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Howait M, Zahran S, Abulhamael AM, Barayan MA, Khawaji S, Sanari M, Alshehri L, Zarei L, Marghalani A, Al-Habib MA. Characterizing the Root Canal Configuration of Mandibular Incisors in a Western Saudi Arabian Sub-population Using Cone Beam Computed Tomography. Cureus 2024; 16:e60650. [PMID: 38899247 PMCID: PMC11185986 DOI: 10.7759/cureus.60650] [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: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Aim This study aimed to explore the morphology and complexity of mandibular anterior teeth in a Western Saudi Arabian sub-population using cone beam computed tomography (CBCT). Methodology CBCT scans from 818 patients were evaluated, and 3193 mandibular anterior teeth were analyzed for the number of roots, canal, canal configurations, separation level, bilateral symmetry, and gender associations. Results The results showed that all examined central and lateral incisors had a single root, and the majority exhibited a single canal. The prevalence of two canals in mandibular central and lateral incisors was 20.1% and 23.2%, respectively, resulting in an overall prevalence of 21.7% for two root canals in mandibular anterior teeth. The separation level of the two canals was predominantly located in the middle third of the root. Type I canal configuration was the most common, followed by type III. A high degree of bilateral symmetry in the number of canals and canal configurations was noted. Conclusion The findings contribute to the understanding of root canal anatomy in the Saudi population and provide valuable information for endodontic treatment planning.
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Affiliation(s)
- Mohammed Howait
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
| | - Shatha Zahran
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
| | | | - Mohammed A Barayan
- Department of Oral and Maxillofacial Radiology, King Abdulaziz University, Jeddah, SAU
| | - Sara Khawaji
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Mohammed Sanari
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Layan Alshehri
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Lamees Zarei
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Ammar Marghalani
- Department of Periodontology, King Abdulaziz University, Jeddah, SAU
| | - Mey A Al-Habib
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
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Kudryashov D, Versiani MA. Clinical strategies for successful palato-mesiobuccal canal management-Report of 2 cases. Int Endod J 2024. [PMID: 38687130 DOI: 10.1111/iej.14076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
AIM To describe the management of the palato-mesiobuccal (PMB) canal in maxillary second molars with fused roots using conventional techniques. SUMMARY Root canal treatment success hinges upon effectively addressing the intricate and variable anatomy of molar teeth. Failure to do so can lead to persistent infections and treatment failure. Recent advancements in imaging technologies have provided unparalleled insights into dental anatomy, especially in molars. Among these discoveries is the PMB canal, a unique anatomical variant recently reported for the first time in Endodontic literature. This canal, found in maxillary second molars with fused roots and originating from the coronal third of the palatal canal while traversing towards the mesiobuccal root presents challenges in clinical management due to its location. This article is the first to showcase the management of the PMB canal using conventional techniques. In the first case, a 38-year-old male patient presented with asymptomatic irreversible pulpitis in the maxillary second right molar. Following thorough instrumentation and irrigation, the presence of the PMB canal was discovered during root canal preparation. The canal was managed using rotary instruments and obturated successfully, resulting in a symptom-free tooth at an 8-year follow-up. The second case illustrates a similar scenario in a 23-year-old female patient presenting with symptomatic irreversible pulpitis in tooth 17. The PMB canal was identified during treatment and managed using rotary nickel-titanium instruments, leading to a favourable outcome at a 9-year follow-up. KEY LEARNING POINTS In fused roots of maxillary second molars, a PMB canal might be expected. Exploration of the buccal wall of the palatal canal under magnification after shaping procedures can reveal the PMB canal orifice in fused roots. Small tapers are suggested for the enlargement of the PMB canal. Continuous bleeding spots in the palatal canal might indicate a possible PMB canal orifice in vital cases. The use of an apex locator is suggested for the differential diagnosis of the PMB canal orifice from a perforation site.
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Affiliation(s)
- Dmitry Kudryashov
- Department of Therapeutic Dentistry, Samara State Medical University, Samara, Russian Federation
| | - Marco A Versiani
- Dental Specialty Centre, Brazilian Military Police, Minas Gerais, Brazil
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Machado R, Moreira G, Comparin D, Barroso AP, Nascimento J, Ferraz CCR, Ignácio SA, da Fonseca Roberti Garcia L, Amaral RR, Shadid D, da Silva Neto UX. Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial. BMC Oral Health 2024; 24:481. [PMID: 38643087 PMCID: PMC11032596 DOI: 10.1186/s12903-024-04225-6] [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: 12/28/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
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Affiliation(s)
- Ricardo Machado
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA.
| | - Guilherme Moreira
- Clinical Practice Limited to Endodontics, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Clinical Practice Limited to Endodontics, Cunha Porã and Francisco Beltrão, Paraná, Brazil
| | - Arthur Pimentel Barroso
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Jaqueline Nascimento
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Caio Cézar Randi Ferraz
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Sérgio Aparecido Ignácio
- School of Dentistry, Department of Statistics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Division of Endodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - David Shadid
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA
| | - Ulisses Xavier da Silva Neto
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Whitten T, Tzoumakis S, Green MJ, Dean K. Global Prevalence of Childhood Exposure to Physical Violence within Domestic and Family Relationships in the General Population: A Systematic Review and Proportional Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1411-1430. [PMID: 37300288 PMCID: PMC10913340 DOI: 10.1177/15248380231179133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Efforts to identify and prevent childhood exposure to physical violence within domestic and family relationships must be underpinned by reliable prevalence estimates to ensure the appropriate allocation of resources and benchmarks for assessing intervention efficacy. We conducted a systematic review and meta-analysis of the global prevalence of childhood exposure to physical domestic and family violence separately as a victim or witness. Searches were conducted in Criminal Justice Abstracts, Embase, Scopus, PubMed, PsychInfo, and Google Scholar. Studies were included if they were peer-reviewed, published in English, had a representative sample, unweighted estimates, and were published between January 2010 and December 2022. One-hundred-and-sixteen studies comprising 56 independent samples were retained. Proportional meta-analysis was conducted to calculate the pooled prevalence for each exposure. Pooled prevalence estimates were also stratified by region and sex. The global pooled prevalence of childhood exposure to physical domestic and family violence as a victim or witness was 17.3% and 16.5%, respectively. Prevalence estimates were highest in West Asia and Africa (victim = 42.8%; witness = 38.3%) and lowest for the Developed Asia Pacific region (victim = 3.7%; witness = 5.4%). Males were 25% more likely than females to be the victim of physical domestic and family violence during childhood, while both were equally likely to have witnessed it. These findings suggest that childhood exposure to domestic and family violence is relatively common, affecting around one-in-six people by 18 years of age globally. Regional variations in prevalence estimates may reflect underlying economic conditions, cultural norms, and service availability.
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Affiliation(s)
- Tyson Whitten
- Center for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
| | - Stacy Tzoumakis
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- School of Criminology and Criminal Justice, Griffith University, Southport, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Melissa J. Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
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Mustafa M, Batul R, Karobari MI, Alamri HM, Abdulwahed A, Almokhatieb AA, Hashem Q, Alsakaker A, Alam MK, Ahmed HMA. Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review. BMC Oral Health 2024; 24:343. [PMID: 38493123 PMCID: PMC10944621 DOI: 10.1186/s12903-024-04101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Consultant Endodontics, Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Ahmed A Almokhatieb
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Qamar Hashem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Abdullah Alsakaker
- Consultant endodontist, Department of endodontics, Prince Abdulrahman Advanced Dental Institute, Ministry of defence, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Elsayed MA, Elmesellawy MY, Schäfer E. Prevalence of multiple roots and complex canal morphology in mandibular premolars among a selected Southern Egyptian sub-population: a CBCT-analysis. Odontology 2024:10.1007/s10266-024-00903-7. [PMID: 38351258 DOI: 10.1007/s10266-024-00903-7] [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: 08/11/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
The mandibular premolars can pose a significant challenge in root canal treatment due to their complex canal system. This study investigated the prevalence of multiple roots and complex canal morphology of mandibular premolars in a selected Egyptian sub-population using cone beam computed tomography (CBCT). 283 CBCT scans (131 males, 152 females, age 18-70) included 1132 mandibular premolars (566 first, and 566 second premolars) were viewed for incidences ofvariation in root numbers and canal configuration according to Vertucci's classification. CBCT images were assessed by two endodontists, data were statistically analyzed using Fisher exact and Chi-square tests. The majority of first premolars (85.7%) exhibited a single root, whereas 14.7% had 2 roots with a significantly higher frequency in males (19.8%) than in females (9.5%) (P < .05). The most prevalent type was type I (57.8%), followed by type V (21.7%), while types II and VII made up only 1%. Types V and III were more prevalent among females, while males had a higher prevalence of types I and IV. In 2.5% of cases, mandibular second premolars were found to have 2 roots, with a higher incidence in males (P < .05). Type I canals were significantly more prevalent (90.8%) than other types, followed by type V (5.3%) (P < .05). A statistically significant gender correlation was found regarding root number and canal configuration. It is not uncommon to find mandibular first premolars with two roots in the southern Egyptian population, particularly in males. These observations may be valuable for dentists who treat Southern Egyptians, in Egypt and other countries.
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Affiliation(s)
- Mohamed Ahmed Elsayed
- Department of Endodontics, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
- Department of Endodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
| | | | - Edgar Schäfer
- Central Interdisciplinary Ambulance, School of Dentistry, University of Münster, Waldeyerstr. 30, 48149, Münster, Germany.
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Srivastava S, Aldakhail NS, Javed MQ. Morphometric relationships in mesio-buccal roots of maxillary first molars in Saudi subpopulation: A CBCT study. AUST ENDOD J 2023; 49:614-622. [PMID: 37665125 DOI: 10.1111/aej.12793] [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: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
This CBCT-based study analysed morphometric relationships in Mesio-Buccal (MB) roots of maxillary first molars (MFM). 133 MFM with two MB canals were assessed and classified using Vertucci's classification. MB roots' length and MB1-MB2 canals inter-orifice distances (IOD) were noted. The data were analysed using SPSS software. The most frequently present canal was type IV (59.4%) followed by type II (40.6%). Mean MB roots' length for canals exhibiting type IV was 9.26 ± 0.21 mm and of those exhibiting type II was 12.8 ± 0.42 mm. Statistically significant relationship was found between MB root length and canal type. Mean IOD for type II and type IV canals was 2.4 ± 0.47 and 3.8 ± 0.21 mm, respectively. Statistically significant relationship was found between IOD and canal type. Length of MB root and IOD had a significant association with canal type present in MFM. This knowledge can enhance clinicians' understanding of canal morphology which can increase predictability and success rate of endodontic treatment.
