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Wu W, Meng Y, Tsauo C, Chen M, Huang D, Zhou X, Zou L, Gao Y. Internal and external morphological analysis of fused-rooted mandibular second molars in the Chinese population: A micro-computed tomographic study. AUST ENDOD J 2024; 50:285-298. [PMID: 38361279 DOI: 10.1111/aej.12833] [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: 09/20/2022] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
This study investigated the root canal morphology of fused-rooted mandibular second molars based on the pulp chamber floor (PCF) and analysed the correlation between the external morphology of the radicular groove, and the internal morphology of the PCF and root canal configuration. A total of 291 fused-rooted teeth collected from the Chinese population were scanned using micro-computed tomography and a dental operating microscope was used for observing the PCFs. The classification of the PCF and root canal configuration were identified according to modified Min et al.'s and Gao et al.'s classifications, respectively. Additionally, a new radicular groove classification was proposed. The correlation among these morphological characteristics was investigated using the chi-square test and Fisher's exact test (p < 0.05). The results showed that 74.2% of teeth had C-shaped PCFs, while 21.0% had non-C-shaped PCFs. As for the root canal configurations, 37.5% of teeth were merging type, 40.9% were symmetrical type, and 14.8% were asymmetrical type. Statistical analysis revealed a significant correlation between the PCF types and the root canal configurations (p < 0.001). The dominant root canal types for teeth with C-shaped PCFs were merging and symmetrical types, while the asymmetrical type was not identified in non-C-shaped PCFs. In addition, significant morphological association between the root canals and radicular grooves was also revealed (p < 0.001). Teeth with different PCF morphologies exhibit specific patterns of root canal category distribution. Understanding the morphological nuances of the root canal based on the PCF can assist clinicians in predicting and identifying the canal configuration beneath the visible orifice.
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Affiliation(s)
- Weiwei Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yajun Meng
- Department of VIP Dental Care, Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chialing Tsauo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Min Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Burse A, Mahapatra J, Reche A, Awghad SS. Uncovering the Enigma of the C-shaped Root Canal Morphology. Cureus 2024; 16:e61883. [PMID: 38975401 PMCID: PMC11227744 DOI: 10.7759/cureus.61883] [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: 04/22/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024] Open
Abstract
A C-shaped canal describes an anatomical configuration of a tooth's root canal that resembles the alphabet C when viewed occlusally in a prepared access cavity. In the second molar of the maxillary arch, the root canals unite into a single, continuous, extensive root canal morphology to form a C-shaped canal. The natural crevices found in tooth roots where blood vessels and nerves are housed are called root canals. The frequently referred etiology resulting in the development of the C-shaped canal arrangement is the inability of Hertwig's epithelial root sheath to undergo fusion. The occurrence of the C-shaped canal anatomic variation varies among populations, with the majority of cases occurring in mandibular second molars. C-shaped canals pose several challenges in endodontic treatment such as in their diagnosis, biomechanical preparation, debridement, and obturation. Nevertheless, the desired result can be achieved with relative ease if one has a solid grasp of the different root canal configurations and uses the relevant clinical expertise. Therefore, three-dimensional radiography is utilized to help identify and negotiate C-shaped canals by enabling three-dimensional reconstruction of the root canal system. Efficient C-shaped canal configuration treatment may be attained using hand-driven and rotary instruments assisted by sonic or ultrasonic hand-pieces. Four alternative gutta-percha filling methods are used in C-shaped canals: core-carrier, ultrasonic compaction, cold lateral compaction, and single cone with injectable gutta-percha. The core-carrier technique is the most efficient obturation technique in the C-shaped canal. Calcium silicate materials (CSMs) are also used for the obturation of C-shaped canals. The most frequently used CSMs are mineral trioxide aggregate and biodentine.
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Affiliation(s)
- Ankita Burse
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Joyeeta Mahapatra
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Srushti S Awghad
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
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Shaikh S, Patil AG, Kalgutkar VU, Bhandarkar SA, Hakke Patil A. The Assessment of C-shaped Canal Prevalence in Mandibular Second Molars Using Endodontic Microscopy and Cone Beam Computed Tomography: An In Vivo Investigation. Cureus 2024; 16:e62026. [PMID: 38989337 PMCID: PMC11233462 DOI: 10.7759/cureus.62026] [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: 06/09/2024] [Indexed: 07/12/2024] Open
Abstract
Background Understanding root canal anatomy variations, particularly C-shaped canals, is crucial for successful endodontic treatment. This study used clinical and radiographic methods to assess the prevalence and characteristics of C-shaped canals in mandibular second molars in Western Maharashtra. Materials and methods This prospective study was conducted in the western region of Maharashtra, India. The samples included patients requiring endodontic treatment for mandibular second molars. Clinical evaluation was conducted using a surgical endodontic microscope and cone beam computed tomography (CBCT) imaging. Inclusion and exclusion criteria ensured the selection of a focused and homogeneous sample. Data analysis included assessment of unilateral/bilateral occurrence, canal distribution, and cross-sectional characteristics. Results Out of 200 mandibular second molars, 7.5% exhibited C-shaped root canals, with no significant gender differences. Canal distribution varied across coronal, middle, and apical levels, with prevalent configurations being C1, C2, C3, and C4. No significant differences were observed in canal distribution based on root levels. No significant gender differences were found in the presence of grooves on the root surfaces. Conclusion This study provides valuable insights into the prevalence and characteristics of C-shaped canals in mandibular second molars in Western Maharashtra. Further research into histological and genetic aspects can enhance our understanding, leading to improved treatment strategies for complex root canal anatomy variations.
