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Martinho FC, Qadir SJ, Price JB, Tordik PA, Bernardes RA, Griffin IL. Real-Time Three-dimensional Dynamic Navigation for Post Space Preparation in Root Canal-Treated Teeth: An In vitro Study. J Endod 2024; 50:976-981. [PMID: 38522577 DOI: 10.1016/j.joen.2024.03.006] [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: 11/05/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The aim of this study was to investigate the feasibility of a real-time three-dimensional dynamic navigation system (3D-DNS) for post space preparation (PSP) in root canal-treated teeth and to compare the accuracy and efficiency of 3D-DNS to freehand (FH) for PSP. METHODS Fifty-four maxillary molars were divided into two groups: 3D-DNS (n = 27) and FH group (n = 27). Cone beam computed tomography (CBCT) scans were taken preoperatively and postoperatively. The drilling path for the PSP was virtually planned in the preoperative CBCT scan in the X-guide software (X-Nav Technologies, Lansdale, PA). For the 3D-DNS group, the PSP drilling was conducted under dynamic navigation. The 3D deviations and angular deflections were calculated. The residual dentin thickness (RDT) was determined after PSP. The operation time and the total number of mishaps were recorded. Shapiro-Wilk, t-test or Mann-Whitney rank sum, weighted Cohen's kappa, and Fisher exact tests were used (P < .05). RESULTS The PSP was completed in all samples (54/54). The 3D-DNS was more accurate than the FH, with significantly fewer 3D deviations and angular deflections (all, P < .05). The 3D-DNS required less operating time than the FH (P < .05). For the 3D-DNS, no teeth had RDT < 1 mm, whereas 6/27 in the FH showed RDT < 1 mm after the PSP. There was no difference in the total number of mishaps (P > .05). CONCLUSION Within the limitations of this in vitro study, the 3D-DNS is feasible for PSP. The 3D-DNS improved the accuracy and efficiency of PSP. The dynamic navigation system can potentially become a safe and reliable technology for PSP.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Syed J Qadir
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ricardo A Bernardes
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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Arılı-Öztürk E, Büyükgöze-Dindar M. Evaluation of Radicular Dentin Thickness in Maxillary and Mandibular Central Incisor, Canine, and Premolar Teeth. Cureus 2024; 16:e56974. [PMID: 38665753 PMCID: PMC11045158 DOI: 10.7759/cureus.56974] [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: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Background This study aimed to compare the radicular dentin thickness in single-rooted maxillary and mandibular anterior and premolar teeth by measuring on four different surfaces (buccal, lingual, mesial, and distal) at three different levels (apical, middle, and coronal). Methods A total of 150 single-rooted human anterior and premolar teeth were included in the present study. The teeth were sectioned at the cemento-enamel junction (CEJ; coronal), 4 mm away from the apex (apical), and the midpoint between these two distances (middle). First, the teeth were divided buccolingually into two parts, and the dentin thickness in the mesial/distal region was measured. Subsequently, both parts were divided again to measure the dentin thickness in the buccal/lingual region. All measurements were recorded, and statistical analysis was performed. Results Apical radicular dentin thickness was significantly less than CEJ (p < 0.001). The maxillary central incisor, maxillary, and mandibular canine exhibited the maximum radicular dentin thickness, whereas the mandibular premolars showed the minimum. Radicular dentin thicknesses on the lingual and buccal surfaces were significantly higher than those on other surfaces (p < 0.001). Conclusion The lowest radicular dentin thickness values were observed in the premolars, especially on mesial and distal surfaces. Considering these areas as danger zones and paying attention during dental procedures are essential to avoid possible complications.