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Affiliation(s)
- Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
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Javed MQ, Srivastava S, Alotaibi BBR, Bhatti UA, Abulhamael AM, Habib SR. A Cone Beam Computed Tomography-Based Investigation of the Frequency and Pattern of Radix Entomolaris in the Saudi Arabian Population. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2025. [PMID: 38004074 PMCID: PMC10673087 DOI: 10.3390/medicina59112025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: An understanding of the anatomical complexity of teeth is a significant factor for a successful endodontic treatment outcome. The aim of this study was to explore the frequency and pattern of distribution of radix entomolaris (RE) in mandibular first molars (MFMs) of a Saudi Arabian subpopulation using CBCT scans. Materials and Methods: This study was conducted at dental clinics of Qassim University from February to May 2023 by evaluating CBCT scans that were previously obtained for diagnostic purposes. Scans of Saudi national patients with bilaterally present MFMs and fully formed root apices were included. Conversely, scans with one/or two missing MFMs, MFMs with incomplete root apices, full- or partial-coverage prosthesis, endodontic treatment, and associated radicular resorption were excluded from study. A total of 303 CBCT scans with 606 bilateral MFMs were analyzed by two calibrated evaluators for the presence of, and type according to Song's typolgy of RE. The data were analyzed using SPPS-24. The descriptive variables were documented as frequencies and percentages. The chi-square test was used to determine the association between the prevalence of RE with the gender, jaw side and age group. Both inter-rater and intra-rater agreements were estimated for detecting and classifying RE using Cohen's kappa test. Results: The sample had 63.7% males and 36.3% females. The prevalence of RE was 6.6%, with Song's type III (57.5%) as the most common variant. Absolute agreement was noted between the raters about the presence of RE and very strong agreement was noted for the classification of the RE. Conclusions: RE is an uncommon finding among the mandibular first molars of the Saudi population without any gender and quadrant predilection. The clinicians' knowledge of the presence and Song's type of RE may contribute towards the enhancement of endodontic treatment outcomes.
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Affiliation(s)
- Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Badi Baen Rashed Alotaibi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Usman Anwer Bhatti
- Department of Operative Dentistry, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan;
| | - Ayman M. Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia;
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
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Alak SG, Keleş A, Keskin C, Martins JNR, Versiani MA. Age-related changes in the morphology of the root canal system of mandibular first molars: a micro-CT study. Clin Oral Investig 2023; 27:4667-4675. [PMID: 37247087 DOI: 10.1007/s00784-023-05093-0] [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: 08/17/2022] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study aimed to evaluate changes on root canal morphology in patients with different ages using micro-CT technology. MATERIALS AND METHODS Mandibular first molars (n = 150) were scanned at a pixel size of 13.68 µm, categorized into 3 groups according to patient's age and analyzed regarding configuration, orifices, apical foramina, root length, canal volume, and surface area. Morphological 2D and 3D parameters were evaluated in distal roots with Type I configuration (n = 109) as well as the morphology of isthmuses Types I and III in 68 mesial roots. One-way ANOVA post hoc Tukey and Kruskal-Wallis tests were used for statistical analyses (α = 5%). RESULTS A great variation in the canal configuration was found. No difference was observed in roots' length (p > 0.05). Canal volume reduced with age (p < 0.05), while surface area increased (p < 0.05) in patients ≤ 30 years. There was no difference in canal/root length, area, and from foramen to the apex in distal roots with Type I configuration (p > 0.05), but 2D and 3D parameters significantly decreased with age (p < 0.05). Overall, the diameter of the isthmuses' roof reduced with age (p < 0.05). In patients ≥ 31 years with Type III isthmus the distance from the isthmus floor to the foramen of the mesiolingual canal also decreased (p < 0.05). CONCLUSION Overall, the internal morphology of the mesial roots of mandibular first molars was more affected by aging than distal canals. The most relevant tested parameter that significantly reduced in both roots was the volume of the root canal systems. CLINICAL RELEVANCE A detailed evaluation of fine anatomical aspects of the root canal system of mandibular first molars of patients with different ages showed that the internal morphology of mesial roots is more affected by aging than distal canals.
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Affiliation(s)
| | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
- Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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Nagahara T, Takeda K, Wada K, Naruse T, Shiba H. Rare root canal morphology of maxillary second molars: A report of three cases. Clin Case Rep 2023; 11:e7547. [PMID: 37415578 PMCID: PMC10320364 DOI: 10.1002/ccr3.7547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Key Clinical Message Endodontists should be aware that some maxillary second molars can have more than three roots. If any unusual anatomical features are detected during dental radiography or endodontic procedures, it is necessary to conduct cone-beam computed tomography (CBCT) scanning to prevent procedural mishaps. Abstract CBCT can provide three-dimensional reconstructed images of the root canal system. With the help of CBCT, variations in tooth root number and root canal morphology, such as extra canals, apical ramifications, apical deltas, and lateral canals, can be identified. Knowledge of the variations is very important for the success of endodontic treatment. This report suggests that endodontists must not assume that a MSM has only three tooth roots, which is the most prevalent number.
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Affiliation(s)
- Takayoshi Nagahara
- Nippon Kokan Fukuyama HospitalHiroshimaJapan
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Katsuhiro Takeda
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Tomoya Naruse
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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11
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Martins JNR, Versiani MA. Worldwide Prevalence of the Lingual Canal in Mandibular Incisors - A Multi-Center Cross-Sectional Study with Meta-Analysis. J Endod 2023:S0099-2399(23)00282-0. [PMID: 37225039 DOI: 10.1016/j.joen.2023.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION This cross-sectional study assessed the influence of patient demographics on the worldwide prevalence of a lingual canal in mandibular incisors. METHODS 26,400 mandibular incisors were evaluated using cone-beam computed tomography imaging by pre-calibrated observers from 44 countries. A standardized screening method was employed to collect data on the presence of a lingual canal, the anatomic configuration of the root canal, and number of roots. Patient demographic information (age, sex, and ethnicity) was also recorded. Multiple intra- and inter-rater tests assessed the reliability of the observers and groups, and a meta-analysis was used to examine differences and heterogeneities (α=5%). RESULTS The prevalence of the lingual canal in mandibular central and lateral incisors varied from 2.3% (0.06%-4.0%; Nigeria) to 45.3% (39.7%-51.0%; Syria) and from 2.3% (0.06%-4.0%; Nigeria) to 55.0% (49.4%-60.6%; India), respectively. Ethnicity had a significant impact on the prevalence of the lingual canal, with African, Asian, and Hispanic groups having the lowest proportions (P<.05), while Caucasians, Indians, and Arabs showed the highest (P<.05) for both incisor groups. Additionally, males had a significantly higher odds ratio for both the central (1.334) and lateral (1.178) incisors, while older patients had a lower prevalence for both tooth groups (P<.05). The side and tooth group did not influenced on the outcomes. CONCLUSIONS The prevalence of lingual root canals in mandibular incisors varies significantly based on geographic location, ethnicity, age, and gender. The overall prevalence was 21.9% for mandibular central incisors and 26.0% for lateral incisors.
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Affiliation(s)
- Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Marco A Versiani
- Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
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12
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Al-Maswary AA, Almadhoon HW, Elkhateb A, Hamdallah A, Halboub E. The global prevalence of middle mesial canal in mandibular first and second molars assessed by cone beam computed tomography: A systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00236-4. [PMID: 37116828 DOI: 10.1016/j.joen.2023.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND This meta-analysis sought to identify the in vivo prevalence and influencing factors of middle mesial canal (MMC) in mandibular first and second molars based on cone-beam computed tomography (CBCT) scans. METHODS MEDLINE/PubMed, Web of Science, Scopus, SciELO, Google Scholar databases/search engines were searched in period between 15th and 21st November 2022, to retrieve the in vivo CBCT-based studies that assessed the prevalence of MMC in mandibular first and/or second molars. The studies were strictly assessed using pre-defined inclusion and exclusion criteria for relevancy and eligibility through screening the title and abstract, and then assessed through reading the full texts using the same criteria. Subsequently, the fulfilled studies were assessed qualitatively using the Newcastle-Ottawa Quality Assessment Scale, and quantitatively using meta-analysis to calculate the pooled prevalence rates of MMC. The publication bias was assessed using funnel plot and Egger's test. RESULTS Out of 1,122 studies, 33 studies comprised 13,349 and 7,624 mandibular first and second molars, respectively, were eligible for inclusion. Twenty studies scored high quality, while thirteen scored moderate quality. The global prevalence of MMC in the first molar was 4.4% (95% CI = 0.035-0.053, P<0.001), significantly higher than that of the second molar which was 1.3% (95%, CI = 0.008-0.018, P<0.001). Gender, molar side, and age were not influencing factors of MMC prevalence. CONCLUSION The prevalence of MMC is not uncommon, being higher in the mandibular first molar compared to the mandibular second molar. The prevalence of MMC is not influenced by age, molar's side, and gender.
