy is a prerequisite for adequate root canal treatment. The aim of the present cone beam computed tomography (CBCT) study was to describe the anatomical characteristics of the mesiobuccal (MB) root canals of maxillary molars and to understand if a correlation exists between the position of the canal orifices and the anatomical features of the root. Methods For the purposes of the study, a total of 100 CBCT scans of maxillary molars with two MB canals were selected and studied. The features of root canal anatomy of the MB root of the same teeth were analyzed and recorded (root length, confluence, and Vertucci classification). The distance between MB1 and MB2 orifices and the palatal orifice were recorded, as well as the distance between the orifices and the line joining the palatal orifice and the others. A statistical analysis was performed by providing descriptive measures, the measure of the correlation between different parameters, and the influence of some of these measures on the presence of a confluence between MB1 and MB2. Results It resulted that the most frequent configuration is type II Vertucci. The length measured on the sagittal plane was significantly correlated to the presence of a confluence in the MB root. When the root length was higher than 14.56 mm, the confluence is three times more frequent than when the length is lower (OR = 3.635). The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for length on the sagittal plane was 0.632 (P=0.036). Conclusions The presence of a confluence between the MB canals of maxillary molars is correlated to the length of the root that could be measured on the sagittal plane and to the distance between the canal orifices. The relative position of the root canal orifices in relation to anatomic landmarks needs to be further explored.
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Affiliation(s)
- Isabella Perondi
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | - Luca Francetti
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Stefano Corbella
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Kuzekanani M, Azami Sardoei M, Walsh LJ. The Prevalence of Middle Mesial Canals in the Second Mandibular Molars of an Iranian Subpopulation: A Cross-Sectional CBCT Study. Cureus 2023; 15:e51179. [PMID: 38283515 PMCID: PMC10817710 DOI: 10.7759/cureus.51179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Missed additional canals are a common reason for the failure of root canal treatments. The prevalence of additional canals in molar teeth can vary because of ethnic differences. Hence, this study aimed to determine the prevalence and distribution of middle mesial canals (MMCs) in the second mandibular molars using cone beam computed tomography (CBCT), for an adult population from Kerman in southeast Iran. Methodology De-identified retrospective provided CBCT scans from three private radiology centers in Kerman were reviewed (131 patients; 58 males (44.3%), 73 females (55.7%); age range: 13 to 54 years, mean age: 33). The presence of MMCs in mandibular second molars (222 teeth; 112 left and 110 right) was recorded, along with the morphology of the distal roots in the same teeth. Frequency data were analyzed using the Chi-square test and Fisher's exact test. Results The overall prevalence of MMC in the second mandibular molars was 2.3%. MMCs were found both unilaterally and bilaterally. More MMCs were found in females than males (2.7% vs. 1.7%), and on the left side (2.7% vs. 1.8%), but these differences were not statistically significant (p=1.0). There was no association between the existence of MMC in the mesial root and a second canal in the distal root of the same tooth. Conclusion Based on CBCT scans, the overall prevalence of MMC in mandibular second molars in this population was just below one in 44. Clinicians performing endodontic treatment on second molars should check for the presence of MMC so that this possible additional canal is not missed.
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Affiliation(s)
- Maryam Kuzekanani
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Mousa Azami Sardoei
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Laurence J Walsh
- Dentistry, School of Dentistry, the University of Queensland, Brisbane, AUS
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Hatipoğlu FP, Mağat G, Hatipoğlu Ö, Al-Khatib H, Elatrash AS, Abidin IZ, Kulczyk T, Ahmed Mohamed Alkhawas MB, Buchanan GD, Kopbayeva M, Surendar S, Javed MQ, Madfa AA, Bürklein S, Mimica S, Bhatti UA, Maratovna TI, Palma PJ, Brochado Martins JF. Assessment of the Prevalence of Radix Entomolaris and Distolingual Canal in Mandibular First Molars in 15 Countries: A Multinational Cross-sectional Study with Meta-analysis. J Endod 2023; 49:1308-1318. [PMID: 37393948 DOI: 10.1016/j.joen.2023.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 07/04/2023]
Abstract
AIM The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. METHODS CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/no) was identified and recorded. RESULTS Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P < .05). The prevalence of DLC ranged from 3% to 50%, and the overall prevalence was 22% (95% CI: 15%-29%). RE prevalence ranged from 0% to 12%, and the overall prevalence was 3% (95% CI: 2%-5%). There were no significant differences between left and right M1Ms or between genders for either DLC or RE (P > .05). CONCLUSION The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications.
