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Martinho FC, Bisi BG, Gavini G, Griffin IL, Tordik PA. Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-post Removal: Small versus Large Field-of-view Registration Workflows. J Endod 2024; 50:1455-1462. [PMID: 38945199 DOI: 10.1016/j.joen.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION This study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw). METHODS Fifty-six extracted human maxillary molars were divided into DNS-SFOVw (n = 28) and DNS-LFOVw (n = 28). The palatal canal was restored with an intraradicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam computed tomography (CBCT) scan was taken with a 40 × 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional deviations, angular deflection, number of mishaps, registration, and total operation time were calculated. RESULTS The DNS-SFOVw was as accurate as DNS-LFOVw (P > .05). The DNS-LFOVw registration time was less than DNS-SFOVw (P < .05). There was no difference in the number of mishaps (P > .05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (P < .05). CONCLUSION Within the limitations of this in-vitro study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiberpost removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland.
| | - Bruno G Bisi
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil; Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
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Busi S, Nagarathna PJ, Deoghare A, Parakh K, Lokhande RS, Malladi S. Evaluation and Comparison of Dentin Thickness, Centering Ability, Canal Transportation, and Instrumentation Time of Pro AF Baby Gold and Pedoflex Files in Primary Root Canals Using a Cone Beam Computed Tomographic Analysis: An In Vitro Study. Int J Clin Pediatr Dent 2024; 17:892-897. [PMID: 39372350 PMCID: PMC11451867 DOI: 10.5005/jp-journals-10005-2929] [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] [Indexed: 10/08/2024] Open
Abstract
Introduction Pediatric rotary systems have the advantage of improved canal centricity and conservative canal preparation with better obturation quality. Pro AF Baby Gold and Pedoflex files are two exclusive pediatric rotary file systems that were introduced in recent times. Aim and objective The aim of the present study is to compare and evaluate the dentine thickness, centering ability, canal transportation, and instrumentation time of Pro AF Baby Gold and Pedoflex files using cone beam computed tomography (CBCT). Materials and methods A total of 40 extracted human primary molar teeth with a minimum 7 mm root length were included in the study and randomly divided into two groups: group I, Pro AF Baby Gold; group II, Pedoflex files. Teeth were imaged preoperatively with CBCT, then root canal preparation was done in both groups with respective files, followed by postoperative CBCT imaging to evaluate the dentin thickness, centering ability, and canal transportation of both groups. Instrumentation time was noted using a stopwatch. Results There is a statistically significant difference in the instrumentation time; Pedoflex took a shorter time when compared to Pro AF Baby Gold files. Regarding canal transportation, there was no significant difference between the two files, with Pedoflex showing a better value than the other files. Regarding centering ability, there was no significant difference between the two files, with Pro AF Baby Gold having a better value than the other files (p < 0.001). Conclusion From the findings of our present study, it was found that both systems were able to effectively shape curved root canals in terms of canal transportation and centering ability. How to cite this article Busi S, PJ N, Deoghare A, et al. Evaluation and Comparison of Dentin Thickness, Centering Ability, Canal Transportation, and Instrumentation Time of Pro AF Baby Gold and Pedoflex Files in Primary Root Canals Using a Cone Beam Computed Tomographic Analysis: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(8):892-897.
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Affiliation(s)
- Sravanthy Busi
- Department of Pedodontics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
| | - PJ Nagarathna
- Department of Pedodontics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
| | - Anushka Deoghare
- Department of Pedodontics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
| | - Keyura Parakh
- Department of Pedodontics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
| | - Rashmi S Lokhande
- Department of Pedodontics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
| | - Swati Malladi
- Department of Pediatrics and Preventive Dentistry, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, Chhattisgarh, India
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Solomonov M, Hadad A, Ben Itzhak J, Lvovsky A, Azizi H. Is a Pre-Existent Cone-Beam Computed Tomography Able to Detect Metal Dental Posts? Dent J (Basel) 2024; 12:229. [PMID: 39057016 PMCID: PMC11276458 DOI: 10.3390/dj12070229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/30/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: In this study, the efficacy of cone-beam computed tomography (CBCT) in detecting dental posts was compared to periapical radiography. (2) Methods: A retrospective evaluation of 53 patients' periapical radiographs and CBCT images was performed. The presence and type of the intra-canal dental post were initially determined on the periapical images (PA) radiographs' examination and were then compared to the observer's ability to detect the dental post on a CBCT image. The effect of the post's type (metal cast or prefabricated) on its detection on CBCT images was determined. (3) Results: 10.5% of teeth that were identified as having a post on a PA radiograph were not identified as having a post on the CBCT examination (p < 0.05). Approximately 17.6% of teeth that were identified as not having a post on a PA radiograph were identified as having a post on the CBCT examination (p < 0.05). Moreover, 16.3% and 50% of teeth with a prefabricated or cast posts on PA radiographs were falsely identified on the CBCT examination, respectively (p < 0.05). (4) Conclusions: A CBCT image is an insufficient tool for the identification of metal prefabricated and cast posts. A PA image is the recommended radiographic tool for achieving information about the post-endodontic restoration status of teeth candidates for endodontic retreatment in patients with a former CBCT scan.
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Affiliation(s)
- Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Alex Lvovsky
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
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Alhumaidi AM, Mirza MB, Karobari MI, Abuelqomsan MA, Hashem Q, Aldaijy MT, Albarr NY, Aldaijy RT, Al Moaleem M. Classifying the internal anatomy of anterior teeth in the Yemeni population using two systems: a retrospective CBCT study. Odontology 2024:10.1007/s10266-024-00965-7. [PMID: 38935196 DOI: 10.1007/s10266-024-00965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
A precursor for effective root canal treatment (RCT) is a complete understanding of the internal anatomy of teeth. In this study, the authors aimed to classify the root canal morphology of anterior teeth in the Yemeni population and identify gender-based variations among them. In addition, the symmetry among adjacent quadrants was also evaluated. Cone beam computed tomography (CBCT) scans of 2935 anterior teeth, 1502 maxillary, and 1433 mandibular were analyzed for root canal morphology and symmetry. Comparison between groups and among different genders was done using the Chi-square test. All the maxillary teeth were single-rooted and had a predominantly 1TN1 (Vertucci Type I) canal morphology. In addition to 1TN1, the presence of 1TN1-2-1 (Vertucci type III) and 1TN1-2-1-2-1 (not classified NC according to Vertucci) morphologies were noticed in the maxillary canines. Among the mandibular anteriors, the canal morphologies identified include 1TN1 in majority of the scans followed by 1TN2-1 (Vertucci II), 1TN1-2-1, 1TN1-2 (Vertucci V), 1TN1-2-1-2 (Vertucci VII) was seen only in incisors and newer canal types like 1TN2-1-2-1 (NC Vertucci) and 1TN1-2-1-2-1 (NC Vertucci) was seen in canines and lateral incisors. Two roots were only seen in the mandibular canines and classified as 2TN1-2 (NC Vertucci). Variations in root and root canal morphologies were seen among both genders. However, the results were not significant. All the maxillary teeth except 0.8% were bilaterally symmetrical. In mandible, symmetry ranged between 84.5 and 86.5%. In conclusion, single-rooted teeth with 1TN1 classification are most commonly seen in all the anterior teeth. Gender-based differences were non-significant, and bilateral symmetry was high. Ahmed et al. classification could precisely represent the root canal morphology in two rooted teeth.
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Affiliation(s)
| | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia.
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Mohammed Ali Abuelqomsan
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | - Qamar Hashem
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | - Mohammed Al Moaleem
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Moss D, Nuni E, Slutzky H, Moreinos D, Slutzky-Goldberg I. The Outcome of Decoronation in Severe Cases of External Cervical Root Resorption in Young Patients. Cureus 2024; 16:e62853. [PMID: 39036151 PMCID: PMC11260440 DOI: 10.7759/cureus.62853] [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: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
This study examines decoronation as a treatment option for teeth with progressive external cervical root resorption (ECR). Six young patients aged 9.5-13, with a total of nine incisor teeth affected by ECR due to previous dental trauma, were treated by decoronation. Six teeth were classified as class 4 and two as class 3, according to Heithersay's classification. Another tooth with class 2 resorption also had a perforation. After decoronation, all cases showed favorable outcomes during a follow-up period of 2.5-8 years. The procedure halted the progression of ECR and promoted vertical and horizontal ridge development above the submerged root. Decoronation can be considered for the successful treatment of advanced cases of ECR in young patients.