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Qiu S, Chen Y, Tsauo C, Wu W, Huang D, Zhou X, Peng L, Gao Y. Microcomputed tomography analysis of the radicular residual dentin thickness in mandibular second molars after virtual fiber post placement: Identification of danger zones. J Prosthet Dent 2023:S0022-3913(23)00262-7. [PMID: 37210223 DOI: 10.1016/j.prosdent.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/22/2023]
Abstract
STATEMENT OF PROBLEM Mandibular second molars have variable root, pulp chamber floor, and radicular groove morphologies, potentially affecting residual dentin thickness and post placement suitability. However, an identification of the danger zones is lacking. PURPOSE The purpose of this in vitro study was to investigate the residual dentin thickness in the danger zone of mandibular second molars after virtual fiber post placement by using a simulation method based on microcomputed tomography (μCT). MATERIAL AND METHODS A total of 84 extracted mandibular second molars were scanned using μCT and classified according to root morphology (separate or fused) and pulp chamber floor morphologies (C-shaped, non-C-shaped, or no pulp chamber floor). Fused-root mandibular second molars were further classified based on the radicular groove type (V-, U-, or Ω-shaped). All specimens were accessed, instrumented, and rescanned with μCT. Two types of commercial fiber posts were also scanned. Clinical fiber post placement was simulated in all prepared canals by using a multifunctional software program. The minimum residual dentin thickness of each root canal was measured and analyzed by using nonparametric tests to identify the danger zone. Perforation rates were calculated and recorded. RESULTS Larger fiber posts decreased minimum residual dentin thickness (P<.05) and increased perforation rate. In regard to mandibular second molars with separate roots, the distal root canal exhibited a significantly higher minimum residual dentin thickness than the mesiobuccal and mesiolingual root canals (P<.05). However, no significant difference in minimum residual dentin thickness was found between the different canals in fused-root mandibular second molars with C-shaped pulp chamber floors (P<.05). Fused-root mandibular second molars with Ω-shaped radicular grooves had a lower minimum residual dentin thickness than those with V-shaped radicular grooves (P<.05) and demonstrated the highest perforation rate. CONCLUSIONS The morphologies of the root, pulp chamber floor, and radicular groove were correlated with residual dentin thickness distribution in mandibular second molars after fiber post placement. A comprehensive understanding of mandibular second molar morphology is essential for determining the suitability of post-and-core crown restorations after endodontic treatment.
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Affiliation(s)
- Shenghao Qiu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Yue Chen
- Undergraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chialing Tsauo
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Weiwei Wu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Dingming Huang
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Xuedong Zhou
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lin Peng
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - Yuan Gao
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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Zhang Y, Lai H, Meng Q, Gong Q, Tong Z. The synergetic effect of pulp chamber extension depth and occlusal thickness on stress distribution of molar endocrowns: a 3-dimensional finite element analysis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:56. [PMID: 35723747 PMCID: PMC9209353 DOI: 10.1007/s10856-022-06677-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/29/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to evaluate the effects of butt margin, occlusal thickness and pulp chamber extension depth on stress distributions on mandibular molar endodontically treated teeth (ETT) with EMAX endocrown restoration using 3-dimensional finite element analysis (FEA). The FEA models of endocrown with flat surface or curve surface of butt margin were firstly evaluated stress distributions, and then 9 FEA models of endocrown with 1-, 2- or 3-mm pulp chamber extension depth and 1-, 2- or 3-mm occlusal thickness were generated using curve surface of butt margin. In all of FEA models, a 200 N of vertical load or horizontal load was applied, and the von Mises stress (VMS) were evaluated. The results showed that curve surface of butt margin offered more adhesive area of enamel, though VMS on the prepared teeth was similar in flat surface and curve surface models. In 9 endocrown models, 2-mm occlusal thickness showed the lowest VMS on restorations, teeth tissue and root furcations, and 2-mm extension depth displayed the lowest VMS on root furcations under vertical load. Also, 2-mm extension depth exhibited the lowest VMS on restorations and teeth tissue under horizontal load. Within the limitations of this FEA study, the results of this study could be used as an aid for dentists to better devise endocrown restorations. Graphical abstract.
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Affiliation(s)
- Yuejiao Zhang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hongbin Lai
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingzhen Meng
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qimei Gong
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongchun Tong
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Ha WN, Chaves GS, Decurcio D, Estrela C, Peters OA, Rossi-Fedele G. Remaining dentinal thickness after simulated post space preparation and the fit of prefabricated posts to root canal preparation shapes. J Am Dent Assoc 2021; 152:1020-1032.e12. [PMID: 34656294 DOI: 10.1016/j.adaj.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/30/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Post space preparation can increase the risk of experiencing perforation and root fracture. The authors assessed remaining dentin thickness after post space preparation and the fit of different prefabricated posts to root canal preparation systems in a theoretical model. METHODS Ten datasets per type of tooth from cone-beam computed tomography were analyzed to determine the minimum root diameter from 5 through 13 mm from the apical foramen. The preparation shapes of 10 root canal preparation systems were calculated and compared with the root dimensions to determine the remaining dentin thickness. Eight post brands were compared with root dimensions to determine the areas where there was less than 1 mm dentin thickness. RESULTS The average root canal preparation shape produced canal diameters of 0.57 mm at 5 mm from the canal terminus and 0.94 mm at 13 mm from the canal terminus. The mean post size tip diameter was 1.03 mm, which is larger than the dimensions of the average canal preparation. Post preparation would result in less than 1 mm of dentin thickness remaining in premolars, smaller roots of molars, and mandibular incisors. The area with less than 1 mm of dentin thickness was around the post tip. CONCLUSIONS Endosequence Fiber Post (Brasseler USA), RelyX Fiber Post 3D (3M), and Rebilda (VOCO) were the better fitting posts with the root canal preparation shapes. PRACTICAL IMPLICATIONS Many posts would result in less than 1 mm dentin thickness. Clinicians should use posts that fit their root canal preparations to minimize dentin removal.
