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Alhumaidi AM, Mirza MB, Karobari MI, Abuelqomsan MA, Hashem Q, Aldaijy MT, Albarr NY, Aldaijy RT, Al Moaleem M. Classifying the internal anatomy of anterior teeth in the Yemeni population using two systems: a retrospective CBCT study. Odontology 2024:10.1007/s10266-024-00965-7. [PMID: 38935196 DOI: 10.1007/s10266-024-00965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
A precursor for effective root canal treatment (RCT) is a complete understanding of the internal anatomy of teeth. In this study, the authors aimed to classify the root canal morphology of anterior teeth in the Yemeni population and identify gender-based variations among them. In addition, the symmetry among adjacent quadrants was also evaluated. Cone beam computed tomography (CBCT) scans of 2935 anterior teeth, 1502 maxillary, and 1433 mandibular were analyzed for root canal morphology and symmetry. Comparison between groups and among different genders was done using the Chi-square test. All the maxillary teeth were single-rooted and had a predominantly 1TN1 (Vertucci Type I) canal morphology. In addition to 1TN1, the presence of 1TN1-2-1 (Vertucci type III) and 1TN1-2-1-2-1 (not classified NC according to Vertucci) morphologies were noticed in the maxillary canines. Among the mandibular anteriors, the canal morphologies identified include 1TN1 in majority of the scans followed by 1TN2-1 (Vertucci II), 1TN1-2-1, 1TN1-2 (Vertucci V), 1TN1-2-1-2 (Vertucci VII) was seen only in incisors and newer canal types like 1TN2-1-2-1 (NC Vertucci) and 1TN1-2-1-2-1 (NC Vertucci) was seen in canines and lateral incisors. Two roots were only seen in the mandibular canines and classified as 2TN1-2 (NC Vertucci). Variations in root and root canal morphologies were seen among both genders. However, the results were not significant. All the maxillary teeth except 0.8% were bilaterally symmetrical. In mandible, symmetry ranged between 84.5 and 86.5%. In conclusion, single-rooted teeth with 1TN1 classification are most commonly seen in all the anterior teeth. Gender-based differences were non-significant, and bilateral symmetry was high. Ahmed et al. classification could precisely represent the root canal morphology in two rooted teeth.
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Affiliation(s)
| | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia.
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Mohammed Ali Abuelqomsan
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | - Qamar Hashem
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | - Mohammed Al Moaleem
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Martins JNR. Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis. J Endod 2024:S0099-2399(24)00362-5. [PMID: 38936508 DOI: 10.1016/j.joen.2024.06.010] [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: 04/23/2024] [Revised: 06/09/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. METHODS Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. RESULTS The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05). CONCLUSIONS The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.
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Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Department of Endodontics, 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, Lisbon, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
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Nosrat A, Verma P, Dianat O, Ramzy N, Mehrzad S, Valancius M, Aminoshariae A, Fouad AF. Incidence of Middle Mesial Canals in Mandibular Molars during Root Canal Treatment and Nonsurgical Retreatment. J Endod 2024; 50:774-783. [PMID: 38460881 DOI: 10.1016/j.joen.2024.02.024] [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: 11/17/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Large-scale clinical studies on the incidence of middle mesial canals (MMCs) in nonsurgical root canal treatment (RCT) and retreatment of mandibular molars are lacking. The primary aim of this observational study was to determine the incidence of MMCs in mandibular first and second molars that received RCT or nonsurgical retreatment (NSRetx). The secondary aim was to determine factors associated with incidence of MMCs. METHODS Included were 3018 mandibular molars that received RCT (n = 1624) or NSRetx (n = 1394) by 3 endodontists in a private practice. Demographic and procedural data were collected. Bivariate and multivariable (Poisson regression model) analyses were performed. RESULTS Incidence of MMCs was 8.8% (n = 267). Although the bivariate analysis showed that NSRetx was significantly associated with incidence of MMCs, this association did not reach the threshold for statistical significance after controlling for all covariates (P = .07). Multivariable analysis on the entire cohort showed that incidence of MMCs was significantly associated with younger age (risk ratio [RR] = 1.62; 95% confidence interval [CI], 1.28-2.06), male gender (RR = 1.48; 95% CI, 1.18-1.85), preoperative cone-beam computed tomography (CBCT) (RR = 1.48; 95% CI, 1.17-1.89), and first molar (RR = 2.30; 95% CI:1.74-3.05). Subgroup multivariable analyses revealed that incidence of MMCs was associated with male gender only in the RCT group (RR = 2.26; 95% CI, 1.55-3.30) but not in the NSRetx group (RR = 1.11; 95% CI, 0.82, 1.50); and with preoperative CBCT only in the NSRetx group (RR = 1.78; 95% CI, 1.28, 2.50) but not in the RCT group (RR = 1.10; 95% CI, 0.71, 1.69). Associations with younger age and first molar remained unchanged. CONCLUSIONS Overall incidence of MMCs was 8.8%. Incidence of MMCs was significantly higher in younger patients and in mandibular first molars but was not associated with the type of treatment.