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Affiliation(s)
- Dina Moss
- Department of Endoodntics, Hebrew University Hadassah School of Dental Medicine, Jerusalem, ISR
| | - Eyal Nuni
- Department of Endodontics, Galilee College of Dental Sciences, Nahariya, ISR
| | - Hagay Slutzky
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, ISR
| | - Daniel Moreinos
- Department of Endodontics, Galilee College of Dental Sciences, Nahariya, ISR
- Faculty of Medicine, Bar Ilan University, Sefad, ISR
| | - Iris Slutzky-Goldberg
- Department of Endodontics, Galilee College of Dental Sciences, Nahariya, ISR
- Faculty of Medicine, Bar Ilan University, Sefad, ISR
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Xiang Y, Wu Z, Yang L, Zhang W, Cao N, Xu X, Lin Y. Morphology and classification of the second mesiobuccal canal in maxillary first molars: a cone-beam computed tomography analysis in a Chinese population. BMC Oral Health 2024; 24:568. [PMID: 38745216 PMCID: PMC11094936 DOI: 10.1186/s12903-024-04363-x] [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: 12/11/2023] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Understanding the tooth anatomy is crucial for ensuring effective endodontic treatment. This study investigated the root canal morphology of the second mesiobuccal (MB2) canal in maxillary first molars (MFMs) in a Chinese population using cone-beam computed tomography (CBCT). METHODS This study evaluated 486 MFMs with MB2 canals from 285 participants undergoing CBCT examination and determined the Vertucci's classification and position of the MB2 canal orifice. The prevalence of the MB2 canal was correlated with the sex, age, and tooth side. The correlations between the prevalence of the MB2 canal and sex and tooth side were assessed using the Fisher's exact test. The chi-square test was used for evaluating the correlation between the prevalence of the MB2 canal and age. RESULTS The number of type II, III, IV, V, VI, VII, and other root canals in the MFMs was 30.9%, 0.6%, 65.0%, 1.2%, 1.2%, 0.4%, and 0.6%, respectively. Among the 201 cases with bilateral inclusion, 87.6% showed consistent canal configuration. Results of the first clear apparent position (FCAP) of the MB2 canals showed that 434, 44, and 3 teeth had FCAP at the upper, middle, and bottom one-third of the root, respectively. The FCAPs of the MB2 canal in the MFMs with types II, IV, and VI, as well as types III and V canals showed significant differences (p<0.05). The horizontal distance between the MB1 and MB2 canal orifices in the type II canals of MFMs was significantly lesser than those in the type IV canals of MFMs (p < 0.01). The longitudinal distance between the pulp chamber floor plane and MB2 canal orifice significantly correlated with age (p < 0.05). CONCLUSIONS The morphology of the mesiobuccal root canal in the MFMs is complex. Complete understanding of the anatomical morphology of the root canal combined with the CBCT and dental operating microscope is necessary for the accurate detection of the MB2 canal and consequently improved success rate of root canal treatment. Our study findings can help endodontists improve endodontic treatment outcomes.
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Affiliation(s)
- Yan Xiang
- Endodontics Department of Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China
| | - Zhaojun Wu
- Endodontics Department of Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China
| | - Lvli Yang
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China
- Departments of Dental and Maxillofacial Radiology, Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China
| | - Wei Zhang
- Endodontics Department of Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China
| | - Na Cao
- Endodontics Department of Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China
| | | | - Yao Lin
- Endodontics Department of Stomatological Hospital of Xiamen Medical College, Xiamen, 361008, China.
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Huli District, No. 1309, Lvling Road, Xiamen, 361008, Fujian, China.
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Jang YE, Kim Y, Kim SY, Kim BS. Predicting early endodontic treatment failure following primary root canal treatment. BMC Oral Health 2024; 24:327. [PMID: 38475776 DOI: 10.1186/s12903-024-03974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Understanding when and why endodontic treatments fail could help clinicians make prognoses and thus improve treatment outcomes. This study was aimed to assess potential predictors of early endodontic treatment failure. We explored factors contributing to the failure of initial root canal treatment were explored, with a specific emphasis on evaluating the influence of the time elapsed since the initial treatment. METHODS This retrospective cohort study enrolled 1262 patients who sought endodontic treatment at our department and 175 patients were included for analysis. Potential causes of endodontic treatment failure were investigated, such as inadequate obturation quality, inadequate coronal status, the presence of additional untreated canals, anatomical complexity, instrument separation, iatrogenic perforation, cracks, and endodontic-periodontal lesions. The patients were divided into "short-term" and "long-term" groups depending on the time that had passed since the initial treatment (i.e., < 5 and > 10 years, respectively). The causes of failure in the short-term and long-term group were analyzed and compared using logistic regression analyses. Subgroup analysis was performed according to the number of years since the initial treatment in the short-term group to further investigate the association between the time and cause of failure (i.e., < 1, 2, 3, and 4 years, respectively). RESULTS Untreated additional canals were present in 21.7% of all cases, and in 36.9 and 6.4% of cases in the short-term and long-term groups, respectively. Multivariable analysis showed that the presence of untreated additional canals was significantly associated with short-term compared to long-term failure. Untreated additional canals were also associated with endodontic failure within 1, 2, 3, and 4 years. CONCLUSIONS The presence of untreated additional canals was a predictor of endodontic failure within 5 years following initial root canal treatment. To optimize long-term prognosis, it is important to detect and treat all root canals during the initial treatment.
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Affiliation(s)
- Young-Eun Jang
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Yemi Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| | - Bom Sahn Kim
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
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Kenawi LM, Jaha HS, Alzahrani MM, Alharbi JI, Alharbi SF, Almuqati TA, Alsubhi RA, Elkwatehy WM. Cone-Beam Computed Tomography-Based Investigation of the Prevalence and Distribution of Pulp Stones and Their Relation to Local and Systemic Factors in the Makkah Population: A Cross-Sectional Study. Cureus 2024; 16:e51633. [PMID: 38314002 PMCID: PMC10837681 DOI: 10.7759/cureus.51633] [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: 01/02/2024] [Indexed: 02/06/2024] Open
Abstract
Objectives This study aimed to assess the prevalence and distribution of dental pulp stones and evaluated their possible associations with local and systemic factors in the Makkah population in Saudi Arabia. Materials and methods Archived cone-beam computed tomography (CBCT) images for 390 patients, from the electronic health records (EHR) in the Dental Teaching Hospital, Umm Al-Qura University, were used. Images were examined in all planes (coronal, sagittal, and axial) for a discrete radiopaque mass in the pulp of all teeth, in both arches. The teeth conditions (the presence of caries, restoration, the periodontal condition, and the presence of pulp stones) were recorded. Additional patient information, including age, gender, and medical condition, was obtained from the patients' archived files. The collected data were statistically analyzed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY) software; a p-value of ≤ 0.05 is considered statistically significant. Results Pulp stone prevalence was 78.97% of the subjects (308 out of 390) and 15.92% of the examined teeth (1644 out of 10326). There were statistically significant differences regarding nationality (p=0.043) and age (p=0.023) but no significant difference between males and females (p=0.876), maxillary and mandibular teeth (p=0.392), and right and left sides (p=0.222) in pulp stone prevalence. Significant differences were found between pulp stone prevalence of sound versus and carious and restored teeth and between periodontally affected teeth and periodontally healthy teeth (p=0.031). Conclusion The prevalence of pulp stones in the Makkah population is high. A positive association was found between nationality, age, tooth restorations, caries, periodontal diseases, and pulp stone prevalence, but no correlation was found with patients' health or gender. The molars were the most affected teeth, while the incisors were the least.