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Affiliation(s)
| | - Güldane Mağat
- Faculty of Dentistry, Department of Oral Radiology, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey
| | | | - Anas S Elatrash
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Libyan International Medical University, Benghazi, Libya
| | - Imran Zainal Abidin
- Department of Restorative Dentistry, International Islamic University Malaysia (IIUM), Kuala Lumpur, Malaysia
| | - Tomasz Kulczyk
- Department of Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Sugumaran Surendar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia; Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Sarah Mimica
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry and Endodontics, Riphah International University, Islamabad, Pakistan
| | | | - Paulo J Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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Rosado LPL, Freitas DQ, Rovaris K, Oliveira ML, Neves FS. Can maxillary molar dimensions predict the presence of the second mesiobuccal canal? Oral Radiol 2023; 39:482-490. [PMID: 36266556 DOI: 10.1007/s11282-022-00661-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/09/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the potential of maxillary molar dimensions as predictors of the presence of the second mesiobuccal (MB2) canal. METHODS Micro-computed tomography scans were obtained from 47 maxillary molars, out of which 26 had the MB2 canal. The distance between root canals, extension of the canals, and thickness of surrounding dentin were obtained from axial images at the furcation level, 3 mm from the apex, and 5 mm from the apex. The association between the measurements and the presence of the MB2 canal was assessed using multiple logistic regression and odds ratio. RESULTS At the furcation level, the bucco-palatal extension of the MB1 canal significantly decreased the chance of the presence of the MB2 canal. Regarding the thickness of surrounding dentin measurements, the mesial and distal aspects of the MB1 canal at 3 mm from the apex were statistically significant to decrease and increase the chance of presence of the MB2 canal, respectively. Regarding the extension of the canals, only buccal-palatal extension seems to decrease the chance of the presence of the MB2 canal. CONCLUSION The presence of the MB2 canal in the mesiobuccal root of maxillary molars is associated with the bucco-palatal extension and surrounding dentin thickness of the first mesiobuccal canal, and seems to be unrelated to the dimensions of the distobuccal and palatal roots.
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Affiliation(s)
- Lucas P Lopes Rosado
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Karla Rovaris
- Department of Pathology and Dentistry Clinic, School of Dentistry, Federal University of Piauí (UFPI), Teresina, Piauí, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology, Piracicaba Dental School, Department of Oral Diagnosis, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
- Division of Oral Radiology, School of Dentistry, Department of Propedeutics and Integrated Clinic, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Pertek Hatipoğlu F, Mağat G, Hatipoğlu Ö, Taha N, Alfirjani S, Abidin IZ, Lehmann AP, Alkhawas MBAM, Buchanan GD, Kopbayeva M, Surendar S, Javed MQ, Madfa AA, Donnermeyer D, Krmek SJ, Bhatti UA, Palma PJ, Brochado Martins JF. Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis. J Endod 2023; 49:549-558. [PMID: 36863567 DOI: 10.1016/j.joen.2023.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence. METHODS Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. RESULTS In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P < .05). MMC prevalence ranged from 1% to 23%, and the overall prevalence was 7% (95% confidence interval [CI]: 5%-9%). No significant differences were found between the left and right M1M (odds ratio = 1.09, 95% CI: 0.93, 1.27; P > .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). CONCLUSIONS The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral.
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Affiliation(s)
| | - Güldane Mağat
- Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey.
