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Wolf TG, Rempapi T, Wierichs RJ, Waber AL. Morphology and root canal configuration of maxillary lateral incisors: a systematic review and meta-analysis. Sci Rep 2024; 14:22418. [PMID: 39341889 PMCID: PMC11439037 DOI: 10.1038/s41598-024-74026-y] [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: 07/17/2024] [Accepted: 09/23/2024] [Indexed: 10/01/2024] Open
Abstract
The purpose of this study was to explore maxillary lateral incisors (MxLI) intern morphology by analyzing existing literature. We searched five electronical databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed) using keywords and predefined search terms. Additional studies were identified by cross-referencing and reviewing bibliographies of relevant articles. From 92 initial studies, 27 duplicates were removed, and 65 records screened. After full-text review and hand searching were 19 studies included. The most reported root canal configurations (RCC) of MxLI were Vertucci (Ve) I (1-1-1/1; 78.1-100%), Ve II (2-2-1/1; 0.2-5%), Ve III (1-2-1/1; 0.1-14.6%), Ve IV (2-2-2/2; 0.5%), and Ve V (1-1-2/2; 0.5-4.9%). A meta-analysis of six studies from Europe and Asia indicated sex-differentiated patterns in RCC prevalence: higher occurrences of Ve II (2-2-1/1; OR [95%CI] = 1.19 [0.51, 2.73]), Ve III (1-2-1/1; (OR [95%CI] = 1.72 [0.61, 4.85]), and Ve V (1-1-2/2; (OR [95%CI] = 2.95 [1.02, 8.55]) configurations were noted in males, whereas females predominantly exhibited Ve I (1-1-1/1; [95%CI] = 0.99 [0.97, 1.02]), and Ve IV (2-2-2/2; (OR [95%CI] = 0.11 [0.01, 2.02]). Examination methods varied, with cone beam computed tomography (CBCT) being most commonly (n = 11), followed by staining & clearing (n = 5), and radiographic analysis (n = 1). The predominant RCC in MxLI is type Vertucci I. CBCT is the most common method for assessing the morphology of root canals. However, up to 20% of cases may present with complex and sex-specific patterns, highlighting the need for clinicians to be aware of these differences to prevent complications during endodontic treatments.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Theodora Rempapi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Andrea Lisa Waber
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Sevgi U, Johnsen GF, Hussain B, Piasecki L, Nogueira LP, Haugen HJ. Morphometric micro-CT study of contralateral mandibular incisors. Clin Oral Investig 2023; 28:20. [PMID: 38147175 PMCID: PMC10751267 DOI: 10.1007/s00784-023-05419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This study aimed to determine the degree of similarity and symmetry in the anatomy of contralateral mandibular incisors. Three-dimensional (3D) models of extracted teeth were obtained from microtomography (micro-CT) scans. Qualitative and quantitative assessments of the morphology and comparison of contralateral pairs were made. The null hypothesis was that contralateral mandibular incisors could not be considered identical in simple morphometric measurements. METHODS Sixty pairs of mandibular incisors were extracted from 30 patients and scanned with micro-CT. Virtual models of the cemento-enamel junction to the root apex were rendered. Parameters such as length, canal width, dentinal thicknesses, tortuosity, centerline length, accessory canals, root canal configurations, and root canal orifice cross-sections were used to compare the teeth. Width and thickness comparisons between paired teeth in the same individual were made by paired t-test (Wilcoxon signed-rank test for variables not normally distributed). An online randomization tool generated randomized pairs (independent of the individual/patient). Subsequently, an unpaired t-test (or Mann-Whitney U test for non-normally distributed parameters) and a correlation analysis were conducted. Canal configurations were classified according to preexisting classification schemes. The number and location of accessory canals and apical foramina were registered and compared. RESULTS Utilizing advanced imaging techniques and quantitative analyses, our study establishes that contralateral mandibular incisors exhibit a remarkable degree of symmetry in multiple morphological parameters, including length, canal width, and dentinal thicknesses. The apical third showed a high degree of inter-variability for the contralateral pairs. The rigorous statistical analysis of the normalized parameters by Z-score showed no statistically significant differences between the contralateral mandibular incisors. Comparisons between central and lateral teeth revealed differences in root length but no significant disparity in the distribution of accessory canals. Central teeth, on average, were longer, while accessory canals were distributed relatively evenly between central and lateral teeth. CONCLUSIONS The findings of this study further establish the significant similarities between contralateral mandibular incisors, reinforcing their suitability as a reliable substrate for root canal comparison studies. CLINICAL RELEVANCE The absence of statistically significant differences between contralateral pairs in normalized parameters underscores their potential as a reliable reference point for root canal comparison studies in clinical dentistry. Furthermore, our findings emphasize the importance of individualized treatment planning, considering the natural symmetry in mandibular incisors to enhance clinical decision-making. This research contributes valuable insights to the field of endodontics, offering a standardized approach to sample selection and enriching the understanding of dental anatomy.