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Affiliation(s)
- Laila M Kenawi
- Department of Restorative Dentistry, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, EGY
| | - Haytham S Jaha
- Department of Restorative Dentistry, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Jihan I Alharbi
- Department of Dentistry, Umm Al-Qura University, Makkah, SAU
| | | | - Taif A Almuqati
- Department of Dentistry, Umm Al-Qura University, Makkah, SAU
| | - Rehab A Alsubhi
- Department of Dentistry, Umm Al-Qura University, Makkah, SAU
| | - Wahdan M Elkwatehy
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, EGY
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Karobari MI, Alam BF, Bashir R, Fahim MF, Mirza MB, Noorani TY. Bibliometric analysis: Root and root canal morphology using cone-beam computed tomography. Clin Exp Dent Res 2023; 9:1156-1168. [PMID: 37877522 PMCID: PMC10728536 DOI: 10.1002/cre2.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/25/2023] [Accepted: 10/07/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVES This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning scientific publications based on root and root canal morphology using the CBCT. MATERIAL AND METHODS For this bibliometric analysis, an extensive search was carried out on September 25, 2023 using the Scopus database. Pertinent articles in the field were scrutinized after applying inclusion and exclusion criteria. Data were evaluated using Vosviewer and Microsoft Excel. RESULTS A literature search revealed the initiation of scientific publication in 2008. Significant contributions made by Saudi Arabia, India, and China concerning the number of publications were seen. Similarly, Jazan University from SA was recognized as the leading institute. The Journal of Endodontics was the leading journal, while authors JNR Martins and G Gambarini produced the highest number of papers. CONCLUSIONS This bibliometric analysis demonstrated that scientific publications have increased tremendously since 2008. Significant contributions have been made by developing and developed nations. The Journal of Endodontics and Jazan University have been identified as the leading journal and institute.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
| | | | - Raima Bashir
- Department of Oral BiologyBahria University Dental CollegeKarachiPakistan
| | | | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of DentistryPrince Sattam bin Abdulaziz UniversityAl‐KharjSaudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental SciencesUniversiti Sains MalaysiaKota BharuKelantanMalaysia
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10
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Zhang MM, Fang GF, Wang ZH, Liang YH. Clinical Outcome and Predictors of Endodontic Microsurgery Using Cone-beam Computed Tomography: A Retrospective Cohort Study. J Endod 2023; 49:1464-1471. [PMID: 37633517 DOI: 10.1016/j.joen.2023.08.011] [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: 06/05/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION The aim of this retrospective cohort study was to evaluate the clinical outcomes and identify the prognostic factors of endodontic microsurgery based on cone-beam computed tomographic (CBCT) scans. METHODS Patients who underwent endodontic microsurgery in teeth with asymptomatic apical periodontitis were included. The clinical outcomes were determined based on clinical and radiographic examinations after surgery 12-48 months. Radiographic healing was assessed on CBCT images by using the modified PENN 3-dimensional criteria and classified into 4 categories: complete, limited, uncertain, and unsatisfactory healing. Multivariate logistic regression was performed to detect outcome risk factors. RESULTS Of the 204 teeth in 173 invited patients, 148 teeth of 126 patients were examined at review. On CBCT images, 88 teeth (59.5%) showed complete healing, and 42 (28.4%) teeth showed limited healing. All these 130 teeth were asymptomatic and achieved a clinical success rate of 87.8%. Uncertain healing was observed in 9 teeth, one of which was symptomatic. The remaining 9 teeth were unsatisfactory healing on CBCT scans, including 6 teeth with clinical symptoms and 3 free. Lesion type and root-end filling quality were significant outcome predictors (P < .05). The risk of treatment failure for teeth with combined endodontic-periodontal lesions was 8.6 times higher than that for teeth with isolated endodontic lesions. Adequate root-end filling quality improved the probability of success by 5.3 times. CONCLUSIONS Based on CBCT data, an adequate performed endodontic microsurgery could have predictable success in teeth without periodontal involvement.
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Affiliation(s)
- Ming-Ming Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Gao-Feng Fang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Zu-Hua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China; Department of Stomatology, Peking University International Hospital, Beijing, China.
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11
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Haupt F, Wiegand A, Kanzow P. Risk factors for and clinical presentations indicative of vertical root fracture in endodontically treated teeth - a systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00323-0. [PMID: 37307871 DOI: 10.1016/j.joen.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The aim of this study was to identify specific clinical signs or symptoms and potential risk factors which are most likely associated with the presence of a vertical root fracture (VRF) in endodontically treated teeth (ETT). METHODS Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Scopus, and Web of Science) were searched by two reviewers in October 2022 for clinical studies, in which at least either the clinical presentation or potential risk factors associated with a VRF were assessed. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analyses of odds ratios (ORs) were performed separately for several signs or symptoms and risk factors. RESULTS Fourteen sources reporting on 2,875 teeth (489 with VRF and 2,388 without VRF) were included in the meta-analyses. Regarding the clinical presentation, the presence of sinus tracts (OR=4.87; 95%-CI: 1.58-15.0), increased periodontal probing depths (OR=13.24; 95%-CI: 5.44-32.22), swelling/abscess (OR=2.86; 95%-CI: 1.74-4.70), and tenderness to percussion (OR=1.74; 95% CI: 1.18-2.61) were significantly associated with the presence of a VRF (Padj. value<.05). None of the assessed risk factors (sex, type of teeth, tooth location, posts, indirect restoration, apical extension of the root canal filling), were found to be significantly associated with the presence of a VRF (Padj. value>.05). CONCLUSIONS Four clinical presentations were identified to be the most significant signs or symptoms for a VRF in ETT: presence of sinus tracts, increased probing depths, swelling/abscess, tenderness to percussion. None of the assessed risk factors pointed out to be significantly associated with a VRF. REGISTRATION CRD42022354108 (PROSPERO).
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
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12
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Chen C, Zhu T, Wu H, Zhao X, Leng D, Wang J, Yang L, Wu D. Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals. Sci Rep 2022; 12:19779. [PMID: 36396689 PMCID: PMC9671964 DOI: 10.1038/s41598-022-24381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).
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Affiliation(s)
- Cheng Chen
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Tingting Zhu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Lianfeng Yang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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13
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Alnaqbi HS, Gorduysus MO, Al Shehadat S, Al Bayatti SW, Mahmoud I. Evaluation of Variations in Root Canal Anatomy and Morphology of Permanent Maxillary Premolars among the Emirate Population using CBCT. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2208152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Many types of research have revealed that root canal anatomy differs by race and country based on various national populations, but no study has been conducted on the UAE population.
Objectives:
Identifying the most common morphology of the upper premolars in a group of local and non-local people in the UAE.
Methods:
Cone-beam computed tomography (CBCT) images of 215 intact maxillary premolars were analyzed. The Pearson Chi-squared test and the two samples t-test were applied.
Results:
Most of the maxillary first premolars were two-root formed (90%). Single-rooted teeth were less common (8%). Three-rooted maxillary first premolars represented a low frequency of 1.9%. Most of the maxillary second premolar teeth studied in this research (52%) had two roots. Almost all local and non-local populations had two canals for both first and second maxillary premolar. Only two maxillary first premolars (0.2%) had the three-canal morphology. The most frequent canal morphology in the maxillary first premolar group among local UAE and non-local was type V. The maxillary second premolar group among local UAE was type II (32%). In non-local UAE, type V (25%). In addition, six types of uncommon canal anatomic variants (types 1-2-3, 2-3-2, 3-2-1, 1-2-3-2, 2-1-2-1, and 3-2) were discovered in 3.7% of local UAE and 36.3% of non-local UAE.
Conclusion:
The results suggest a more quantitative approach to maxillary first and second premolar access cavity preparation in the UAE population to prevent errors and iatrogenic damage when identifying the canals.
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14
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Alhujhuj RR, Jouhar R, Ahmed MA, Almujhim AA, Albutayh MT, Adanir N. Evaluation of Root Canal Configuration of Maxillary and Mandibular First Molar by CBCT: A Retrospective Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12092121. [PMID: 36140523 PMCID: PMC9497805 DOI: 10.3390/diagnostics12092121] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/04/2022] Open
Abstract
Adequate knowledge of root canal morphology along with its probable variations is imperative to acquire successful endodontic treatment. This retrospective cross-sectional study aimed to investigate the root canal configuration of maxillary and mandibular first molar using Cone-Beam Computed Tomography (CBCT) among patients in Al-Ahsa region, Saudi Arabia. A total of 377 samples were included, out of which 123 CBCT (I-CAT Vision QTM) scans with intact all first permanent molars were selected in this study and scanned in sagittal, axial, and coronal views by using BlueSkyPlan software. The number of canals in each root and their configuration according to the Vertucci classification system was evaluated. Statistical analysis was analyzed using SPSS version 21 (IBM). Chi-square test was applied to evaluate the association of root canal morphology and mandibular and maxillary first molars with respect to gender. Out of 123 CBCT scans, 59 (48.0%) were males and 64 (52.0%) were females; the mean age was 26.95 ± 10.65 years. The mesiobuccal root of bilateral maxillary first molar had Type-I (87.0%) of Vertucci classification followed by Type-IV (9.8%). Additionally, all mesiobuccal roots (100%) of the left mandibular first molar had Type-I of Vertucci’s classification. A significant association has been observed between gender and a number of canals in bilateral maxillary first molars. Females showed a significantly higher prevalence of three-root canal configuration in maxillary first molars of both sides compared four canals found most commonly in males (p = 0.004). This study concluded that the majority of maxillary and mandibular permanent first molars had three roots and three canals with Type-I Vertucci’s classification in patients belonging to the Al-Ahsa region of the Saudi Arabia. It was also proved that gender is significantly associated with the number of canals in a bilateral maxillary molar.
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15
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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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16
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Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique. Case Rep Dent 2022; 2022:3752466. [PMID: 35909436 PMCID: PMC9337978 DOI: 10.1155/2022/3752466] [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: 04/12/2022] [Accepted: 07/02/2022] [Indexed: 11/17/2022] Open
Abstract
This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.