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya
| | | | - Anna Paulina Lehmann
- Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań, Poznań, Poland
| | | | - Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Maira Kopbayeva
- Kazakh National Medical University Asfendiyarov, Almaty, Kazakhstan
| | - Sugumaran Surendar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Saudi Arabia; Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry and Endodontics, Riphah International University, Pakistan
| | - Paulo J Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Filipe Brochado Martins
- Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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A CBCT based cross sectional study on the prevalence and anatomical feature of C shaped molar among Jordanian. Sci Rep 2022; 12:17137. [PMID: 36229628 PMCID: PMC9561530 DOI: 10.1038/s41598-022-20921-1] [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: 04/16/2022] [Accepted: 09/20/2022] [Indexed: 01/04/2023] Open
Abstract
The prevalence and anatomical features of C-Shaped Mandibular Second Molars (MSMs) are rarely studied in Jordanian sub-population. This study then took a part to evaluate the prevalence of C-shaped in MSMs using cone-beam computed tomography (CBCT) in the Jordanian sub-population. It used a cross-sectional design and three thousand scans collected over eight years between 2011 and 2019. The data were then reviewed for whether they were fully formed of MSMs. A total of 2037 cases that had 2845 MSMs were evaluated to identify C-shaped canals at coronal, middle, and apical sites. An oblique slicing module perpendicular to the long axis of MSMs was used to evaluate the teeth. The type and frequency of C-shaped canals, as well as the correlations between sex and side (right/left) and between sex and groove direction (buccal/lingual) were measured using the chi-square test on SPSS software at the significance level of 95%. A total of 342 teeth of 243 patients were C-shaped molars, which comprised 12% of the patient's teeth and 99 of them as a bilateral C-shaped canal with mean age of 40 years and sex ratio of 2:1 between female and male. With the limitations of this study, the lingual groove and type 3 were the most common properties of MSM. Besides, the Jordanian population mostly had C-shaped canals.
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Colakoglu G, Kaya Buyukbayram I, Elcin MA, Garip Berker Y, Ercalik Yalcinkaya S. Association between second mesiobuccal canal and apical periodontitis in retrospective cone‐beam computed tomographic images. AUST ENDOD J 2022; 49:20-26. [PMID: 35908285 DOI: 10.1111/aej.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
This retrospective cone-beam computed tomography study aimed to investigate the possible associations of apical periodontitis (AP) with missed/unmissed second mesiobuccal (MB2) canals. MB2 canals and AP were investigated in 257 endodontically treated and 673 untreated maxillary molars, and the former were analyzed regarding missed/unmissed MB2 canals. The chi-squared test and odds ratio (OR) were used for statistics. The prevalence of MB2 canals in maxillary first molars was higher than that in second molars (p = 0.001). MB2 canals were 1.751 times more common in males than in females (OR: 1.751; 95% CI: 1.334-2.297), with a significant difference in the 18-39 age groups (p = 0.005). The risk for AP was 5.5 times greater in endodontically treated maxillary molars with missed MB2 canals than in those with unmissed MB2 canals (p = 0.012) (OR: 5.5, 95% CI: 1.549-19.527). The findings of this study reveal that the likelihood of the MB2 canal is higher in the maxillary first molars of young adult males.
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Affiliation(s)
- Gizem Colakoglu
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Isil Kaya Buyukbayram
- Department of Endodontics, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Mehmet Ali Elcin
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | | | - Sebnem Ercalik Yalcinkaya
- Department of Dentomaxillofacial Radiology, Faculty of DentistryMarmara UniversityMaltepe, IstanbulTurkey
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Camacho-Aparicio LA, Borges-Yáñez SA, Estrada D, Azcárraga M, Jiménez R, González-Plata-R R. Validity of the dental operating microscope and selective dentin removal with ultrasonic tips for locating the second mesiobuccal canal (MB2) in maxillary first molars: An in vivo study. J Clin Exp Dent 2022; 14:e471-e478. [PMID: 35765353 PMCID: PMC9233913 DOI: 10.4317/jced.59347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/04/2022] [Indexed: 11/05/2022] Open
Abstract