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Affiliation(s)
- Sabina Shaikh
- Department of Conservative Dentistry and Endodontics, DY Patil Dental School, Pune, IND
| | - Amey G Patil
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, USA
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, USA
- Department of Endodontics, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital, Maharashtra University of Health Sciences, Nashik, IND
| | - Vedant U Kalgutkar
- Department of Oral and Maxillofacial Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital, Maharashtra University of Health Sciences, Nashik, IND
| | - Sailee A Bhandarkar
- Department of Endodontics, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital, Maharashtra University of Health Sciences, Nashik, IND
| | - Anuja Hakke Patil
- Department of Conservative Dentistry and Endodontics, DY Patil Dental School, Pune, IND
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Park DM, Seok WH, Yoon JY. Factors Influencing Non-Surgical Root Canal Treatment Outcomes in Mandibular Second Molars: A Retrospective Cone-Beam Computed Tomography Analysis. J Clin Med 2024; 13:2931. [PMID: 38792472 PMCID: PMC11122081 DOI: 10.3390/jcm13102931] [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: 04/30/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: This study aimed to investigate the influence of the root canal morphology and various treatment variables on the outcomes of root canal treatments (RCTs) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 of previously treated root canals with normal apices in the mandibular second molars. CBCT was utilized to evaluate the root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore the correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p = 0.05). Factors influencing endodontic treatment outcomes included missing canals (p = 0.018), underfilling or overfilling (p = 0.045), and inadequate coronal restoration (p = 0.006). Missing a canal was identified as the variable most significantly associated with periapical lesions (OR = 3.103). Inhomogeneous root canal obturation was more commonly observed in C-shaped root canals (p < 0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.
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Affiliation(s)
- Da-Min Park
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
| | - Woo-Hyun Seok
- Department of Public Health Administration, Yanggugun Public Health Center, Yanggu-gun 24522, Republic of Korea;
| | - Ji-Young Yoon
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
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Gharechahi M, Hoseinzadeh M, Moradi S, Mehrjouei M. Evaluation of various obturation techniques with bioceramic sealers in 3D-printed C-shaped canals. BMC Oral Health 2024; 24:554. [PMID: 38735924 PMCID: PMC11089720 DOI: 10.1186/s12903-024-04334-2] [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: 09/18/2023] [Accepted: 05/06/2024] [Indexed: 05/14/2024] Open
Abstract
This in vitro study compared various obturation techniques with bioceramic sealers for filling C-shaped 3D-printed replicas. A mandibular molar with a C-shaped root canal with a C1 configuration was obtained. After instrumenting with M3 Pro Gold files (United Dental, Shanghai, China) up to size #30/0.04, a CBCT scan of the tooth was taken. Sixty 3D-printed replicas of the tooth were created. The samples were obturated with EndoSeal TCS sealer (E. TCS; Maruchi, Wonju, Korea) or EndoSeal MTA (E. MTA; Maruchi, Wonju, Korea) (n = 30). The samples in each group were obturated with the following techniques (n = 10): (1) single-cone technique (SC), (2) SC with ultrasonic activation (UA), and (3) cold hydraulic compaction (CHC). Following incubation, the replicas' apical, middle, and coronal thirds were inspected under a digital microscope, and the proportion of filling material and void were calculated. Also, the obturation time and sealer extrusion were recorded. Data were analyzed using ANOVA, LSD post-hoc, and the chi-square tests (α = 0.05). The results indicated that in the apical third, E. TCS-SC, E. TCS-UA, and E. MTA-UA had the lowest void percentage among groups (p < 0.05). In the middle thirds, samples obturated with E. TCS-UA showed a significantly lower void percentage among all groups (p < 0.05). However, in the coronal third, E. TCS-CHC showed the least void percentage (p < 0.05), followed by E. TCS-UA and E. MTA-CHC. The E. TCS-SC and E. TCS-UA were the least time-consuming methods (p < 0.05). Sealer extrusion significantly differed among the groups, with E. MTA-UA and E. TCS-UA showing higher incidence (p = 0.019). It was concluded that E. TCS-UA was the most convenient obturation technique. However, care must be taken when obturating the canals with high flow and ultrasonic activation near the vital anatomical landmarks.
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Affiliation(s)
- Maryam Gharechahi
- Department of Endodontics, Faculty of Dentistry, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hoseinzadeh
- Dentist, Research Assistant, Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Moradi
- Department of Endodontics, Faculty of Dentistry, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Mehrjouei
- Department of Endodontics, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran.
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Huang D, Wang X, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen X, Li J, Ye L, Cheng L, Xu X, Hu T, Wu H, Guo B, Su Q, Chen Z, Qiu L, Chen W, Wei X, Huang Z, Yu J, Lin Z, Zhang Q, Yang D, Zhao J, Pan S, Yang J, Wu J, Pan Y, Xie X, Deng S, Huang X, Zhang L, Yue L, Zhou X. Expert consensus on difficulty assessment of endodontic therapy. Int J Oral Sci 2024; 16:22. [PMID: 38429281 PMCID: PMC10907570 DOI: 10.1038/s41368-024-00285-0] [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: 12/29/2023] [Accepted: 01/19/2024] [Indexed: 03/03/2024] Open
Abstract
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
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Affiliation(s)
- Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Xinmei Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Geriatric dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Guo
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qin Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jinhua Yu
- Department of Endodontics, School and Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Zhengmei Lin
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Shuang Pan
- Department of Endodontics, Schoolof Stomatology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Jiayuan Wu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Yihuai Pan
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Xie
- Department of Cariology and Endodontics, Xiangya Stomatological School, Central South University, Changsha, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaojing Huang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Aydın H, Harorlı H. Predictor factors of 1-rooted mandibular second molars on complicated root and canal anatomies of other mandibular teeth. Restor Dent Endod 2024; 49:e2. [PMID: 38449499 PMCID: PMC10912550 DOI: 10.5395/rde.2024.49.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 03/08/2024] Open
Abstract
Objectives This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.