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Tan AY, Poon L, Ng ELM, Monsour P, El Masoud BM, Moule A, Bogen G. Cone beam computed tomography analysis of residual dentin thickness after virtual post placement in the palatal roots of maxillary first molars. J Prosthet Dent 2021; 128:702-708. [PMID: 33714551 DOI: 10.1016/j.prosdent.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM In endodontically treated maxillary first molars, post space preparations in the palatal roots can compromise the residual dentin thickness (RDT) and increase the risk of perforations or root fractures. This can be attributed to the direction of the buccopalatal curvature that cannot be viewed with conventional 2D imaging. PURPOSE The purpose of this clinical study was to investigate the RDT of palatal roots following the placement of digital post analogs of different diameters positioned at various distances from the radiographic apex by using cone beam computed tomography (CBCT). MATERIAL AND METHODS A total of 122 deidentified CBCT data sets containing both maxillary permanent first molars were randomly selected from a private radiology practice. Digital parallel-sided post analogs were superimposed onto the CBCT coronal images at distances of 3 mm, 4 mm, and 5 mm from the radiographic apex and at a depth equal to the height of the anatomic crown (1:1 crown/post ratio). Post analogs of 0.9 mm, 1.0 mm, and 1.14 mm in diameter were matched with safety zone analogs representing 1 mm of circumferential RDT. The minimum RDT for each analog was determined and grouped into 3 categories: RDT≤0 mm, 0 mm<RDT<1 mm, and RDT≥1 mm. The statistical significance between post diameters and post depth was analyzed with the Friedman test and Conover post hoc test (α=.05). RESULTS Significant differences in RDT were found at all tested depths and diameters of post analogs (P<.001). Generally, the amount of RDT increased as the post length was reduced. Most teeth (>50.0%) had inadequate or no RDT. The depth of the post (P<.001) had a greater impact on RDT than the post diameter (P>.017). No similarities were found in the RDT between contralateral molars in 86.9% of the images. CONCLUSIONS The risk of insufficient RDT (<1 mm) after the placement of parallel-sided posts in the palatal roots of maxillary first molars is minimized if the post is inserted to a depth equaling the height of the crown compared with 3, 4, and 5 mm from the radiographic apex. The RDT of the palatal root of a maxillary first molar is not a reliable predictor of the contralateral palatal root RDT in the same patient.
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Affiliation(s)
- An Yan Tan
- Honors student, School of Dentistry, University of Queensland, Brisbane, Australia
| | - Lawrence Poon
- Honors student, School of Dentistry, University of Queensland, Brisbane, Australia
| | - Ee Lin Michelle Ng
- Honors student, School of Dentistry, University of Queensland, Brisbane, Australia
| | - Paul Monsour
- Discipline Lead, Emeritus Professor of Dento-Maxillofacial Radiology, Faculty of Health and Behavioural Sciences, School of Dentistry, University of Queensland, Brisbane, Australia
| | - Bilal Mohammed El Masoud
- Senior Lecturer, Discipline of Prosthodontics, Faculty of Health and Behavioural Sciences School of Dentistry, University of Queensland, Brisbane, Australia
| | - Alex Moule
- Discipline lead, Honorary Professor of Endodontics, Faculty of Health and Behavioural Science, School of Dentistry, University of Queensland, Brisbane, Australia
| | - George Bogen
- Senior Lecturer, Discipline of Endodontics, Faculty of Health and Behavioural Sciences, School of Dentistry, University of Queensland, Brisbane, Australia.
