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Wolf TG, Rempapi T, Wierichs RJ, Waber AL. Morphology and root canal configuration of maxillary canines: a systematic review and meta-analysis. BMC Oral Health 2024; 24:944. [PMID: 39143543 PMCID: PMC11325658 DOI: 10.1186/s12903-024-04682-z] [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: 04/09/2024] [Accepted: 07/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND This study assessed the internal morphology of maxillary canines (MxC) through a systematic review of existing literature. METHODS Research articles up to June 2024 were retrieved from five electronic databases (MEDLINE via PubMed, Embase, Scopus, LILACS, and Cochrane). Predefined search terms and keywords were used, and potential studies were identified by cross-referencing and bibliographies of the selected articles reviewed. RESULTS Two hundred studies were identified, 73 duplicates were removed, 127 records were screened, and 113 were removed after consultation of title and abstract. After full-text consultation and hand searching, finally 22 studies were included. Using the method for describing the root canal configuration (RCC) of Briseño Marroquín et al. (2015) and Vertucci (Ve) (1984), the most frequently reported RCC of MxC were 1-1-1/1 (Ve I, 75.4-100%), 2-2-1/1 (Ve II, 0.1-20%), 1-2-1/1 (Ve III, 0.1-11.6%), 2-2-2/2 (Ve IV, 0.1-0.4%), 1-1-2/2 (Ve V, 0.1-2.4%), 2-1-2/2 (Ve VI, 0.5-1.2%), and 1-2-1/2 (Ve VII, 0.1-0.2%). The meta-analysis of six studies (Europe/Asia) showed that a significantly higher number of RCC of 2-2-1/1 (Ve II) (OR [95%CI] = 1.34 [0.53, 3.41]), 1-2-1/1 (Ve III) (OR [95%CI] = 2.07 [1.01, 4.26]), and 1-1-2/2 (Ve V) (OR [95%CI] = 2.93 [1.07, 8.07]), were observed in males, and 2-2-2/2 (Ve IV) (OR [95%CI] = 0.08 [0.00, 4.00]) in females. No sex differences in the RCC of 1-1-1/1 (Ve I) and 1-2-1/2 (Ve VII) were observed. CONCLUSIONS Cone beam computed tomography is the most frequently used method for research on the RCC of MxC. Despite the high prevalence of type 1-1-1/1 (Ve I) RCC in MxC, clinicians should remain vigilant for more complex and sex-differentiated patterns in up to 25% of cases to prevent endodontic treatment complications or failures.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Theodora Rempapi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Lisa Waber
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Algarni HA, Alonazi MA, Arshad H, Zahra F, Umer F, Maqbool I, Iqbal A, Karobari MI. Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study. Eur J Med Res 2024; 29:391. [PMID: 39068434 PMCID: PMC11282603 DOI: 10.1186/s40001-024-01990-6] [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: 06/05/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. METHOD This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761-70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. RESULTS The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. CONCLUSION This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.
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Affiliation(s)
- Hmoud Ali Algarni
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Hamza Arshad
- Prosthodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fatima Zahra
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fahad Umer
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | | | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Department of Dental Research, CGHR, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
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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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Wolf TG, Rempapi T, Schumann S, Campus G, Spagnuolo G, Armogida NG, Waber AL. Micro-computed tomographic analysis of the morphology of maxillary lateral incisors. Clin Oral Investig 2024; 28:335. [PMID: 38780805 PMCID: PMC11116233 DOI: 10.1007/s00784-024-05727-x] [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: 02/27/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE This study aimed to investigate the morphology of maxillary lateral incisors (MxLI) using micro-computed tomography (micro-CT). MATERIALS AND METHODS The root canal configurations (RCC) of maxillary lateral incisors (MxLI) of a mixed Swiss-German population were examined using micro-CT, 3D imaging, and a 4-digit system code indicating the main root canal from coronal to apical thirds and the main foramina number. RESULTS The most frequently observed RCC of MxLI were 1-1-1/1 (Vertucci I/Ve I, 80.0%), 1-1-2/2 (Ve V, 7.3%), 1-2-1/1 (Ve III, 6.4%), 2-1-1/1 (Ve II, 1.8%), and 1-1-1/2 (1.8%)(n = 110). Three additional RCC were observed less frequently (0.9%). The MxLI showed one physiological foramen in 89.1%, two in 9.1%, and seldom three (1.8%). Most accessory canals were identified in the apical third of a root (20.0%), and no accessory canals in 72.7% of the samples. CONCLUSIONS Detailed information on the internal morphology of MxLI of a Swiss-German population is given. The most frequently observed RCC of MxLI is 1-1-1/1 (Ve I). However, accessory canals may occur in all apical thirds, and 20% of all teeth investigated showed a challenging RCC for clinical treatment. CLINICAL RELEVANCE This study offers clinicians comprehensive data on MxLI morphology, emphasizing the significance of understanding varied RCC and accessory canal presence for improving root canal treatment outcomes. Over 25% of teeth exhibited complex RCC or accessory canals, influencing decisions during root canal treatment.
