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Liu H, Shen Y. Locating and Treating Three Calcified Canals in a Mandibular First Molar With Radix Entomolaris and Five Canals: A Case Report. Cureus 2024; 16:e52931. [PMID: 38406086 PMCID: PMC10893908 DOI: 10.7759/cureus.52931] [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: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
The success of root canal treatment is highly contingent on the comprehensive shaping, cleaning, and filling of the entire root canal system. Failure to address one or more canals often results in an increased likelihood of post-treatment apical periodontitis. Typically, mandibular first molars feature two roots and three canals, but they may also exhibit anatomical variations, such as a mesial middle canal or radix entomolaris (RE). This article presents a case where three calcified canals in a mandibular first molar with RE and five canals were successfully located and treated.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, University of British Columbia, Vacnouver, CAN
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Kuzekanani M, Azami Sardoei M, Walsh LJ. The Prevalence of Middle Mesial Canals in the Second Mandibular Molars of an Iranian Subpopulation: A Cross-Sectional CBCT Study. Cureus 2023; 15:e51179. [PMID: 38283515 PMCID: PMC10817710 DOI: 10.7759/cureus.51179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Missed additional canals are a common reason for the failure of root canal treatments. The prevalence of additional canals in molar teeth can vary because of ethnic differences. Hence, this study aimed to determine the prevalence and distribution of middle mesial canals (MMCs) in the second mandibular molars using cone beam computed tomography (CBCT), for an adult population from Kerman in southeast Iran. Methodology De-identified retrospective provided CBCT scans from three private radiology centers in Kerman were reviewed (131 patients; 58 males (44.3%), 73 females (55.7%); age range: 13 to 54 years, mean age: 33). The presence of MMCs in mandibular second molars (222 teeth; 112 left and 110 right) was recorded, along with the morphology of the distal roots in the same teeth. Frequency data were analyzed using the Chi-square test and Fisher's exact test. Results The overall prevalence of MMC in the second mandibular molars was 2.3%. MMCs were found both unilaterally and bilaterally. More MMCs were found in females than males (2.7% vs. 1.7%), and on the left side (2.7% vs. 1.8%), but these differences were not statistically significant (p=1.0). There was no association between the existence of MMC in the mesial root and a second canal in the distal root of the same tooth. Conclusion Based on CBCT scans, the overall prevalence of MMC in mandibular second molars in this population was just below one in 44. Clinicians performing endodontic treatment on second molars should check for the presence of MMC so that this possible additional canal is not missed.
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Affiliation(s)
- Maryam Kuzekanani
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Mousa Azami Sardoei
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Laurence J Walsh
- Dentistry, School of Dentistry, the University of Queensland, Brisbane, AUS
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Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: A narrative review. Saudi Dent J 2023; 35:468-475. [PMID: 37520597 PMCID: PMC10373078 DOI: 10.1016/j.sdentj.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This review aimed to assess the incidence, anatomical characteristics, identification, and clinical management using conventional techniques and advanced tools to manage MMCs successfully. Methods Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references. Results The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures. Conclusion The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
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Affiliation(s)
- Raghavendra Penukonda
- Department of Endodontics, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Harshada Pattar
- Department of Oral Pathology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Phrabhakaran Nambiar
- Head of the Department, Department of Oral Biology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
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Tartuk GA, Kaya S. Incidence of missed middle mesial canal in endodontically treated mandibular molar teeth: A cone-beam computed tomography study. Niger J Clin Pract 2023; 26:756-759. [PMID: 37470649 DOI: 10.4103/njcp.njcp_743_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background In endodontic treatment, the aim is to completely determine, shape, and fill all root canals in a three-dimensional way. Missed canals lead to treatment failure. In mandibular molars, there may be an extra canal called the middle mesial canal between the mesiobuccal and mesiolingual canals. Aim The aim of this study was to evaluate the prevalence of missed middle mesial canals in root canal-treated mandibular molar teeth. Materials and Methods In this study, cone-beam computed tomography (CBCT) images of 1054 patients were analyzed. We identified 121 endodontically treated mandibular molars and evaluated the prevalence of missed canals. Results Although 33.05% of the root canal-treated teeth did not have a middle mesial canal, this canal was detected in the other 66.94%; 97.53% of teeth with a middle mesial canal could not be detected by clinicians. Conclusion Clinicians performing endodontic treatment of mandibular molar teeth should not ignore the presence of the middle mesial canal. Thus, it is very important for clinicians to have sufficient information about the localization, morphology, and variations of the middle mesial canal.