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Affiliation(s)
- Usame Sevgi
- DF Dental Group, Istanbul, Turkey
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Gaute Floer Johnsen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Tanngarden AS, Sørumsand, Norway
| | - Badra Hussain
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, Buffalo, NY, USA
| | - Liebert Parreiras Nogueira
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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Liu YJ, Liu S, Liu T, Zhang J, Zhu YN. Root canal morphology and bifurcating/merging sites of permanent mandibular incisors in 9- to 12-year-old children: An in-vivo 3D visualization analysis in China. Arch Oral Biol 2023; 155:105781. [PMID: 37556979 DOI: 10.1016/j.archoralbio.2023.105781] [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: 04/12/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE This retrospective study aims to analyze the root canal morphology of permanent mandibular incisors and the bifurcating/merging sites of root canal systems in children aged 9-12 in a Chinese subpopulation.Design Cone-beam computed tomography scans of 976 healthy, untreated and fully developed mandibular incisors were collected. Root canal morphology was identified by Vertucci's classification. Combined three-dimensional reconstruction and visualization techniques were used to locate bifurcating/merging sites in root canals. RESULTS Vertucci I was the most common classification of mandibular central incisors (42.3%) while Vertucci III was most common in mandibular lateral incisors (37.9%). Females more frequently showed Vertucci I classification (49.5% central incisors and 36.7% lateral incisors) while Vertucci III was most common among males (44.5% central incisors and 41.0% lateral incisors). The difference in canal classification by sex was statistically significant (p < 0.05). 58.7% of Vertucci V canals bifurcated in the apical third (AT) in central incisors, while 69.5% bifurcated in the middle third (MT) in lateral incisors. Bifurcating and merging in AT (44.3%) was the most common style of Vertucci III canals in central incisors, while bifurcating in MT and merging in AT (53.8%) was the most common in lateral incisors. CONCLUSION The root canal morphology of mandibular incisors in children aged 9-12 was different from that reported in previous studies on adults, and closely related to sex. Males had significantly greater canal variability than females. Lateral incisors had greater canal variability than central incisors. The bifurcating/merging sites were closely related to tooth type.
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Affiliation(s)
- Ya-Jing Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shu Liu
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ting Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jun Zhang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ya-Nan Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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Machado R, Pamplona GF, de Souza Júnior C, Nascimento J, Back EDEE, Comparin D, Ignácio SA, Reinke SMG, Kovalik AC, da Silva Neto UX. Clinical determination of anatomical diameter in different dental groups correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis: an observational clinical study. Sci Rep 2023; 13:16215. [PMID: 37758735 PMCID: PMC10533535 DOI: 10.1038/s41598-023-41967-9] [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: 05/17/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this observational clinical study (OCS) was to determine the clinical anatomical diameter (CAD) in several dental groups, thus correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis. Three-hundred fifty-nine teeth/584 vital or necrotic root canals from patients of both genders and different ages composed the sample. After performing the necessary previous procedures, K-Flexofiles were used to determine the CAD. Then, the gender and age of the patients, as well as the pulpoperiradicular diagnosis of the teeth were tabulated to conduct the statistical analysis (p < 0.05). Of the 359 teeth/584 root canals evaluated, 208/342 were from women (mean age 38.85 ± 13.42 years) and 151/242 were from men (mean age 45.41 ± 14.90 years). Statistically significant differences between the CAD means of root canals from women and men were not identified (p = 0.411). The analysis of the correlation between the CAD and age also showed a total independence (p = 0.271). Teeth with pulp necrosis and asymptomatic apical periodontitis diagnosed radiographically (TPNAAPDR) had a significantly larger CAD mean than teeth with pulp necrosis and no asymptomatic apical periodontitis diagnosed radiographically (TPNNAAPDR) and teeth with vital pulp and normal apical tissues (TVPNAT) (p = 0.0297); and the last two did not differ statistically (p > 0.05). The largest CAD mean was observed in single canals of maxillary central incisors. The lowest values of this variable were identified in the mesiobuccal and mesial canals of maxillary and mandibular first molars, respectively. The CAD of the root canals was influenced only by the root canal/tooth and pulpoperiradicular diagnosis.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil.