Background Several investigations have determined whether the use of a dental operating microscope (DOM) in combination with selective dentine removal with ultrasonic tips increases the percentage of location of the Mesiobuccal 2 (MB2) root canal in maxillary first molars (MFM). However, these studies did not report the performance of in vivo measurements with the comparison with a gold standard. The aim of this study was to determine the validity of the DOM and selective dentin removal with ultrasonic tips to locate the MB2 root canal in MFM using Cone Beam Computed Tomography (CBCT) as the gold standard. Material and Methods The initial sample size was 91 patients, but 7 were excluded, so the sample size was 84 patients who signed the informed consent. Inclusion criteria: MFM indicated for root canal treatment. An expert blinded observer identified the MB2 in the CBCT. Two standardized examiners (Kappa=91%) performed the clinical assessment in three stages: Stage 1, canal location with an endodontic explorer and a mirror; Stage 2, use of DOM and Stage 3, use of DOM plus selective dentine removal with ultrasonic tips. The validity of each stage was calculated. Results The prevalence of MB2 using CBCT was 79%, by clinical location was 68%. Sensitivity was 79%, 82%, 86% for stage 1, 2 and 3, respectively. Specificity and Positive Predictive Values were 100% for all methods. Negative Predictive Value was 56%, 60%, 67%, respectively. Positive Likelihood Ratio tends to infinity for all methods, Negative Likelihood Ratio= 0.21, 0.18 and 0.14 and Accuracy= 83%, 86% and 89%, respectively. Conclusions The use of DOM with selective dentine removal with ultrasonic tips is the most valid method for locating MB2 canal in MFM. There was an increase in the location of the MB2 root canal with the DOM and ultrasonic tips, which definitely help the clinician. Key words:Cone beam computed tomography, microscopy, second mesiobuccal canal, sensitivity and specificity, validity.
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Affiliation(s)
- Liliana A Camacho-Aparicio
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
| | - S Aída Borges-Yáñez
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
| | - Daniel Estrada
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
| | - Minerva Azcárraga
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
| | - Reneé Jiménez
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
| | - Ricardo González-Plata-R
- Dental Public Health Department, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Av. Universidad 3000, Del. Coyoacán, C.P. 04510, México City, México
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Aung NM, Myint KK. Diagnostic Accuracy of CBCT for Detection of Second Canal of Permanent Teeth: A Systematic Review and Meta-Analysis. Int J Dent 2021; 2021:1107471. [PMID: 34335767 PMCID: PMC8315866 DOI: 10.1155/2021/1107471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Missed canal is one of the common reasons for nonsurgical endodontic retreatments. The missed canals were frequently associated with periapical pathology. The aim of this systematic review was to find the diagnostic accuracy of CBCT for detection of the second canal of the root canal system of permanent teeth. MATERIALS AND METHODS The articles were selected from seven electronic databases according to selection criteria. All eligible studies were judged by the reviewers. The selected studies were checked with the QUADAS-2 tool for risk of bias and applicability concerns. Finally, 12 studies were selected for qualitative and quantitative analyses. The summary estimates of sensitivities and specificities and SROC curves were calculated and drawn by RevMan 5.3 and MetaDTA software. RESULTS Summary estimates of CBCT for detection of second canal anatomy in permanent teeth were 94% sensitivity and 93.1% specificity. 96.6% sensitivity of MB2 was followed by 88.8% sensitivity of maxillary and mandibular premolars and 81% that of mandibular molars. The specificity of 97.6% for premolars was trialed by 85% specificity of mandibular molars and MB2. For permanent mandibular canines, 67% sensitivity and 100% specificity were estimated. CBCT showed more agreement with detecting the second canal with micro-CT, estimating 100% sensitivity and 95.6% specificity. The highest prevalence of the second canal comprised the highest sensitivity of 99.1% and lowest specificity of 77.5%. After the exclusion of case-control studies, a 3% drop of sensitivity from the summary estimate was observed. Multiple spectrum of the second canal had 8.6% higher sensitivity and 4.4% lower specificity than single spectrum. CONCLUSION CBCT is informative for detecting the second canal. Clinicians should keep in mind that the accuracy can vary in different types of teeth, with the prevalence of second canal across different populations, and with the spectrum of second canal anatomy in spite of the reviewers having postulated overestimation of the findings.