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Chen X, Min Y, Gao Y, Peng L. Microcomputer tomography measurement of minimum residual dentin thickness in mandibular first molars after virtual fiber post placement. J Prosthet Dent 2019; 123:506-513. [PMID: 31227234 DOI: 10.1016/j.prosdent.2018.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM In endodontically treated teeth, the residual dentin thickness (RDT) after post space preparation plays a major role in preventing strip perforation and vertical root fracture. PURPOSE The purpose of this in vitro study was to estimate and identify danger areas in mandibular first molars submitted to post space preparation by virtual fiber post placement and to determine a minimum RDT (mRDT) measurement by microcomputer tomography (μCT) combined with multifunctional software. MATERIAL AND METHODS A total of 24 human mandibular first molars prepared with ProTaper instruments and commercial fiber posts (#1 to #4) were scanned by using a μCT system. A framework based on MeVisLab was used to simulate clinical post placement in 2 mesial and single distal root canals. The mRDTs were measured on 4 sides (buccal, lingual, mesial, and distal) at positions 1-, 3-, and 5-mm apically from the root canal orifice. The associations between mRDT and different characteristics were examined and analyzed by 4-way ANOVA (α=.05). For each level of each root canal, the least value from the mean mRDTs of 4 sides was selected, and the side related to the least value was identified and recorded. The perforation rate of each level in different root canals was also calculated. RESULTS Significant differences were detected among the different posts, root canals, levels, and sides (P<.001). The mean mRDT was higher in distal root canals than in mesiobuccal and mesiolingual root canals (P<.001). mRDTs of each level were mainly found on the mesial sides of distal roots and the distal sides of mesial roots. The perforation rate was higher when using #3 and #4 posts, and perforation mainly occurred at the distal side of mesial roots and at a level 5-mm apically from the canal orifice. CONCLUSIONS For post placement in endodontically treated mandibular first molars, using a larger-sized post decreased the RDT and increased the perforation rate. Small fiber posts were safer and prevented perforation, with the distal root being the first choice. If more posts are required in a mesiobuccal and mesiolingual canal, the smallest appropriately sized post should be placed less than 3 mm from the root canal orifice. Combining virtual fiber post placement performed using a framework based on MeVisLab with μCT scanning is a convenient and accurate method of evaluating the risk of canal wall perforation.
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Affiliation(s)
- Xue Chen
- Graduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Yi Min
- Associate Professor, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yuan Gao
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lin Peng
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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Pelozo LL, Silva-Neto RD, Corona SAM, Palma-Dibb RG, Souza-Gabriel AE. Dentin pretreatment with Er:YAG laser and sodium ascorbate to improve the bond strength of glass fiber post. Lasers Med Sci 2018; 34:47-54. [DOI: 10.1007/s10103-018-2579-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/29/2018] [Indexed: 12/13/2022]
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Xu J, He J, Yang Q, Huang D, Zhou X, Peters OA, Gao Y. Accuracy of Cone-beam Computed Tomography in Measuring Dentin Thickness and Its Potential of Predicting the Remaining Dentin Thickness after Removing Fractured Instruments. J Endod 2017; 43:1522-1527. [DOI: 10.1016/j.joen.2017.03.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/05/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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Aggarwal V, Singla M. Lining prefabricated dowel(s) with fibre reinforced resin composite. AUST ENDOD J 2016; 43:23-28. [PMID: 27237930 DOI: 10.1111/aej.12160] [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: 03/29/2016] [Indexed: 11/27/2022]
Abstract
The study evaluated the adaptation and push-out bond force of two different lined fibre dowels in oval canals. Dowel spaces were prepared in 30 obturated mandibular premolars with oval roots. The samples were divided into three groups (n = 10). The first group received non-lined fibre dowels (NL). The fibre dowels in the second group were lined with a resin composite (PL). The fibre dowels in third group were lined with resin composite reinforced with polyethylene fibre ribbon (PFL). The proportion of surface area (PSA) occupied by the dowel and push-out bond force were analysed. The data were statistically analysed using two-way anova with post-hoc Holm-Sidak and Tukey tests. The PSA was higher in lined dowels. Highest push-out bond forces were recorded in PFL. Fibre reinforced composite lining improves the adaptation and push-out bond force of fibre dowel in oval canals.