| | - Gabriel Filipe Pamplona
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | | | - Jaqueline Nascimento
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | | | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University-UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Biostatistics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Stella Maria Glaci Reinke
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | - Ana Cristina Kovalik
- Department of Periodontics, School of Dentistry, Regional University of Blumenau-FURB, Blumenau, Santa Catarina, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
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Bai B, Tang Y, Wu Y, Pei F, Zhu Q, Zhu P, Gu Y. Ex vivo detection of mandibular incisors' root canal morphology using cone-beam computed tomography with 4 different voxel sizes and micro-computed tomography. BMC Oral Health 2023; 23:656. [PMID: 37689620 PMCID: PMC10492267 DOI: 10.1186/s12903-023-03376-2] [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: 04/23/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND In recent years, cone-beam computed tomography (CBCT) has been widely used to evaluate patients' root canal anatomy due to its high resolution and noninvasive nature. As voxel size is one of the most important parameters affecting CBCT image quality, the current study evaluated the diagnostic potential of CBCT with 4 different voxel sizes in the detection of double root canal systems and accessory canals (ACs) in permanent mandibular incisors. METHODS A total of 106 extracted mandibular permanent incisors were collected from the dental clinics, and then were scanned by using micro-CT with a voxel size of 9 μm. The teeth were then fixed in the tooth sockets of human dry mandibles and scanned by using a CBCT device with 4 different voxel sizes (300, 200, 250, and 125 μm). Four observers detected in blind the root canal morphology of the teeth according to the CBCT images, and the presence or absence of a double root canal system, and the presence or absence of ACs, were scored according to a 5-point scale, respectively. Receiver operating characteristic (ROC) analysis was performed, and DeLong test was used to compare the area under the curve (AUC) values and the micro-CT data was taken as a gold standard. RESULTS Among 106 sample teeth, 25 specimens with a double root canal system were identified by the micro-CT. ROC curve analysis of the data obtained by the four observers showed that in the detection of double root canal systems, the AUC values ranged from 0.765 to 0.889 for 300 μm voxel size, from 0.877 to 0.926 for 250 μm voxel size, from 0.893 to 0.967 for 200 μm voxel size, and from 0.914 to 0.967 for 125 μm voxel size (all p < 0.01). In general, we observed a trend that the AUC values, sensitivity, and specialty increased with the decrease in the voxel size, and significantly higher AUC values were detected in 125 μm voxel size images. In the detection of ACs, ROC curve analysis showed that among the four observers, the AUC values ranged from 0.554 to 0.639 for 300 μm voxel size, from 0.532 to 0.654 for 250 μm voxel size, from 0.567 to 0.626 for 200 μm voxel size, and from 0.638 to 0.678 for 125 μm voxel size. CBCT images at a voxel size of 125 μm had a weak diagnostic potential (AUC: 0.5-0.7, all p < 0.05) in the detection of AC, with a lower sensitivity ranging from 36.8 to 57.9% and a higher specialty ranging from 73.6 to 98.8%. CONCLUSIONS CBCT with 300 μm voxel size could only provide moderate diagnostic accuracy in the detection of a double canal system in mandibular incisors. CBCT with a voxel size of 125 μm exhibited high diagnostic value in the detection of double canal systems, while showing low but statistically significant value in the detection of ACs.
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Affiliation(s)
- Bingbing Bai
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Ying Tang
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Yihan Wu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Fan Pei
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Qi Zhu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Peng Zhu
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Yongchun Gu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China.