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Affiliation(s)
- Ali Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Baltimore, Maryland; Private practice, Centreville Endodontics, Centreville, Virginia.
| | - Prashant Verma
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Baltimore, Maryland; Private practice, Centreville Endodontics, Centreville, Virginia; Private practice, Capitol Endodontics, Washington, District of Columbia
| | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Baltimore, Maryland; Private practice, Centreville Endodontics, Centreville, Virginia; Private Practice, Irvine Endodontics, Irvine, California
| | - Noreen Ramzy
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia
| | - Sahar Mehrzad
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Fairfax, Virginia
| | - Michael Valancius
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Anita Aminoshariae
- Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Ashraf F Fouad
- Department of Endodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama
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Martins JNR, Versiani MA. Worldwide Anatomic Characteristics of the Mandibular Canine-A Multicenter Cross-Sectional Study with Meta-Analysis. J Endod 2024; 50:456-471. [PMID: 38280512 DOI: 10.1016/j.joen.2024.01.016] [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: 12/28/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Abstract
INTRODUCTION This study aimed to examine the global prevalence of root and root canal morphologies in mandibular canines and analyze potential influences of region, ethnicity, sex, and age on the proportion of a second root and root canal configuration. METHODS Observers from 44 countries screened 13,200 canines using cone-beam computed tomographic exams and gathered data on the percentages of 2 root canal morphologies and 2-rooted configurations (primary outcomes), as well as the root canal configurations (secondary outcome). Demographic factors (ethnicity, sex, and age) were collected for each participant. Primary outcomes were represented as odds ratios and untransformed proportions accompanied by 95% confidence interval (CI) forest plots. Meta-analysis compared subgroups and identified sources of heterogeneity. Intra- and inter-rater tests were conducted. Statistical significance was set at 5%. RESULTS The worldwide prevalence of a second canal was 7.5% (95% CI, 6.3%-8.7%), ranging from 0.7% in Nigeria to 17.7% in Uruguay. The meta-analysis also revealed significant variations when comparing ethnicity, gender, and age (P < .05). The global prevalence of a second root was 1.9% (95% CI, 1.5%-2.3%), with the highest proportion observed in Spain (6.7%). Caucasian and Indian (south Asian) ethnic groups, females, and older patients exhibited higher proportions of 2 roots (P < .05). Meta-regression excluded side, voxel size, and field of view as sources of heterogeneity (P > .05). CONCLUSIONS The prevalence of 2 root canals and 2-rooted configurations in the mandibular canine exhibited variations based on geographic location, ethnicity, sex, and age. The global prevalence of 2 root canals and 2-root configuration was 7.5% and 1.9%, respectively.