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Affiliation(s)
- Hakan Aydın
- Department of Endodontics, Faculty of Dentistry, Antalya Bilim University, Antalya, Türkiye
| | - Hatice Harorlı
- Departent of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Türkiye
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8
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Liu H, Shen Y. Endodontic Retreatment of a Mandibular Second Molar With a C-shaped Root Canal Configuration: A Case Report. Cureus 2024; 16:e52812. [PMID: 38389597 PMCID: PMC10883750 DOI: 10.7759/cureus.52812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Root canal retreatment in mandibular second molars with C-shaped root canal configurations presents notable challenges. This article presents a case of successful root canal retreatment in a mandibular second molar exhibiting this complex configuration. Achieving a successful endodontic outcome in such cases necessitates a comprehensive understanding of the unique root canal anatomy. Moreover, the employment of advanced instruments and techniques is crucial to effectively address the intricacies of the C-shaped root canal system.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
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9
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Macdonald AA, Ziehmer B, Kitchener AC, Gelang M, Åblad B, Lintonsson R, von Pückler K, Schaub S, Kiefer I, Schwarz T. A Computed Tomographic Study of the Premolar Teeth of Babyrousa spp. J Vet Dent 2024; 41:31-42. [PMID: 36998227 PMCID: PMC10676034 DOI: 10.1177/08987564231166551] [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] [Indexed: 04/01/2023]
Abstract
A photographic and computed tomography (CT) scanning study was carried out on the premolar teeth of 18 adult male Babyrousa babyrussa skulls, 10 skulls of Babyrousa celebensis, including 6 adult males, 1 adult female, 1 subadult male, 1 subadult female, and 1 juvenile male. The occlusal morphology of the permanent maxillary premolar teeth of B. babyrussa was very similar to that of B. celebensis. Almost all the maxillary third premolar teeth (107/207) had 2 roots, whereas maxillary fourth premolar teeth (108/208) had 3 or 4 roots. All of the mesial tooth roots of 107/207 and 108/208 were tapering rod-like structures; each contained a single pulp canal. Almost all distal roots of 107/207 were "C" shaped and contained 2 pulp canals. The 108/208 palatal roots were "C" shaped and contained 2 pulp canals. The mesial and distal roots of the mandibular third premolar teeth (307/407) teeth were uniformly rod-like, as were the mesial roots of the mandibular fourth premolar teeth (308/408) teeth. The distal roots of the 308/408 teeth were "C" shaped. All B. babyrussa 307/407 teeth have a single pulp canal located in each of the mesial and distal roots. The 308/408 mesial tooth root contained 1 pulp canal. In all but 3 of the 36 distal 308/408 roots of B. babyrussa teeth and in 7 of the 14 distal roots of B. celebensis teeth there was a single pulp canal; in the other 7 teeth there were 2 pulp canals. Each of the 3 medial roots contained 1 pulp canal.
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Affiliation(s)
- Alastair A. Macdonald
- Royal (Dick) School of Veterinary Studies & The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Bianca Ziehmer
- Department of Viticulture and Agriculture, Ministry of Economic Affairs, Transport, Agriculture and Viticulture Rhineland Palatinate (MWVLW), Mainz, Germany
| | - Andrew C. Kitchener
- Department of Natural Sciences, National Museums Scotland, Edinburgh, UK
- Institute of Geography, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | | | - Björn Åblad
- Blåstjärnans Djursjukhus, Bildenheten, Göteborg, Sweden
| | | | - Kerstin von Pückler
- Justus-Liebig-Universität Giessen, Klinik für Kleintiere, Radiologie, Justus-Liebig Universität, Gießen, Germany
| | - Sebastian Schaub
- Justus-Liebig-Universität Giessen, Klinik für Kleintiere, Radiologie, Justus-Liebig Universität, Gießen, Germany
| | - Ingmar Kiefer
- Universität Leipzig, Veterinärmedizinische Fakultät, Klinik für Kleintiere, Leipzig, Germany
| | - Tobias Schwarz
- Royal (Dick) School of Veterinary Studies & The Roslin Institute, University of Edinburgh, Edinburgh, UK
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10
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Candemil AP, Mazzi-Chaves JF, Oliveira ML, Ambrosano GB, Vasconcelos KF, Pauwels R, Jacobs R, Sousa-Neto MD. Assessment of the root filling volume in C-shaped root canal on cone-beam CT and micro-CT in relation to nano-CT. Clin Oral Investig 2023; 27:6413-6420. [PMID: 37704914 DOI: 10.1007/s00784-023-05244-3] [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: 04/18/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
AIM To assess the observed volume of filled C-shaped root canals from different CBCT and micro-CT having nano-CT as a reference. MATERIALS AND METHODS Twelve extracted mandibular molars with C-shaped root canals were endodontically treated using Reciproc Blue R25 (VDW GMBH, Munich, Germany) in a reciprocating system and filled with gutta-percha (Dentsply Maillefer) and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). CBCT scans were performed using 3 units-3D Accuitomo 170 (J. Morita, Kyoto, Japan), ProMax 3D Max (Planmeca, Helsinki, Finland), and NewTom VGi EVO (Cefla QR, Verona, Italy)-at two resolution modes: standard and high. Micro-CT and nano-CT scans were also obtained. The volume of all filled C-shaped root canals was obtained using CTAn software (Bruker, Kontich, Belgium), and the blooming artifact, in relation to nano-CT volume, was calculated. The data were evaluated by the Bland-Altman plots and ANOVA two-way for repeated measures (α = 0.05). RESULTS All CBCT units and micro-CT showed significantly larger observed volume of root canal filling when compared to nano-CT. The blooming artifact of root canal filling in standard resolution was significantly larger than that in high resolution (p < 0.05) in all CBCT units. CONCLUSIONS Endodontic filling material with AH Plus sealer causes blooming artifacts in CBCT units and micro-CT. CLINICAL RELEVANCE Considering the anatomical complexity of C-shaped root canals and the challenges associated with endodontic treatment, CBCT is frequently recommended for follow-up evaluations. However, the presence of endodontic filling material can result in blooming artifacts that may potentially impact the accurate diagnosis of endodontic complications.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Guilherme Bovi Ambrosano
- Department of Statistical Genetics, Luiz de Queiroz College of Agriculture, University of São Paulo, São Paulo, Brazil
| | | | - Ruben Pauwels
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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11