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Affiliation(s)
- Arwa A Al-Maswary
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen; Faculty of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sana'a, Yemen.
| | | | | | | | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
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13
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Nawar NN, Elkholy MMA, Ha WN, Saber SM, Kim HC. Optimum shaping parameters of the middle mesial canal in mandibular first molars: A finite element analysis study. J Endod 2023; 49:567-574. [PMID: 36965769 DOI: 10.1016/j.joen.2023.03.007] [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: 12/30/2022] [Revised: 01/27/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION This study investigated the effect of shaping parameters of two different configurations of middle mesial canals (MMC) on the biomechanical behavior and life span of a mandibular first molar using finite element analysis (FEA). METHODS A mandibular molar with an independent MMC and another with a confluent MMC were scanned via micro-CT, and FEA models were produced. For each tooth, an intact model and 5 experimental models were produced differed by parameters of how MMC was shaped: unshaped MMC, 25/.04, 25/.06, 30/.04, and 30/.06. Cyclic loading of 50 N was applied on the occlusal surface in vertical and oblique scenarios, and the number of cycles until failure (NCF) was compared to the intact models. In addition, mathematical analyses evaluated the stress distribution patterns and calculated maximum von Mises and maximum principal stresses. RESULTS For both the independent and confluent MMC models, shaping the MMC reduced the NCF. The lifelog percentage of models was inversely proportional with radicular shaping parameters during the vertical and oblique loading scenarios. The shaping size of 30/.06 resulted in lower lifelog percentage than the cases with shaping size of 25/.04 in both of the independent and confluent MMC models. For all models, oblique loading reduced NCF more than vertical loading. CONCLUSION Shaping the MMC should be kept as conservative as 25/.04. Also, whether the MMC is independent or confluent is a deciding factor in whether to increase the apical diameter or the root canal taper when larger shaping parameters are needed.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Mostafa M A Elkholy
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Wang Y, Li Y, Huang S, Huang J, Huang X. An easily achievable strategy to promote the penetration of methylene blue into dentinal tubules. Photodiagnosis Photodyn Ther 2023; 41:103237. [PMID: 36496126 DOI: 10.1016/j.pdpdt.2022.103237] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/12/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND One critical issue that impairs the therapeutic effects of antimicrobial photodynamic therapy (aPDT) in root canal disinfection is the insufficient penetration of photosensitizer into dentinal tubules. Therefore, this study aimed to compare the treatments in enhancing photosensitizers' penetrability for aPDT in root canal therapy. METHODS Thirty premolars with a single root canal were randomly divided into three groups (n = 10), using Methylene blue (MB) as a photosensitizer and treated with different approaches: sonic-assisted diffusing group, ultrasonic-assisted diffusing group and the control without treatment. All specimens were observed by stereomicroscope to measure the penetration depth of MB into dentinal tubules. RESULTS Both sonic and ultrasonic treatments substantially improved the penetrability of MB. The former achieved a deeper penetration depth than the latter did in the same region of root (P<0.05). Regarding the dye penetration depths at different root regions, the control group showed a declining trend from coronal to apical. In contrast, the penetration depths of sonic and ultrasonic-assisted diffusing groups from highest to lowest were middle > coronal > apical (P<0.05). CONCLUSIONS This study showed that both sonic and ultrasonic treatments remarkably promoted MB's penetration depth into dentinal tubules. Maximum penetration was achieved when treated with a sonic approach.
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Affiliation(s)
- Yanhuang Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Yijun Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Shan Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Jing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China.
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Prevalence of Second Root and Root Canal in Mandibular and Maxillary Premolars Based on Two Classification Systems in Sub-Population of Northern Region (Saudi Arabia) Assessed Using Cone Beam Computed Tomography (CBCT): A Retrospective Study. Diagnostics (Basel) 2023; 13:diagnostics13030498. [PMID: 36766603 PMCID: PMC9914268 DOI: 10.3390/diagnostics13030498] [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: 12/24/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The objective of this paper is to assess the prevalence of a second canal in maxillary and mandibular premolars based on two classification systems of root canal morphology using Cone beam computed tomography (CBCT) images. A total of 286 CBCT scans from the archive of the Radiology department of a hospital were assessed for the presence of a second canal in maxillary and mandibular premolars. The canal configuration and its assessment was undertaken using Vertucci and Ahmed's classification. A Chi-square test was used to test the significance of the difference between gender and age. A total of 286 premolars were examined (217 mandibular premolars and 69 maxillary premolars); of these, 173 teeth (60.5%) were from males and 113 were from females (39.5%). Some 62% of maxillary left first premolars had two roots, followed by maxillary right first premolars (47%), and then maxillary left second premolars (30%) and maxillary right ones (27%), respectively. Type IV Vertucci were seen in maxillary premolars, while type I were ordinarily seen in the included mandibular premolars. Surprisingly, Vertucci type III was only found in mandibular left first premolars at a frequency of 2%. One orifice with two separate canals and two orifices of two distinct canals with two portals of exit were predominantly noticed with maxillary first premolars (2 FP B1 P1) in 73% and 81%, respectively, followed by (1 FP 2) 19%. The prevalence of a second canal in maxillary and mandibular premolars was low in the investigated premolars in comparison to the premolars that had just one root and canal, as assessed based on Vertucci and Ahmed's root canal system classification.
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16
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Atav Ateş A, Arıcan B, Çiftçioğlu E, Küçükay ES. Negotiating the second mesiobuccal canal: A comparison of nickel titanium files through the experience of undergraduate dental students. J Dent Educ 2023; 87:694-701. [PMID: 36625222 DOI: 10.1002/jdd.13165] [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: 06/06/2022] [Revised: 11/23/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to compare the ability of undergraduate students to reach working length (WL) in second mesiobuccal root canals (MB2) of maxillary first molars (n = 210) by using Reciproc Blue without glide path preparation, and One Curve with glide path preparation. METHODS The students (n = 105) attended theoretical and practical courses. The first group (n = 53) shaped MB2 root canals using the One Curve system and then Reciproc Blue; the second group (n = 52) shaped MB2 root canals following the reverse sequence. Participants completed a questionnaire. The chi-square and Mann-Whitney U test were used for statistical analysis using significance of p < 0.05. RESULTS The full WL was reached and shaping procedures were completed without complications in Reciproc Blue and One Curve groups at rates of 86.67% and 82.85%, respectively (p > 0.05). Treatment time was shorter in Reciproc Blue (p < 0.05). More (62.9%) students felt the One Curve system safer, while 61% felt the Reciproc Blue system faster. CONCLUSIONS Within the limitations of this study, instrument kinematics and glide path preparation did not interfere with undergraduate students' ability to achieve the WL in MB2 root canals.
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Affiliation(s)
- Ayfer Atav Ateş
- Faculty of Dentistry, Department of Endodontics, Istinye University, Istanbul, Turkey
| | - Burçin Arıcan
- School of Dental Medicine, Department of Endodontics, Bahçeşehir University, Istanbul, Turkey
| | - Elif Çiftçioğlu
- Faculty of Dentistry, Department of Endodontics, Istanbul Okan University, Istanbul, Turkey
| | - Enver Sedat Küçükay
- Faculty of Dentistry, Department of Endodontics, Istanbul Okan University, Istanbul, Turkey
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17
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Lepperdinger U, Angwin C, Milnes D, Sobey G, Ghali N, Johnson D, Brady AF, Kammin T, Bowen JM, Gröbner R, Lundberg P, Scott J, Zschocke J, van Dijk FS, Kapferer‐Seebacher I. Oral characteristics in adult individuals with periodontal Ehlers-Danlos syndrome. J Clin Periodontol 2022; 49:1244-1252. [PMID: 35833531 PMCID: PMC9796896 DOI: 10.1111/jcpe.13698] [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: 01/28/2022] [Revised: 06/09/2022] [Accepted: 07/06/2022] [Indexed: 01/07/2023]
Abstract
AIM Periodontal Ehlers-Danlos syndrome (pEDS) is a monogenic type of Ehlers-Danlos syndrome characterized by periodontal destruction at a young age. The present study aimed to document the oral phenotype of pEDS based on prospective clinical investigations. MATERIALS AND METHODS Thirty-five adult individuals from 13 families with a clinically and genetically confirmed diagnosis of pEDS underwent a systematic oral assessment. RESULTS Periodontitis stage 3 or 4 or edentulism due to periodontal destruction were diagnosed in 94% of the individuals. First permanent tooth loss was reported at the age of 21.5 years (median; range 13-43 years). Deep periodontal pockets were infrequent, with 94% measuring <4 mm. However, there was increased clinical attachment loss (CAL) averaging 8 mm (range 4-13 mm), and the probability of being edentate between the age of 35 and 44 years was 28-47% compared with less than 0.25% of the general population. Radiographic anomalous findings were only found in a portion of subjects and consisted of fused roots of maxillary second molars (81%), root hypoplasia (57%), taurodontism (26%) and tooth rotation of premolars (67%). As such, radiographic findings are not considered common characteristics of pEDS. CONCLUSIONS Characteristic oral traits of pEDS in adults are severe CAL with shallow probing depths and marked gingival recession. This is complemented by a lack of attached gingiva. These indications need to be paralleled by genetic analyses to diagnose pEDS unambiguously.
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Affiliation(s)
- Ulrike Lepperdinger
- Department of Operative and Restorative DentistryMedical University of InnsbruckInnsbruckAustria
| | - Chloe Angwin
- National Ehlers Danlos Syndrome ServiceLondon North West University Healthcare NHS TrustLondonUK,Department of Metabolism, Digestion and ReproductionSection of Genetics and Genomics, Imperial College LondonLondonUK
| | - Di Milnes
- Genetic Health QueenslandRoyal Brisbane and Women's HospitalHerstonQueenslandAustralia
| | - Glenda Sobey
- Ehlers Danlos Syndrome National Diagnostic ServiceSheffield Children's HospitalSheffieldUK
| | - Neeti Ghali
- National Ehlers Danlos Syndrome ServiceLondon North West University Healthcare NHS TrustLondonUK,Department of Metabolism, Digestion and ReproductionSection of Genetics and Genomics, Imperial College LondonLondonUK
| | - Diana Johnson
- Ehlers Danlos Syndrome National Diagnostic ServiceSheffield Children's HospitalSheffieldUK
| | - Angela F. Brady
- National Ehlers Danlos Syndrome ServiceLondon North West University Healthcare NHS TrustLondonUK,Department of Metabolism, Digestion and ReproductionSection of Genetics and Genomics, Imperial College LondonLondonUK
| | - Tammy Kammin
- Ehlers Danlos Syndrome National Diagnostic ServiceSheffield Children's HospitalSheffieldUK
| | - Jessica M. Bowen
- Ehlers Danlos Syndrome National Diagnostic ServiceSheffield Children's HospitalSheffieldUK
| | - Rebekka Gröbner
- Institute of Human GeneticsMedical University of InnsbruckInnsbruckAustria
| | | | - James Scott
- Academic Unit of Restorative DentistrySheffield UniversitySheffieldUK
| | - Johannes Zschocke
- Institute of Human GeneticsMedical University of InnsbruckInnsbruckAustria
| | - Fleur S. van Dijk
- National Ehlers Danlos Syndrome ServiceLondon North West University Healthcare NHS TrustLondonUK,Department of Metabolism, Digestion and ReproductionSection of Genetics and Genomics, Imperial College LondonLondonUK
| | - Ines Kapferer‐Seebacher
- Department of Operative and Restorative DentistryMedical University of InnsbruckInnsbruckAustria
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Pawar AM, Singh S. The morphology of the pulp chamber floor of permanent mandibular first and second molars in an Indian subpopulation-a descriptive cross-sectional study employing Pawar and Singh classification. PeerJ 2022; 10:e14392. [PMID: 36518276 PMCID: PMC9744145 DOI: 10.7717/peerj.14392] [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: 08/22/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mandibular molars are multi-rooted teeth with a complex and strenuous root canal anatomy. Because there is relatively negligible literature describing the pulp chamber floor anatomy, predicting the exact anatomical layout and its variations is daunting. A thorough comprehension and knowledge of the same is required for efficacious endodontic treatment consequence. The purpose of this study was to characterise and ascertain the pulp chamber floor anatomy of permanent mandibular first (ManFMs) and second (ManSMs) molars in an Indian population. Methods On 2,134 extracted human mandibular first (ManFMs = 1,067) and second molars (ManSMs = 1,067), a descriptive cross-sectional investigation was executed. Cleaning and removal of hard and soft tissue debris were performed, followed by flattening the anatomical crown until the pupal architecture was uncovered. A stereomicroscope with a magnification of 4.5 magnification was used to investigate the pulpal anatomy. Statistical analysis was carried out using chi square test, with 95% confidence intervals and a p value of 0.05 considered statistically significant. Results The majority of the ManFMs showed presence of three canal orifices in 57.73%, followed by four orifices 31.31%, five orifices 8.81%, and six orifices 2.15%. For ManSMs, majorly three orifices were found in 39.83% specimens, followed by two orifices in 37.39%, four orifices in 16.31%, and single root canal orifice was observed in 6.47%. The mesio-buccal, mesio-lingual, disto-buccal, disto-lingual canal orifices exhibited round and oval shapes in both ManFMs and ManSMs. The shape was predominantly oval with a single distal canal orifice (84.25% ManFMs and 74.16% ManSMs). In ManSMs, among the single root canal orifice, 66.66% were round in shape and 33.34% were C-shaped. In ManSMs with two root canal orifices, mesially 79.44% exhibited oval and 20.56% round shape. Distally, 74.16% were oval and 25.84% were round. The shapes of the access cavities for ManFMs were rectangular in 46.67% and triangular in 53.33%. For the ManSMs, the access cavities were triangular in 39.83%, rectangular in 16.31% and non-classified (others) in 43.86% of specimen. In both ManFMs and ManSMs, the pulp chamber floor morphology was predominately Y shaped (57.73% and 39.83%) according to the Pawar and Singh classification© of pulp chamber floor anatomy. Conclusion Our study indicated that the orifices on the pulp chamber floor are arranged in a typical manner, supporting the proposed categorization. Furthermore, description of the anatomical patterns of the pulp chamber guides the clinicians in chair-side treatment decisions.