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Tang Y, Wu Y, Pei F, Liu C, Qiu Y, Yang T, Gu Y. A micro-computed tomographic analysis of the root canal systems in the permanent mandibular incisors in a Chinese population. BMC Oral Health 2023; 23:129. [PMID: 36890470 PMCID: PMC9996864 DOI: 10.1186/s12903-023-02830-5] [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: 11/02/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Comprehensive understanding of the root canal system complexity is critical important for successful root canal therapy. A double root canal system may be present in permanent mandibular incisors with a variable incidence in different ethnic populations. Ignorance or improper management of this canal variation can lead to treatment failure. This in vitro study aimed to identify the anatomic features of root canal systems in the mandibular incisors in a Chinese population by using micro-CT. METHODS A total of 106 permanent mandibular incisors (53 central incisors and 53 lateral incisors) were collected from a native Chinese population. The teeth were scanned by a micro-CT scanner and then reconstructed three-dimensionally. The canal configurations were detected by Vertucci's classification, and the number and location of the accessory canals were also identified. The long (D) and short diameters (d) of the main and accessory canals were measured and D/d ratio was calculated at different root levels (cemento-enamel junction [CEJ] level, mid-root level and 1, 2, 3 and 4 mm from the apex). The root canal curvatures in the double-canaled mandibular incisors were measured at the proximal view by using modified Schneider's method. Chi-square test or Fisher's exact test was used for comparison of occurrence rates. Comparison of means from multiple groups was performed by using one-way ANOVA and LSD post-hoc test. RESULTS In regard to the occurrence of double root canals, gender difference was neither detected in the mandibular central (16.0% [male] vs 14.3% [female]; p = 0.862), nor in the mandibular lateral incisors (26.9% [male] vs 33.3% [female]; p = 0.611). Age group difference was also not detected in the mandibular central (p = 0.717) and lateral incisors (p = 0.521). The incidence of double root canals was 15.1% (8/53) in the central incisors, and 30.2% (16/53) in the lateral incisors, but the difference did not reach statistical significance (p = 0.063). The most frequent non-single canal type was the type III (1-2-1) (18.9% [20/106]), and the other types identified included 1 case of type II (2-1) and 3 cases of type V (1-2). The incidence of accessory canals was 17.9% (19/106), with a mean level of 1.92 ± 1.19 mm from the apex. The frequency of long-oval (2 ≤ D/d < 4) and flattened canals (D/d ≥ 4), as well as the mean value of D, d and D/d ratio increased from the apical 1 mm to the apical 4 mm level (the D/d ratio increased from 1.9 to 2.9 for the single canals, from 1.4 to 3.3 for the buccal canals and from 1.2 to 2.3 for the lingual canals), and the D/d ratio reached the peak at the mid-root level. Double curvatures were detected in 33.3% (8/24) of the buccal canals and 37.5% (9/24) of the lingual canals, and the difference has no statistical significance (p = 0.063). The degrees of the primary curvatures were 21.5 ± 7.1 degrees for the buccal and 30.1 ± 9.2 degrees for the lingual canals, and the degrees of secondary curvatures were 27.0 ± 11.4 degrees for the buccal and 30.5 ± 12.5 degrees for the lingual canals in the double curvatures. The degrees of the single curvatures were 14.2 ± 6.3 degrees for the buccal and 15.6 ± 6.0 degrees for the lingual canals. Significant difference was detected among above 6 groups of canal curvatures (p = 0.000), and severe curvatures (≥ 20 degrees) were more frequently detected in the double curved canals. CONCLUSIONS Double-canaled mandibular incisors were not uncommon in the Chinese population, and type 1-2-1 was the most frequent non-single canal type. Gender and age did not significantly impact the occurrence of a second canal in mandibular incisors. Long-oval and flattened canals were very common at different root levels and their incidence increased from apex to the mid-root level. Severe curvatures were frequently detected in the double canal systems, especially in those canals with double curvatures.
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Affiliation(s)
- Ying Tang
- Department of Central Laboratory and Pathology, Ninth People's Hospital of Suzhou, Soochow University, Suzhou, China
| | - Yihan Wu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., 215200, Suzhou, China
| | - Fan Pei
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., 215200, Suzhou, China
| | - Chao Liu
- Department of Central Laboratory and Pathology, Ninth People's Hospital of Suzhou, Soochow University, Suzhou, China
| | - Yinfeng Qiu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., 215200, Suzhou, China
| | - Tao Yang
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., 215200, Suzhou, China
| | - Yongchun Gu
- Department of Central Laboratory and Pathology, Ninth People's Hospital of Suzhou, Soochow University, Suzhou, China. .,Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist., 215200, Suzhou, China.