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17
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Guo J, Wu Y, Chen L, Long S, Chen D, Ouyang H, Zhang C, Tang Y, Wang W. A perspective on the diagnosis of cracked tooth: imaging modalities evolve to AI-based analysis. Biomed Eng Online 2022; 21:36. [PMID: 35706023 PMCID: PMC9202175 DOI: 10.1186/s12938-022-01008-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Despite numerous clinical trials and pre-clinical developments, the diagnosis of cracked tooth, especially in the early stages, remains a challenge. Cracked tooth syndrome is often accompanied by dramatic painful responses from occlusion and temperature stimulation, which has become one of the leading causes for tooth loss in adults. Current clinical diagnostical approaches for cracked tooth have been widely investigated based on X-rays, optical light, ultrasound wave, etc. Advances in artificial intelligence (AI) development have unlocked the possibility of detecting the crack in a more intellectual and automotive way. This may lead to the possibility of further enhancement of the diagnostic accuracy for cracked tooth disease. In this review, various medical imaging technologies for diagnosing cracked tooth are overviewed. In particular, the imaging modality, effect and the advantages of each diagnostic technique are discussed. What's more, AI-based crack detection and classification methods, especially the convolutional neural network (CNN)-based algorithms, including image classification (AlexNet), object detection (YOLO, Faster-RCNN), semantic segmentation (U-Net, Segnet) are comprehensively reviewed. Finally, the future perspectives and challenges in the diagnosis of the cracked tooth are lighted.
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Affiliation(s)
- Juncheng Guo
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yuyan Wu
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Lizhi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Shangbin Long
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Daqi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Haibing Ouyang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Chunliang Zhang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yadong Tang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Wenlong Wang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China.
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18
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Alaugaily I, Azim AA. CBCT Patterns of Bone Loss and Clinical Predictors for the Diagnosis of Cracked Teeth and Teeth with Vertical Root Fracture. J Endod 2022; 48:1100-1106. [PMID: 35714728 DOI: 10.1016/j.joen.2022.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/16/2022]
Abstract
AIM This study aimed to identify clinical and radiographic characteristics of teeth with longitudinal fractures to assist in the diagnosis and differentiation between cracked teeth and teeth with vertical root fracture (VRF). METHODS Ninety-five patients (95 teeth) diagnosed with a longitudinal fracture (only cracked teeth or VRF) through clinical visualization of the fracture line were included in this study. Clinical and radiographic data were collected from the patients' record to identify the characteristics associated with each condition. Fifty-four patients (54 teeth) had full radiographic [periapical radiograph (PA) and cone-beam computed tomography scan (CBCT)] and clinical findings (probing depths and clinical images of the fracture line). PA and CBCT images were evaluated by two independent examiners to identify the different patterns of bone loss associated with these teeth (no defect, angular defect, J-shaped defect, combined defect). Cohen Kappa analysis was used to compare the results between the two examiners and between the findings of the PA and the CBCT. Pearson's chi-square analysis, fisher exact test, and Adjusted Bonferroni post Hoc testing were used to establish an association between the type and extension of the longitudinal fracture with the probing depth, the CBCT pattern of bony defects, and the presence/absence of the buccal plate. Also, to compare the clinical and radiographic characteristics of cracked teeth and teeth with VRF (P<0.05). RESULTS CBCT images had 4.4 times the odds of detecting bony defects suggestive of longitudinal fractures compared to PA. Teeth with VRF were more associated with indirect restorations, deep probing (>6mm), absence of the cortical plate and a J-shaped defect on the CBCT (P<0.05). Cracked teeth, on the other hand, were associated with direct restorations, shallow probing (<6mm), intact cortical plate, and the presence of an angular defect on the CBCT (P<0.001). There was a significant correlation between a radicular extension of the fracture line and deep probing, as well as J-shaped defects (P<0.05). CONCLUSION Patterns of bone loss on the CBCT can likely differentiate between cracked teeth and teeth with VRF. The presence of an angular defect may suggest the presence of a crack in the tooth prior to intervention. J-shaped defects, deep probing (>6mm), and loss of the cortical plate are likely suggestive of VRF.
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Affiliation(s)
- Ibrahim Alaugaily
- Division of Endodontics, University at Buffalo, School of dental medicine; Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Adham A Azim
- Division of Endodontics, University at Buffalo, School of dental medicine; Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry.
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Alnowailaty Y, Alghamdi F. The Prevalence and Location of the Second Mesiobuccal Canals in Maxillary First and Second Molars Assessed by Cone-Beam Computed Tomography. Cureus 2022; 14:e24900. [PMID: 35698689 PMCID: PMC9185178 DOI: 10.7759/cureus.24900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/05/2022] Open
Abstract
Objective This retrospective study aimed to investigate the prevalence and location of the second mesiobuccal (MB2) canal in the mesiobuccal root of the maxillary first molar (MFM) and the maxillary second molar (MSM) through cone-beam computed tomography (CBCT) imaging. Methods One thousand two hundred CBCT images of the MFM and MSM were divided equally and analyzed. To standardize the methodology of MB2 detection, the observation and measurements were located at the pulpal floor by 1 mm apically. The distances between canals were calculated from the center point of the MB2 canal (PMB2) to the center point of both the first mesiobuccal canal (PMB1) and the palatal canal (PP). The data were provided in the form of frequencies and percentages. The chi-square test was used to analyze the differences among maxillary molars, while the significance level was set at 0.05. Results The prevalence of the MB2 canal in the MFM and MSM was 46.7% (p=0.020) and 17.7% (p=0.457), respectively. Additionally, the prevalence of the MB2 canal was more frequent in females. The average distance between PMB1 and PMB2 for MFM and MSM was 1.87±0.42 mm and 1.24±0.76 mm, respectively. Furthermore, the average distances of PMB2 and PP were 0.74±0.21 mm and 0.43±0.18 mm for MFM and MSM, respectively. Conclusion The MB2 canal was found in 386 (32.2%) of the maxillary molars. The Saudi people have a high possibility of discovering the MB2 canal. The CBCT is a useful and high-precision diagnostic tool not only for detecting but also for locating in vivo MB2 canal in the mesiobuccal root of maxillary molars.
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20
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Mavridou AM, Rubbers E, Schryvers A, Maes A, Linssen M, Barendregt DS, Bergmans L, Lambrechts P. A clinical approach strategy for the diagnosis, treatment and evaluation of external cervical resorption. Int Endod J 2022; 55:347-373. [PMID: 35034370 DOI: 10.1111/iej.13680] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Abstract
AIM To propose a clinical approach strategy on the diagnosis, treatment, and evaluation of external cervical tooth resorption (ECR) cases. To investigate and discuss the outcome of this approach. METHODOLOGY A clinical approach strategy on ECR was developed based on a retrospective observation study of 542 teeth. 47 teeth were excluded due to lack of clinical/radiographical information, and 182 were immediately extracted. This approach had three steps: diagnosis, treatment planning, and evaluation. During diagnosis, the medical, dental history and clinical/radiographical characteristics were evaluated. Depending on the resorption extent, ECR cases were categorized into four classes according to Heithersay's classification. During treatment planning, a treatment decision flowchart was prepared based on four main decisive criteria: probing feasibility, pain, location and extent of resorption (class), and existence of bonelike tissue. Three treatment options were applied: a) extraction, b) monitoring, or c) conservative treatment by external, internal, or combination of internal-external treatments. During evaluation, assessment of ECR progression, tooth survival and other factors like esthetics and periodontal attachment were performed. Descriptive statistical analysis of the outcome for up to ten years (for the overall clinical approach and for each individual treatment decision), was carried out with OriginLabs OriginPro 9 and Microsoft Excel 365. RESULTS A three-step strategy was developed on how to deal with ECR cases. Indicative examples of each treatment decision were presented and discussed. The overall survival rate of this strategy was 84.6% (3 years), 70.3% (5 years), 42.7% (8 years) and 28.6% (10 years). Higher survival rate was observed for external treatment decision than for internal. The success of each treatment decision depended on the extent of the resorption (class). The success of a treatment decision should be based on the long-term outcome, as a different evolution can be observed with time. CONCLUSIONS A clinical approach strategy was introduced on ECR pathosis. This strategy was not solely based on ECR class, as other important decisive criteria were considered. This step-wise approach, has a 70.3% survival rate with a mean of 5 years. This work will hopefully provide an incentive for a broader collaboration, to potentially establish a universally accepted ECR treatment strategy.