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Affiliation(s)
- 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.
| | - Theodora Rempapi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sven Schumann
- Institute for Anatomy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Cariology, Saveetha Dental College and Hospitals, SIMATS, Chennai, India
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | - Niccolò Giuseppe Armogida
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | - Andrea Lisa Waber
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Karobari MI, Iqbal A, Batul R, Adil AH, Syed J, Algarni HA, Alonazi MA, Noorani TY. Exploring age and gender variations in root canal morphology of maxillary premolars in Saudi sub population: a cross-sectional CBCT study. BMC Oral Health 2024; 24:543. [PMID: 38724952 PMCID: PMC11084092 DOI: 10.1186/s12903-024-04310-w] [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: 11/18/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In complex teeth like maxillary premolars, endodontic treatment success depends on a complete comprehension of root canal anatomy. The research on mandibular premolars' root canal anatomy has been extensive and well-documented in existing literature. However, there appears to be a notable gap in available data concerning the root canal anatomy of maxillary premolars. This study aimed to explore the root canal morphology of maxillary premolars using cone-beam computed tomography (CBCT) imaging, considering age and gender variations. METHODS From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10-20, 21-30, 31-40, 41-50, 51-60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology. RESULTS The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1-2-1 showed significant gender differences. For classifications 1MPM1 and 1MPM1-2-1, age-related changes were seen in the left and right maxillary first premolars. CONCLUSION This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Rumesa Batul
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Abdul Habeeb Adil
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Jamaluddin Syed
- Director Research & Development, OWA Medical and Research Center, Sugarland, TX, USA
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box, Jeddah, 80209, Saudi Arabia
| | - Hmoud Ali Algarni
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Kota Bharu, Kelantan, Malaysia
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamil Nadu, India
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Howait M, Zahran S, Abulhamael AM, Barayan MA, Khawaji S, Sanari M, Alshehri L, Zarei L, Marghalani A, Al-Habib MA. Characterizing the Root Canal Configuration of Mandibular Incisors in a Western Saudi Arabian Sub-population Using Cone Beam Computed Tomography. Cureus 2024; 16:e60650. [PMID: 38899247 PMCID: PMC11185986 DOI: 10.7759/cureus.60650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Aim This study aimed to explore the morphology and complexity of mandibular anterior teeth in a Western Saudi Arabian sub-population using cone beam computed tomography (CBCT). Methodology CBCT scans from 818 patients were evaluated, and 3193 mandibular anterior teeth were analyzed for the number of roots, canal, canal configurations, separation level, bilateral symmetry, and gender associations. Results The results showed that all examined central and lateral incisors had a single root, and the majority exhibited a single canal. The prevalence of two canals in mandibular central and lateral incisors was 20.1% and 23.2%, respectively, resulting in an overall prevalence of 21.7% for two root canals in mandibular anterior teeth. The separation level of the two canals was predominantly located in the middle third of the root. Type I canal configuration was the most common, followed by type III. A high degree of bilateral symmetry in the number of canals and canal configurations was noted. Conclusion The findings contribute to the understanding of root canal anatomy in the Saudi population and provide valuable information for endodontic treatment planning.
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Affiliation(s)
- Mohammed Howait
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
| | - Shatha Zahran
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
| | | | - Mohammed A Barayan
- Department of Oral and Maxillofacial Radiology, King Abdulaziz University, Jeddah, SAU
| | - Sara Khawaji
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Mohammed Sanari
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Layan Alshehri
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Lamees Zarei
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Ammar Marghalani
- Department of Periodontology, King Abdulaziz University, Jeddah, SAU
| | - Mey A Al-Habib
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
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Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH. Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study. Odontology 2024; 112:570-587. [PMID: 37957521 DOI: 10.1007/s10266-023-00870-5] [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: 07/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P < 0.05). Younger age groups showed a higher prevalence of Vertucci Type I configuration (P < 0.05). Bilateral symmetry was seen in more than half of the maxillary premolars. There is a considerable variation in the number of roots and root canal configurations of maxillary premolars in the studied Iraqi population, with a significant difference by gender and age groups. Ahmed et al. classification provided more accurate presentation of the root and canal anatomy in maxillary premolars compared to Vertucci's classification.
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Affiliation(s)
- Abdullah Mohammed Aljawhar
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Basrah, Basrah, Iraq
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Azwatee Abdul Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayati Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Mustafa M, Batul R, Karobari MI, Alamri HM, Abdulwahed A, Almokhatieb AA, Hashem Q, Alsakaker A, Alam MK, Ahmed HMA. Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review. BMC Oral Health 2024; 24:343. [PMID: 38493123 PMCID: PMC10944621 DOI: 10.1186/s12903-024-04101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Consultant Endodontics, Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Ahmed A Almokhatieb
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Qamar Hashem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Abdullah Alsakaker
- Consultant endodontist, Department of endodontics, Prince Abdulrahman Advanced Dental Institute, Ministry of defence, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Elsayed MA, Elmesellawy MY, Schäfer E. Prevalence of multiple roots and complex canal morphology in mandibular premolars among a selected Southern Egyptian sub-population: a CBCT-analysis. Odontology 2024:10.1007/s10266-024-00903-7. [PMID: 38351258 DOI: 10.1007/s10266-024-00903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
The mandibular premolars can pose a significant challenge in root canal treatment due to their complex canal system. This study investigated the prevalence of multiple roots and complex canal morphology of mandibular premolars in a selected Egyptian sub-population using cone beam computed tomography (CBCT). 283 CBCT scans (131 males, 152 females, age 18-70) included 1132 mandibular premolars (566 first, and 566 second premolars) were viewed for incidences ofvariation in root numbers and canal configuration according to Vertucci's classification. CBCT images were assessed by two endodontists, data were statistically analyzed using Fisher exact and Chi-square tests. The majority of first premolars (85.7%) exhibited a single root, whereas 14.7% had 2 roots with a significantly higher frequency in males (19.8%) than in females (9.5%) (P < .05). The most prevalent type was type I (57.8%), followed by type V (21.7%), while types II and VII made up only 1%. Types V and III were more prevalent among females, while males had a higher prevalence of types I and IV. In 2.5% of cases, mandibular second premolars were found to have 2 roots, with a higher incidence in males (P < .05). Type I canals were significantly more prevalent (90.8%) than other types, followed by type V (5.3%) (P < .05). A statistically significant gender correlation was found regarding root number and canal configuration. It is not uncommon to find mandibular first premolars with two roots in the southern Egyptian population, particularly in males. These observations may be valuable for dentists who treat Southern Egyptians, in Egypt and other countries.
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Affiliation(s)
- Mohamed Ahmed Elsayed
- Department of Endodontics, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
- Department of Endodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
| | | | - Edgar Schäfer
- Central Interdisciplinary Ambulance, School of Dentistry, University of Münster, Waldeyerstr. 30, 48149, Münster, Germany.