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Zheng L, Liu Y, Jiang L, Wang X, Chen Y, Li L, Song M, Zhang H, Zhang YS, Zhang X. Injectable decellularized dental pulp matrix-functionalized hydrogel microspheres for endodontic regeneration. Acta Biomater 2023; 156:37-48. [PMID: 36455855 DOI: 10.1016/j.actbio.2022.11.047] [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: 04/07/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022]
Abstract
The sufficient imitation of tissue structures and components represents an effective and promising approach for tissue engineering and regenerative medicine applications. Dental pulp disease is one of the most common oral diseases, although functional pulp regeneration remains challenging. Herein, we propose a strategy that employs hydrogel microspheres incorporated with decellularized dental pulp matrix-derived bioactive factors to simulate a pulp-specific three-dimensional (3D) microenvironment. The dental pulp microenvironment-specific microspheres constructed by this regenerative strategy exhibited favorable plasticity, biocompatibility, and biological performances. Human dental pulp stem cells (hDPSCs) cultured on the constructed microspheres exhibited enhanced pulp-formation ability in vitro. Furthermore, the hDPSCs-microcarriers achieved the regeneration of pulp-like tissue and new dentin in a semi-orthotopic model in vivo. Mechanistically, the decellularized pulp matrix-derived bioactive factors mediated the multi-directional differentiation of hDPSCs to regenerate the pulp tissue by eliciting the secretion of crucial bioactive cues. Our findings demonstrated that a 3D dental pulp-specific microenvironment facilitated by hydrogel microspheres and dental pulp-specific bioactive factors regenerated the pulp-dentin complex and could be served as a promising treatment option for dental pulp disease. STATEMENT OF SIGNIFICANCE: Injectable bioscaffolds are increasingly used for regenerative endodontic treatment. Despite their success related to their ability to load stem cells, bioactive factors, and injectability, conventional bulk bioscaffolds have drawbacks such as ischemic necrosis in the central region. Various studies have shown that ischemic necrosis in the central region can be corrected by injectable hydrogel microspheres. Unfortunately, pristine microspheres or microspheres without dental pulp-specific bioactive factor would oftentimes fail to regulate stem cells fates in dental pulp multi-directional differentiation. Our present study reported the biofabrication of dental pulp-derived decellularized matrix functionalized gelatin microspheres, which contained dental pulp-specific bioactive factors and have the potential application in endodontic regeneration.
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Affiliation(s)
- Liwen Zheng
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China
| | - Yaxian Liu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China
| | - Lin Jiang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China
| | - Xiaoping Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China
| | - Yuqin Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, PR China
| | - Lan Li
- Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, PR China
| | - Mingyu Song
- Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, PR China
| | - Hongmei Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China.
| | - Yu Shrike Zhang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA.
| | - Ximu Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, PR China; Stomatological Hospital of Chongqing Medical University, Chongqing 401174, PR China.
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8
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Chen C, Zhu T, Wu H, Zhao X, Leng D, Wang J, Yang L, Wu D. Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals. Sci Rep 2022; 12:19779. [PMID: 36396689 PMCID: PMC9671964 DOI: 10.1038/s41598-022-24381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).
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Affiliation(s)
- Cheng Chen
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Tingting Zhu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Lianfeng Yang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Karobari MI, Arshad S, Noorani TY, Ahmed N, Basheer SN, Peeran SW, Marya A, Marya CM, Messina P, Scardina GA. Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review. J Clin Med 2022; 11:jcm11092287. [PMID: 35566414 PMCID: PMC9099997 DOI: 10.3390/jcm11092287] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6).