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Affiliation(s)
- Nyan M. Aung
- Department of Oral Biological Science, University of Dental Medicine, Mandalay 05041, Myanmar
| | - Kyaw K. Myint
- Department of Oral Biological Science, University of Dental Medicine, Mandalay 05041, Myanmar
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Yang Y, Wu B, Zeng J, Chen M. Classification and morphology of middle mesial canals of mandibular first molars in a southern Chinese subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2020; 20:358. [PMID: 33302951 PMCID: PMC7726862 DOI: 10.1186/s12903-020-01339-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/22/2020] [Indexed: 01/21/2023] Open
Abstract
Background Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs). Methods CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (< 40 years old) and group B (≥ 40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P < 0.05 was considered statistically significant. Results In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P < 0.05). The curvature in the mesiodistal direction was 29.39 ± 8.53° in group A and 26.06 ± 8.50° in group B, and this difference was also significant (P < 0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P > 0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy. *Yeqing Yang and Buling Wu have contribute equally to this article.
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Affiliation(s)
- Yeqing Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Buling Wu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Junkai Zeng
- Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ming Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. .,School of Stomatology, Southern Medical University, Guangzhou, China.
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Al-Saedi A, Al-Bakhakh B, Al-Taee RG. Using Cone-Beam Computed Tomography to Determine the Prevalence of the Second Mesiobuccal Canal in Maxillary First Molar Teeth in a Sample of an Iraqi Population. Clin Cosmet Investig Dent 2020; 12:505-514. [PMID: 33235509 PMCID: PMC7678691 DOI: 10.2147/ccide.s281159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/29/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose This study aimed to determine the prevalence of the second mesiobuccal canal in maxillary first molar teeth in a sample of population from Basrah city in the south of Iraq. Patients and Methods Cone-beam computed tomography (CBCT) images of 353 Iraqi patients from Basrah city were included in the study. These images revealed 691 maxillary first molars, but only 655 of them were included. The images were obtained using a Gendex (GXDP-7000) CBCT machine (Hatfield, PA, USA) and studied for the prevalence of second mesiobuccal canal in the mesiobuccal root canal configuration, according to Vertucci’s classification, by scrolling through the images. Pearson’s chi-square tests were used to correlate canal type distribution to gender and age. The distributions of canal type on the right and left sides were assessed using the Kendal tau correlation coefficient. A P-value <0.001 was considered highly significant. For intra-examiner reliability analysis, Cohen’s kappa test was used. Results The second mesiobuccal canal was identified in 81.68% of the Iraqi population sample. The most common type was type II (44.58%), followed by type IV (31.30%). Type I occurred in 18.32% of cases. Other types were less frequent. Conclusion The second mesiobuccal canal occurred in most of the examined samples of the Iraqi population (81.68%), with the most common type being type II, followed by type IV.
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Affiliation(s)
- Aqeel Al-Saedi
- Oral Diagnosis Department, College of Dentistry, University of Basrah, Basrah, Iraq
| | - Bahaa Al-Bakhakh
- Conservative Dentistry Department, College of Dentistry, University of Basrah, Basrah, Iraq
| | - Riad G Al-Taee
- Oral and Maxillofacial Surgery Department, College of Dentistry, University of Basrah, Basrah, Iraq
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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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do Carmo WD, Verner FS, Aguiar LM, Visconti MA, Ferreira MD, Lacerda MFLS, Junqueira RB. Missed canals in endodontically treated maxillary molars of a Brazilian subpopulation: prevalence and association with periapical lesion using cone-beam computed tomography. Clin Oral Investig 2020; 25:2317-2323. [PMID: 32875385 DOI: 10.1007/s00784-020-03554-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/26/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To evaluate the prevalence of missed canals in endodontically treated maxillary molars through cone-beam computed tomography (CBCT) images and to verify their association with the presence of periapical lesions. MATERIAL AND METHODS Three oral radiologists evaluated 633 maxillary molars in CBCT exams regarding number of roots, number of root canals, number of missed canals, anatomic identification of missed canals, presence of periapical lesions, and root location of the periapical lesions. Data were statistically analyzed at a 5% significance level. RESULTS Descriptive statistical analysis showed that among 395 first molars, 218 had at least one missed canal, and 186 (46.5%) had a missed canal and periapical lesion simultaneously. Of these, 72.4% (134) of the missed canals were only mesiobuccal 2 (MB2). Among 238 s molars evaluated, 121 presented at least one missed canal, and 104 (43.6%) had a missed canal and periapical lesion simultaneously. Of these, 81.7% (85) of the missed canals were only MB2. The chi-squared test showed an association between the presence of missed canals and periapical lesions for 1st and 2nd maxillary molars. Teeth that presented a missed canal showed an odds ratio (OR) of 2.57 (p < 0.0001) of being associated with a periapical lesion. Missed canal occurrence was positively related to the number of root canals (z = 13.06, p < 0.0001), meaning when the number of root canals is higher, there is a higher probability of missed canal occurrence. According to the model calculated prediction, for a one-unit increase in the number of canals, the probability of missed canals increases by 4.22%. CONCLUSIONS It was concluded that MB2 was the most frequently missed canal, associated with the presence of periapical lesions in endodontically treated maxillary molars. CLINICAL RELEVANCE Professionals' negligence of anatomical root variations has been contributed to the high prevalence of missed canals, leading to failures in endodontic treatment. Their association with periapical lesion occurrence emphasizes the importance of correct detection and instrumentation of these canals.