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Taha NA, Makahleh N, Hatipoglu FP. Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study. BMC Oral Health 2024; 24:170. [PMID: 38308267 PMCID: PMC10837869 DOI: 10.1186/s12903-024-03934-2] [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: 10/16/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems. METHODS 3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal's morphology were described according to Vertucci and Ahmed classifications. RESULTS Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root. CONCLUSIONS One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology. CLINICAL RELEVANCE The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.
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Affiliation(s)
- Nessrin A Taha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Box 3030, Irbid, Jordan.
| | - Nisrein Makahleh
- Dental Teaching Clinics, Jordan University of Science and Technology, Irbid, Jordan
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Sheth K, Banga KS, Pawar A, Wahjuningrum DA, Karobari MI. Distolingual root prevalence in mandibular first molar and complex root canal morphology in incisors: a CBCT analysis in Indian population. Sci Rep 2024; 14:443. [PMID: 38172235 PMCID: PMC10764885 DOI: 10.1038/s41598-024-51198-1] [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: 06/04/2023] [Accepted: 01/02/2024] [Indexed: 01/05/2024] Open
Abstract
Cone-beam computed tomography was used to understand the possible correlation between the prevalence of distolingual root (DLR) in permanent mandibular first molars (MFMs) and the associated complicated mandibular incisor's root canal morphology (MIs) in an Indian population. A total of 400 scans were evaluated for MFMs and MIs. The prevalence of DLRs and root canal anatomy of MIs were assessed based on Vertucci's classification, and then the sample were grouped according to age, sex and side. Statistical analysis was used to evaluate the possible correlation between the presence of DLRs in the first molar and root canal morphology of incisors. Chi square test was used to evaluate the correlation between the root canal configurations of MIs with the existence of DLRs in MFMs. There was no statistically significant difference between sexes or ages for the prevalence of DLRs in the first molars (p > 0.05), which was 6.62%, with the right side having a greater frequency of DLRs (7.8%) than the left (5.5%). Vertucci Type I canal configuration was most common for the mandibular central (66.75%) and lateral incisors (58.62%). Vertucci Type III was the most common complicated canal morphology, followed by Types V, II, and IV for MIs, with no statistically significant difference in the studied sample's age and sex. (p < 0.05). No association was observed between the presence of DLRs in first molars and complicated root canal configurations in MIs. Taken together, the possibility of complicated root canal configuration in MIs was lesser in the presence of DLRs in MFMs among the Indian population.
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Affiliation(s)
- Komal Sheth
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
| | - K S Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
| | - Ajinkya Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mohmed Isaqali Karobari
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India.
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Karobari MI, Batul R, Khan M, Patil SR, Basheer SN, Rezallah NNF, Luke AM, Noorani TY. Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health 2024; 24:1. [PMID: 38167114 PMCID: PMC10763367 DOI: 10.1186/s12903-023-03624-5] [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: 09/12/2023] [Accepted: 11/05/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This systematic review and meta-analysis aim to study the characterization of root and canal morphology of the first mandibular premolar using micro-computed tomography. METHODOLOGY The literature search was conducted using electronic web databases like PubMed, Scopus, ScienceDirect and Cochrane with the chosen MeSH key words and data was retrieved until May 2023. Further to perform the statistical analysis, R v 4.3.1 software with "meta", 'metafor" "metaviz" " ggplot2" package was used, and results were represented by odds ratios (OR) and the percentage of forest plots along a 95 per cent confidence interval (CI). RESULTS The total number of studies meeting the inclusion criteria was 13; these studies were conducted on mandibular first premolar using Micro-CT; the total sample size was 1817. To scan the sample, an X-ray micro-focus CT system (Siemens Inveon CT, Erlangen, Germany) was used in four studies and seven different machines were used in the respective studies. Mimics 10.01 software (Materialize, Leuven, Belgium) and NRecon v.1.6.9 software (Bruker, Kontich, Belgium) were commonly operated. The minimum and maximum voxel size ranges between 11.94 and 50 μm. Vertucci's classification was frequently used (9), while one study applied Ahmed et al. and Vertucci's classification. CONCLUSION This systematic review provides essential information about the root and canal configurations, radicular grooves, accessory canals, and apical foramina through Micro-CT, aiming to improve the accuracy of endodontic treatment and help practitioners.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Dental Research Unit, Centre for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
| | - Mohammad Khan
- New Age Health Science Research Center, Muradpur, Chattogram, 4331, Bangladesh
| | - Santosh R Patil
- Department of Oral Medicine and Radiology, Chhattisgarh Dental College & Research Institute, Sundra, India
| | - Syed Nahid Basheer
- Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
- Center for Medical and Bio-Allied Health Sciences Research (CMBAHSR), Ajman University, Ajman, UAE
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
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Ahmed HMA, Rossi-Fedele G, Dummer PMH. Critical analysis of a new system to classify root and canal morphology - A systematic review. AUST ENDOD J 2023; 49:750-768. [PMID: 37688283 DOI: 10.1111/aej.12780] [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: 02/03/2023] [Revised: 06/27/2023] [Accepted: 07/08/2023] [Indexed: 09/10/2023]
Abstract
A novel system to classify root and canal morphology was recently introduced (Ahmed et al. 2017). This systematic review aimed to answer the following research question: Does the Ahmed et al. system provide a more accurate and practical classification of root and canal anatomy compared to other classifications? A literature search was conducted in Google Scholar, Scopus and Wiley Online Library to identify the citation counts for the article entitled 'A new system for classifying root and root canal morphology; doi.org/10.1111/iej.12685'. After removal of duplicates and unrelated articles, 15 studies were included and analysed. All studies compared the Ahmed et al. system with the Vertucci classification. Results revealed that both systems were able to classify simple canal configurations in single-rooted anterior and premolar teeth, disto-buccal and palatal roots of maxillary molars. However, the Ahmed et al. system provided more accurate and comprehensive categorisations of single-rooted teeth with complex canal anatomy, multi-rooted maxillary and mandibular premolars and the mesio-buccal root of maxillary molars. Further evidence on the utility of the Ahmed et al. system is required using other diagnostic devices especially in molars.