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Affiliation(s)
- G A Tartuk
- Department of Endodontics, Diyarbakir Oral and Dental Health Hospital, Diyarbakır, Turkey
| | - S Kaya
- Department of Endodontics, Dicle University, Diyarbakır, Turkey
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Solete P, Antony DP, Govindaraju L, Kavoor S, Sandeep A H, Chandragupta MS. Endodontic Management of Middle Mesial Canal in Mandibular Molars: A Report of Three Cases. Cureus 2023; 15:e35826. [PMID: 37033591 PMCID: PMC10075278 DOI: 10.7759/cureus.35826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 03/08/2023] Open
Abstract
Knowledge of both normal and aberrant root canal anatomy is the key to any successful root canal treatment. A mandibular molar demonstrates considerable variations with respect to additional canals or roots. The clinician must aim to identify all possible canals with the help of any magnification aids. This report discusses the variations of the middle mesial canal in mandibular molars.
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Bhatti UA, Muhammad M, Javed MQ, Sajid M. Frequency of middle mesial canal in mandibular first molars and its association with various anatomic variables. AUST ENDOD J 2022; 48:494-500. [PMID: 34929069 DOI: 10.1111/aej.12607] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/10/2021] [Accepted: 12/05/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to determine the frequency of the middle mesial canal in the mandibular first molars and its association with various anatomical features. Two experienced endodontists evaluated 149 CBCT images, containing n = 298 mandibular first molars and n = 298 mandibular second molars. Binary logistic regression was used to explore the relationship between the presence of middle mesial canal and other independent variables. The middle mesial canal was found in 7.7% (n = 23) of mandibular first molars and 11.4% of which exhibited adjacent C-shaped mandibular second molars. The presence of an adjacent C-shaped mandibular second molar was associated with a 3 times increased likelihood of finding a middle mesial canal (P = 0.048, OR: 3.108) in mandibular first molars. The middle mesial canal is an uncommon finding with a rare occurrence of bilateral presence in mandibular molars; however, an adjacent C-molar is an important predictor of middle mesial canal presence.
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Affiliation(s)
- Usman Anwer Bhatti
- Department of Operative Dentistry, Riphah International University, Islamabad, Pakistan
| | - Muhammad Muhammad
- Department of Operative Dentistry, Riphah International University, Islamabad, Pakistan
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | - Muhammad Sajid
- Department of Dental Materials, Islamabad Medical and Dental College, Islamabad, Pakistan
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Patel F, Ujariya U, Bharatiya R, Kothari A. Four distal root canals in a two-rooted permanent mandibular first molar: Report of a rare case, its incidence, and literature review. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_191_21] [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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Yang Y, Wu B, Zeng J, Chen M. Classification and morphology of middle mesial canals of mandibular first molars in a southern Chinese subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2020; 20:358. [PMID: 33302951 PMCID: PMC7726862 DOI: 10.1186/s12903-020-01339-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/22/2020] [Indexed: 01/21/2023] Open
Abstract
Background Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs). Methods CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (< 40 years old) and group B (≥ 40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P < 0.05 was considered statistically significant. Results In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P < 0.05). The curvature in the mesiodistal direction was 29.39 ± 8.53° in group A and 26.06 ± 8.50° in group B, and this difference was also significant (P < 0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P > 0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy. *Yeqing Yang and Buling Wu have contribute equally to this article.
