Methodology for Morphometric Analysis of Modern Human Contralateral Premolars:

Cone-Beam Computed Tomography for the Evaluation of Dental Pulp Chamber Volume: Implications for Clinics and Teaching

The dental pulp chamber volume is a fundamental measurement in the field of endodontics, but also in forensic sciences, teaching and training, or tissue engineering. This study evaluates the precision of cone-beam computed tomography (CBCT) in comparison with computed micro-tomography (micro-CT) in evaluating the pulp chamber volume of the upper central incisors ex vivo. The intra-operator and inter-operator errors were evaluated, and the results for the two techniques were compared with those of a T-test for paired samples. The intra-operator and inter-operator errors were >0.05, indicating adequate reproducibility in each operator and no significant differences between their measurements. On the other hand, no significant differences between the two measurement techniques were found. The present results demonstrate that CBCT is a precise, feasible, and reproducible technique for the evaluation of the dental pulp chamber volume ex vivo. The results provided with this method are useful for different medical domains but also for the teaching and training of undergraduate and postgraduate students. Furthermore, the findings of this study carry significant clinical implications, as the accurate assessment of the pulp chamber volume is critical in the diagnosis and treatment of various endodontic conditions. The ability of CBCT to provide reliable 3D dental anatomy measurements can enhance the planning of endodontic treatments by allowing for a better understanding of the internal tooth morphology. Additionally, the precision and reproducibility of CBCT in assessing the pulp chamber volume can contribute to improved clinical outcomes and reduced complications during endodontic procedures. These findings further support the increasingly vital role of CBCT in modern clinical practice and underscore its value as an indispensable tool in the field of dentistry.

Morphometric micro-CT study of contralateral mandibular incisors

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.

Anatomic Comparison of Contralateral Maxillary Second Molars Using High-Resolution Micro-CT

The present study aimed to measure and compare anatomic parameters in contralateral maxillary second molars. A total of 18 intact maxillary second molar pairs (n = 36) extracted from 18 patients were scanned with micro-computed tomography (micro-CT) and then reconstructed. Axial, sagittal, and cross-sectional slices were used to analyze the parameters (lengths, widths, and thicknesses) and evaluate the symmetry of the right and left sides. The number of root canals and their internal patterns were classified following Vertucci’s classification. The number of lateral canals and their locations were also noted. Contralateral second molar pairs demonstrated a high degree of similarity in terms of the linear measurements (lengths, widths, and thicknesses). The root canal anatomy configuration symmetry of mesiobuccal, distobuccal, and palatal roots according to Vertucci’s classification were 41.1%, 88.2%, and 94.4%, respectively. In total, 41.6% of mesiobuccal roots, 2.7% of distobuccal roots, and 30.6% of palatal roots had at least one lateral canal. The apical third (38.7%) was the most frequent location of lateral canals, followed by the middle third (32.3%) of the root. This study provides insight into the anatomy of the root canals of contralateral maxillary second molars, which is valuable for both practitioners and researchers.

Assessment of the Root Canal Similarity in Contralateral Mandibular Incisors

INTRODUCTION

The purpose of this study was to determine the degree of similarity between contralateral mandibular incisors utilising 3-dimensional (3D) models obtained from micro-computed tomographic (micro-CT) scans of extracted human teeth. The null hypothesis was that contralateral mandibular incisors do not exhibit matching symmetry.

METHODS

Sixty pairs (n = 120) of extracted mandibular incisors were obtained from 30 patients and scanned with micro-CT with a voxel size of 15.0 μm. 3D virtual models of the pulpal cavities were rendered. Geometric morphometric deviation analysis was performed after mirroring, automatic alignment, and co-registration of the models of contralateral teeth root mean square (RMS) errors were calculated. The quantitative analysis of the 3D models included 6 different geometric parameters. Data sets were examined with a 2-sample Kolmogorov-Smirnov test. Post hoc retrospective power analysis was performed to find statistical power (α = 0.05).

RESULTS

Contralateral pairs had a narrower distribution in deviation than random pairs. Also, contralateral pairs showed a statistically higher similarity coefficient (5 out of 6 geometric parameters) compared to random pairs (P < .001); no difference was found when comparing central to lateral pairs or between Vertucci type I configurations compared to non-type I. RMS errors had significantly lower Contralateral premolars (CPs) values than random pairs (P < .001).

CONCLUSIONS

A high degree of similarity was demonstrated for pairing contralateral mandibular incisors using 3D models. The similarity between contralateral central and lateral incisors suggests that when screened and matched, these 4 teeth might be used in endodontic research where similar root canal anatomy is crucial.

Effects of antibiotics on the developing enamel in neonatal mice

PURPOSE

Identifying factors causing Molar-Incisor Hypomineralization (MIH) is an ongoing challenge. Preterm infants, routinely treated with antibiotics in cases of suspected sepsis, are more commonly affected by dental developmental defects. This study aimed to investigate the effects of gentamycin and ampicillin on the developing enamel in neonatal CD-1 mice in vivo.

METHODS

Neonatal mice were randomized into a study (n = 36) and a control (n = 35) group. Antibiotics were injected intravenously for 4 days. All mice were sacrificed after 15-18 days. Micro-CT was used to analyse the mineral density (MD) of the enamel and the proportion of the enamel object volume (vol%) in first molars and incisors.

RESULTS

We demonstrated a significantly lower vol% enamel in the maxillary (30.9% vs. 32.7%; p = 0.004) and mandibular (32.5% vs. 34.6%; p = 0.015) molars in the study group than in the controls. The incisors were divided into segments upon analysis. We demonstrated both lower vol% and lower MD of the enamel in most segments in treated individuals compared to controls (p < 0.05).

CONCLUSION

The reduced MD and vol% in the molars and incisors are likely to have been caused by the antibiotics given during tooth development. The presented analysis of teeth in neonatal mice with micro-CT could be a valid model for further research on dental developmental defects.

A critical appraisal of research methods and experimental models for studies on root canal preparation

It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.

Evaluation of root canal morphology of mandibular premolars in a Saudi population using cone beam computed tomography: A retrospective study

Objective

To investigate the root canal morphology of mandibular first and second premolars using Cone-Beam Computed Tomography (CBCT) in a Saudi population.

Methods

CBCT images of 707 patients, number of roots and canal configuration were identified and categorized according to Vertucci classification. Bilateral symmetry and association between gender and number of roots, as well as gender and root canal configuration were investigated.

Results

Majority of the patients had one root and type I root canal configuration in mandibular first (96.4%) and second premolar (95.6%). All types of canal configurations were observed except Type VII for the mandibular first premolar, and Types VI and VII for the mandibular second premolar. High degree of bilateral symmetry was seen in both mandibular first and second premolars in terms of the number of roots and canal configuration; 93.8% and 97.8%, respectively. There was an association between gender and number of roots (P = 0.04) and gender and root canal configuration in mandibular first premolar (P = 0.030).

Conclusions

Single-root with type I canal configuration was the most prevalent of mandibular premolars in the Saudi population. However, incidence of more than one root with different canal configurations was detected.