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Affiliation(s)
- A M Mavridou
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium.,Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - E Rubbers
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - A Schryvers
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - A Maes
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - M Linssen
- Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - D S Barendregt
- Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - L Bergmans
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - P Lambrechts
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
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Al-Mahroos NE, Al-Mahroos SE, Al-Shahrani S. Management of mandibular premolars with various C-shaped root canal configurations: A case series. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_27_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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22
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Ferreira MD, Barros-Costa M, Costa FF, Freitas DQ. The prevalence and characteristics of external cervical resorption based on cone-beam computed tomographic imaging: a cross-sectional study. Restor Dent Endod 2022; 47:e39. [DOI: 10.5395/rde.2022.47.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Matheus Diniz Ferreira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Matheus Barros-Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Felipe Ferreira Costa
- Department of Oral Diagnosis, São Paulo Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Alkadi M, Almohareb R, Mansour S, Mehanny M, Alsadhan R. Assessment of dens invaginatus and its characteristics in maxillary anterior teeth using cone-beam computed tomography. Sci Rep 2021; 11:19727. [PMID: 34611255 PMCID: PMC8492853 DOI: 10.1038/s41598-021-99258-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/22/2021] [Indexed: 01/01/2023] Open
Abstract
This cone-beam computed tomographic (CBCT) study aimed to evaluate the prevalence of dens invaginatus (DI) and its characteristics in maxillary anterior teeth in a Saudi population. A total of 505 CBCT scans were evaluated, including a total of 2790 maxillary anterior teeth. The patients' demographic data, including age and sex, were recorded. The presence of DI and the related characteristics including bilateral occurrence; DI type according to Oehlers classification; and presence of periapical radiolucency, open apex, and/or nearby impacted teeth were analyzed. The associations between DI and the other factors were analyzed using the chi-square and fisher exact tests. DI was detected in 7.3% of the patients and 1.6% of the teeth examined. Most of the DI-affected teeth were maxillary lateral incisors (76.1%), followed by mesiodens (19.6%) and maxillary central incisors (4.3%), while no DI was observed in the maxillary canines. Bilateral DI was found in 24.3% of the affected patients. Oehlers type I DI was the most frequent (80%). Periapical radiolucencies, open apices, and nearby impacted teeth were observed in 10.9%, 4.3%, and 30% of the invaginated teeth, respectively. DI was significantly associated with tooth type (P < 0.0001) but not with sex (P > 0.05). Although most of the DI cases are limited to the crown, CBCT imaging is essential for DI evaluation and management.
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Affiliation(s)
- Manal Alkadi
- Division of Endodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rahaf Almohareb
- Division of Endodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Soad Mansour
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohamed Mehanny
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Raed Alsadhan
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Sherwood AA, Sherwood AI, Setzer FC, K SD, Shamili JV, John C, Schwendicke F. A Deep Learning Approach to Segment and Classify C-Shaped Canal Morphologies in Mandibular Second Molars Using Cone-beam Computed Tomography. J Endod 2021; 47:1907-1916. [PMID: 34563507 DOI: 10.1016/j.joen.2021.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The identification of C-shaped root canal anatomy on radiographic images affects clinical decision making and treatment. The aims of this study were to develop a deep learning (DL) model to classify C-shaped canal anatomy in mandibular second molars from cone-beam computed tomographic (CBCT) volumes and to compare the performance of 3 different architectures. METHODS U-Net, residual U-Net, and Xception U-Net architectures were used for image segmentation and classification of C-shaped anatomies. Model training and validation were performed on 100 of a total of 135 available limited field of view CBCT images containing mandibular molars with C-shaped anatomy. Thirty-five CBCT images were used for testing. Voxel-matching accuracy of the automated labeling of the C-shaped anatomy was assessed with the Dice index. The mean sensitivity of predicting the correct C-shape subcategory was calculated based on detection accuracy. One-way analysis of variance and post hoc Tukey honestly significant difference tests were used for statistical evaluation. RESULTS The mean Dice coefficients were 0.768 ± 0.0349 for Xception U-Net, 0.736 ± 0.0297 for residual U-Net, and 0.660 ± 0.0354 for U-Net on the test data set. The performance of the 3 models was significantly different overall (analysis of variance, P = .000779). Both Xception U-Net (Q = 7.23, P = .00070) and residual U-Net (Q = 5.09, P = .00951) performed significantly better than U-Net (post hoc Tukey honestly significant difference test). The mean sensitivity values were 0.786 ± 0.0378 for Xception U-Net, 0.746 ± 0.0391 for residual U-Net, and 0.720 ± 0.0495 for U-Net. The mean positive predictive values were 77.6% ± 0.1998% for U-Net, 78.2% ± 0.0.1971% for residual U-Net, and 80.0% ± 0.1098% for Xception U-Net. The addition of contrast-limited adaptive histogram equalization had improved overall architecture efficacy by a mean of 4.6% (P < .0001). CONCLUSIONS DL may aid in the detection and classification of C-shaped canal anatomy.
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Affiliation(s)
- Adithya A Sherwood
- Mahatma Montessori Matriculation Higher Secondary School, Madurai, Tamil Nadu, India
| | - Anand I Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India.
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Sheela Devi K
- Mahatma Montessori Matriculation Higher Secondary School, Madurai, Tamil Nadu, India
| | - Jasmin V Shamili
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - Caroline John
- Department of Computer Science, Hal Marcus College of Science and Engineering, University of West Florida, Pensacola, Florida
| | - Falk Schwendicke
- Department of Oral Diagnostics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Talpos-Niculescu RM, Nica LM, Popa M, Talpos-Niculescu S, Rusu LC. External cervical resorption: Radiological diagnosis and literature (Review). Exp Ther Med 2021; 22:1065. [PMID: 34434279 PMCID: PMC8353645 DOI: 10.3892/etm.2021.10499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 01/28/2023] Open
Abstract
External cervical resorption (ECR) is a relatively unknown and insidious pathology characterized by the loss of hard dental tissues such as: Enamel, cementum and dentine due to clastic function. It begins as a localized resorptive process that initiates on the area of the root beneath the epithelial attachment and the coronal part of the alveolar process, involving vital and non-vital tissues. Despite the fact that there are several potential predisposing factors related to ECR, its aetiology still remains poorly understood and more research is needed to establish the cause-and-effect relationship of all the etiological factors. Improved radiographic detection using cone-beam computed tomography (CBCT) is required in order to correctly classify and assess this entity. This provides a three-dimensional insight into the lesion, regarding the location, the size, the depth and the circumferential spread of the ECR defect. It also allows establishment of the most efficacious treatment plan and management. The purpose of this literature review is to cover the relevant literature concerning the etiology, pathogenesis, clinical and radiological presentation and management of ECRs (based on the CBCT findings).
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Affiliation(s)
- Roxana-Maria Talpos-Niculescu
- Third Department, Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300070 Timisoara, Romania
| | - Luminita-Maria Nica
- Third Department, Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300070 Timisoara, Romania
| | - Malina Popa
- Second Department, Discipline of Pedodontics, Pediatric Dentistry Research Center, Faculty of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300070 Timisoara, Romania
| | - Serban Talpos-Niculescu
- Second Department, Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy, 300062 Timisoara, Romania
| | - Laura Cristina Rusu
- First Department, Discipline of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, Faculty of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300174 Timisoara, Romania
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Al-Zubaidi SM, Almansour MI, Al Mansour NN, Alshammari AS, Alshammari AF, Altamimi YS, Madfa AA. Assessment of root morphology and canal configuration of maxillary premolars in a Saudi subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2021; 21:397. [PMID: 34389013 PMCID: PMC8364052 DOI: 10.1186/s12903-021-01739-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to use CBCT to look into the root canal morphology of maxillary premolars in a Saudi Arabian subpopulation and associate the results to existing canal morphology classifications. METHODS The sample size for this analysis was 500 right and left untreated maxillary first and second premolars with fully formed roots from 250 Saudi residents (125 male and 125 female). The following observations were made using CBCT on the teeth related: (1) The number and morphology of roots; (2) The canal morphology for each root according to Vertucci's classification. The frequency and similarities between the right and left sides, as well as between females and males, were studied. The Chi-square test was used to assess the results. RESULTS Of the 500 maxillary first premolars studied, 199 teeth had one root (39.8%), whilst 293 (58.6%) were two-rooted. Three-rooted maxillary first premolars were found in 8 (1.6%). For maxillary second premolars, 416 premolars had one root (83.2%), whilst 79 (15.8%) had two roots and the rest 5 (1.0%) were three roots. There were significant differences of number of root were found between groups (p > 0.05). For maxillary first premolar, Type IV was the most frequent, accounting for 57.8% of the sample (n = 289), followed by type II (32.8%, n = 164). For maxillary second premolar, Type I was mainly occurrence 302 (60.4%), followed by Type II (16.4%, n = 82). CONCLUSIONS The majority of maxillary first premolars had two roots and two root canals, while one root and one root canal was the most common anatomical configuration for maxillary second premolars. Additional canal forms do occur on occasion, and clinicians should pay close attention to them.