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Affiliation(s)
- Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Sohaib Arshad
- Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Syed Wali Peeran
- Department of Periodontics, Armed Forces Hospital Jizan, Jazan 82722, Saudi Arabia;
| | - Anand Marya
- Department of Orthodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India;
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India;
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
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Chen C, Zhang W, Liang Y. Evaluation of apical root defects during canal instrumentation with two different nickel-titanium (NiTi) systems by optical coherence tomography (OCT) scan. J Dent Sci 2022; 17:763-770. [PMID: 35756775 PMCID: PMC9201542 DOI: 10.1016/j.jds.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/02/2021] [Indexed: 01/20/2023] Open
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THE PREVALENCE OF A SECOND ROOT CANAL IN MANDIBULAR ANTERIOR TEETH VARIES BY GEOGRAPHIC REGIONS AND DEMOGRAPHIC FACTORS. J Evid Based Dent Pract 2021; 21:101652. [PMID: 34922730 DOI: 10.1016/j.jebdp.2021.101652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Martins JNR et al. Influence of Demographic Factors on the Prevalence of a Second Root Canal in Mandibular Anterior Teeth - A Systematic Review and Meta-Analysis of Cross-Sectional Studies Using Cone Beam Computed Tomography. Arch Oral Biol. 2020 Aug;116:104,749. doi: 10.1016/j.archoralbio.2020.104749. SOURCE OF FUNDING No funding was obtained for this research TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.
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Internal morphology of 101 mandibular canines of a Swiss-German population by means of micro-CT: An ex vivo study. Sci Rep 2021; 11:21281. [PMID: 34711902 PMCID: PMC8553763 DOI: 10.1038/s41598-021-00758-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/01/2021] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate the root canal system morphology by means of a root canal configuration (RCC) classification described with a four-digit system, the physiological foramen geometry and accessory canal frequency and morphology, of 101 mandibular canines (MaCa) of a Swiss-German population by means of micro-computed tomography. Micro-CT examination of the MaCa was performed and the obtained images analyzed with a 3D imaging software. In single-rooted MaCas, the most frequently observed RCCs were 1-1-1/1 (74.5%) and 1-1-1/2 (14.3%). Seven other RCCs were less frequently observed with a frequency from 4.1 to 1.0%. One physiological foramen was observed in 80.6% of the MaCas, two in 16.3%, three in 1.0% and four in 2.0%. Accessory and connecting canals were apparent only in the middle and apical root thirds. Two-rooted MaCas occurred less frequently (n = 3). When one physiological foramen was present, the mean size of the narrow and wide diameters were 0.28 mm (± 0.07) and 0.40 mm (± 0.11), while the distance between physiological and anatomical foramen was 0.45 mm (± 0.17). MaCas are predominantly single-rooted teeth with a 1-1-1/1 or 1-1-1/2 RCC. Most MaCas had one physiological foramen with an oval shape.
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Wolf TG, Anderegg AL, Yilmaz B, Campus G. Root Canal Morphology and Configuration of the Mandibular Canine: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10197. [PMID: 34639498 PMCID: PMC8507995 DOI: 10.3390/ijerph181910197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 01/04/2023]
Abstract
The aim of this study was to systematically review the root canal morphology and configuration (RCC) of mandibular canines (MaCa). The review was registered in the PROSPERO database (ID-272297) and it was carried out following the PRISMA guidelines. Three electronic databases (MEDLINE via PubMed, Embase, Scopus) were searched. Randomized controlled trials, cross-sectional, cohort, comparative, evaluation and validation studies have been included. The anatomical quality assessment (AQUA) tool was used for a quality assessment of the anatomical studies. Of 910 studies retrieved from the systematic search, 28 studies investigating RCCs were included. Most MaCa were single-rooted (87.9-100%), while two-rooted MaCa were present up to 12.1%. The 1-1-1/1 (35.8-96.4%) was the most commonly reported RCC, followed by 2-2-1/1 (0.2-22.0%) and 1-2-1/1 (0.9-20.0%). A high frequency of 1-1-1/1 RCC in MaCa has been described. Most systematic review reports confirm that two-rooted MaCa are found considerably less frequently than single-rooted ones.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (A.L.A.); (B.Y.); (G.C.)
- Department of Periodontology and Operative Dentistry, University Medical Center, Johannes Gutenberg-University Mainz, 553131 Mainz, Germany
| | - Andrea Lisa Anderegg
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (A.L.A.); (B.Y.); (G.C.)
| | - Burak Yilmaz
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (A.L.A.); (B.Y.); (G.C.)
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (A.L.A.); (B.Y.); (G.C.)