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Affiliation(s)
- Vivek Aggarwal
- Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mamta Singla
- Department of Conservative Dentistry & Endodontics, SGT Dental College, Gurgaon, India
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Schroeder AA, Ford NL, Coil JM. Micro-computed tomography analysis of post space preparation in root canals filled with carrier-based thermoplasticized gutta-percha. Int Endod J 2016; 50:293-302. [PMID: 26865499 DOI: 10.1111/iej.12618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 02/06/2016] [Indexed: 11/27/2022]
Abstract
AIM To determine whether post space preparation deviated from the root canal preparation in canals filled with Thermafil, GuttaCore or warm vertically compacted gutta-percha. METHODOLOGY Forty-two extracted human permanent maxillary lateral incisors were decoronated, and their root canals instrumented using a standardized protocol. Samples were divided into three groups and filled with Thermafil (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA), GuttaCore (Dentsply Tulsa Dental Specialties) or warm vertically compacted gutta-percha, before post space preparation was performed with a GT Post drill (Dentsply Tulsa Dental Specialties). Teeth were scanned using micro-computed tomography after root filling and again after post space preparation. Scans were examined for number of samples with post space deviation, linear deviation of post space preparation and minimum root thickness before and after post space preparation. Parametric data were analysed with one-way analysis of variance (anova) or one-tailed paired Student's t-tests, whilst nonparametric data were analysed with Fisher's exact test. RESULTS Deviation occurred in eight of forty-two teeth (19%), seven of fourteen from the Thermafil group (50%), one of fourteen from the GuttaCore group (7%), and none from the gutta-percha group. Deviation occurred significantly more often in the Thermafil group than in each of the other two groups (P < 0.05). Linear deviation of post space preparation was greater in the Thermafil group than in both of the other groups and was significantly greater than that of the gutta-percha group (P < 0.05). Minimum root thickness before post space preparation was significantly greater than it was after post space preparation for all groups (P < 0.01). CONCLUSIONS The differences between the Thermafil, GuttaCore and gutta-percha groups in the number of samples with post space deviation and in linear deviation of post space preparation were associated with the presence or absence of a carrier as well as the different carrier materials.
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Affiliation(s)
- A A Schroeder
- Division of Endodontics, University of British Columbia, Vancouver, BC, Canada
| | - N L Ford
- Centre for High-Throughput Phenogenomics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - J M Coil
- Division of Endodontics, University of British Columbia, Vancouver, BC, Canada
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Yang Q, Cheung GSP, Shen Y, Huang D, Zhou X, Gao Y. The remaining dentin thickness investigation of the attempt to remove broken instrument from mesiobuccal canals of maxillary first molars with virtual simulation technique. BMC Oral Health 2015. [PMID: 26215404 PMCID: PMC4517344 DOI: 10.1186/s12903-015-0075-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background To investigate differences in the estimated minimum remaining dentin thickness (RDT) between periapical radiographs using the paralleling and parallax technique, after simulated removal of broken instrument from the mesiobuccal (MB) canal of maxillary first molar in virtual simulation model. The 3D measurement was taken as the standard for comparison. Methods Thirty-six maxillary first molars were scanned by micro-CT and reconstructed as 3-dimensional (3D) model. A virtual fragment of an instrument was created within the MB canal in software. Removal of the broken instrument was simulated in both the 3D and 2D dataset. Then, the models of all specimens were submitted to 2D and 3D measurements for the lowest (RDT) value in each. Differences in the values between the paralleling and parallax radiographic technique and the 3D-RDT value were analyzed with two-way Analysis of Variance. The Intra-class Correlation Coefficient (ICC) was used to assess consistency of the RDT measurements between the two periapical radiographic and techniques and 3D analysis. Results There was significant difference between RDT value obtained from the paralleling technique and 3D-RDT. There were no differences between RDT obtained from parallax (angled) technique and 3D-RDT. The ICC of RDT values between paralleling technique and 3D measurement were lower than 0.75. ICC between angled radiographs and 3D technique was close to 0.75. The optimal horizontal angle for the parallax technique was about 21°. Conclusions The virtual simulation technique can provide valuable insight into the benefit/risk analysis before removal of a broken instrument. Parallel radiographs overestimate the actual remain dentin thickness in mesiobuccal canals of maxillary first molars, whereas the parallel technique would give a closer estimate to the actual thickness at a projection angle of about 21°.