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Affiliation(s)
- Saad M Al-Zubaidi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
| | - Moazzy I Almansour
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | | | | | - Ahad F Alshammari
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Yazeed S Altamimi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
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Friedlander-Barenboim S, Hamed W, Zini A, Yarom N, Abramovitz I, Chweidan H, Finkelstein T, Almoznino G. Patterns of Cone-Beam Computed Tomography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center. Healthcare (Basel) 2021; 9:1042. [PMID: 34442182 PMCID: PMC8392371 DOI: 10.3390/healthcare9081042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 01/30/2023] Open
Abstract
The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9-86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.
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Affiliation(s)
| | - Wafi Hamed
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Avraham Zini
- Hadassah Medical Center, Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Noam Yarom
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
| | - Itzhak Abramovitz
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Harry Chweidan
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Tamar Finkelstein
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel
| | - Galit Almoznino
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
- Hadassah Medical Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Hadassah Medical Center, Big Biomedical Data Research Laboratory, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
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Sisli SN, Gulen O. Root canal length measurement of molar teeth using conebeam computed tomography (CBCT): comparison of two dimensional versus three-dimensional methods. Eur Oral Res 2021; 55:94-98. [PMID: 34250476 PMCID: PMC8244943 DOI: 10.26650/eor.20210124] [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: 11/02/2019] [Revised: 03/07/2020] [Accepted: 01/22/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: This study aimed to evaluate the validity of 2-dimensional (2D) and 3-dimensional
(3D) cone-beam computed tomographic (CBCT) root canal length measurements
of molar teeth compared with actual root canal lengths and the influence of canal
curvature on the accuracy of CBCT measurements. Materials and methods: Seventy root canals of 24 molar teeth were scanned using CBCT, and the root canals
were categorized as; ‘straight/curved,’ ‘highly curved,’ and ‘multiple curved.’ The 2D
measurements were performed within a suitable slice between the major foramen
and the corresponding cusp. The 3D measurements were performed within the
slices in regular intervals of axial planes in between the same reference points.
The reproducibility and reliability of the methods were analyzed by intraclass
correlation coefficient. Differences between the actual and CBCT root canal lengths
were evaluated by chi-square and McNemar tests if the measurements were within
acceptable limits of ±0.5 mm. Results: Both methods were found to be reproducible and presented excellent reliability.
However, the 3D method was significantly more accurate, with an 85.7% frequency
of measurements within acceptable limits (p<0.05). In ‘multiple curved’ root canals,
the 3D method presented more reliable measurements than the 2D method. For
‘straight/curved’ root canals, the 2D method gave results significantly closer to the
actual root canal length in comparison with ‘highly curved’ root canals (p<0.05). Conclusion: The 3D measurements are more accurate than 2D measurements. If an already
existing CBCT is present, it could be an alternative method for predetermination of
root canal lengths in molar teeth.
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Affiliation(s)
- Selen Nihal Sisli
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Orhan Gulen
- Dentomaxillofacial Radiology, DentisTomo Private Imaging Center, AnkaraTurkey
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KOŞAR T, GÜNAÇAR DN, KÖSE T. Three-Dimensional Volumetric/ Linear Analysis and Axial Classification of Root Resorptions Using Cone Beam Computed Tomography: A Retrospective Study. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.890067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Miyashita H, Asaumi R, Sakamoto A, Kawai T, Igarashi M. Root canal sealers affect artifacts on cone-beam computed tomography images. Odontology 2021; 109:679-686. [PMID: 33550479 DOI: 10.1007/s10266-021-00590-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to evaluate the appearance of artifacts by four types of root canal filling sealers on cone-beam computed tomography (CBCT) images. Thirty standardized tooth models were given the radiopacity equivalent to human teeth, and root canal preparation was performed using WaveOne Gold. Root canal filling by a single-point method was performed using WaveOne Gold gutta-percha points and four types of root canal sealers: AH Plus (AH), CANALS (CA), BioRoot RCS (BR), and MTA Fillapex (MTA). Samples were taken by periapical radiography at 60 kV and scanned by CBCT at three tube voltages (70, 85, and 100 kV). The gray-scale values (GVs) of the periapical radiographs were measured and the aluminum equivalents were calculated. On the CBCT axial images, the artifact and dentin area GVs were measured and the rate of change in the GV (RCGV) was calculated as follows: RCGV (%) = (dentin area GV - artifact GV)/dentin area GV × 100. High-density areas with artifacts on the CBCT images were also measured. On the periapical radiographs, the aluminum equivalent was largest for AH and smallest for MTA. On the CBCT images, AH showed the largest values for both RCGV and the high-density areas, while BR and MTA showed comparable values. Correlations were found between the radiopacity on the periapical radiographs and the degree of artifacts on the CBCT images. These findings suggest that the greater the contrast in the 2D image, the higher the artifacts in the 3D image.
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Affiliation(s)
- Hazuki Miyashita
- Department of Endodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.
| | - Rieko Asaumi
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Ayaka Sakamoto
- Radiographic Laboratory, The Nippon Dental University Hospital, Tokyo, Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Masaru Igarashi
- Department of Endodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
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Use of Cone Beam Computed Tomography for Identification of a Distant Causative Tooth: An Unusual Case of an Apical Lesion from a Maxillary Premolar Mimicking That from Maxillary Incisors. Case Rep Dent 2021; 2020:8830524. [PMID: 33489383 PMCID: PMC7790565 DOI: 10.1155/2020/8830524] [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: 09/02/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
The article describes an unusual case of an apical lesion at the first premolar with spontaneous pain and swelling around the root and tooth mobility at the maxillary right central and lateral incisors. The patient was a 45-year-old man with a chief complaint of discomfort at the maxillary right central and lateral incisors for one year. Oral examination showed spontaneous pain, swelling, and tooth mobility of the maxillary right central and lateral incisors. Intraoral and panoramic radiographs showed clear apical radiolucency at these sites, although there were no carious incisors. Neither tooth had periodontal pockets, and there was no bleeding on probing sites. A cold thermal examination revealed normal responses of the vital dental pulp. Initial panoramic radiography showed an apical lesion of the maxillary right first premolar, which was root filled and without inflammatory symptoms. A cone beam computed tomography (CBCT) revealed that the apical lesion of the premolar had extensively spread to the anterior through the palatal side, circumventing the palatal side of the adjacent canine, and reached the apical areas of the central and lateral incisors. We treated the apical lesion of the first premolar, and the radiolucent regions had almost disappeared after three years with regard to not only the apical lesion in the first premolar and incisors but also the primary symptoms on the incisors without endodontic treatment. This case shows that CBCT is an effective alternative that allows appropriate treatment to be selected more reliably.
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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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Bunn DL, Corrêa M, Dutra KL, Schimdt TF, Teixeira CDS, Garcia LDFR, Bortoluzzi EA. Accuracy of Cone-Beam Computed Tomography in Measuring the Thickness of Radicular Dentin. Braz Dent J 2020; 31:516-522. [PMID: 33146336 DOI: 10.1590/0103-6440202002938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/02/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to evaluate the accuracy of Cone-Beam Computed Tomography (CBCT) in measuring radicular dentin thickness focused on intraradicular post placement planning treatment. Ten single-rooted human premolars were selected. The teeth were divided into three segments (cervical, middle and apical). The coronal face of the apical and middle sections was selected for the dentin thickness assessment; which was measured from the external root surface to the root canal wall, on the buccal, lingual, mesial, and distal surfaces of each tooth. In situ anatomical measurement was the reference standard, and the corresponding axial CBCT imaging were evaluated by the i-CAT software. The one-way ANOVA test and the Bonferroni post hoc test were applied to compare the groups (p>0.05). CBCT imaging measurements (p=0.003) overestimated the radicular dentin thickness compared to the reference standard. Descriptive analysis showed that the greatest difference between the reference standard and the tomographic measurement means were 0.20 mm. One-way ANOVA test found the statistical significant difference among group's measurements. Bonferroni correction demonstrated statistically significant difference only related lingual surface for the CBCT imaging measurements. CBCT imaging measurements overestimated the radicular dentin thickness. However, the measurement difference was clinically acceptable.