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Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Karobari MI, Alam BF, Bashir R, Fahim MF, Mirza MB, Noorani TY. Bibliometric analysis: Root and root canal morphology using cone-beam computed tomography. Clin Exp Dent Res 2023; 9:1156-1168. [PMID: 37877522 PMCID: PMC10728536 DOI: 10.1002/cre2.801] [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: 07/27/2023] [Revised: 09/25/2023] [Accepted: 10/07/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVES This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning scientific publications based on root and root canal morphology using the CBCT. MATERIAL AND METHODS For this bibliometric analysis, an extensive search was carried out on September 25, 2023 using the Scopus database. Pertinent articles in the field were scrutinized after applying inclusion and exclusion criteria. Data were evaluated using Vosviewer and Microsoft Excel. RESULTS A literature search revealed the initiation of scientific publication in 2008. Significant contributions made by Saudi Arabia, India, and China concerning the number of publications were seen. Similarly, Jazan University from SA was recognized as the leading institute. The Journal of Endodontics was the leading journal, while authors JNR Martins and G Gambarini produced the highest number of papers. CONCLUSIONS This bibliometric analysis demonstrated that scientific publications have increased tremendously since 2008. Significant contributions have been made by developing and developed nations. The Journal of Endodontics and Jazan University have been identified as the leading journal and institute.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
| | | | - Raima Bashir
- Department of Oral BiologyBahria University Dental CollegeKarachiPakistan
| | | | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of DentistryPrince Sattam bin Abdulaziz UniversityAl‐KharjSaudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental SciencesUniversiti Sains MalaysiaKota BharuKelantanMalaysia
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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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Al-Qudah A, Afaneh A, Hassouneh L. A Case Report of a Maxillary Second Molar with Two Distinct Palatal Canals, Confirmed by CBCT. Clin Cosmet Investig Dent 2023; 15:199-203. [PMID: 37790248 PMCID: PMC10542588 DOI: 10.2147/ccide.s431563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
Cases of unusual and complex root canal morphology could be difficult to diagnose and treat. This report describes the diagnosis and management of a rare maxillary right second molar (tooth #17) with two distinct palatal canals. The tooth was diagnosed with irreversible pulpitis and symptomatic apical periodontitis. Non-surgical root canal treatment was performed. Accurate diagnosis and comprehensive treatment of cases with unusual root canal morphology can be achieved by evaluation of periapical radiographs at different angulations, advanced magnification techniques, and the Cone Beam Computed Tomography (CBCT) scanning. Clinicians should be aware that two separate palatal canals could exist in maxillary second molar teeth.
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Affiliation(s)
- Aladdin Al-Qudah
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Asem Afaneh
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Layla Hassouneh
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Karobari MI, Iqbal A, Syed J, Batul R, Adil AH, Khawaji SA, Howait M, Khattak O, Noorani TY. Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study. BMC Oral Health 2023; 23:291. [PMID: 37189077 DOI: 10.1186/s12903-023-03002-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The clinician should have complete knowledge of the normal anatomy of the root as well as complexities in the root canal configuration for a better outcome, as missed or improper handling of the canal system can lead to the failure of an entire endodontic procedure. The present study aims to assess the morphology of roots and canals in permanent mandibular premolars in the Saudi subpopulation with a new classification system. METHODS The present study includes 1230 mandibular premolars (645 first premolars and 585-second premolars) from 500 CBCT images of the patients, including retrospective data. iCAT scanner system (Imaging Sciences International, Hatfield, PA, USA) was used to obtain the images; scanning of 8 × 8 cm images was performed at 120 KVp and 5-7 mA with a voxel size of 0.2 mm. The new method of classification presented by Ahmed et al. 2017 was used to record and classify the root canal morphology, followed by recording the differences regarding the age and gender of the patients. Comparison of canal morphology in lower permanent premolars and its association with gender and age of the patients was done by Chi-square test/ Fisher exact test; the significance level was set at 5% (p ≤ 0.05). RESULTS The left mandibular 1st and 2nd premolars with one root were 47.31%, with two roots were 2.19%. However, three roots (0.24%) and C-shaped canals (0.24%) were reported only in the left mandibular 2nd premolar. The right mandibular 1st and 2nd premolars with one root were 47.56%, with two roots were 2.03%. The overall percentage of the number of roots and canals in the first and second premolars 1 PM 1 (88.38%), 2 PM 1 B 1 L 1 (3.5%), 2 PM B 1 L 1 (0.65%), 1 PM 1-2-1 (3.08%), 1 PM 1-2 (3.17%), 1 PM 1-2-1-2 (0.24%), 3 PMMB 1 DB 1 L1 (0.48%). However, the C-shaped canals (0.40%) were reported in right and left mandibular second premolars. No statistically significant difference was reported between mandibular premolars and gender. A statistically significant difference was reported between mandibular premolars and the age of the study subjects. CONCLUSION Type I (1 TN 1) was the major root canal configuration in permanent mandibular premolars, which was higher among males. The CBCT imaging provides thorough details about the root canal morphology of lower premolars. These findings could support diagnosis, decision-making, and root canal treatment, for dental professionals.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Department of Conservative Dentistry & Endodontics, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Jamaluddin Syed
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Abdul Habeeb Adil
- Department of Community Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Sara Akili Khawaji
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Osama Khattak
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
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Aydın H. Comparing the crown and root metric properties of double-rooted and single-rooted mandibular canine teeth. Oral Radiol 2023; 39:301-311. [PMID: 35819742 DOI: 10.1007/s11282-022-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the crown and root metric properties of two- and single-rooted/multi-canal mandibular canines (MnCn) with single-rooted/single-canal MnCn. METHODS Cone-beam computed tomography images of 1000 patients (500 women and 500 men) with both right and left MnCn were analyzed. First, the root and canal morphologies of all teeth were examined. Then, the teeth were divided into three groups; (a) 2-rooted, (b) 1-rooted and multi-canals, (c) 1-rooted and single-canal. Crown lengths/sizes and tooth lengths were compared between the three groups. Statistical analyses were performed using Chi-square, one-way ANOVA, Welch, post hoc pairwise comparison, and independent sample t-tests. The significance level was set at 5%. RESULTS Of all the teeth, 2.35% were 2-rooted, and 6.3% were 1-rooted/multi-canal. The frequency of double roots was higher in women (p < 0.05). Double-rooted teeth had longer crown lengths but shorter tooth lengths than single-rooted teeth (p < 0.05). In 2-rooted teeth, buccal and lingual root lengths were similar, root bifurcation levels were mostly at the mid-root, and the mean distance of the bifurcation points of the canals to the cemento-enamel junction was 4.09 mm. Double-rooted teeth were mostly observed unilaterally. CONCLUSIONS Since 2-rooted MnCn do not differ significantly from other teeth in terms of crown sizes, it is not possible to differentiate between single- vs. double-rooted MnCn based on clinical examination.