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Affiliation(s)
- Weslley Duarte do Carmo
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Francielle Silvestre Verner
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Larisse Martins Aguiar
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Maria Augusta Visconti
- School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Matheus Diniz Ferreira
- School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mariane Floriano Lopes Santos Lacerda
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil.
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Influence of the Intracanal Material and Metal Artifact Reduction Tool in the Detection of the Second Mesiobuccal Canal in Cone-beam Computed Tomographic Examinations. J Endod 2020; 46:1067-1073. [DOI: 10.1016/j.joen.2020.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 11/22/2022]
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Borges CC, Estrela C, Decurcio DDA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G. Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 2020; 34:e056. [PMID: 32578799 DOI: 10.1590/1807-3107bor-2020.vol34.0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022] Open
Abstract
This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.
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Affiliation(s)
- Caroline Cristina Borges
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Jesus Djalma PÉcora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Complicated Root Canal Morphology of Permanent Mandibular Lateral Incisors is Associated with the Presence of a Second Mesiobuccal Canal in Permanent Maxillary First Molars. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Many studies have been conducted in order to define the root canal morphology based on age, gender, ethnic and racial characteristics of the population. However, relations within morphological variations of certain groups of teeth have rarely been investigated. The aim of this study was to evaluate the root canal morphology of mandibular lateral incisors and to determine the association between their morphologic characteristics and the presence of a second mesiobuccal canal of maxillary first molars. Cone-beam computed tomography images from a pre-existing base were analyzed for the bilateral presence of both permanent mandibular lateral incisors and permanent maxillary first molars. Root canal morphology was analyzed according to the Vertucci classification. Associations of root canal morphologies between incisors and molars were calculated as probabilities using binary logistic regression analysis. In total, 126 mandibular lateral incisors and 126 maxillary first molars were included. 46% of all mandibular lateral incisors showed complicated root canal morphology and Vertucci type III canal configuration as the most frequent. Second mesiobuccal root canal was present in 62.7%. Root canal morphologies showed high level of bilateral symmetry in both tooth groups. The probability of a subject having complicated root canal morphology in lateral incisors was significantly higher when the second mesiobuccal canal was present. Clinicians should consider all available information on patients’ root canal morphology when planning new endodontic treatment. Root canal morphology of permanent mandibular lateral incisors showed high association with the root canal morphology of permanent maxillary first molars.