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Affiliation(s)
- Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, TPCT’s Dental College and Hospital, Navi Mumbai, Maharashtra, India,Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Shishir Singh
- Department of Conservative Dentistry and Endodontics, TPCT’s Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Gellis JJ, Foley RA. Patterns of variation in canal and root number in human post-canine teeth. J Anat 2022; 241:896-918. [PMID: 36082500 PMCID: PMC9482695 DOI: 10.1111/joa.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/31/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022] Open
Abstract
Descriptive morphology of tooth roots traditionally focuses on number of canals and roots. However, how or if canal and root number are related is poorly understood. While it is often assumed that canal number is concomitant with root number and morphology, in practice canal number and morphology do not always covary with external root features. To investigate the relationship between canal and root number, fully developed, adult post‐canine teeth were examined and quantified from computerized tomography scans from a global sample of 945 modern humans. We tested the hypotheses that root and canal number do not follow a 1:1 ratio, that canal to root ratios differ between teeth, and that canal to root ratios differ across major human geographical groups. Results indicate that not only is root number dependent on canal number, but that this relationship becomes more variable as canal number increases, varies between individual teeth and by major geographical group, and changes as these groups increase in geographical distance from Sub‐Saharan Africa. These results show that the ratio of canal number to root number is an important indicator of variation in dental phenotypes.
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Affiliation(s)
- Jason J Gellis
- University of Cambridge Leverhulme Centre for Human Evolutionary Studies, Cambridge, UK
| | - Robert A Foley
- University of Cambridge Leverhulme Centre for Human Evolutionary Studies, Cambridge, UK
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20
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Versiani MA, Carvalho KKT, Martins JNR, Custódio ALN, Castro MAA, Akaki E, Silva-Sousa YTCS, Sousa-Neto MD. Effects of root canal enlargement on unprepared areas and coronal dentine thickness of three-rooted maxillary first premolars with different root configurations: a stepwise micro-CT study. Int Endod J 2022; 55:1262-1273. [PMID: 35993556 DOI: 10.1111/iej.13818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations. METHODOLOGY Thirty three-rooted maxillary first premolars with 3 root configurations (n=10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2), and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels, and minimal dentine thickness. Statistic analyses were performed with one-way ANOVA post hoc Tukey tests and paired sample t-test at a significance level of 5%. RESULTS No statistical differences were observed among groups regarding the morphometric parameters and static voxels (p > 0.05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p < 0.05), while no differences were observed in the other roots (p > 0.05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction of dentine thickness was higher in the buccal roots than in the palatal root (p < 0.05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3. CONCLUSIONS Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.
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Affiliation(s)
- Marco A Versiani
- Dental Specialty Centre, Brazilian Military Police, Minas Gerais, Brazil.,Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Kleber K T Carvalho
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jorge N R Martins
- Centro de Estudo de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Portugal
| | - Antonio L N Custódio
- Department of Morphology, Biologic Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Maurício A A Castro
- Department of Clinic, Pathology and Dental Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Emílio Akaki
- Department of Dentistry, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Brazil
| | - Yara T C S Silva-Sousa
- Department of Endodontics, Faculty of Dentistry, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Barbhai S, Shetty R, Joshi P, Mehta V, Mathur A, Sharma T, Chakraborty D, Porwal P, Meto A, Wahjuningrum DA, Luke AM, Pawar AM. Evaluation of Root Anatomy and Canal Configuration of Human Permanent Maxillary First Molar Using Cone-Beam Computed Tomography: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10160. [PMID: 36011794 PMCID: PMC9408299 DOI: 10.3390/ijerph191610160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to review the literature on root canal configuration (RCC) and the frequency of occurrence of a second mesiobuccal canal (MB) in human permanent maxillary first molars where cone-beam computed tomography (CBCT) is used. Online electronic databases such as PubMed-Medline, Embase, Scopus and Cochrane Library were searched using appropriate keywords from the earliest available date until 12th June 2022, without restriction on language. In the mesiobuccal root, type I was the most frequent (33.29%), followed by types II and IV (27.18% and 26.36%, respectively). Moreover, 68.2% of maxillary first molars had a second MB canal. For both the distobuccal and palatal roots, type I was the most prevalent, with 99.08% and 97.83% occurrence, respectively. All other types were infrequent. Type I RCC is most frequent in all the roots of the maxillary first molars. Hence, care must be taken during biomechanical preparation of the MB roots.
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Affiliation(s)
- Sourabh Barbhai
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Rajesh Shetty
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Poonam Joshi
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Ankita Mathur
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Tanvi Sharma
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Damini Chakraborty
- Bhowal’s Dental and Implant Clinic, Bengal GreenField Heights, Galaxy-6FS, beside Apollo Pharmacy, DJ Block (Newtown), Newtown, Kolkata 700136, West Bengal, India
| | - Priyanka Porwal
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya 60132, East Java, Indonesia
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
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Asiri AA, AlQahtani KW, Tarrosh MY, Shaiban AS, Al Shawkani HA, Alaajam WH, Bamasud MS, Alqahtani M, Alyousefy MA, Al Moaleem MM. Root Morphology and Canal Configuration of Permanent Canines Among Saudi Population: Systematic Review and Comparison with Worldwide Studies. Int J Gen Med 2022; 15:6849-6860. [PMID: 36061964 PMCID: PMC9439648 DOI: 10.2147/ijgm.s380084] [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] [Received: 06/26/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
Aim The root morphology and canal configuration (RMCC) of mandibular and maxillary canines among Saudi population is systematically reviewed and compared with international studies in this research. Methods This study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The electronic databases of PubMed, Science Direct, Scopus, Wiley Library, Google website search, and Web of Science were searched. Only local and international cross-sectional, comparative, evaluation, and validation studies or case reports published between 2016 and 2022 that directly evaluated canine RMCC and assessed participants using cone beam computed tomography were included. Results Forty-three studies that investigated RMCCs (17 local and 26 international) were involved in this review. The original Saudi research recorded that almost 100% of maxillary canines had one root and one canal, whereas 98.4% and 94.1% had one root and one canal in the mandibular arch. Vertucci’s class I had the highest percentages in the maxillary and mandibular arches at 98.3% and 95.8%, respectively, followed by class III with 0.7% and 1.9% for the same arches, respectively. International studies recorded that 100% of maxillary canines had one canal and root; the percentages of the mandibular arch were 92.3 and 98% for single canal and root, respectively; and the highest percentage was obtained by Vertucci’s class I (91.1%), followed by class III (4.7%). Conclusion This review reports and confirmed the symmetry of the RMCCs of maxillary and mandibular canines between Saudi studies and other populations. Moreover, Vertucci’s classes I and III were the most frequent RMCCs, and two-rooted canines in both arches were considerably less frequently than single-rooted ones.
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Affiliation(s)
| | | | - Mohammed Y Tarrosh
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Amal S Shaiban
- Department of Restorative Dental Sciences, Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Hamed A Al Shawkani
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Wafa H Alaajam
- Department of Restorative Dental Sciences, Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Maryam S Bamasud
- Dental Department, Ministry of Health, Sakaka City, Jouf Region, Saudi Arabia
| | - Muqbil Alqahtani
- General Practitioner, King Faisal University, Alhafuf City, Saudi Arabia
| | - Mohanad A Alyousefy
- Department of Oral Medicine and Periodontology, College of Dentistry, Sana’a University, Sana’a, Yemen
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia
- Faculty of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sana’a, 4337, Yemen
- Correspondence: Mohammed M Al Moaleem, Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia, Tel +00966-550599553, Email ;
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Almansour MI, Al-Zubaidi SM, Enizy AS, Madfa AA. Comprehensive evaluation of root and root canal morphology of mandibular second molars in a Saudi subpopulation evaluated by cone-beam computed tomography. BMC Oral Health 2022; 22:267. [PMID: 35778729 PMCID: PMC9250273 DOI: 10.1186/s12903-022-02305-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study's goal was to use Cone Beam Computed Tomography (CBCT) to assess the root and root canal anatomy of mandibular second molars with C-shaped root canal configurations in residents of the Hail district. The impact of gender and side on the frequency of root canal morphology was considered. METHODS The sample size for this study was 304 untreated mandibular second molars with completely developed roots on the right and left sides. Using CBCT on the teeth, the root form and canal morphology for each root are based on Vertucci's classification. The occurrence of canals in the shape of a C. The prevalence and resemblance of the left and right sides or men and females were investigated. The Chi-square test was performed to evaluate the findings. RESULTS Of the 304 mandibular second molars studied, 286 teeth had two roots (94.1%), whilst 13 (4.3%) were C-shaped root canal systems. 77 molars (25.3%) had two canal orifices, 219 (72.0%) had three canal orifices, and six (2.0%) and one (0.3%) had four and five root canal orifices, respectively. Type IV was the most common for mesial root, accounting for 57.7% of the sample (n = 176). For distal root, the most common occurrence was type I, which occurred 282 times (96.60%). The most prevalent root canal morphology was the presence of two canals in the mesial root and one canal in the distal root of teeth with two distinct roots (variant 3). (69.4%). The overall prevalence of C-shaped root canal systems is (4.3%) (n = 13). CONCLUSIONS The patient's race is an undeniable factor that influences root canal anatomy. The root canal morphology of mandibular second molars revealed significant differences between Saudi subpopulations. The majority of mandibular second molars had two roots and three root canals. When treating these molars, the presence of a C-shaped root canal system must be taken into account.