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, I-07100 Sassari, Italy
- Department of Pediatric, Prophylaxis Dentistry and Orthodontics, School of Dentistry, Sechenov University, 119991 Moscow, Russia
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Lin X, Fu Y, Ren G, Yang X, Duan W, Chen Y, Zhang Q. Micro-Computed Tomography-Guided Artificial Intelligence for Pulp Cavity and Tooth Segmentation on Cone-beam Computed Tomography. J Endod 2021; 47:1933-1941. [PMID: 34520812 DOI: 10.1016/j.joen.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study proposes a novel data pipeline based on micro-computed tomographic (micro-CT) data for training the U-Net network to realize the automatic and accurate segmentation of the pulp cavity and tooth on cone-beam computed tomographic (CBCT) images. METHODS We collected CBCT data and micro-CT data of 30 teeth. CBCT data were processed and transformed into small field of view and high-resolution CBCT images of each tooth. Twenty-five sets were randomly assigned to the training set and the remaining 5 sets to the test set. We used 2 data pipelines for U-Net network training: one manually labeled by an endodontic specialist as the control group and one processed from the micro-CT data as the experimental group. The 3-dimensional models constructed using micro-CT data in the test set were taken as the ground truth. The Dice similarity coefficient, precision rate, recall rate, average symmetric surface distance, Hausdorff distance, and morphologic analysis were used for performance evaluation. RESULTS The segmentation accuracy of the experimental group measured by the Dice similarity coefficient, precision rate, recall rate, average symmetric surface distance, and Hausdorff distance were 96.20% ± 0.58%, 97.31% ± 0.38%, 95.11% ± 0.97%, 0.09 ± 0.01 mm, and 1.54 ± 0.51 mm in the tooth and 86.75% ± 2.42%, 84.45% ± 7.77%, 89.94% ± 4.56%, 0.08 ± 0.02 mm, and 1.99 ± 0.67 mm in the pulp cavity, respectively, which were better than the control group. Morphologic analysis suggested the segmentation results of the experimental group were better than those of the control group. CONCLUSIONS This study proposed an automatic and accurate approach for tooth and pulp cavity segmentation on CBCT images, which can be applied in research and clinical tasks.
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Affiliation(s)
- Xiang Lin
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yujie Fu
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Genqiang Ren
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Xiaoyu Yang
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Wei Duan
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Yufei Chen
- College of Electronics and Information Engineering, Tongji University, Shanghai, China.
| | - Qi Zhang
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.
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Micro-computed tomography analysis of root canal morphology and thickness of crown and root of mandibular incisors in Chinese population. Clin Oral Investig 2021; 26:901-910. [PMID: 34338894 DOI: 10.1007/s00784-021-04071-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/04/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the root canal morphology and the thickness of crown and root of mandibular incisors in a Chinese subpopulation by micro-computed tomography (micro-CT). METHODS In total, 208 mandibular incisors were scanned using micro-CT. The anatomical features of the canals (canal configuration, apical constriction, foramen-to-apex distance, accessory canal vertical distribution, and canal geometrical parameters) and the thickness of the crown and root 2/3 were evaluated. RESULTS Three canal categories, labeled as Single (77.88%), Merged (15.87%), and Separated (6.25%), were summarized. The most frequent constriction type in main foramina was single constriction (42.53%). Wide and narrow diameters in a single main foramen were 0.37 ± 0.14 mm and 0.26 ± 0.07 mm, respectively. The distance from the anatomical foramen to the physiological foramen and the anatomical apex was 0.49 ± 0.20 mm and 0.36 ± 0.28 mm, respectively. During the virtual root-end resection, 97.12% of roots underwent successful resection at the 2-mm level, with the foramina visible on the resection surface. During 2-D cross-sectional analyses, the shape parameters of the root and canal showed significant positive correlation (P < 0.05). The thickest and thinnest walls were the incisal and proximal walls (P < 0.05) of the crown, respectively. The buccal walls were significantly thicker than the lingual walls on the crown (P < 0.05), whereas the lingual walls were thicker on the root 2/3 (P < 0.05). CONCLUSIONS This study provides detailed information about the root canal morphology and thickness of the crown and root of mandibular incisors in a Chinese population. An understanding of morphology can benefit endodontic treatment. CLINICAL RELEVANCE Adequate knowledge of the crown, root, and canal morphology, as well as the thickness distribution of the crown and root, is essential for successful root canal therapy and prevention of complications.