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Affiliation(s)
- Yeqing Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Buling Wu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Junkai Zeng
- Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ming Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. .,School of Stomatology, Southern Medical University, Guangzhou, China.
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Keleş A, Keskin C, Alqawasmi R, Versiani MA. Micro-computed tomographic analysis of the mesial root of mandibular first molars with bifid apex. Arch Oral Biol 2020; 117:104792. [DOI: 10.1016/j.archoralbio.2020.104792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
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12
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Keles A, Keskin C, Alqawasmi R, Aydemir H. Accuracy of an endoscope to detect root canal anastomoses in mandibular molar teeth: a comparative study with micro-computed tomography. Acta Odontol Scand 2020; 78:433-437. [PMID: 32141355 DOI: 10.1080/00016357.2020.1735515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study was to investigate the accuracy of endoscopic visualization to detect root canal anastomoses at the coronal half of the mesial root canals of mandibular molars using micro-computed tomographic (micro-CT) images as reference.Material and methods: Seventy-four mesial roots of mandibular first molars with (n = 47) or without (n = 27) intercanal anastomosis were selected based on the micro-CT scans of 269 mandibular first molars at a pixel size of 10 µm. The specimens were mounted on the mannequins and their root canals were evaluated using dental operating microscope (DOM) and endoscope. The endoscopic probe was inserted into the main mesial root canals and 2 blinded observers evaluated the presence of a divergence point of anastomosis (where the branching occurs) as 'present' or 'absent'. The scorings were compared with the three-dimensional reconstructed images of the specimens and recorded as 'correct' or 'incorrect' evaluation. Degree of agreement between evaluators was assessed with Kappa test and the accuracy of endoscopic visualization according to the presence and location of anastomosis was compared using Fisher exact tests with a significance threshold at 5%.Results: High inter-examiner reliability was reported (0.91). None of the divergence points were identified using DOM whereas 11 divergence points were detected using endoscope, corresponding the 23.4% of the intercanal anastomoses. The endoscope also showed the absence of an intercanal anastomosis correctly in all of the specimens without an anastomosis. Detectability of a divergence point using endoscope was not affected by its location within the coronal half of root canal (p > .05).Conclusions: The endoscopes were able to visualize the divergence points of 23.4% of the intercanal anastomoses located at the coronal halves of root canals.
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Affiliation(s)
- Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Rawan Alqawasmi
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Hikmet Aydemir
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Mendes EB, Soares AJ, Martins JNR, Silva EJNL, Frozoni MR. Influence of access cavity design and use of operating microscope and ultrasonic troughing to detect middle mesial canals in extracted mandibular first molars. Int Endod J 2020; 53:1430-1437. [DOI: 10.1111/iej.13352] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 12/20/2022]
Affiliation(s)
- E. B. Mendes
- Department of Endodontics Faculdade São Leopoldo Mandic Centro de Pesquisa São Leopondo Mandic Campinas Brazil
| | - A. J. Soares
- Department of Endodontics Faculdade São Leopoldo Mandic Centro de Pesquisa São Leopondo Mandic Campinas Brazil
| | - J. N. R. Martins
- Department of Endodontics Faculdade de Medicina Dentária Universidade de Lisboa LisbonPortugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência Faculdade de Medicina Dentária Universidade de Lisboa Lisbon Portugal
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University (UNIGRANRIO) Rio de JaneiroBrazil
- Department of Endodontics Rio de Janeiro State University (UERJ) Rio de Janeiro Brazil
| | - M. R. Frozoni
- Department of Endodontics Faculdade São Leopoldo Mandic Centro de Pesquisa São Leopondo Mandic Campinas Brazil
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Nagahara T, Takeda K, Wada K, Shirawachi S, Iwata T, Kurihara H, Shiba H. A mandibular second molar with a middle mesial root canal. Clin Case Rep 2020; 8:1015-1020. [PMID: 32577255 PMCID: PMC7303868 DOI: 10.1002/ccr3.2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 11/17/2022] Open
Abstract
The present case report describes the clinical detection and root canal management of a rare middle mesial canal of a Japanese mandibular second molar by troughing preparation using an operating microscope and cone-beam computed tomography.