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Affiliation(s)
- Qian Yang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Gary Shun-Pan Cheung
- Area of Endodontics, Comprehensive Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| | - Dingming Huang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Xuedong Zhou
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Yuan Gao
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
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Does an intracanal composite anchorage replace posts? Clin Oral Investig 2014; 18:147-53. [DOI: 10.1007/s00784-013-0964-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 02/28/2013] [Indexed: 11/26/2022]
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Scotti N, Rota R, Scansetti M, Paolino DS, Chiandussi G, Pasqualini D, Berutti E. Influence of adhesive techniques on fracture resistance of endodontically treated premolars with various residual wall thicknesses. J Prosthet Dent 2013; 110:376-82. [PMID: 24095213 DOI: 10.1016/j.prosdent.2013.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
STATEMENT OF PROBLEM The choice of restorative method is commonly based on the cavity configuration and the residual number of cavity walls. However, the residual wall thickness could be a valuable clinical parameter in the choice of restoration for endodontically treated teeth. PURPOSE The fracture resistance of endodontically treated premolars was compared with different wall thicknesses restored with direct composite resin with and without cuspal coverage and with and without fiber post insertion. MATERIAL AND METHODS This study included 104 intact human maxillary premolars extracted for periodontal or orthodontic reasons. Standardized mesio-occluso-distal cavities were prepared with different palatal wall thicknesses (1.5, 2, and 2.5 mm) and a buccal wall thickness of 2 mm. Teeth were restored with or without a fiber post and with or without cuspal coverage. Specimens were subjected to thermocycling (3000 cycles, 5 to 55°C) and embedded in polymerized acrylic resin. Teeth were submitted to cyclic fatigue followed by a static fatigue test with a universal testing machine; a compressive force was applied 30 degrees to the long axis of the teeth until fracture. The results were statistically analyzed by 3-way ANOVA (α=.05). RESULTS Residual wall thickness (P=.004), the type of adhesive restoration (P<.001), and fiber post insertion (P<.001) significantly influenced the fracture resistance of endodontically treated premolars. CONCLUSIONS In specimens with a cavity wall thickness >2 mm, direct intracuspal composite resin restorations supported by a fiber post achieved comparable fracture resistance. With a residual wall thickness <2 mm, only cuspal coverage with or without a fiber post provided satisfactory fracture resistance.
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Affiliation(s)
- Nicola Scotti
- Assistant Professor, Department of Cariology and Operative Dentistry, Dental School Lingotto, University of Turin, Turin, Italy.
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Ghoddusi J, Bagherpour A, Mahmudabadi F, Forghani M, Sarmad M. Residual dentin thickness of bifurcated maxillary premolars following two post space preparation methods. IRANIAN ENDODONTIC JOURNAL 2013; 8:94-8. [PMID: 23922568 PMCID: PMC3734522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/01/2013] [Accepted: 04/18/2013] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this in vitro study was to compare the effect of Gates-Glidden and Peeso reamer drills on residual dentin thickness during post space preparation in order to discover which method has minimum root structure damage. MATERIALS AND METHODS Thirty extracted human maxillary premolars with bifurcations at root middle were horizontally cut 15 mm coronal to the apical end after root canal treatment. The samples were scannedby Cone Beam Computed Tomography (CBCT) before and after preparing the post space. Residual dentin thicknesses were measured at 4-, 6-, and 8-mm levels from the apex. Data were analyzed using repeated measured ANOVA. RESULTS Endodontic therapy and post space preparations removed more dentin within the bifurcation of both roots compared to outer dentin. The difference in residual dentin thickness was highly significant regarding stage (before and after post space preparation) in all levels and stage × device in coronal and middle levels (P<.05). This in vitro study emphasizes the minimal dentin width in the buccal root of maxillary premolars, especially near the bifurcation. CONCLUSION Lack of adequate residual dentin thickness after post space preparation implies that the use of posts in maxillary first premolars should be limited. When mandatory, it is recommended that post space be prepared with Gates-Glidden drill in the palatal root of maxillary first premolars and use of Peeso reamer be avoided.
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Affiliation(s)
- Jamileh Ghoddusi
- Department of Endodontics, Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashad, Iran
| | - Ali Bagherpour
- Department of Oral and Maxillofacial Radiology, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Forghani
- Department of Endodontics, Dental Material Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Maryam Forghani, Dental Material Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-915 5143349, Fax: +98-511 8829500,
| | - Majid Sarmad
- Department of Statistics, Mathematical Sciences School, Ferdowsi University of Mashhad, Mashhad, Iran
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Fornara R, Gorni F, Gagliani M. Le perforazioni radicolari iatrogene: classificazione e possibilità di trattamento ortogrado. GIORNALE ITALIANO DI ENDODONZIA 2012. [DOI: 10.1016/j.gien.2012.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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