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Affiliation(s)
- Hakan Aydın
- Private Ballıpınar Dental Center, Çağlayan Mahallesi, Barınaklar Bulvari, 07230, Muratpaşa, Antalya, Turkey.
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Chen Y, Dai Y, Yan Z, You Y, Wu B, Lu B. Morphological analysis of anterior permanent dentition in a Chinese population using cone-beam computed tomography. Head Face Med 2023; 19:12. [PMID: 36959644 PMCID: PMC10037846 DOI: 10.1186/s13005-023-00357-2] [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: 12/05/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
PURPOSE Morphological analysis of permanent anterior dentition is essential for achieving an ideal treatment outcome and avoiding unnecessary failure. This study aimed to analyze the morphologies of anterior teeth in the Chinese population in depth. METHODS In this retrospective study, 4309 anterior teeth from 401 Chinese patients were investigated using cone-beam computed tomography (CBCT) from 2019-2021. We summarized the morphological characteristics of the anterior teeth in terms of the root length, cementoenamel junction curvature (CEJ-C), root furcation and canal variations. RESULTS We found that the root lengths of the maxillary anterior incisors were similar (13.3 mm), while the root lengths of the mandibular central (12.2 mm) and lateral incisors (13.4 mm) varied significantly (p < .0001). Both the maxillary (16.6 mm) and mandibular canines (15.5 mm) were found to have greater root lengths than the corresponding incisors (p < .0001). The CEJ-C was significantly greater around incisors (2.5 mm) than around the canines (2.0 mm) in the maxilla (p < .0001), while the curvature remained similar in mandibular anterior teeth (1.8 mm). Root furcation was observed in mandibular canines and lateral incisors. Moreover, all types of Vertucci's classification in anterior dentitions were observed, while two other new types were found. Among them, the maxilla was only observed to exhibit types I, II, III, and ST II, while the mandible was found to exhibit almost all types. However, Type I still accounts for the majority of dentitions. CONCLUSIONS Morphological analysis of permanent anterior dentition revealed diversity in the tooth length, CEJ-C, furcation proportion, and canal variations. In general, mandibular anterior teeth showed a more complex structure than maxillary teeth.
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Affiliation(s)
- Yu Chen
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Yu Dai
- Department of Dentistry, Shenzhen People’s Hospital, Shenzhen, 518020 Guangdong China
| | - Zhengbin Yan
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Yuehua You
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Bin Wu
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Bingtai Lu
- Medical Research Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong 510080 Guangzhou, 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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Prevalence of Second Root and Root Canal in Mandibular and Maxillary Premolars Based on Two Classification Systems in Sub-Population of Northern Region (Saudi Arabia) Assessed Using Cone Beam Computed Tomography (CBCT): A Retrospective Study. Diagnostics (Basel) 2023; 13:diagnostics13030498. [PMID: 36766603 PMCID: PMC9914268 DOI: 10.3390/diagnostics13030498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The objective of this paper is to assess the prevalence of a second canal in maxillary and mandibular premolars based on two classification systems of root canal morphology using Cone beam computed tomography (CBCT) images. A total of 286 CBCT scans from the archive of the Radiology department of a hospital were assessed for the presence of a second canal in maxillary and mandibular premolars. The canal configuration and its assessment was undertaken using Vertucci and Ahmed's classification. A Chi-square test was used to test the significance of the difference between gender and age. A total of 286 premolars were examined (217 mandibular premolars and 69 maxillary premolars); of these, 173 teeth (60.5%) were from males and 113 were from females (39.5%). Some 62% of maxillary left first premolars had two roots, followed by maxillary right first premolars (47%), and then maxillary left second premolars (30%) and maxillary right ones (27%), respectively. Type IV Vertucci were seen in maxillary premolars, while type I were ordinarily seen in the included mandibular premolars. Surprisingly, Vertucci type III was only found in mandibular left first premolars at a frequency of 2%. One orifice with two separate canals and two orifices of two distinct canals with two portals of exit were predominantly noticed with maxillary first premolars (2 FP B1 P1) in 73% and 81%, respectively, followed by (1 FP 2) 19%. The prevalence of a second canal in maxillary and mandibular premolars was low in the investigated premolars in comparison to the premolars that had just one root and canal, as assessed based on Vertucci and Ahmed's root canal system classification.
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, van Schoor A, Uys A. A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems. J Oral Sci 2022; 64:300-306. [PMID: 36089376 DOI: 10.2334/josnusd.22-0239] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans. METHODS Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05). RESULTS Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al. 1MP1) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created. CONCLUSION Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.