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Affiliation(s)
- Moazzy I Almansour
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
| | - Saad M Al-Zubaidi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Abdulmjeed S Enizy
- Department of Dentistry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
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Fenelon TA, Parashos P. Prevalence and morphology of C-shaped and non-C-shaped root canal systems in mandibular second molars. Aust Dent J 2022; 67 Suppl 1:S65-S75. [PMID: 35716050 DOI: 10.1111/adj.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are no cone-beam computed tomography (CBCT)-based data on the anatomy of mandibular second molars in an Australian population. This study investigated the prevalence and descending morphology of mandibular second molars with and without C-shaped canals using retrospective analysis of CBCT scans. METHODS Scans from 715 patients were screened for the presence of C-shaped canals and assessed for cross-sectional configuration at 5 axial levels. Non-C-shaped molars were assessed for other morphological characteristics. Data were modelled against patient, tooth and CBCT scan characteristics. RESULTS A total of 1278 teeth from 657 patients were evaluated. The overall prevalence of C-shaped canals was 13%. Cross-sectional configuration of C-shaped canals was variable, with an average of 2.8 unique cross-sections per tooth. Non-C-shaped teeth were predominantly Vertucci Type II (60%) and Type IV (29%) configurations in mesial roots, and Type I (91%) in distal roots. Additional roots occurred in 4.3% of teeth and there was a significant association between radix paramolaris and distal root bifurcation (P < 0.001). CONCLUSIONS Cross-sectional analysis confirmed the complexity and variability of C-shaped canals. Clinicians should be cognisant of the prevalence and variability of C-shaped root canal morphology and how this may affect endodontic treatment. © 2022 Australian Dental Association.
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Affiliation(s)
- Thomas Alexander Fenelon
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Peter Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
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Alnowailaty Y, Alghamdi F. Prevalence of Endodontically Treated Premolars and Molars With Untreated Canals and Their Association With Apical Periodontitis Using Cone-Beam Computed Tomography. Cureus 2022; 14:e25619. [PMID: 35795507 PMCID: PMC9250691 DOI: 10.7759/cureus.25619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/05/2022] Open
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Yang Y, Jiang C, Chen M, Zeng J, Wu B. Vertucci’s root canal configuration of 11,376 mandibular anteriors and its relationship with distolingual roots in mandibular first molars in a Cantonese population: a cone-beam computed tomography study. BMC Oral Health 2022; 22:130. [PMID: 35429982 PMCID: PMC9013457 DOI: 10.1186/s12903-022-02078-5] [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] [Received: 11/15/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).
Methods
A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student’s t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.
Results
In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.
Conclusion
In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.
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Anirudhan S, Suneelkumar C, Uppalapati H, Anumula L, Kirubakaran R. Detection of second mesiobuccal canals in maxillary first molars of the Indian population - a systematic review and meta-analysis. Evid Based Dent 2022:10.1038/s41432-022-0233-3. [PMID: 35246612 DOI: 10.1038/s41432-022-0233-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/09/2021] [Indexed: 11/09/2022]
Abstract
Objective The aim of this systematic review and meta-analysis was to integrate the detection of second mesiobuccal (MB2) canals in maxillary first molars reported by different studies and methods on the Indian population.Methods This systematic review was conducted following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and PRISMA guidelines. A comprehensive search was conducted in PubMed, Medline, LILACS, Science Direct, Clinicaltrials.gov, CTRI and Cochrane databases to identify manuscripts published until 20 May 2021. Two independent reviewers assessed eligibility for inclusion, extracted data and assessed quality using the Newcastle-Ottawa Scale for cross-sectional studies.Results The database search identified 534 citations, including 36 citations through manual search, and communications from authors. After removing duplicates and going through 534 abstracts followed by 26 full-text articles, 16 articles met the inclusion criteria and contributed data for the review. The included studies used CBCT, radiographs, direct vision (DV), dental operating microscope (DOM) or dental operating microscope with ultrasonic instrumentation (DOMI) for MB2 detection. Meta-analysis and forest plot showed a pooled prevalence of 64.76% of MB2 canals in permanent maxillary first molars using CBCT, 26.5% for DV, 60.4% for using magnification in addition to DV and 71.9% for DV and magnification assisted with ultrasonic instrumentation. The prevalence of MB2 was found to be more in men than women.Conclusion The pooled prevalence in this systematic review and meta-analysis for detection of MB2 canals using CBCT was 64.76% compared to the global prevalence of 73.8%. Further well-designed studies are required to establish maxillary first molar MB2 prevalence in the Indian population.
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Affiliation(s)
- Subha Anirudhan
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, The Tamilnadu Dr.MGR Medical University, Tamilnadu, India.
| | - Chinni Suneelkumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Himasindhu Uppalapati
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Lavanya Anumula
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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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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Drouri S, Dhaimy S, Benkiran I, Jabri M, Al Jalil Z, Hamza M. Root and canal morphology of mandibular first molars in a Moroccan subpopulation by cone-beam computed tomography and its international comparison: A cross-sectional study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_104_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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Kartik SN, Shetty K, Vergis BA, Natarajan S, D'Souza JL. Analysis of root morphology and internal anatomy of 400 maxillary first premolars using cone-beam computed tomography in an Indian Dravidian subpopulation: An ex vivo study. J Conserv Dent 2022; 25:487-491. [PMID: 36506628 PMCID: PMC9733556 DOI: 10.4103/jcd.jcd_158_22] [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: 03/17/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 12/15/2022] Open
Abstract
Background There have been numerous cone-beam computed tomography (CBCT) studies done over the years to analyze the canal configurations among various racial and ethnic population groups. Several of these studies have highlighted a certain consistency in the incidence of particular features within these population subsets. Aim The study aimed to analyze the root morphology and canal configurations of the maxillary first premolar (Mx1PM) in the Indian Dravidian subpopulation using CBCT. Setting and Design This study involved a retrospective analysis of 200 CBCT scans, which included 400 Mx1PM. Methods The CBCT images were evaluated, and the number of roots and canal configurations was recorded as per the Vertucci's classification. Statistical Analysis Variations in the number of roots and canal anatomies were statistically interpreted using the Chi-square test of association with the significance level set at P < 0.05. Results Among the 400 Mx1PM studied, 116 (29%) teeth displayed single roots and 284 (71%) showed the presence of two roots. The single-rooted premolars revealed a varied canal configuration with a predominance of Vertucci's Type II configuration in around 53.4% of the Mx1PM. The two-rooted premolars revealed 100% Type I canal configuration. Conclusion The Mx1PM studied predominantly showed the two-rooted morphology with independent canals in each root. There was no significant difference between the teeth on either side of the same arch. The CBCT is an excellent nondestructive modality that can help us study the internal anatomy of pulp space accurately.
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Affiliation(s)
- S. Nath Kartik
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Karthik Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India,Address for correspondence: Dr. Karthik Shetty, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore. Affiliated to Manipal Academy of Higher Education, Karnataka, India. E-mail:
| | - Bettina Ashwini Vergis
- Department of Conservative Dentistry and Endodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Janina Loren D'Souza
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India
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Nino-Barrera J, Alzate-Mendoza D, Olaya-Abril C, Gamboa-Martinez LF, Guamán-Laverde M, Lagos-Rosero N, Romero-Diaz AC, Duran N, Vanegas-Hoyose L. Atypical Radicular Anatomy in Permanent Human Teeth: A Systematic Review. Crit Rev Biomed Eng 2022; 50:19-34. [PMID: 35997108 DOI: 10.1615/critrevbiomedeng.2022043742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of the present study is to classify and quantify the anatomical variations of teeth in terms of form and number of root canals reported in human teeth employing the classification systems proposed previously. An electronic (PubMed) and manual search were performed to identify case reports noting any of the anatomical variations. Each alteration was studied independently. The electronic search was performed using the following keywords: anatomical aberration, root canal, permanent Dentition, case report, c-shaped canal, dens invaginatus, palato-radicular groove, palato-radicular groove, palato-gingival groove, radix entomolaris, dental fusion, dental gemination, taurodontism, dilaceration. The initial search revealed 1497 papers, of which 938 were excluded after analyzing the titles and abstracts. Therefore, 559 potential papers were considered. Of those, 140 articles did not meet the inclusion criteria. For the final revision, 419 papers were considered. We found that the mandibular first premolar had the highest prevalence of C-shaped canals. Dens invaginatus was more frequently found in the mandibular lateral incisor. Taurodontism was more prevalent in the maxillary first molar and in the mandibular first molar. Dilaceration was not clearly associated with a particular tooth. The classifications systems used in this review allowed for the better understanding and analysis of the many anatomical variations present in teeth. The variations in shape most found were dens invaginatus and radix entomolaris. The most frequently reported anatomical variation was in the number of canals.