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Su CC, Huang RY, Wu YC, Cheng WC, Chiang HS, Chung MP, Cathy Tsai YW, Chung CH, Shieh YS. Detection and location of second mesiobuccal canal in permanent maxillary teeth: A cone-beam computed tomography analysis in a Taiwanese population. Arch Oral Biol 2019; 98:108-114. [DOI: 10.1016/j.archoralbio.2018.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 11/24/2022]
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Hayashi T, Arai Y, Chikui T, Hayashi-Sakai S, Honda K, Indo H, Kawai T, Kobayashi K, Murakami S, Nagasawa M, Naitoh M, Nakayama E, Nikkuni Y, Nishiyama H, Shoji N, Suenaga S, Tanaka R. Clinical guidelines for dental cone-beam computed tomography. Oral Radiol 2018; 34:89-104. [PMID: 30484133 DOI: 10.1007/s11282-018-0314-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/28/2022]
Abstract
Dental cone-beam computed tomography (CBCT) received regulatory approval in Japan in 2000 and has been widely used since being approved for coverage by the National Health Insurance system in 2012. This imaging technique allows dental practitioners to observe and diagnose lesions in the dental hard tissue in three dimensions (3D). When performing routine radiography, the examination must be justified, and optimal protection should be provided according to the ALARA (as low as reasonably achievable) principles laid down by the International Commission on Radiological Protection. Dental CBCT should be performed in such a way that the radiation exposure is minimized and the benefits to the patient are maximized. There is a growing demand for widespread access to cutting-edge health care through Japan's universal health insurance system. However, at the same time, people want our limited human, material, and financial resources to be used efficiently while providing safe health care at the least possible cost to society. Japan's aging population is expected to reach a peak in 2025, when most of the baby boomer generation will be aged 75 years or older. Comprehensive health care networks are needed to overcome these challenges. Against this background, we hope that this text will contribute to the nation's oral health by encouraging efficient use of dental CBCT.
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Affiliation(s)
- Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Toru Chikui
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Sachiko Hayashi-Sakai
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Hiroko Indo
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Kaoru Kobayashi
- Department of Oral and Maxillofacial Radiology and Diagnosis, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masako Nagasawa
- Division of Bio-Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Munetaka Naitoh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Eiji Nakayama
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Yutaka Nikkuni
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Noriaki Shoji
- Division of Oral Diagnosis, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Shigeaki Suenaga
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China
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Studebaker B, Hollender L, Mancl L, Johnson JD, Paranjpe A. The Incidence of Second Mesiobuccal Canals Located in Maxillary Molars with the Aid of Cone-beam Computed Tomography. J Endod 2017; 44:565-570. [PMID: 29153734 DOI: 10.1016/j.joen.2017.08.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/16/2017] [Accepted: 08/26/2017] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Many endodontic treatment failures in maxillary molars result from missed second mesiobuccal (MB2) canals. An MB2 canal orifice is present in as many as 95% of maxillary molars, but these canals are not always located during endodontic procedures. Additional tools, such as cone-beam computed tomographic (CBCT) imaging, may be needed to locate these canals in maxillary molars. Hence, the aims of this study were to investigate the frequency of use of CBCT imaging during the treatment of maxillary molars and to evaluate the influence of its use on the detection of MB2 canals. METHODS Endodontic treatment records, digital intraoral radiographs (when present), and CBCT images from all maxillary first and second molars treated at the University of Washington, Seattle, WA, between 2010 and 2014 (N = 886) were reviewed. Statistical analysis was performed to assess differences between the groups. RESULTS Overall, an MB2 canal was found in 55.8% of the maxillary molars studied, and CBCT imaging assisted in detecting 11.7% of these canals. CBCT imaging was used in 16.5% of the cases treated and was used significantly more for retreatment cases. CBCT imaging was used preoperatively in 5.6% of cases, and the data show that significantly more MB2 canals were located when a preoperative CBCT image was available. More MB2 canals were located in first molars without full-coverage crowns. CONCLUSIONS The data show that CBCT imaging is a valuable tool in locating MB2 canals. Based on the results of his study, the use of CBCT imaging could be warranted when treating maxillary molars.
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Affiliation(s)
- Ben Studebaker
- Department of Endodontics, University of Washington, Seattle, Washington
| | - Lars Hollender
- Department of Oral and Maxillofacial Radiology, University of Washington, Seattle, Washington
| | - Lloyd Mancl
- Department of Oral Health Sciences, University of Washington, Seattle, Washington
| | - James D Johnson
- Department of Endodontics, University of Washington, Seattle, Washington
| | - Avina Paranjpe
- Department of Endodontics, University of Washington, Seattle, Washington.