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Affiliation(s)
- Daiana Lopes Bunn
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Márcio Corrêa
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Kamile Leonardi Dutra
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Tamer Ferreira Schimdt
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Cleonice da Silveira Teixeira
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Manigandan K, Ravishankar P, Sridevi K, Keerthi V, Prashanth P, Pradeep Kumar AR. Impact of dental operating microscope, selective dentin removal and cone beam computed tomography on detection of second mesiobuccal canal in maxillary molars: A clinical study. Indian J Dent Res 2020; 31:526-530. [PMID: 33107451 DOI: 10.4103/ijdr.ijdr_353_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Maxillary molars may frequently require root canal therapy and can have complex anatomy. It is important to locate and treat the second mesiobuccal canal to significantly improve prognosis. Aim of the Study The purpose of this study was to evaluate direct vision, dental operating microscope (DOM), selective dentin removal under DOM, and cone beam computed tomography (CBCT) in clinical detection of second mesiobuccal root canal (MB2) in maxillary molars. Materials and Methods A total of 122 maxillary first and second molars indicated for root canal treatment were included in our study. Following access cavity preparation, the presence of MB2 canal orifice was assessed in four stages. Stage I: with direct vision. Stage II: under DOM, Stage III: after selective dentin removal under DOM and Stage IV: teeth in which MB2 canal was not identified by Stage III were further investigated with CBCT. The number of canals identified during each stage was analyzed statistically. Results Clinical detection of MB2 canal in our study was 90%, with 93% in maxillary first molar and 86% in maxillary second molar. 64% MB2 canals were located at Stage I (direct vision) which improved to 84% at Stage II (under DOM) and 90% at Stage III (selective dentin removal under DOM). CBCT investigation (Stage IV) further improved the identification of MB2 canal leading to overall prevalence of 93%. Conclusion The results of our study demonstrated that MB2 canal can be clinically detected in up to 90% of maxillary molars by the use of DOM and selective dentin removal. CBCT investigation is indicated when MB2 canals are not clinically detected.
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Affiliation(s)
- Kuzhanchinathan Manigandan
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Periasamy Ravishankar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, Tamil Nadu, India
| | - Krishnamoorthy Sridevi
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, Tamil Nadu, India
| | - Venkatesan Keerthi
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, Tamil Nadu, India
| | - Prakash Prashanth
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, Tamil Nadu, India
| | - Angambakkam Rajasekaran Pradeep Kumar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, Tamil Nadu, India
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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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A Rare Case of Single-Rooted Mandibular Second Molar with Single Canal. Case Rep Dent 2020; 2020:8096539. [PMID: 32607261 PMCID: PMC7315308 DOI: 10.1155/2020/8096539] [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: 01/04/2020] [Revised: 04/22/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022] Open
Abstract
The root canal anatomy of mandibular second molar teeth is known to be highly variable. Whilst the most frequently seen configuration is two mesial canals and one distal canal, other variations such as four canals, two canals, and C-shaped canal system do also exist. This case report describes the diagnosis and management of unusual root canal configuration of a mandibular second molar, with one canal in a single conical root, using the contemporary advancements in endodontics. Following clinical and radiographic examinations of the case, a diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis of tooth #47 was established, and root canal treatment followed by composite buildup and crown were planned. Clinicians should be aware of the different anatomic variants each tooth may exhibit. Furthermore, clinicians need to possess the proper knowledge and skills that allow them to utilize the diagnostic and therapeutic tools available at their disposal in order to optimize the quality of care provided to their patients.
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Schürz A, Gehrig H, Schuessler DL, Mente J. Preservation of a Split Tooth: Nonsurgical Clinical Management. J Endod 2020; 46:1002-1008. [DOI: 10.1016/j.joen.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/28/2020] [Accepted: 03/08/2020] [Indexed: 11/29/2022]
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Davide M, Hagay S, Michela B, Claudia D, Elisabetta C. The effectiveness of ultrasound examination to assess the healing process of bone lesions of the jaws: a systematic review. Clin Oral Investig 2020; 24:3739-3747. [PMID: 32418014 DOI: 10.1007/s00784-020-03339-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the potential of ultrasound examination (USE) as an adjunctive method to conventional radiology to evaluate the healing processes occurring after the treatment of bone lesions of the jaws. The research question was: what is the effectiveness of USE to evaluate the healing of intra-osseous bone lesions when compared to radiological or clinical examination? MATERIALS AND METHODS Six databases (PubMed, the Web of Science, Scopus, Embase, the Cochrane Library, and Best Evidence) were searched from their inception (PROSPERO CRD42019134482). A quality assessment was performed combining the Downs and Black tool and the Newcastle-Ottawa scale. The risk of bias was calculated using the Cochrane collaboration tool to assess the risk of bias. RESULTS A total of 4404 records were screened, and 7 studies meeting the inclusion criteria were included in the systematic review. USE allowed to evaluate the healing of jaw bone lesions by assessing their reduction in size, the increase in echogenicity of the affected area, and the progressive decrease\disappearance of the vascular flow signal within the lesions. CONCLUSIONS USE implemented with color power Doppler is an advanced imaging technique feasible to monitor the early and long-term response of the intra-osseous lesions of the jaws to both surgical and nonsurgical treatment. CLINICAL RELEVANCE This systematic review brought evidence that USE can constitute a safe alternative imaging technique in the dental clinical practice for the management of central lesions of the maxillary bones.
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Affiliation(s)
- Musu Davide
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy.
| | - Shemesh Hagay
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Boccuzzi Michela
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
| | - Dettori Claudia
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
| | - Cotti Elisabetta
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
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39
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Mena Álvarez J, Zubizarreta Macho Á. Applications of CBCT in Endodontics. Oral Dis 2020. [DOI: 10.5772/intechopen.89956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Martins JN, Marques D, Silva EJNL, Caramês J, Mata A, Versiani MA. Second mesiobuccal root canal in maxillary molars—A systematic review and meta-analysis of prevalence studies using cone beam computed tomography. Arch Oral Biol 2020; 113:104589. [DOI: 10.1016/j.archoralbio.2019.104589] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 12/19/2022]
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41
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Pereira B, Martins JNR, Baruwa AO, Meirinhos J, Gouveia J, Quaresma SA, Monroe A, Ginjeira A. Association between Endodontically Treated Maxillary and Mandibular Molars with Fused Roots and Periapical Lesions: A Cone-beam Computed Tomography Cross-sectional Study. J Endod 2020; 46:771-777.e1. [PMID: 32299702 DOI: 10.1016/j.joen.2020.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 02/20/2020] [Accepted: 03/01/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Fused root variations of the root canal system increase the complexity of the inner root canal system anatomy. The aim of the present study was to determine, in in vivo conditions, the proportion of periapical lesions in association with endodontically treated maxillary and mandibular molars with fused roots presenting previous root canal treatment by assessing preexisting data via cone-beam computed tomographic volumes. METHODS A total of 1160 CBCT scans with an overall sample of 20,836 teeth were screened. A global count of 3701 maxillary molars and mandibular second molars were included in the study. The Cohen kappa test and interclass correlation coefficient tested the intra- and interrater reliability, respectively. The percentage of periapical lesions associated with molars with or without root fusion was determined. Proportions were expressed with 95% confidence intervals (CIs). The z test for proportions was used to analyze differences between subgroups, and an odds ratio was calculated in order to understand the association between periapical lesions and root configuration. RESULTS Fused molars presented a prevalence of periapical lesions in endodontically treated teeth of 74.0% (95% CI, 65.2%-82.8%), whereas nonfused molars had a proportion of periapical lesions in root canal-treated teeth of 69.5% (95% CI, 65.2%-73.8%; P > .05). Endodontically treated molars with fused roots presented with 1.3 higher odds of being associated with periapical lesions than endodontically treated molars with nonfused roots. CONCLUSIONS A tendency of a higher proportion of periapical lesions was found in the fused rooted molars with a history of root canal treatment when compared with nonfused teeth; however, no statistically significant difference was noted.
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Affiliation(s)
- Beatriz Pereira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
| | - Abayomi Omokeji Baruwa
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - João Meirinhos
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - José Gouveia
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Sérgio A Quaresma
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | | | - António Ginjeira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
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Regenerative Endodontic Management of an Immature Molar Using Calcium Hydroxide and Triple Antibiotic Paste: a Two-Year Follow-Up. Case Rep Dent 2020; 2020:9025847. [PMID: 32095292 PMCID: PMC7035542 DOI: 10.1155/2020/9025847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/22/2020] [Indexed: 01/01/2023] Open
Abstract
The regenerative endodontic procedure (REP) is considered a viable treatment option for immature teeth with necrotic pulp and periapical radiolucency which can facilitate continued root formation. In this report, an immature necrotic mandibular molar received REP in three appointments wherein chemomechanical debridement was performed with a sequential application of nonsetting calcium hydroxide (in the whole canal) and triple antibiotics paste (in the root's middle third) dressings in the first and second appointments, respectively. In the third appointment, blood clots were created in the root canals. MTA was placed over the blood clots and the tooth was restored with a composite filling and stainless-steel crown. Recall appointments were performed for two years where the tooth was deemed asymptomatic clinically and a complete root formation with significant periapical healing was evident radiographically. More cases are required to warrant the feasibility of this disinfection protocol.