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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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Martins JNR, Versiani MA. Worldwide Assessment of the Root and Root Canal Characteristics of Maxillary Premolars - A Multi-center Cone-beam Computed Tomography Cross-sectional Study With Meta-analysis. J Endod 2024; 50:31-54. [PMID: 37898333 DOI: 10.1016/j.joen.2023.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION This worldwide study examined the root and root canal characteristics of maxillary premolars and explored how demographic factors impact the outcomes. METHODS Observers from 44 countries assessed 26,400 maxillary premolars using cone-beam computed tomography and employed a standardized screening method to gather data on multiple canal morphology and 3-rooted configuration (primary outcomes), as well as secondary outcomes related to root and root canal anatomies. Demographic factors such as ethnicity, sex, and age were collected for each participant. The intra- and inter-observer tests ensured observer reliability. Primary outcomes were represented as odds ratios and untransformed proportions accompanied by 95% confidence interval (CI) forest plots. Meta-analysis compared sub-groups and identified sources of heterogeneity (α = 5%). RESULTS The overall prevalence of multiple canal morphology in the first premolar was 93.5% (95% CI, 93.3%-94.7%), while in the second premolar, it was 49.7% (95% CI, 44.9%-54.6%). The proportion of 3-rooted configuration was 1.8% (95% CI, 1.4%-2.1%) in the first premolar and 0.4% (95% CI, 0.3%-0.5%) in the second. Asian countries generally displayed fewer roots and root canals, while European nations showed higher counts (P < .05). Males exhibited higher percentages and odds ratios for both outcomes in both premolars. Younger patients demonstrated lower percentages of multiple root canal morphologies (P < .05). Factors such as tooth side, voxel size and field-of-view did not influence the outcomes (P > .05). CONCLUSIONS The worldwide assessment of root and root canal characteristics of maxillary premolars has revealed a discernible influence of various factors such as tooth type, geographical region, ethnicity, sex, and age.
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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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Liu J, Tang B, Xu X. Concurrency of additional canals in mandibular incisors and second mesiobuccal canal in maxillary first molars: A cone-beam computed tomography investigation. AUST ENDOD J 2023; 49:563-573. [PMID: 37548258 DOI: 10.1111/aej.12787] [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: 04/12/2023] [Revised: 07/08/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
This study investigated the concurrency of additional canals in mandibular incisors and the second mesiobuccal canal in maxillary first molars among the Chinese population. In total, 8644 cone-beam computed tomography images from 8644 patients with bilateral mandibular incisors and maxillary first molars were examined. The data were analysed using Chi-square test, binary logistic regression analysis and receiver operating characteristic curve. Among the patients with additional canals in mandibular central and lateral incisors, 96.2% and 95.5% of them had second mesiobuccal canal in maxillary first molars, respectively. Additional canals of mandibular incisors and second mesiobuccal canal in maxillary first molars exhibited a concurrent relationship. The prevalence of second mesiobuccal canal in maxillary first molars increased with the number of mandibular incisors with additional canals. Moreover, when there was at least one mandibular incisor with additional canals, the presence of the second mesiobuccal canal in maxillary first molars could be highly expected.
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Affiliation(s)
- Jinchi Liu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bei Tang
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Aminoshariae A, Azarpazhooh A, Fouad AF, Glickman GN, He J, Kim SG, Kishen A, Letra AM, Levin L, Setzer FC, Tay FR, Hargreaves KM. Insights into the July 2023 Issue of the Journal of Endodontics. J Endod 2023; 49:773-775. [PMID: 37290558 DOI: 10.1016/j.joen.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | | | - Ashraf F Fouad
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Jianing He
- Texas A&M College of Dentistry, Dallas, Texas
| | - Sahng G Kim
- Columbia University College of Dental Medicine, New York, New York
| | - Anil Kishen
- Faculty of Dentistry University of Toronto, Toronto, Canada
| | - Ariadne M Letra
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, University of Pittsburgh, School of Dental Medicine, Pittsburgh, Pennsylvania
| | | | - Frank C Setzer
- University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [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] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica 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
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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