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23
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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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24
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Sousa TO, Hassan B, Mirmohammadi H, Shemesh H, Haiter-Neto F. Feasibility of Cone-beam Computed Tomography in Detecting Lateral Canals before and after Root Canal Treatment: An Ex Vivo Study. J Endod 2017; 43:1014-1017. [PMID: 28416319 DOI: 10.1016/j.joen.2017.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/04/2017] [Accepted: 01/15/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The study objective was to evaluate the effectiveness of cone-beam computed tomographic (CBCT) imaging for the detection of lateral canals (LCs) in endodontically treated premolars. METHODS Two evaluators classified 80 extracted premolars into 2 groups based on the absence (n = 40) or presence (n = 40) of LCs according to micro-computed tomographic analysis. The extracted teeth were fixated in a human mandible and scanned with CBCT imaging. Subsequently, each tooth was endodontically treated, and CBCT scans were repeated. Three experienced examiners evaluated all images randomly. Receiver operating characteristic curves were compared using the McNemar test, and sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were obtained. RESULTS The area under the receiver operating characteristic curve values were 0.58 and 0.49 before and after root canal treatment, respectively. These values were statistically significantly different (P < .001). Before root canal treatment sensitivity, specificity, positive predictive value, and negative predictive value were 55%, 52%, 55%, and 56%, whereas after root canal treatment the values were 33%, 61%, 46%, and 48%, respectively. CONCLUSIONS LC detection in nontreated teeth presented low accuracy, whereas among treated teeth CBCT imaging showed no efficacy. The results suggest that CBCT imaging is not an effective diagnostic tool for LC detection.
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Affiliation(s)
- Thiago Oliveira Sousa
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
| | - Bassam Hassan
- Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hesam Mirmohammadi
- Department of Endodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hagay Shemesh
- Department of Endodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
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25
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Su CC, Wu YC, Chung MP, Huang RY, Cheng WC, Cathy Tsai YW, Hsieh CY, Chiang HS, Chen CY, Shieh YS. Geometric features of second mesiobuccal canal in permanent maxillary first molars: a cone-beam computed tomography study. J Dent Sci 2017; 12:241-248. [PMID: 30895057 PMCID: PMC6400017 DOI: 10.1016/j.jds.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/01/2017] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Inadequacy to locate the second mesiobuccal canal (MB2) canal leads to the highest probability of endodontic failure in permanent maxillary first molars (PMFMs) and still remains a constant challenge for many clinicians. The aim of this study was to characterize the geometrical features between MB2 and other orifices of examined PMFMs using cone-beam computed tomography images. Materials and methods A total of 108 teeth qualified in the cone-beam computed tomography image archives were enrolled in the present study. The intersecting point (T) was determined as the perpendicular line (h, altitude of triangle) projected from the vertex of the MB2 canal orifice to mesiobuccal canal orifice-palatal canal orifice line (MB1-P). We measured the geometric features of PMFMs with the MB2 canal, including the interorifice distances, area, altitude, and the ratio between the canal orifices. Results The average interorifice distance was found to be 1.91 ± 0.59 mm for MB1-MB2, 5.73 ± 0.66 mm for MB1-P, and 4.11 ± 0.79 mm for MB2-P, with significant gender difference for MB1-MB2 distance. For the MB1-T distance, a significant difference was found between genders (P = 0.02), with males averaging 1.78 ± 0.07 mm, and females 1.48 ± 0.11 mm. For the MB1-P distance, the majorities of both genders were found in the 20–40% cut-off. A portion of the males exhibited a tendency towards the 40–80% cut-off, while females shifted in the reverse direction towards the 0–20% cut-off. Conclusion In clinical scenarios, these anatomical characteristics of the root canals system could be beneficial to locating the MB2 canal.
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Affiliation(s)
- Chi-Chun Su
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chiao Wu
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Ming-Pang Chung
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Ren-Yeong Huang
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Wan-Chien Cheng
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Yi-Wen Cathy Tsai
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Chen-Yu Hsieh
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Ho-Sheng Chiang
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Ching-Yang Chen
- Radiology Division, SongShan Branch, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Yi-Shing Shieh
- School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
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