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Ahmed HMA, El-Karim I, Duncan HF, Krastl G, Galler K. Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures. Clin Oral Investig 2023; 27:6357-6369. [PMID: 37870593 DOI: 10.1007/s00784-023-05284-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES This review aims to discuss the implications of anatomy of the root, pulp chamber, and canals on pulpotomy and revitalization procedures (RPs) as treatment alternatives to root canal treatment procedures. METHODS This narrative review was undertaken to address two main questions - why remove vital pulp tissue in teeth with complex canal anatomy when it can be preserved? And why replace the necrotic pulp in teeth with mature roots with a synthetic material when we can revitalize? This review also aims to discuss anatomical challenges with pulpotomy and revitalization procedures. RESULTS Maintaining the vitality of the pulp via partial or full pulpotomy procedures avoids the multiple potential challenges faced by clinicians during root canal treatment. However, carrying out pulpotomy procedures requires a meticulous understanding of the pulp chamber anatomy, which varies from tooth to tooth. Literature shows an increased interest in the application of RPs in teeth with mature roots; however, to date, the relation between the complexity of the root canal system and outcomes of RPs in necrotic multi-rooted teeth with mature roots is unclear and requires further robust comparative research and long-term follow-up. CONCLUSIONS Whenever indicated, pulpotomy procedures are viable treatment options for vital teeth with mature roots; however, comparative, adequately powered studies with long-term follow-up are needed as a priority in this area. RPs show promising outcomes for necrotic teeth with mature roots that warrant more evidence in different tooth types with long-term follow-ups. CLINICAL RELEVANCE: Clinicians should be aware of the pulp chamber anatomy, which is subject to morphological changes by age or as a defensive mechanism against microbial irritation, before practicing partial and full pulpotomy procedures. RP is a promising treatment option for teeth with immature roots, but more evidence is needed for its applications in teeth with mature roots. A universal consensus and considerably more robust evidence are needed for the standardization of RPs in teeth with mature roots.
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Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Ikhlas El-Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental, Traumatology University Hospital of Würzburg Pleicherwall, 2, 97070, Würzburg, Germany
| | - Kerstin Galler
- Department of Restorative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
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Nouroloyouni A, Moradi N, Salem Milani A, Noorolouny S, Ghoreishi Amin N. Prevalence and Morphology of C-Shaped Canals in Mandibular First and Second Molars of an Iranian Population: A Cone-Beam Computed Tomography Assessment. SCANNING 2023; 2023:5628707. [PMID: 37822804 PMCID: PMC10564578 DOI: 10.1155/2023/5628707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023]
Abstract
Objectives The complex anatomy of C-shaped canals poses challenges for clinicians compared to teeth with normal root canal anatomy. This study is aimed at evaluating the frequency and morphology of C-shaped canals in the mandibular first and second molars among an Iranian population using cone-beam computed tomography (CBCT). Materials and Methods This cross-sectional study evaluated 369 CBCT scans from the archives of a radiology clinic in Ardabil, Iran. The sample included 248 mandibular first molars and 478 mandibular second molars. The presence of C-shaped canals and their classification, according to Fan et al., were evaluated at four levels: orifice, coronal, middle, and apical. Prevalence based on gender and tooth type was also assessed. Results A total of 199 (53.9%) males and 170 (46.1%) females were evaluated. C-shaped canals were found in 11 (8 males/3 females) out of 248 (4.4%) first molars and in 20 (11 males/9 females) out of 478 (3.7%) second molars. The C2 configuration was most prevalent in the orifice, coronal, and middle levels of both molar types, while C3 and C4 morphologies were most commonly found apically in the second and first molars, respectively. A significant difference in configuration was found only at the coronal level between molar types. A significant association between gender and configuration was observed only at the orifice level of the second molars. No other significant differences were found (P > 0.05). Conclusion C-shaped canal configurations should be expected in 4.4% of mandibular first molars and 3.7% of the second molars in this Iranian population, with a predominance of the C2 configuration in the orifice, coronal, and middle levels.
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Affiliation(s)
- Ahmad Nouroloyouni
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Neda Moradi
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Amin Salem Milani
- Department of Endodontics, School of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Sara Noorolouny
- Department of Pediatric Dentistry, Ardabil University of Medical Science, Ardabil, Iran
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Qiu S, Chen Y, Tsauo C, Wu W, Huang D, Zhou X, Peng L, Gao Y. Microcomputed tomography analysis of the radicular residual dentin thickness in mandibular second molars after virtual fiber post placement: Identification of danger zones. J Prosthet Dent 2023:S0022-3913(23)00262-7. [PMID: 37210223 DOI: 10.1016/j.prosdent.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/22/2023]
Abstract
STATEMENT OF PROBLEM Mandibular second molars have variable root, pulp chamber floor, and radicular groove morphologies, potentially affecting residual dentin thickness and post placement suitability. However, an identification of the danger zones is lacking. PURPOSE The purpose of this in vitro study was to investigate the residual dentin thickness in the danger zone of mandibular second molars after virtual fiber post placement by using a simulation method based on microcomputed tomography (μCT). MATERIAL AND METHODS A total of 84 extracted mandibular second molars were scanned using μCT and classified according to root morphology (separate or fused) and pulp chamber floor morphologies (C-shaped, non-C-shaped, or no pulp chamber floor). Fused-root mandibular second molars were further classified based on the radicular groove type (V-, U-, or Ω-shaped). All specimens were accessed, instrumented, and rescanned with μCT. Two types of commercial fiber posts were also scanned. Clinical fiber post placement was simulated in all prepared canals by using a multifunctional software program. The minimum residual dentin thickness of each root canal was measured and analyzed by using nonparametric tests to identify the danger zone. Perforation rates were calculated and recorded. RESULTS Larger fiber posts decreased minimum residual dentin thickness (P<.05) and increased perforation rate. In regard to mandibular second molars with separate roots, the distal root canal exhibited a significantly higher minimum residual dentin thickness than the mesiobuccal and mesiolingual root canals (P<.05). However, no significant difference in minimum residual dentin thickness was found between the different canals in fused-root mandibular second molars with C-shaped pulp chamber floors (P<.05). Fused-root mandibular second molars with Ω-shaped radicular grooves had a lower minimum residual dentin thickness than those with V-shaped radicular grooves (P<.05) and demonstrated the highest perforation rate. CONCLUSIONS The morphologies of the root, pulp chamber floor, and radicular groove were correlated with residual dentin thickness distribution in mandibular second molars after fiber post placement. A comprehensive understanding of mandibular second molar morphology is essential for determining the suitability of post-and-core crown restorations after endodontic treatment.