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Lee JK, Hwang JJ, Kim HC. Treatment of peri-invagination lesion and vitality preservation in an immature type III dens invaginatus: a case report. BMC Oral Health 2020; 20:29. [PMID: 32000767 PMCID: PMC6993444 DOI: 10.1186/s12903-020-1008-x] [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: 02/23/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report a case of type III dens invaginatus associated with peri-invagination periodontitis in an immature permanent mandibular central incisor with open apex, in which only the invagination area was treated and vitality was preserved. CASE PRESENTATION A 9-year-old boy was referred complaining of pain in the mandibular left central incisor. After radiographic examination, an invagination into the pulp chamber of the tooth associated with periapical radiolucency was detected. Endodontic access was performed and the orifice was identified under a dental operating microscope. The invagination area was chemo-mechanically cleaned. After 1 week, the invagination was obturated with mineral trioxide aggregate. During the 2-year follow up period, the tooth was asymptomatic. Radiographic examination revealed significant progression of periapical healing and root development in the main root canal of the tooth. CONCLUSION Non-surgical root canal treatment of the invagination may preserve pulp vitality, and continuous root development of the tooth.
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Affiliation(s)
- Ju-Kyung Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Geumo-ro 20, Mulgeum, Yangsan, Gyeongnam, 50612, Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Geumo-ro 20, Mulgeum, Yangsan, Gyeongnam, 50612, Korea.
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Yadav R, Bhoot H, Chandra A, Verma P, Bharti R, Shakya V. A Comparative Evaluation of Four Different Techniques for Determining the Accuracy of Root Canal Working Length: An In Vitro Study. DENTAL HYPOTHESES 2020. [DOI: 10.4103/denthyp.denthyp_37_19] [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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Chogle S, Zuaitar M, Sarkis R, Saadoun M, Mecham A, Zhao Y. The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning. J Endod 2019; 46:162-168. [PMID: 31837812 DOI: 10.1016/j.joen.2019.10.034] [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: 06/16/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although intraoral radiographs are foundational for diagnosis and planning treatment in dentistry, the resulting 2-dimensional image varies in interpretation requiring judgment. Cone-beam computed tomographic imaging provides a more detailed 3-dimensional image that may affect treatment recommendations. This study aimed to determine the basis for CBCT recommendations and the effect on diagnosis and treatment planning. METHODS The study involved a sample of 45 cases that presented for endodontic treatment, 30 with a CBCT scan on record and 15 without. For phase 1, all 45 cases were reviewed by 3 examiners without access to the CBCT scans. For phase 2, 4 months later, the 3 examiners reanalyzed the 30 cases, this time with the associated CBCT scan. Intra- and interexaminer agreements were recorded and analyzed. Also, the recommendations for CBCT were compared with the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology joint statement. RESULTS Interexaminer agreement in phases 1 and 2 was 65% and 72%, respectively. For endodontic diagnoses, there was a 19% change in the pulpal diagnosis category when CBCT imaging was added, whereas there was a 30% change in the apical category. The selections changed in 55% of the cases when determining etiology and in 49% of the cases when making recommendations. CBCT imaging was recommended 78.8% of the time when the case had a CBCT on record versus 33% of the time in cases without. CONCLUSIONS CBCT imaging has a significant effect in determining the etiology of endodontic pathoses and in recommending treatment. Furthermore, CBCT imaging is not overprescribed in the endodontic department, and the faculty members adhere to the American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology recommendations.
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Affiliation(s)
- Sami Chogle
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts
| | - Maan Zuaitar
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts.
| | - Ramzi Sarkis
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts
| | - Manal Saadoun
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts
| | - Anthony Mecham
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts
| | - Yihong Zhao
- Department of Endodontics, Boston University Henry M. Goldman School of Dentistry, Boston, Massachusetts
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Unusual Maxillary First Molars with C-Shaped Morphology on the Same Patient: Variation in Root Canal Anatomy. Case Rep Dent 2019; 2019:1857289. [PMID: 31772783 PMCID: PMC6854219 DOI: 10.1155/2019/1857289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 11/18/2022] Open
Abstract
A maxillary first molar should be considered a four-canal tooth until proved otherwise; however, a clinician should also be aware of the possibility of the presence of C-shaped root canal configuration with or without possibility of splitting into two or three canals. The two clinical cases reported in this paper describe the endodontic treatment of two maxillary first molars, on the same patient, with uncommon anatomy: the first case is about a maxillary first molar with only one C-shaped root and one oval canal with a large buccolingual diameter, a C1 type according to Fan's classification; the second case, about the contralateral maxillary first molar, is probably the first case documented of a maxillary first molar with a C-shaped root canal and C-shaped root with complete fusion of the three roots, having a C3 configuration.
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47
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Sisli SN. Evaluation of the Relationship between Type II Diabetes Mellitus and the Prevalence of Apical Periodontitis in Root-Filled Teeth Using Cone Beam Computed Tomography: An Observational Cross-Sectional Study. Med Princ Pract 2019; 28:533-538. [PMID: 30999319 PMCID: PMC6944896 DOI: 10.1159/000500472] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/18/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence of apical periodontitis (AP) in patients with type II diabetes mellitus (DM) with either optimal glycemic control (OGC) or poor glycemic control (PGC) compared with nondiabetics using cone beam computed tomography (CBCT). SUBJECTS AND METHODS The periapical status of 75 teeth with adequate root canal treatment performed at least 1 year ago that could be visualized in the field of view of CBCT images of 43 DM patients (29 females, 14 males) was compared with a control group consisting of 162 teeth of 86 nondiabetics (56 females, 30 males). In addition, the DM group was divided into subgroups according to the patients' mean glycated hemoglobin level as either having OGC or PGC. The periapical status of the teeth was evaluated using the CBCT periapical index (CBCTPAI), and AP was diagnosed as a CBCTPAI ≥1. χ2, Fisher's exact test, and independent-samples t tests were used for the statistical analysis, and p < 0.05 was considered significant. RESULTS Significant differences between the DM group and the control group were observed (p< 0.05) in terms of AP (the frequencies of both CBCTPAI ≥1 and CBCTPAI ≥3) and the frequency of cardiovascular disease, while there were no significant differences between the DM subgroups (p > 0.05). CONCLUSION The prevalence of AP and severe bone destruction in periapical tissues was significantly higher in the DM patients compared with the nondiabetic patients.
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Affiliation(s)
- Selen Nihal Sisli
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey,
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48
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The Impact of Different Diagnostic Imaging Modalities on the Evaluation of Root Canal Anatomy and Endodontic Residents' Stress Levels: A Clinical Study. J Endod 2019; 45:406-413. [DOI: 10.1016/j.joen.2018.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/27/2018] [Accepted: 12/01/2018] [Indexed: 12/12/2022]
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49
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Is Hypoxia Related to External Cervical Resorption? A Case Report. J Endod 2019; 45:459-470. [DOI: 10.1016/j.joen.2018.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/16/2018] [Accepted: 12/12/2018] [Indexed: 12/30/2022]
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50
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Bergandi L, Giuggia B, Alovisi M, Comba A, Silvagno F, Maule M, Aldieri E, Scotti N, Scacciatella P, Conrotto F, Berutti E, Pasqualini D. Endothelial Dysfunction Marker Variation in Young Adults with Chronic Apical Periodontitis before and after Endodontic Treatment. J Endod 2019; 45:500-506. [PMID: 30910354 DOI: 10.1016/j.joen.2019.01.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Cardiovascular diseases are the leading cause of mortality worldwide. Apical periodontitis (AP) has been associated with an increased risk of cardiovascular diseases. A correlation has been shown between chronic AP and endothelial dysfunction (ED), but there is no evidence to indicate ED improves after endodontic treatment in patients with periapical lesions. The aim of this study was to investigate vascular and molecular markers of early ED before and after root canal treatment in young adults with chronic AP. METHODS Twenty control subjects and 21 patients with AP were assessed at baseline. The AP patients were also evaluated 2 and 12 months post-treatment. Endothelial flow reserve was assessed via an endothelial function test, and enzyme-linked immunosorbent assays were used to evaluate plasma levels of proinflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor alpha; vasoconstrictor ED marker endothelin (ET)-1; circulating endothelial adhesion markers intercellular adhesion molecule 1 (ICAM-1)/CD54 and soluble vascular cellular adhesion molecule (sVCAM)-1/CD106; soluble CD14; and the endothelial leukocyte adhesion molecule (E-selectin). RESULTS AP was associated with increased serum levels of ET-1, ICAM-1, E-selectin, IL-1, and sCD14, suggesting early vascular ED, with no macroscopic evidence of a reduction in endothelial flow reserve. Root canal treatment ameliorated inflammation and early ED, lowering plasma levels of IL-1, sCD14, ET-1, ICAM-1/CD54, and E-selectin to those of control subjects. CONCLUSIONS Our findings suggest that AP may drive early vascular ED and that the endodontic therapy of AP ameliorates early ED.
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Affiliation(s)
| | - Beatrice Giuggia
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | | | - Milena Maule
- Department of Medical Sciences, Division of Cardiology, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Paolo Scacciatella
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Federico Conrotto
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Elio Berutti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy.
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