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Affiliation(s)
- Javier Nino-Barrera
- Faculty of Dentistry, School of Endodontics, Universidad Nacional de Colombia, Bogota, Colombia; Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia; Research Group on Biomechanics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Diana Alzate-Mendoza
- Program Director, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | - Carolina Olaya-Abril
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | | | - Mishell Guamán-Laverde
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
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Worldwide Assessment of the Mandibular First Molar Second Distal Root and Root Canal: A Cross-sectional Study with Meta-analysis. J Endod 2021; 48:223-233. [PMID: 34848251 DOI: 10.1016/j.joen.2021.11.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/23/2021] [Accepted: 11/20/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This study assessed the prevalence of radix entomolaris and 2 canals at the distal aspect of mandibular first molars among different geographic regions by means of cone-beam computed tomographic imaging. METHODS Precalibrated observers from 23 worldwide geographic locations followed a standardized screening protocol to assess 5750 cone-beam computed tomographic images of mandibular first molars (250 per region), gathering demographic data and recording the presence of radix entomolaris and a second canal at the distal aspect of teeth. Intra- and interrater reliability tests were conducted and comparisons among groups were performed using proportions and odds ratio forest plots. The significance level was set at 5%. RESULTS The results of intra- and interrater tests were above 0.79. The prevalence of radix entomolaris varied from 0.9% in Venezuela (95% confidence interval [CI], 0%-1.9%) to 22.4% in China (95% CI, 17.2%-27.6%). Regarding the proportion of a second distal canal, it ranged from 16.4% in Venezuela (95% CI, 11.8%-21.0%) to 60.0% in Egypt (95% CI, 53.9%-66.1%). The East Asia subgroup was associated with a significantly higher prevalence of an extra distolingual root, whereas the American subgroup, the American native ethnic group, and elderly patients were linked to significantly lower percentages of a second canal at the distal aspect of teeth. No significant differences were noted between male or female patients. CONCLUSIONS The overall worldwide prevalence rates of radix entomolaris and a second canal at the distal aspect of the mandibular first molar were 5.6% and 36.9%, respectively. The East Asia geographic region and Asian ethnic group had a higher prevalence of a second distal root.
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Prevalence and features of elongated styloid process on imaging studies: a systematic review and meta-analysis. Clin Oral Investig 2021; 26:1199-1215. [PMID: 34800204 DOI: 10.1007/s00784-021-04285-w] [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: 08/09/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the prevalence of the elongated styloid process (ESP) and its characteristics, such as sex and age of the patient, unilateral and bilateral incidence, besides variations between different populations and panoramic and CBCT examinations. MATERIALS AND METHODS A search was performed in six databases (PubMed, Web of Science, Scopus, Cochrane, Lilacs, and Embase) to identify observational studies that used imaging exams and assessed ESP prevalence among panoramic radiograph CBCT examinations, whose transversal prevalence studies were included. Furthermore, studies with a specific group of patients or symptomatic patients were excluded. Additionally, Joanna Briggs Institute checklist was used to evaluate the quality of the studies. A meta-analysis was conducted, then subgroup analyses were performed by grouping studies according to the secondary outcomes, with a significance level set at 5%. The Grading of Recommendations Assessment, Development, and Evaluation system was used to rate the certainty in the evidence. RESULTS The initial search resulted in 1635 studies, from which 39 articles met the inclusion criteria, encompassing 50,655 participants. The sample size varied between 82 and 5,000 participants. The prevalence of the ESP ranged from 1.3 to 94.8%, with an overall prevalence of 30.2%. The bilateral occurrence was higher than the unilateral one, but no significant predilection was observed according to sex, age, or population. The type of imaging examination also showed no difference in its detection. CONCLUSION The overall prevalence of ESP was 30.2%, with a propensity for bilaterality, but not for any sex, age, or population geographic location. The imaging examination modality did not influence the diagnosis of ESP. However, the quality level of the studies evaluated was very low, demonstrating the need for more homogeneous primary studies on the prevalence of the ESP with a more standardized methodology. CLINICAL RELEVANCE There is no consensus in the literature regarding the prevalence of the ESP and the characteristics of the affected patients that can cause chronic and debilitating discomfort in the head and neck region. Therefore, knowledge about the prevalence and characteristics of this condition would help dental clinicians reach the correct diagnosis.
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Prevalence of Three-Rooted Deciduous Mandibular Molars in the Children of Northwestern Iran. Int J Dent 2021; 2021:5643668. [PMID: 34737775 PMCID: PMC8563133 DOI: 10.1155/2021/5643668] [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: 07/03/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Although primary teeth have a determinative role in development of normal occlusion, few studies about anomalies related to deciduous dentition have been conducted so far. Regarding recent improvements in common knowledge and the importance of maintaining primary teeth until eruption of succedaneous teeth, identifying the morphology of primary teeth and probable variations is of great importance to achieve optimal therapeutic outcome. This study aims to determine the prevalence of three-rooted mandibular primary molars in a population of northwestern Iran. Materials and Methods In this descriptive cross-sectional study, periapical radiographs of patients attending private oral and maxillofacial radiology offices in the northwestern region of Iran from 2017 to 2019 were retrospectively reviewed. A total of 300 cases in the 3-10-year age range having bilateral periapical radiographs from mandibular primary molars were screened. First and second primary molars were observed meticulously. Gender, side of the mandible (right or left), symmetry, overall prevalence, and prevalence considering the type of molar (D or E) were recorded and analyzed. Results Overall prevalence of three-rooted mandibular primary molars was 9.33% ( 28/300), 92.9% of which were unilateral. The prevalence of teeth showing supernumerary roots among all teeth examined was 2.5% (30/1200). Considering symmetry and gender, the occurrence of these three-rooted primary molars did not differ significantly (respectively, p=0.832 and p=0.541). However, there was a significant relationship between the occurrence of supernumerary roots and left side for three-rooted first molars and right side for three-rooted second molars (p=0.021). Conclusion Obtained data show that three-rooted mandibular primary molars in children of northwest region of Iran have a prevalence of approximately 10 % which urges some specific considerations in exodontic and endodontic procedures.
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Ali NT, El-Boghdadi RM, Ibrahim AM, Amin SAW. Clinical and microbiological effects of ultrasonically activated irrigation versus syringe irrigation during endodontic treatment: a systematic review and meta-analysis of randomized clinical trials. Odontology 2021; 110:419-433. [PMID: 34729673 DOI: 10.1007/s10266-021-00671-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
This study aimed to systematically review clinical and microbiology-related effects of ultrasonically activated irrigation (UAI) compared to syringe irrigation (SI) during endodontic treatment. Electronic databases searching and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing UAI to SI. The RoB 2.0 Cochrane tool was used for risk-of-bias (RoB) assessment. The main outcomes were postoperative pain, treatment failure, and microbiology-related outcomes. Qualitative and quantitative analyses, wherever applicable, were performed. Risk ratios (RR) and [standardized] mean differences {[S]MD} were calculated for dichotomous and continuous outcomes, respectively. Certainty of evidence (CoE) was assessed using GRADE tool. Ten RCTs were included. UAI reduced pain incidence within the first 24 h (RR 0.50, 95% CI 0.35-0.71, 308 teeth) and microbial counts (SMDpooled - 0.40, 95% CI [- 0.78, - 0.02], I2 = 0%, 126 teeth) than SI in non-vital teeth with apical periodontitis (AP). Both groups, however, had similar effects regarding pain intensity, lipopolysaccharide amounts, and the incidence of rescue-analgesic intake, treatment failure, and microbial presence (p > 0.05). CoE ranged from low to very low. Very limited evidence suggests that UAI could reduce postoperative-pain risk within the first 24 h and microbial counts for non-vital teeth with AP compared to SI. Most meta-analyses, however, are based on very few studies, mostly low-powered, with an overall very-low-to-low CoE. Further well-designed, larger RCTs are, thus, required.
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Affiliation(s)
- Noha Tawfik Ali
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Randa Mohamed El-Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Ahmed Mohamed Ibrahim
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Suzan Abdul Wanees Amin
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt.
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Zeng C, Everett J, Sidow S, Bergeron BE, Tian F, Ma J, Tay FR. In vitro evaluation of efficacy of two endodontic sonic-powered irrigant agitation systems in killing single-species intracanal biofilms. J Dent 2021; 115:103859. [PMID: 34706267 DOI: 10.1016/j.jdent.2021.103859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of two sonic-powered irrigation systems, EDDY and EndoActivator, in killing intracanal biofilms. METHODS Eighty-three instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days to generate mature, single-species biofilms. The teeth were devided into four groups: irrigation with saline (N = 11); irrigation with 2% NaOCl without agitation (N = 24); irrigation with 2% NaOCl with agitation by the EndoActivaor (N = 24); irrigation with 2% NaOCl with agitation by the EDDY (N = 24). Colony-forming unit (CFU) counts and XTT assay were used to evaluate bacterial load. Additional teeth were split into root-halves for fluorescence staining to examine the percentages of live/dead bacteria in the dentinal tubules present in different canal locations (coronal, mid-root and apical portions). RESULTS Agitation of 2% NaOCl by EDDY or EndoActivator reduced bacteria load more proficiently than the use of 2%NaOCl without agitation (p < 0.05). No significant difference was detected between the two sonic-powered irrigant agitation systems (p > 0.05). Confocal laser scanning microscopy indicated that both devices had better intratubular bacteria killing efficacy than the use of 2% NaOCl only in all parts of the canal space (p < 0.05), with no significant difference detected between EDDY and EndoActivator (p > 0.05). Elimination of intracanal and intratubular bacteria were less efficient in the apical portion of the canal space for all experimental groups. CONCLUSION The two sonic-powered irrigant activation systems demonstrated comparable intracanal bacteria reduction efficacy when 2% NaOCl was used for disinfecting E. faecalis biofilms in single-rooted teeth. CLINICAL SIGNIFICANCE With the use of 2% NaOCl as irrigant, the EDDY and EndoActivator sonic-powered irrigant agitation systems have improved and equivalent intracanal bacteria reduction efficacy but are incapable of completely killing all bacteria that resided within the dentinal tubules of root canals.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Joseph Everett
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Fucong Tian
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Ren HY, Kum KY, Zhao YS, Yoo YJ, Jeong JS, Perinpanayagam H, Wang XY, Li GJ, Wang F, Fang H, Gu Y. Maxillary molar root and canal morphology of Neolithic and modern Chinese. Arch Oral Biol 2021; 131:105272. [PMID: 34600333 DOI: 10.1016/j.archoralbio.2021.105272] [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: 05/25/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study aimed to characterize Neolithic human maxillary molars from archeological remains at the Jiaojia site, Shandong, China, and compare their ultrastructural features with sex and age-matched modern locals. DESIGN Maxillary first (n = 86) and second (n = 80) molars in 5000-year-old individuals (n = 50) from the Jiaojia site were scanned by cone-beam computed tomography (CBCT). Sex and age-matched control groups were assigned from oral surgical patients at Shandong University. Images were analyzed for crown size, root length, root morphology, canal inter-orifice distances, mesiobuccal canal morphology, and second mesiobuccal (MB2) canal prevalence and location. Neolithic and modern values were compared statistically using Chi-squared and Mann-Whitney test at p < .05. RESULTS Crown and root size were smaller, and canal inter-orifice distances were shorter in Neolithic maxillary molars than their modern counterparts. For mesiobuccal roots, Weine's Type I single canals were the most prevalent in Neolithic and modern first and second molars. MB2 canal prevalence were not significantly different (p > .05) in Neolithic (53.3%) or modern (60.5%) first molars, and Neolithic (11.3%) or modern (21.3%) second molars. But, MB2 prevalence was significantly higher for modern than ancient male first (p = .032) and second (p = .005) molars. Additionally, MB2 were located more mesially and closer to MB1 in Neolithic than modern molars. CONCLUSIONS Maxillary molar root and canal morphology of ancient 5000-year-old remains at the Jiaojia site resemble that of local patients. A trend towards larger tooth size, and more dispersed MB2 canals over this short evolutionary period warrants additional investigation.