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Affiliation(s)
- Shenghao Qiu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Yue Chen
- Undergraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chialing Tsauo
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Weiwei Wu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Dingming Huang
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Xuedong Zhou
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lin Peng
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - Yuan Gao
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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Mittal N, Baranwal HC, Gupta S, Shankari T, Gupta S, Kharat S. Comparative analysis of reduction in pain scores after single visit root canal treatment using endodontic irrigation protocols, namely, Conventional needle irrigation, PUI, PIPS and SWEEPS: A randomized control trial. J Conserv Dent 2023; 26:143-149. [PMID: 37205889 PMCID: PMC10190097 DOI: 10.4103/jcd.jcd_450_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/09/2022] [Accepted: 12/01/2022] [Indexed: 05/21/2023] Open
Abstract
Introduction To assess the effects of different irrigation activation systems on postoperative pain using a Visual Analog Scale (VAS), using new laser irrigation activation system shock wave-enhanced emission photoacoustic streaming (SWEEPS), photon-induced photoacoustic streaming (PIPS), passive ultrasonic irrigation activation techniques, compared with the conventional irrigation (CI) method. Materials and Methods Sixty patients suffering from symptomatic irreversible pulpitis in maxillary or mandibular molars were enrolled and randomly assigned to four different irrigation activation groups (n = 15) after chemomechanical root canal preparation. Preoperative and postoperative pain scores were recorded using VAS. The data were collected and subjected to statistical analysis using IBM SPSS 20.0 software at a level of significance being 0.05. Results We observed that mean pain scores decreased with time in all patients in all groups. The decrease in pain score was found to be statistically significant (P < 0.05) among both the genders in Group 3 (PIPS) and Group 4 (SWEEPS). Postoperatively, pain scores decreased significantly using Group 4 (SWEEPS), followed by Group 3 (PIPS), Group 2 (ultrasonic activation), and Group 1 (conventional needle irrigation). No significant relation was observed statistically between pain scores and age groups among all groups, except for preoperative score in Group 3 and age groups. Conclusion Postoperative scores were lower in laser-activated irrigation systems as compared to the other activation systems. The highest pain scores were observed in case of CI method, at pre- and post-operative periods.
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Affiliation(s)
- Neelam Mittal
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
| | - Harakh Chand Baranwal
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
| | - Sakshi Gupta
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
| | - Thivya Shankari
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
| | - Supriya Gupta
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
| | - Shubham Kharat
- Department of Conservative Dentistry and Endodontics, FODS, BHU, Varanasi, Uttar Pradesh, India
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Association of Mandibular Posterior Anatomic Limit with Skeletal Patterns and Root Morphology Using Three-Dimensional Cone Beam Computed Tomography Comprehensive Analysis. Diagnostics (Basel) 2022; 12:diagnostics12123019. [PMID: 36553025 PMCID: PMC9777482 DOI: 10.3390/diagnostics12123019] [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: 10/11/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
This study aimed to clarify the relationship between the mandibular posterior anatomic limit (MPAL) and skeletal anteroposterior and vertical skeletal patterns, with consideration of factors that may be related. In total, 230 people were included: 49 Japanese, 122 Egyptian, and 59 Korean people. The MPAL was measured at 0, 2, 4, and 6 mm from the root furcation along the sagittal and cuspal lines at the distance from the distal root of the mandibular right second molar to the mandibular cortex of the lingual bone. Eight different MPALs were evaluated using multiple regression analysis with explanatory variables for anteroposterior and vertical skeletal patterns and qualitative variables for age, sex, population, the presence of third molars, number of roots, presence of C-shaped roots, and Angle malocclusion classification. The MPAL was significantly larger as the mandibular plane angle decreased. The MPAL near the root apex was significantly larger as the A-nasion-point B angle increased, and the MPAL near the root apex measured at the cuspal line was significantly larger for C-type roots. The present study showed that a C-shaped root affected the MPAL in addition to the anteroposterior and vertical skeletal patterns.
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Chen C, Zhu T, Wu H, Zhao X, Leng D, Wang J, Yang L, Wu D. Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals. Sci Rep 2022; 12:19779. [PMID: 36396689 PMCID: PMC9671964 DOI: 10.1038/s41598-022-24381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).