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Affiliation(s)
- Glynn D Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria.,Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Mohamed Y Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Inger Fabris-Rotelli
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria
| | - Albert van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Andre Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
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Alobaid MA, Alshahrani EM, Alshehri EM, Shaiban AS, Haralur SB, Chaturvedi S, Khaled Addas M. Radiographic assessment of root canal morphology of mandibular central incisors using new classification system: A cross-sectional study. Medicine (Baltimore) 2022; 101:e30751. [PMID: 36123867 PMCID: PMC9478269 DOI: 10.1097/md.0000000000030751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Lack of basic knowledge about the external and internal anatomies of the root canal system and common variations in teeth may lead to various procedural errors or treatment failure. In this study, the root canal configurations of mandibular incisors and the symmetry of the contralateral incisors of Saudi Arabian subpopulations were analyzed and determined using cone beam computed tomography (CBCT). A retrospective evaluation of 700 patients was conducted, and 1260 fully developed permanent mandibular central incisors were assessed. The number of root canals was determined, and the internal root canal anatomies were categorized based on Ahmed et al.'s criteria. The CBCT images were independently evaluated by 2 trained dentists and an endodontist. The data were assessed using the chi-square and one-way analysis of variance tests. All the mandibular central incisors included in the study were single-rooted. According to Ahmed et al's classification system, the most common classification (82.6%) was 1ManA1 (Vertucci type I), followed by 1ManA1-2-1 (Vertucci type III; 13%). Second canals were more frequently recorded in the male participants than in the female participants. The root canal configuration between contralateral incisors was largely symmetrical. Most of the mandibular incisors in the examined Saudi Arabian population had a single canal. Nevertheless, a substantial number of patients had a complex root morphology. Hence, CBCT can be utilized as a potential supplementary tool during root canal treatment.
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Affiliation(s)
- Mohammed A. Alobaid
- Restorative Dental Science Department & Department of Dental Education, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Amal S. Shaiban
- Restorative Dental Science Department, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Satheesh B. Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Saurabh Chaturvedi
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohamed Khaled Addas
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Asiri AA, AlQahtani KW, Tarrosh MY, Shaiban AS, Al Shawkani HA, Alaajam WH, Bamasud MS, Alqahtani M, Alyousefy MA, Al Moaleem MM. Root Morphology and Canal Configuration of Permanent Canines Among Saudi Population: Systematic Review and Comparison with Worldwide Studies. Int J Gen Med 2022; 15:6849-6860. [PMID: 36061964 PMCID: PMC9439648 DOI: 10.2147/ijgm.s380084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
Aim The root morphology and canal configuration (RMCC) of mandibular and maxillary canines among Saudi population is systematically reviewed and compared with international studies in this research. Methods This study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The electronic databases of PubMed, Science Direct, Scopus, Wiley Library, Google website search, and Web of Science were searched. Only local and international cross-sectional, comparative, evaluation, and validation studies or case reports published between 2016 and 2022 that directly evaluated canine RMCC and assessed participants using cone beam computed tomography were included. Results Forty-three studies that investigated RMCCs (17 local and 26 international) were involved in this review. The original Saudi research recorded that almost 100% of maxillary canines had one root and one canal, whereas 98.4% and 94.1% had one root and one canal in the mandibular arch. Vertucci’s class I had the highest percentages in the maxillary and mandibular arches at 98.3% and 95.8%, respectively, followed by class III with 0.7% and 1.9% for the same arches, respectively. International studies recorded that 100% of maxillary canines had one canal and root; the percentages of the mandibular arch were 92.3 and 98% for single canal and root, respectively; and the highest percentage was obtained by Vertucci’s class I (91.1%), followed by class III (4.7%). Conclusion This review reports and confirmed the symmetry of the RMCCs of maxillary and mandibular canines between Saudi studies and other populations. Moreover, Vertucci’s classes I and III were the most frequent RMCCs, and two-rooted canines in both arches were considerably less frequently than single-rooted ones.
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Affiliation(s)
| | | | - Mohammed Y Tarrosh
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Amal S Shaiban
- Department of Restorative Dental Sciences, Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Hamed A Al Shawkani
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Wafa H Alaajam
- Department of Restorative Dental Sciences, Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Maryam S Bamasud
- Dental Department, Ministry of Health, Sakaka City, Jouf Region, Saudi Arabia
| | - Muqbil Alqahtani
- General Practitioner, King Faisal University, Alhafuf City, Saudi Arabia
| | - Mohanad A Alyousefy
- Department of Oral Medicine and Periodontology, College of Dentistry, Sana’a University, Sana’a, Yemen
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia
- Faculty of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sana’a, 4337, Yemen
- Correspondence: Mohammed M Al Moaleem, Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia, Tel +00966-550599553, Email ;
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Heboyan A, Avetisyan A, Karobari MI, Marya A, Khurshid Z, Rokaya D, Zafar MS, Fernandes GVDO. Tooth root resorption: A review. Sci Prog 2022; 105:368504221109217. [PMID: 35759366 PMCID: PMC10358711 DOI: 10.1177/00368504221109217] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Tooth root resorption is multifactorial, leading to progressive destruction and eventual loss of tooth root dentin and cement. There are internal and external types of root resorption, each having its variety. The etiology and pathogenesis of tooth root resorption are poorly understood, and the most significant etiological factors are trauma, pulpal infection, tooth bleaching, and orthodontic treatment. Tooth root resorption is primarily asymptomatic; thus, it is revealed accidentally by radiographic examination. Progressive clinical manifestations are pain, tooth discoloration, tooth mobility, and other conditions. Awareness of the causes and risk factors allowing tooth root resorption, and regular radiographic examination, in case of necessity, make it possible to reveal resorption at an early stage and to prevent its further development. Thus, the aim of this study is to present etiopathogenesis, a clinical course, and diagnostic peculiarities of internal and external types of tooth root resorption, enabling practicing dentists to timely diagnose root resorption and take appropriate measures to avoid further complications. Within the limitation of this review, even though the etiopathogenesis of tooth root resorption is yet not fully understood, it is suggested that the etiological factors fall into two groups (endogenic and exogenic) to enhance further understanding of the possible causes and mechanisms of root resorption and allow practitioners to monitor high-risk patients and make timely diagnoses. Moreover, radiographic examination and CBCT are indispensable for the diagnosis of root resorption.