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Affiliation(s)
| | - Katsuhiro Takeda
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Satomi Shirawachi
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tomoyuki Iwata
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hidemi Kurihara
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Shiba
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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15
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Keles A, Keskin C, Alqawasmi R, Versiani MA. Evaluation of dentine thickness of middle mesial canals of mandibular molars prepared with rotary instruments: a micro‐CT study. Int Endod J 2019; 53:519-528. [DOI: 10.1111/iej.13247] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 12/18/2022]
Affiliation(s)
- A. Keles
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Samsun Turkey
| | - C. Keskin
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Samsun Turkey
| | - R. Alqawasmi
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Samsun Turkey
| | - M. A. Versiani
- Dental Specialty Center Brazilian Military Police Minas Gerais Brazil
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Prade AC, Mostardeiro RDT, Tibúrcio-Machado CDS, Morgental RD, Bier CAS. Detectability of Middle Mesial Canal in Mandibular Molar After Troughing Using Ultrasonics and Magnification: An Ex Vivo Study. Braz Dent J 2019; 30:227-231. [PMID: 31166387 DOI: 10.1590/0103-6440201802152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/03/2018] [Indexed: 01/30/2023] Open
Abstract
The aim of this study was to evaluate the frequency of the identification of middle mesial (MM) canals in extracted permanent first and second mandibular molars before and after executing a troughing technique with high magnification. Sample consisted of 105 mandibular molars. After gaining access to the pulp chamber and cleaning the chamber floor, root canals were detected in three different stages. The initial location was performed under direct viewing without magnification. In the second stage, a dental operating microscope was employed at 12 magnification. If the MM canal was not observed, a standardized troughing technique was executed with the use of an ultrasonic tip between the mesiobuccal and mesiolingual canals under magnification. Statistical differences in the frequency of MM canals before and after troughing were determined using McNemar's test, with the significance level set at 5%. No significant increase in the identification of the MM canal was found when comparing observations before (9.52%) and after (12.38%) the troughing technique under high magnification. However, viewing under magnification and the execution of troughing significantly increased the location of the MM canal (12.38%) when compared to viewing without magnification (3.81%) (p<0.01). The troughing technique with the aid of a dental operating microscope significantly improved the identification of MM canals compared to viewing without magnification. Troughing is a safe, minimally invasive procedure that benefits the treatment of mandibular molars.
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Affiliation(s)
- Ana Carla Prade
- Department of Stomatology, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Keles A, Keskin C. Deviations of Mesial Root Canals of Mandibular First Molar Teeth at the Apical Third: A Micro-computed Tomographic Study. J Endod 2018; 44:1030-1032. [PMID: 29681478 DOI: 10.1016/j.joen.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/21/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The present study aimed to quantitatively analyze apical foramen deviations of mesial root canals of mandibular first molar teeth by means of micro-computed tomographic (micro-CT) imaging. METHODS Micro-CT images of the mesial roots of 109 mandibular first molar teeth with independent mesiobuccal (MB) and mesiolingual (ML) root canals were analyzed. The deviations of the apical foramina of the MB, ML, and middle mesial root canals from the anatomic apex were measured. The vertical distance between the apical foramina of each mesial root canal in relation to each other was also calculated. RESULTS The distances from the apical foramina of the MB, ML, and middle mesial root canals to the anatomic apex of the mesial root were up to 2.51 mm, 3.21 mm, and 5.67 mm, respectively. There was no significant difference between the deviations of MB and ML root canals from each other (P > .05). The middle mesial root canal showed the greatest deviation compared with the MB and ML canals (P < .05). CONCLUSIONS The apical foramina of mesial root canals of mandibular first molar teeth showed greater variations from each other and anatomic apices than previously reported. Clinically, the use of electronic apex locators for the detection of minor apical foramen of each mesial root canal is of the utmost important.
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Affiliation(s)
- Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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