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Affiliation(s)
- Cheng Chen
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Tingting Zhu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Lianfeng Yang
- grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- grid.89957.3a0000 0000 9255 8984Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,grid.89957.3a0000 0000 9255 8984Present Address: Department of Oral & Maxillofacial Imaging, The Affiliated Stomatological Hospital of Nanjing Medical University, 1 Shanghai Road, Nanjing, 210029 People’s Republic of China ,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China ,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Zheng Y, Yang X, Liu S, Xu Y, Bao S, Wang Y, Liu Y, Zhang F, Gou Z. Ball Milling Medium May Tune the Self-Curing Property and Root Canal Microleakage of β-Dicalcium Silicate-Based Cement. MATERIALS 2022; 15:ma15145043. [PMID: 35888510 PMCID: PMC9321766 DOI: 10.3390/ma15145043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022]
Abstract
It is still a challenge to overcome the extended setting process of pure Ca-silicate as root canal fillers. We investigated the effects of attapulgite (a basic hydrous silicate of magnesium and aluminum) and ball-milling liquid medium on the self-curing properties of conventional β-dicalcium silicate (C2Si)-based cements. It was shown that a minor amount of attapulgite nanofibers (1–4%) had only a slight influence on setting time but caused a large increase in compressive resistance and structural stability. In particular, the ball milling media with different acetone/water ratios (3:0, 2:1, 1:2, 0:3) could directly influence the particle size distribution of C2Si powders, and the co-existence of liquid media (2:1 or 1:2) may be beneficial for shortening the setting time, enhancing early-stage compressive strength, and significantly improving the anti-microleakage ability of cement. Moreover, the composite cements also exhibited appreciable antibacterial efficacy in vitro. These findings demonstrated that the physicochemical properties of the Ca-silicate powders could be tuned by adding a minor amount of inorganic silicate nanofibers and a simple ball milling condition, and such a facile strategy is favorable for developing novel (pre-mixed) Ca silicate-based cements as root canal sealers.
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Affiliation(s)
- Youyang Zheng
- Department of Stomatology, The Second Affiliated Hospital, School of Medicine Zhejiang University, Hangzhou 310009, China;
| | - Xianyan Yang
- Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China;
| | - Shuxin Liu
- School of Stomatology, Zhejiang University School of Medicine, Hangzhou 310006, China; (S.L.); (Y.X.); (S.B.)
| | - Yuyue Xu
- School of Stomatology, Zhejiang University School of Medicine, Hangzhou 310006, China; (S.L.); (Y.X.); (S.B.)
| | - Siqi Bao
- School of Stomatology, Zhejiang University School of Medicine, Hangzhou 310006, China; (S.L.); (Y.X.); (S.B.)
| | - Yunyi Wang
- Department of Stomatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, China;
| | - Yuhan Liu
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Feng Zhang
- Department of Stomatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, China;
- Correspondence: (F.Z.); (Z.G.)
| | - Zhongru Gou
- Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou 310058, China;
- Correspondence: (F.Z.); (Z.G.)
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Sun W, Chen H, Zhong Y, Zhang W, Chu F, Li L, Chen Y, Wang X, Wang Q, Wang Y, Wei Y, Liu L, Xu Y. Three-Dimensional Tooth Models with Pulp Cavity Enhance Dental Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2022; 15:566-575. [PMID: 33829672 DOI: 10.1002/ase.2085] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/28/2021] [Accepted: 04/04/2021] [Indexed: 05/22/2023]
Abstract
Dental anatomy is an integrated, core fundamental dental course, which prepares students for all future clinical dental courses. This study aimed to build up an online dental learning platform of micro-computed tomography-based three-dimensional (3D) tooth models with pulp cavity, and to further evaluate its effectiveness for dental anatomy education using a cohort study. First, ninety-six extracted permanent teeth were scanned by micro-computed tomography and the enamel, dentine, and pulp cavity of each was distinguished by different grey-scale intensities using Mimics software. Three-dimensional images allowed further discrimination and insights into permanent three-rooted premolars, central tip, and dental diseases including deep caries and wedge-shaped defects. Furthermore, a second mesiobuccal canal (MB2) in maxillary permanent molar teeth and Vertucci type III root canal configuration in mandibular anterior teeth could be detected using the 3D analytical tool. A digitized 3D tooth model learning platform was implemented. Last, two groups of dental students were assessed to evaluate the effect of 3D models on dental anatomy education. Participants in the Digital group were allowed to use the online dental learning platform freely after class, while the participants in the Traditional group were not. Assessment quizzes showed that participants' scores improved in the Digital group with the use of the learning platform compared with scores in the Traditional group. A questionnaire survey indicated that the participants had a positive attitude toward the 3D models. Thus, adding digital 3D resources to a traditional curriculum may have a positive effect on academic achievements.
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Affiliation(s)
- Wen Sun
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Hongyu Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yi Zhong
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Wei Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Fengqing Chu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Lin Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yue Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Xiang Wang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Qirui Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuxin Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yongyue Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Laikui Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yan Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Periodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People's Republic of China
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Josic U, Mazzitelli C, Maravic T, Fidler A, Breschi L, Mazzoni A. Biofilm in Endodontics: In Vitro Cultivation Possibilities, Sonic-, Ultrasonic- and Laser-Assisted Removal Techniques and Evaluation of the Cleaning Efficacy. Polymers (Basel) 2022; 14:polym14071334. [PMID: 35406207 PMCID: PMC9003475 DOI: 10.3390/polym14071334] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 01/27/2023] Open
Abstract
Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely.
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Affiliation(s)
- Uros Josic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Claudia Mazzitelli
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Tatjana Maravic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Ales Fidler
- Dental Clinic, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Lorenzo Breschi
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
- Correspondence:
| | - Annalisa Mazzoni
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
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20
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Erkan E, Gündoğar M, Uslu G, Özyürek T. Postoperative pain after SWEEPS, PIPS, sonic and ultrasonic-assisted irrigation activation techniques: a randomized clinical trial. Odontology 2022; 110:786-794. [PMID: 35267110 DOI: 10.1007/s10266-022-00700-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
To investigate the efficacy of a new laser irrigation activation system [shock wave-enhanced emission photo-acoustic streaming (SWEEPS)] in terms of postoperative pain after primary root canal treatment compared with other techniques, namely photon-induced photo-acoustic streaming (PIPS), sonic system with EDDY, passive ultrasonic system (PUI), and manual dynamic activation (MDA). Two hundred patients with symptomatic irreversible pulpitis in mandibular premolar teeth were enrolled and randomly allocated to five different irrigation activation groups (n = 40) after chemo-mechanical root canal preparation. For irrigation activation, the SWEEPS and PIPS tips were attached to the Er-YAG laser system in the respective groups, while the Irrisafe tip was used in the PUI group and the EDDY tip in the sonic group. In the MDA group, irrigation was agitated with the master gutta-percha cone. At postoperative hours 8, 24, and 48 and on day 7, pain intensity was evaluated using the 10-mm Visual Analog Scale (VAS) and analgesic intake was recorded. The Kruskal-Wallis test was used to analyze the VAS scores, and pain prevalence and analgesic intake were examined with the Pearson's chi-square test at the 5% significance level. The PIPS and SWEEPS groups had the lowest level and prevalence of pain when compared to the remaining groups (P < 0.001). The PUI, sonic and MDA groups did not differ in terms of pain scores at hours 8 and 48 (P > 0.05). On day 7, the highest score and pain prevalence were recorded in the MDA group (P < 0.001). There was no difference between the groups in terms of analgesic intake (P > 0.05). Laser-activated irrigation systems provided lower postoperative pain scores and levels compared to the other activation systems. The MDA group had the highest pain scores and incidence at the end of the seventh day.