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Affiliation(s)
- Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Mohmed Isaqali Karobari
- Department of Conservative & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai, Tamil Nadu, India
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
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Almohaimede A, Alqahtani A, Alhatlani N, Alsaloom N, Alqahtani S. Analysis of Root Canal Anatomy of Mandibular Permanent Incisors in Saudi Subpopulation: A Cone-Beam Computed Tomography (CBCT) Study. SCIENTIFICA 2022; 2022:3278943. [PMID: 35646406 PMCID: PMC9135577 DOI: 10.1155/2022/3278943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to evaluate the root canal anatomy of central and lateral mandibular incisors in a Saudi population using cone-beam computed tomography (CBCT). Overall, 1370 CBCT images of central (687) and lateral (683) mandibular incisors of Saudi patients who attended the Dental College at King Saud University in Riyadh were examined. The number of roots and canals, canal configuration types, symmetry between bilateral incisors, and the effect of gender and age were determined. For data analysis, the chi-square test was applied, and the p value was set at ≤0.05. Only one tooth had two roots, and 41% of mandibular incisors had two canals. The most common canal configuration type observed was type I (58.83%), followed by type III (28.24%). Type V was more common in men (8.31%) than women (3.9%). Bilateral symmetries were higher in the mandibular central incisors regarding the root and canal numbers and the canal configuration types (100, 100, and 97.92%, respectively) than in the lateral incisors (99.69, 98.16, and 97.24%, respectively). The 21-40 age group showed a higher proportion of teeth with more complicated root canal anatomy than the other age groups. More than one canal in mandibular incisors is a common finding in the Saudi subpopulation, with the type III canal configuration as the most common type.
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Affiliation(s)
- Amal Almohaimede
- Department of Restorative Dental Sciences, Endodontic Division, College of Dentistry, King Saud University, P.O.Box: 5967, Riyadh 11432, Saudi Arabia
| | - Alanoud Alqahtani
- Saudi Board Endodontic Residency Program, King Faisal Specialist Hospital Research Center, Riyadh, Saudi Arabia
| | - Norah Alhatlani
- Saudi Board Pedodontics Residency Program, King Saud Medical City, Riyadh, Saudi Arabia
| | - Nouf Alsaloom
- Saudi Board Periodontics Residency Program, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shafia Alqahtani
- Saudi Board Orthodontics Residency Program, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Iqbal A, Karobari MI, Alam MK, Khattak O, Alshammari SM, Adil AH, Noorani TY, Algarani HA, Alonazi MA, Sirivastava KC, Issrani R. Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study. BMC Oral Health 2022; 22:171. [PMID: 35538514 PMCID: PMC9092761 DOI: 10.1186/s12903-022-02187-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adequate knowledge of root canal morphology and possible variations is essential to achieve perfect root canal treatment and overcome treatment failure. Appropriate knowledge on root and canal morphology, communication, and documentation amongst dentists will be challenging from a diagnostic and successful treatment point of view. METHODS A total of 3420 samples were included in this study from 285 cone-beam computed tomography images of the Saudi residents, including 171 males and 114 females aged 15 to 68 years from retrospective data dated from January 2018 to April 2021. The images were examined in sagittal, axial and coronal views using a 3D version software 1.0.10.6388. The number of canal and canal morphology was recorded using Vertucci and the new classification system. The SPSS 26 was used to conduct the statistical analysis as descriptive statistics such as mean; standard deviation and frequency were calculated. The Chi-square test analysed the data with the significance level set at 0.05. RESULTS A total of 285 subjects participated in the study. Majority of the participants were Saudi nationals (80.7%), followed by Indian (7.4%), Pakistani (4.2%) and other nationalities. According to Vertucci and the new classification system, Type I and 1TN1 were the most common types, followed by Type III and Type IV, and then 1TN1-2-1 and 1TN1-2 in mandibular anteriors. The prevalence of canal variations in mandibular canine was higher in females than in males (P = 0.002). Maxillary laterals and mandibular anteriors showed the significant difference in the prevalence of root canal variation in relation to the ethnicity (P = 0.001) and age of the patients. Younger patients showed more variations than the older patients (P = 0.012, P = 0.023, P = 0.001, P = 0.001) in terms of maxillary laterals, mandibular central, laterals and canines, respectively. CONCLUSION Mandibular permanent anteriors showed a wide range of canal variations and canal complexity. Males and females did not demonstrate a wide range of variation in the root canal morphology except for the canines in relation to the gender of the patients.
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Affiliation(s)
- Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kota Bharu, Kelantan, Malaysia. .,Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.,Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.,Department of Public Health, Faculty of Allied Health Sciences, Daffodil international University, Dhaka, Bangladesh
| | - Osama Khattak
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Sultan Metab Alshammari
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Abdul Habeeb Adil
- Department of Community Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Hamoud Ali Algarani
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Kumar Chandan Sirivastava
- Oral Medicine and Radiology, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Rakhi Issrani
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
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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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Yang Y, Jiang C, Chen M, Zeng J, Wu B. Vertucci’s root canal configuration of 11,376 mandibular anteriors and its relationship with distolingual roots in mandibular first molars in a Cantonese population: a cone-beam computed tomography study. BMC Oral Health 2022; 22:130. [PMID: 35429982 PMCID: PMC9013457 DOI: 10.1186/s12903-022-02078-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).
Methods
A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student’s t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.
Results
In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.
Conclusion
In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.