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Affiliation(s)
- H Y Ren
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - K Y Kum
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Y S Zhao
- Institute of Cultural and Heritage, Shandong University, Qingdao, PR China
| | - Y J Yoo
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - J S Jeong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Shandong Province, PR China
| | - Hiran Perinpanayagam
- Division of Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - X Y Wang
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - G J Li
- Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - F Wang
- Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - H Fang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Y Gu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China.
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Betancourt P, Brocal N, Sans-Serramitjana E, Zaror C. Functionalized Nanoparticles Activated by Photodynamic Therapy as an Antimicrobial Strategy in Endodontics: A Scoping Review. Antibiotics (Basel) 2021; 10:antibiotics10091064. [PMID: 34572645 PMCID: PMC8472326 DOI: 10.3390/antibiotics10091064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
The eradication of endodontic pathogens continues to be the focus of the search for new root canal system (RCS) disinfection strategies. This scoping review provides a comprehensive synthesis of antimicrobial photodynamic therapy (aPDT) using nanoparticles (NPs) as an alternative to optimize RCS disinfection. A systematic search up to March 2021 was carried out using the MEDLINE, EMBASE, Scopus, Lilacs, Central Cochrane Library, and BBO databases. We included studies focused on evaluating the activation of NPs by aPDT in inoculated root canals of human or animal teeth or bacterial cultures in the laboratory. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed. A total of seventeen studies were included, of which twelve showed a substantial antibacterial efficacy, two assessed the substantivity of the disinfection effect, and three showed low cytotoxicity. No adverse effects were reported. The use of functionalized NPs with photosensitizer molecules in aPDT has been shown to be effective in reducing the bacteria count, making it a promising alternative in endodontic disinfection. Further studies are needed to assess the development of this therapy in in vivo conditions, with detailed information about the laser parameters used to allow the development of safe and standardized protocols.
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Affiliation(s)
- Pablo Betancourt
- Center for Research in Dental Sciences (CICO), Endodontic Laboratory, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile;
- Department of Integral Adultos, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Correspondence: (P.B.); (C.Z.); Tel.: +56-45-2-325000 (P.B. & C.Z.)
| | - Nadia Brocal
- Center for Research in Dental Sciences (CICO), Endodontic Laboratory, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile;
| | - Eulàlia Sans-Serramitjana
- Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco 4780000, Chile;
| | - Carlos Zaror
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Correspondence: (P.B.); (C.Z.); Tel.: +56-45-2-325000 (P.B. & C.Z.)
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Gomez F, Brea G, Gomez-Sosa JF. Root canal morphology and variations in mandibular second molars: an in vivo cone-beam computed tomography analysis. BMC Oral Health 2021; 21:424. [PMID: 34470619 PMCID: PMC8411505 DOI: 10.1186/s12903-021-01787-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the anatomical variations of the root canal system of mandibular second molars using cone-beam computed tomography (CBCT). METHODS 190 mandibular second molars cone-beam computed tomography images were reviewed. The evaluation was performed by a radiologist with endodontic experience and two endodontists trained with CBCT technology. Tooth position, number of root and root canals, C-shaped root canal system configuration, presence of extra root (radix), and radicular grooves were assessed. Data was statistically analyzed using The Chi-square test (α = 0,05) to determine any significant difference between gender and the total number of root and root canals, and any significant difference between gender and root canal anatomical variation. RESULTS Overall, 85.5% showed two separated roots, 12.1% a single root, 2.6% three roots or radix. 87.7% showed three root canals, 12.1% two root canals, 2.6% four root canals, and 1.6% a single root canal. 10% showed a single foramen, 75.3% two foramina, 13.6% three foramina and 1% showed four foramina.19.5% showed C-shaped anatomical variation, 51.4% in male patients, 48.6% in female patients. According to Fan classification: C1 13.6% in cervical third, C2 10% in the middle third, C3 17.3% in middle third, 15.5% in apical third, and C4 12.7% in the apical third. Root canals number in these samples were 5.4% a single canal, 21.6% two canals, 70.3% three canals, and 2.7% four canals. The root showed 46% with one foramen, 46% two foramina, and 8% three foramina. Radicular grooves 83.3% were found in the lingual area and 16.2% towards the buccal area. CONCLUSIONS The most prevalent anatomic presentation of the evaluated sample was a mandibular second molars with two roots, three root canals, and two apical foramina. Their variation was C-shaped root canals and Radix Paramolaris.
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Affiliation(s)
- Francisco Gomez
- Postgraduate Department of Endodontics, Universidad Central de Venezuela, Caracas, Venezuela
| | - Gisbeli Brea
- Postgraduate Department of Endodontics, Universidad Central de Venezuela, Caracas, Venezuela
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Heyse JD, Ordinola-Zapata R, Gaalaas L, McClanahan SB. The effect of rotary instrumentation on dentin thickness in the danger zone of the MB2 canal of maxillary first molars. AUST ENDOD J 2021; 48:239-244. [PMID: 34351045 DOI: 10.1111/aej.12555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 01/14/2023]
Abstract
The aim of this study was to measure the initial and remaining dentin thickness in the danger zone of the second mesiobuccal (MB2) canal of maxillary first molars after rotary instrumentation using cone beam computed tomography (CBCT) imaging. After determining initial dentin thickness, each sample was subjected to a standardized protocol of rotary instrumentation files: ProTaper Gold Sx Orifice Opener (maximum depth of 7 mm); Vortex Blue 15.04, 20.04, 25.04, ProTaper Gold S1, S2, F1, F2, and finally Vortex Blue 30.06. Subsequent CBCT measurements were made to compare changes in remaining dentin thickness in comparison to initial presentation. Preoperative dentin thickness in the danger zone had a mean of 0.82 ± 0.17mm. Significant levels of dentin removal in the danger zone were noted after all instrumentation groups when compared to the pre-instrumentation mean (Sx P < 0.001, 25.04 P < 0.0006, F2 P < 0.0001, 30.06 P < 0.0001). It was concluded that a thin area of dentin exists along the distal wall of the MB2 (danger zone) from the furcation to 4 mm apically.
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Affiliation(s)
- Jeffrey D Heyse
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ronald Ordinola-Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Laurence Gaalaas
- Division of Oral Medicine, Diagnosis and Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott B McClanahan
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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Prevalence of Missed Canals and Their Association with Apical Periodontitis in Posterior Endodontically Treated Teeth: A CBCT Study. Int J Dent 2021; 2021:9962429. [PMID: 34257660 PMCID: PMC8257386 DOI: 10.1155/2021/9962429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/28/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to assess the prevalence of missed canals in endodontically treated teeth and their association with apical periodontitis in a Saudi Arabian population using CBCT. Materials and Methods A total of 208 CBCT radiographs were investigated. For each tooth, radiographs of axial, coronal, and sagittal segments were acquired to appraise the external as well as the internal structure of the root canal system and apical area. In root canal-treated teeth, unfilled canals appearing from the cementoenamel junction to the apex were defined as missed untreated canals; and a periapical lesion was considered when disruption of the lamina dura was detected, and the low-density area associated with the radiographic apex was at least twice the width of the periodontal ligament space. The data were presented as frequencies and percentages. The Z-test was used to analyze the differences in proportions with the significance level set at P value <0.05. Results The overall prevalence of missed canals among endodontically treated teeth was 18%. The prevalence of missed canals was higher in maxillary first molars with 40.6%. The overall prevalence of apical periodontitis among teeth with missed canals was 90%. It was 84.2% in the maxilla and 100% in the mandible. The second mesiobuccal canal in the maxillary first molars and mesiobuccal and distobuccal canals in mandibular teeth were the most missed canals. Conclusion Apical periodontitis in root canal-treated teeth with missed canals was high (90%), with most identified missed canals in maxillary and mandibular first molars.
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Vivacqua FD, Hungaro Duarte MA, Vivan RR, Alcalde MP, Furlan RD, Bramante CM. Analysis of Instrumentation Protocols Regarding the Quality of Mesial Canal Preparation in Mandibular Molars: A Micro-computed Tomographic Study. J Endod 2021; 47:1481-1486. [PMID: 34139263 DOI: 10.1016/j.joen.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to use micro-computed tomographic imaging to analyze the quality of the endodontic preparation of mesial canals in mandibular molars provided by 3 instrumentation protocols. METHODS Forty-five extracted mandibular molars with 2 independent mesial canals were selected, and the initial micro-computed tomographic imaging was performed. The initial volume values of the canals were submitted to statistical analysis for paired division. The groups were determined according to the final enlargement of the canal and the working length adopted (ie, G25.06/+1 mm, G35.05/foramen, and G50.01/-1 mm). At the end of each instrumentation sequence, the root canals were scanned and analyzed with regard to the increase in the total and apical volume, centralization, and preparation transportation and the percentage of the total and apical uninstrumented walls. RESULTS For the intragroup comparison, the Wilcoxon test was used, and for the intergroup analysis, the Kruskal-Wallis and Dunn tests were used (P < .05). In the analysis of the canal total volume, a statistical difference was found between G25.06/+1 mm and the remaining groups (P < .05). In the apical third, a statistical difference was observed between G25.06/+1 mm and G50.01/-1 mm (P < .05). No statistical difference was found between the groups in terms of centralization and transportation of the preparation or in terms of the percentage of the total or apical uninstrumented walls. CONCLUSIONS The preparation of the mesial canals of mandibular molars up to larger tip files but with a lower taper at 1 mm before the foramen resulted in a larger volume of apical preparation, kept the preparation centralized, and provided safe apical dentin wear without excessive cervical wear.