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Affiliation(s)
- Erhan Erkan
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| | - Gülşah Uslu
- Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Cumhuriyet Mahallesi Sahilyolu Cad. No: 5 Kepez, Çanakkale, Turkey.
| | - Taha Özyürek
- Department of Endodontics, Faculty of Dentistry, Bahçeşehir University, Istanbul, Turkey
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Al-Nazhan S, Alenezi A, Al-Maflehi N, Aldosimani M. Cone-beam computed tomography evaluation of C-shaped root canal system in mandibular second molars in kuwaiti sub-population. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_11_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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The C-shaped root canal systems in mandibular second molars in an Emirati population. Sci Rep 2021; 11:23863. [PMID: 34903785 PMCID: PMC8668958 DOI: 10.1038/s41598-021-03329-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/01/2021] [Indexed: 12/23/2022] Open
Abstract
Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.
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Choi YJ, Lee C, Jeon KJ, Jang JT, Han SS. Canal configuration and root morphology of mandibular premolars using cone-beam computed tomography in a Korean population. Clin Oral Investig 2021; 26:3325-3332. [PMID: 34846559 DOI: 10.1007/s00784-021-04313-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate the anatomy of mandibular premolars from two perspectives-the canal configuration and radicular grooves-using cone-beam computed tomography (CBCT) in a large Korean population. MATERIALS AND METHODS CBCT images of mandibles acquired from March 2018 to December 2019 for dental treatment were randomly selected. In each image, the root canal of premolars was classified into 8 types according to the canal merging or diverging pattern and the number of apical foramens. The presence and the location of radicular grooves were also assessed. Statistical analysis was performed. RESULTS A total of 1463 first and 1448 s premolars from 732 patients (390 males, 342 females, mean age of 36.1 years) were evaluated. A single canal with one foramen predominated in both first (85.7%) and second (99.5%) premolars, while complete or partial multi-canals accounted for 14.3% and 0.5% of first and second premolars, respectively. The prevalence of radicular grooves was significantly higher in first premolars (13.2%) than in second premolars (0.5%) and in males (4.3%, n = 119) than in females (2.5%, n = 73). CONCLUSIONS Although most premolars were complete single canals, the first premolars showed a relatively higher number of complex canals compared to the second premolar. In addition, radicular grooves in mandibular premolars were significantly more common in male patients. CLINICAL RELEVANCE When planning the endodontic treatment of mandibular premolars, clinicians should be aware of their morphologic complexity, especially in the first premolar of male patients.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Ji-Taek Jang
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
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Cetin MS, Simsek N. Evaluation of fracture strength of different restoration techniques applied to C-shaped 3D model teeth. Odontology 2021; 110:262-268. [PMID: 34495439 DOI: 10.1007/s10266-021-00655-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study is to investigate the effect of different restoration methods applied to model teeth with a C-shaped root canal configuration on fracture strength. A total of 76 artificial tooth models were made using images of a molar tooth with a C-shaped root canal anatomy. The teeth were randomly divided into seven groups and different restorations, such as resin composite (2), bundled fiber post and resin composite (3), vertical fiber post and resin composite (4), horizontal fiber post and resin composite (5), woven fiber post and resin composite (6) and composite endocrown (7) were applied to the different groups except control group (1). The artificial teeth were embedded in acrylic blocks and subjected to fracture tests. The data were analyzed using one-way analysis of variance, Monte Carlo Pearson Chi-square, Pearson Chi-square, and Fisher's exact test (P < 0.05). All groups differed in terms of fracture strength (P = 0.001). The highest fracture strength observed in group 6, and there was a significant difference between group 6 and group 4 based on a least significant difference pairwise comparison test. In terms of fracture type, the highest reparability percentage (100%) observed in group 7. The fracture strength values of endocrown restorations and woven fiber-reinforced resin composite restorations were found to be as high as those of the intact models. Considering also fracture restorability, endocrown restorations may be recommended for teeth with C-shaped root canal anatomy. The usage of the 3D tooth models in the studies offer a valuable opportunity in terms of the standardization of the samples, particularly in teeth with anatomical variations. This study shows that using of this technology, homogeneous groups can be created and experimental studies can be improved.