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Machado R, Vigarani G, Macoppi T, Pawar A, Glaci Reinke SM, Kovalik Gonçalves AC. Extrusion of debris with and without intentional foraminal enlargement - A systematic review and meta-analysis. AUST ENDOD J 2021; 47:741-748. [PMID: 34146366 DOI: 10.1111/aej.12539] [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: 01/15/2021] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 01/22/2023]
Abstract
This systematic review and meta-analysis was sought to assess whether intentional foraminal enlargement (IFE) is responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes. Following the recommendations of Preferred Reporting Items for Systematic Review and Meta-Analysis - PRISMA, electronic and manual searches were performed to identify studies that evaluated the extrusion of debris, comparing different apical limits of instrumentation (with/without IFE). The quality of the studies selected was evaluated, and statistical analysis was conducted. To perform the meta-analysis, just 3 papers could be used. The heterogeneity was high, however; there was no statistically significant difference in relation to the extrusion of debris in teeth either submitted or not submitted to IFE. The general risk of bias was moderate. In conclusion, IFE is not responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Gislayne Vigarani
- Student of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Tainara Macoppi
- Student of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Ajinkya Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Stella Maria Glaci Reinke
- Department of Endodontics, School of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
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Haberthür D, Hlushchuk R, Wolf TG. Automated segmentation and description of the internal morphology of human permanent teeth by means of micro-CT. BMC Oral Health 2021; 21:185. [PMID: 33845806 PMCID: PMC8040229 DOI: 10.1186/s12903-021-01551-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
High-resolution micro-computed tomography is a powerful tool to analyze and visualize the internal morphology of human permanent teeth. It is increasingly used for investigation of epidemiological questions to provide the dentist with the necessary information required for successful endodontic treatment. The aim of the present paper was to propose an image processing method to automate parts of the work needed to fully describe the internal morphology of human permanent teeth. One hundred and four human teeth were scanned on a high-resolution micro-CT scanner using an automatic specimen changer. Python code in a Jupyter notebook was used to verify and process the scans, prepare the datasets for description of the internal morphology and to measure the apical region of the tooth. The presented method offers an easy, non-destructive, rapid and efficient approach to scan, check and preview tomographic datasets of a large number of teeth. It is a helpful tool for the detailed description and characterization of the internal morphology of human permanent teeth using automated segmentation by means of micro-CT with full reproducibility and high standardization.
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Affiliation(s)
- David Haberthür
- Institute of Anatomy, University of Bern, Bern, Switzerland.
| | | | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
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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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Abstract
This article provides a contemporary synopsis of effective cleaning of the root canal system, an essential stage of root canal treatment. It provides a clinical update on the current state of knowledge on cleaning of the root canal system, and presents an outline of essential theory and practical tips for achieving effective and safe cleaning of the root canal system.
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Affiliation(s)
| | - Igor R Blum
- Reader in Primary Dental Care & Advanced General Dental Practice; Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Consultant & Specialist in Restorative Dentistry, King's College Hospital Dental Institute
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Root Canal Morphology of the Permanent Mandibular Incisors by Cone Beam Computed Tomography: A Systematic Review. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10144914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Knowledge of dental anatomy through the assessment of the anatomic variations of each tooth’s root canal system is essential to undertake endodontic therapy. The aim of this systematic review was to analyze the different studies on the internal morphology of permanent mandibular incisors where Cone-Beam Computed Tomography (CBCT) X-ray imaging is used. Pubmed, CENTRAL, Wiley Library and Web of Science electronic databases were searched for scientific studies included until March 2020. The terms used in the search were: “permanent mandibular incisors”, “root canal morphology” and “cone-beam computed tomography”. The search was limited to studies whose aim was the analysis of the morphology of the root canal system evaluating the parameters of methodology, population, sample, number and configuration. A total of 19 studies met the inclusion criteria. There was a noticeable lack of unanimity in the setting adjustments of each of the CBCT devices used. The presence of two root canals varied from 0.4% to 45%. The most frequent configurations were Vertucci’s Types I, III, II, V, IV, VII and VI. Type VIII configuration was non-existent. CBCT revealed the existence of anatomical symmetry patterns, and there was no unanimity of criteria regarding the presence of a second root canal. Results concerning the presence of a second root canal in the mandibular incisors differ widely, with a possible influence of the geographic area where the study was conducted. The prevalence of a second canal is higher in mandibular lateral incisors than in mandibular central incisors. There was no direct relationship between voxel size (0.125–0.3 mm) and increased prevalence of a second canal.
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