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Affiliation(s)
- Flavia Darius Vivacqua
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Murilo Priori Alcalde
- Department of Health Science, University of the Sacred Heart, Bauru, São Paulo, Brazil
| | - Renan Diego Furlan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Clovis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Alghamdi FT, Khalil WA. Root canal morphology and symmetry of mandibular second premolars using cone-beam computed tomography. Oral Radiol 2021; 38:126-138. [PMID: 33963988 DOI: 10.1007/s11282-021-00534-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The current study aims to investigate the morphology and symmetry of root canals of mandibular second premolar teeth via Cone-Beam Computed Tomography (CBCT) among a sample of the Saudi population. METHODS A total of 1200 CBCT images were examined in the study. The number of roots in the mandibular second premolars was identified, and canal configurations were classified according to Vertucci classification. Bilateral symmetry and association between gender and number of roots and root canal configuration were investigated using a chi-square test was utilized for data analysis and p value was set at 0.05 for significance. RESULTS Of the total 2400 Mandibular second premolars, 98.33% were single rooted and 1.67% were double rooted. The prevalence of double roots in females on the right side was significantly higher than that on the left side (p = 0.017), but the opposite was found among males. Only Type I and II canal configurations showed significant differences regarding gender and sides. 98.0% of teeth showed the symmetrical number of roots in both genders. The symmetry in canal configuration was 96.7% in males and 97.3% in females and 99.1% was Type I in both sides, 0.5% Type III, and 0.3% Type IV in both sides. CONCLUSIONS The root morphology of mandibular second premolars in the Saudi population demonstrated a high degree of variability. The vast majority of mandibular premolars have a single root with one canal and a low prevalence of two rooted teeth. Contralateral mandibular second premolars exhibited great symmetry of roots and root canal configuration.
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Affiliation(s)
- Faisal T Alghamdi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, 80209, Jeddah, 21589, Saudi Arabia.
| | - Wafaa A Khalil
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Martins JN, Zhang Y, von Zuben M, Vargas W, Seedat HC, Santiago F, Aguilar RR, Ragnarsson MF, Plotino G, Parashos P, Ounsi HF, Nole C, Monroe A, Kottoor J, Gonzalez JA, Flynn D, Chaniotis A, Cassim I, Boveda C, Berti L, Altaki Z, Alkhawas MBA, Alfawaz H, Silva EJL, Versiani MA. Worldwide Prevalence of a Lingual Canal in Mandibular Premolars: A Multicenter Cross-sectional Study with Meta-analysis. J Endod 2021; 47:1253-1264. [DOI: 10.1016/j.joen.2021.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/08/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
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Santos MC, Souza-Gabriel AE, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Detection of the internal anatomy of lower anterior teeth using cone-beam computed tomography. AUST ENDOD J 2021; 47:442-449. [PMID: 33650769 DOI: 10.1111/aej.12497] [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: 10/20/2020] [Revised: 01/18/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
Morphology study of root canal systems is essential for a correct diagnosis, therapy and prognosis of root canal treatment. This study aimed to analyse the dental anatomy of the lower anterior teeth, using cone-beam computed tomography (CBCT). Lower anterior teeth were classified in terms of type, number and location of root canals, evaluating the bilaterality of anatomical occurrences and determining whether the gender and age influence the findings. We analysed 749 CBCT of patients attending the School of Dentistry for different reasons. Spearman's correlations and Wilcoxon signed-rank test were used to analyse data (α = 0.05). There was no significant correlation between gender (male and female) and anatomy of the canals 33 (P = 0.162), 32 (P = 0.815), 31 (P = 0.708), 41 (P = 0.422), 42 (P = 0.382) and 43 (P = 0.063). There was a significant correlation between age and anatomy of the canals 33 (P = 0.045), 32 (P = 0.033), 31 (P = 0.022), 41 (P = 0.000), 42 (P = 0.037) and 43 (P = 0.037). There was no significant correlation between gender and patients' age (P = 0.325). There was no anatomical difference between the bilateral pairs (right and left homologous teeth) (P > 0.05). The most common anatomical configuration was single-canal teeth (85.29%), followed by the configuration in which one canal leaves the chamber, divides into two and unite again (12.88%). Anatomy of the lateral incisors and lower canines does not change with the gender of patients. However, as age rises, single canals and the incidence of division into two canals ending in a single foramen also increases.
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Affiliation(s)
- Marice C Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aline E Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio M Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo G Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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46
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Print and Try Technique: 3D-Printing of Teeth with Complex Anatomy a Novel Endodontic Approach. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The purpose of this report is to evaluate the applicability of a novel Print and Try technique in the presence of aberrant endodontic anatomies and to achieve a predictable treatment with improved outcome. According to guidelines, cone beam computed tomography (CBCT) is recommended in the presence of complex anatomies. The volumes were utilized to produce a stereo lithographic (STL) file, from which a 3D-plastic tooth model including a hollow root canal system was obtained. The 3D-patient-specific model facilitates the treatment planning and the trial of therapeutic approaches. Using a transparent material, all the treatment steps could be directly visualized. Subsequently, endodontic therapy could be performed in vivo with reduced operating time and with a better overview. Clinicians benefit from the Print and Try technique when facing a complicated root canal system with reduced stress and higher chances of success. In aberrant endodontic anatomies, the use of a transparent 3D plastic model, derived from the CBCT dicom, provides an exact preview of clinical challenges that will be met intra-operatively. A patient centered tailored approach to shaping, cleaning, and filling strategies can be applied.
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47
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Markvart M, Tibbelin N, Pigg M, Fransson H. Frequency of additional treatments in relation to the number of root filled canals in molar teeth in the Swedish adult population. Int Endod J 2021; 54:826-833. [PMID: 33460458 DOI: 10.1111/iej.13478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/13/2021] [Indexed: 12/25/2022]
Abstract
AIM To investigate the 5-year frequency of additional treatments in relation to the number of reported root filled canals in molar teeth in Sweden. METHODOLOGY The cohort included first and second molars in adult individuals who were registered with a root filling performed in 2009. Treatment codes corresponding to root fillings of teeth with from one up to four root filled canals were identified in the Swedish Social Insurance Agency database. The studied additional treatments were extraction, non-surgical root canal retreatment and endodontic surgery during the subsequent 5 years, identified by corresponding codes for these treatments registered on these specific teeth. Differences in the frequency of additional treatments based on the number of root filled canals were analysed using chi-square test and considered statistically significant at P < 0.05. RESULTS In 2009, root fillings on a first or second molar tooth were registered in 100 720 individuals. The study included 32 901 maxillary first molars (6.4% with four root filled canals), 12 763 maxillary second molars (3.3% with four root filled canals), 37 703 mandibular first molars (19.2% with four root filled canals) and 17 353 mandibular second molars (3.7% with four root filled canals). The total frequency of additional treatments was 14.3% (n = 14 425) during the 5-year observational period. Additional treatments were more frequent in teeth with 1-3 root filled canals compared to teeth with four root filled canals for maxillary first molars (15.2% vs. 12.7%, P = 0.002), maxillary second molars (13.8% vs. 9.1%, P = 0.007) and mandibular first molars (14.0% vs. 10.7%, P < 0.001) but not mandibular second molars (15.6% vs. 13.7%, P = 0.200). CONCLUSIONS Over 5 years, 85.7% of the included teeth were not registered with any additional treatments. Maxillary first and second molars and mandibular first molar teeth had a greater frequency of additional treatments when ≤3 root canals were filled compared to four canals.
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Affiliation(s)
- M Markvart
- Cariology and Endodontics, Section of Clinical Oral Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - N Tibbelin
- Specialist Clinic for Endodontics, Public Dental Service, Lund, Sweden
| | - M Pigg
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - H Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Endodontology, University of Gothenburg, Gothenburg, Sweden
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48
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Cheung AWT, Lee AHC, Cheung GSP. Clinical efficacy of activated irrigation in endodontics: a focused review. Restor Dent Endod 2021; 46:e10. [PMID: 33680899 PMCID: PMC7906851 DOI: 10.5395/rde.2021.46.e10] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.
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Affiliation(s)
- Amelia Wan Tin Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Angeline Hui Cheng Lee
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gary Shun Pan Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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49
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Keles A, Keskin C, Alqawasmi R, Gunduz K, Aydemir H. Diagnostic accuracy of endoscopy for the detection of isthmuses of mandibular molar teeth using micro-CT as reference. Eur Oral Res 2021; 55:34-38. [PMID: 33937760 PMCID: PMC8055258 DOI: 10.26650/eor.20210065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose: The aim of this study was to evaluate the efficacy of endoscopic visualisation
to detect the presence and type of isthmuses within the mesial root canals of
mandibular first molar teeth compared with micro-computed tomography (micro-
CT) images as reference. Materials and methods: Thirty-two mesial roots of mandibular first molars presenting isthmuses were
selected based on micro-CT scans. In all, 12 type I and 20 band-shaped isthmuses
were collected. The specimens were mounted in the posterior socket of dental
phantom manikin for endoscopic visualisation. The ability of endoscopes to visualize
the presence of isthmuses and distinguish the type of isthmuses was compared.
Micro-CT images of the specimens were used as references. Data were analyzed
using Fisher’s exact tests. Results: Sensitivity of endoscope to detect isthmuses were also calculated for each
isthmus type. In 37.5% of the samples, isthmus presence was correctly diagnosed
via orthograde endoscopic visualization. Type I istmuses were significantly more
detected than band-shaped isthmuses (P<0.05). Endoscope showed higher
sensitivity to detect type I isthmus than band-shaped isthmus. Conclusion: The endodontic endoscope could detect type I isthmuses more accurately than
band- shaped isthmuses.
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Affiliation(s)
- Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun,Turkey
| | - Cangul 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
| | - Kaan Gunduz
- Department of Dentomaxillofacial Radiology, 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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50
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Likhyani L, Shivagange V, Chacko Y, Thanvi J. Endodontic management of an atypical permanent mandibular second molar with one buccal and two lingual roots. J Conserv Dent 2021; 24:524-527. [PMID: 35399773 PMCID: PMC8989173 DOI: 10.4103/jcd.jcd_459_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/23/2021] [Accepted: 11/02/2021] [Indexed: 11/04/2022] Open
Abstract
This article describes an unusual location of the orifices and roots in a permanent mandibular second molar with symptomatic irreversible pulpitis and symptomatic apical periodontitis. During its micro-endodontic management, the cone-beam computed tomography evaluation revealed a rare variant of a three-rooted permanent mandibular second molar with four canals. The single buccal root had two canals with Vertucci's Type II pattern and a lingual root dividing into two with a single canal in each root, respectively. Interestingly, the concerned tooth had normal occlusal morphology and alignment in the arch. A follow-up of 9 months after the completion of endodontic therapy exhibited satisfactory clinical and radiographic findings.
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