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Mirza MB. Evaluation of root and canal morphologies of permanent canines in a Saudi Arabian sub population using cone-beam computed tomography. J Dent Sci 2022; 17:1626-1633. [PMID: 36299301 PMCID: PMC9588781 DOI: 10.1016/j.jds.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background/purpose Failure to identify and treat the root canal system in its entirety has been known to be one of the leading causes of unsuccessful root canal treatment (RCT). This study aims to retrospectively assess the permanent canines in a Saudi Arabian sub population for the number of roots, root canal morphologies and the presence of symmetry among them using cone-beam computed tomography (CBCT). Materials and methods CBCT scans belonging to 945 patients were screened. A total of 1880 permanent canines, 928 pertaining to maxilla and 952 pertaining to mandible were analyzed for the number of roots, root canal morphologies and the presence of symmetry among them. Comparative evaluation between genders was done using Fisher's exact test, since majority of the groups had expected count of less than 5. A calculated P-value of less than 0.05 was considered significant. Chi square test was used for statistical analysis of the data. Intra operator variability was observed using Cohen's Kappa test. Results Single root was observed in 100% and 98.7% of the maxillary and mandibular canines respectively. Two roots were identified in 1.3% of the MnC's. Type I (97.48%), Type II (0.21%), Type III (1.05%) and Type V (1.26%) Vertucci canal configurations (VC) were observed in MnC's. Statistical significant difference was observed concerning the number of roots and canal morphology according to Vertucci in the mandibular canines. No difference was observed according to Ahmed et al. classification system. Moreover, there was no gender based difference seen among them. Conclusion More variable root and canal morphologies are observed in MnC's, although single root with Type I VC is the most common.
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, van Schoor A, Uys A. Root and canal morphology of the permanent anterior dentition in a Black South African population using cone-beam computed tomography and two classification systems. J Oral Sci 2022; 64:218-223. [DOI: 10.2334/josnusd.22-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Glynn D. Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Mohamed Y. Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Inger Fabris-Rotelli
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria
| | - Albert van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Andre Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
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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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Plywood Jig—A New Technique for Root Canal Curvature Measurement. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11093999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The successful outcome of endodontic treatment is dependent on complete cleaning, shaping as well as three dimensional obturation of the root canal system. A conventional radiograph is a two-dimensional replication of a three-dimensional object and does not provide any conclusive evidence for canal curvatures. An accurate knowledge of the tooth anatomy and curvature is essential to avoid procedural errors. 100 freshly extracted human teeth were used in this study. Digital images were obtained using the plywood JIG and Schneider’s technique. These images were analyzed using the VixWin Pro digital image analyzing software (Gendex system). Statistical analysis was done using paired t test. The canal curvature average values measured using Jig method and Schneider method for mandibular teeth are 28.23° (±9.96) and 22.07° (±9.46) respectively. The smallest/largest curvature angles measured using Jig method and Schneider technique are 12/52° and 8/44° respectively. Canal curvature average values measured using Jig method and Schneider method for maxillary teeth were 23.40° (±11.36) and 19.23° (±11.94) respectively. The smallest/largest average curvature angles measured using Jig method, Schneider technique were 9/70° and 5/72° respectively. The values of the canal curvature angle obtained during routine radiographs in clinics have lower curvature angle and higher radius values as compared to the values obtained by this innovative JIG technique. Therefore, a clinician should always keep in mind the difference while measuring the curvature angle on radiographs during root canal treatment.
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Ahmed HMA, Ibrahim N, Mohamad NS, Nambiar P, Muhammad RF, Yusoff M, Dummer PMH. Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration. Int Endod J 2021; 54:1056-1082. [PMID: 33527452 DOI: 10.1111/iej.13486] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/15/2022]
Abstract
Adequate knowledge and accurate characterization of root and canal anatomy is an essential prerequisite for successful root canal treatment and endodontic surgery. Over the years, an ever-increasing body of knowledge related to root and canal anatomy of the human dentition has accumulated. To correct deficiencies in existing systems, a new coding system for classifying root and canal morphology, accessory canals and anomalies has been introduced. In recent years, micro-computed tomography (micro-CT) and cone beam computed tomography (CBCT) have been used extensively to study the details of root and canal anatomy in extracted teeth and within clinical settings. This review aims to discuss the application of the new coding system in studies using micro-CT and CBCT, provide a detailed guide for appropriate characterization of root and canal anatomy and to discuss several controversial issues that may appear as potential limitations for proper characterization of roots and canals.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N S Mohamad
- Centre of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM) Selangor Branch, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
| | - P Nambiar
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Malaysia
| | - R F Muhammad
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - M Yusoff
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Root and Root Canal Morphology Classification Systems. Int J Dent 2021; 2021:6682189. [PMID: 33679981 PMCID: PMC7910041 DOI: 10.1155/2021/6682189] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction While there are many root morphology classification systems with their own distinct advantages, there are many shortcomings that come along with each system. Objectives The aim of this review was to compare the various root and root canal morphology classifications, their advantages, limitations, and clinical and research implications. Data Sources and Selection. An extensive literature search was conducted on PubMed and Scopus to identify the published data on root and root canal classification systems published until 1 May 2020 using keywords, root canal classification system, classification systems for root canals, and root morphology. The related literature was reviewed and then summarized. Data Synthesis. Several studies have analysed and detailed root and root canal classifications and further added new subsystems, works of Weine et al. (1969) and Vertucci et al. (1974). Besides, Sert and Bayirli (2004) added supplementary types to Vertucci's classification system. A new classification was most recently introduced by Ahmed et al. (2017) involving the use of codes for tooth numbering, number of roots, and canal configuration. Conclusions Weine et al. classified only single-rooted teeth, without considering multirooted teeth and complex configurations. Vertucci's classification included complex configurations, with Sert and Bayirli adding further complex supplemental types. Ahmed et al.'s classification simplifies classifying root and canal morphology while overcoming the limitations of several previous classification systems making it beneficial for implementation in dental schools.
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