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Affiliation(s)
- Melis Sila Cetin
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Neslihan Simsek
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
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Gomez F, Brea G, Gomez-Sosa JF. Root canal morphology and variations in mandibular second molars: an in vivo cone-beam computed tomography analysis. BMC Oral Health 2021; 21:424. [PMID: 34470619 PMCID: PMC8411505 DOI: 10.1186/s12903-021-01787-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the anatomical variations of the root canal system of mandibular second molars using cone-beam computed tomography (CBCT). METHODS 190 mandibular second molars cone-beam computed tomography images were reviewed. The evaluation was performed by a radiologist with endodontic experience and two endodontists trained with CBCT technology. Tooth position, number of root and root canals, C-shaped root canal system configuration, presence of extra root (radix), and radicular grooves were assessed. Data was statistically analyzed using The Chi-square test (α = 0,05) to determine any significant difference between gender and the total number of root and root canals, and any significant difference between gender and root canal anatomical variation. RESULTS Overall, 85.5% showed two separated roots, 12.1% a single root, 2.6% three roots or radix. 87.7% showed three root canals, 12.1% two root canals, 2.6% four root canals, and 1.6% a single root canal. 10% showed a single foramen, 75.3% two foramina, 13.6% three foramina and 1% showed four foramina.19.5% showed C-shaped anatomical variation, 51.4% in male patients, 48.6% in female patients. According to Fan classification: C1 13.6% in cervical third, C2 10% in the middle third, C3 17.3% in middle third, 15.5% in apical third, and C4 12.7% in the apical third. Root canals number in these samples were 5.4% a single canal, 21.6% two canals, 70.3% three canals, and 2.7% four canals. The root showed 46% with one foramen, 46% two foramina, and 8% three foramina. Radicular grooves 83.3% were found in the lingual area and 16.2% towards the buccal area. CONCLUSIONS The most prevalent anatomic presentation of the evaluated sample was a mandibular second molars with two roots, three root canals, and two apical foramina. Their variation was C-shaped root canals and Radix Paramolaris.
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Affiliation(s)
- Francisco Gomez
- Postgraduate Department of Endodontics, Universidad Central de Venezuela, Caracas, Venezuela
| | - Gisbeli Brea
- Postgraduate Department of Endodontics, Universidad Central de Venezuela, Caracas, Venezuela
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Evaluation of C-shaped canals in mandibular second molars of a selected patient group using cone beam computed tomography: prevalence, configuration and radicular groove types. Odontology 2021; 109:949-955. [PMID: 34081247 DOI: 10.1007/s10266-021-00616-1] [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: 12/10/2020] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to examine the prevalence, symmetry and configurations of C-shaped canals and radicular groove types in mandibular second molars according to age and sex in a Turkish sub-population using cone beam computed tomography (CBCT). In total, 674 CBCT images (368 females and 306 males, aged 18-76 years) of 1348 mandibular second molars were evaluated. The symmetry, configuration of C-shaped root canals, radicular groove types with age and sex were noted. One sample chi-square test and chi-square test were used to determine statistically significant differences. The statistical significance level was set at p < 0.05. Of the 1348 mandibular second molars evaluated, 10.7% had C-shaped root canals. C-shaped root canals appeared to be significantly more common in females than in males (p < 0.05). C1 (44.4%) was the most frequent configuration in the coronal third, and C2 (44.4%), and C4 (31.9%) were the most frequent configurations in middle and apical thirds, respectively. Type 2 (45.1%) was the most common radicular groove type (p < 0.05). The frequency of C-shaped root canals in mandibular second molars in a Turkish sub-population was considerably high (10.7%). CBCT can aid the detection of C-shaped canals and their configurations. Dentists should consider the possibility of C-shaped canals in root canal treatment of mandibular second molars, as these configurations have implications for biomechanical preparation and filling methods.
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Azkue JJ. Embedding interactive, three-dimensional content in portable document format to deliver gross anatomy information and knowledge. Clin Anat 2021; 34:919-933. [PMID: 33982339 DOI: 10.1002/ca.23755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 11/11/2022]
Abstract
The Portable Document Format (PDF) is likely the most widely used digital file format for scholarly and scientific electronic publishing. Since format specification version 1.6, three-dimensional (3D) models in Universal 3D (U3D) format can be embedded into PDF files. The present study demonstrates a repertoire of graphic strategies and modes of presentation that exploit the potentials of 3D models embedded in PDF to deliver anatomical information and knowledge. Three-dimensional models and scenes representing anatomical structures generated by 3D surface scanning or by segmentation from either clinical imaging data or cadaver sectional images were converted into U3D format and then embedded into PDF files using both freely and commercially available software. The relevant steps and required software tools are described. Built-in tools in Adobe Acrobat and JavaScript scripting both were used to pre-configure user interaction with 3D contents. Eight successive proof-of-concept examples of increasing complexity are presented and provided as supplementary material, including both unannotated and annotated 3D specimens, use of bitmap-textures, guided navigation through predetermined 3D scenes, 3D animation, and interactive navigation through tri-planar sectional human cadaver images. Three-dimensional contents embedded in PDF files are generally comparable to multimedia and dedicated 3D software in terms of quality, flexibility, and convenience, and offer new unprecedented opportunities to deliver anatomical information and knowledge.
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Affiliation(s)
- Jon Jatsu Azkue
- Department of Neurosciences, School of Medicine and Nursery, University of the Basque Country, UPV/EHU, Leioa, Bizkaia, Spain
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Martin G, Arce Brissón G, Chen B, Noemí de Caso C, Boetto AC, Jacobo MI, Higa R, Braschi SM, Marchegiani S, Monsalvo A, Shen Y, Haapasalo M. Root dentine thickness in C-shaped lower second molars after instrumentation: A CBCT and micro-CT study. AUST ENDOD J 2021; 47:122-129. [PMID: 33729636 DOI: 10.1111/aej.12509] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
Stripping perforation is a possible complication in instrumentation of C-shaped canals. This study evaluated the minimum thickness of the root canal wall in C-shaped teeth after instrumentation. Twelve extracted C-shaped mandibular second molars (four teeth of type I, II and III each) were examined by CBCT (voxel size 90 μm) before and after instrumentation with WOG primary file. Micro-CT scans (voxel size 30 μm) were obtained after instrumentation. Percentage of canal wall area touched by the file and minimum thickness of dentine were measured and compared between CBCT and micro-CT. In type I C-shape canals, less than 10% of the canal wall area was touched by the instrument. In ten teeth, the shortest distance to root surface was from the instrumented area; no perforations occurred. CBCT and micro-CT measurements were in good agreement in ten cases; in two teeth, micro-CT revealed considerably shorter distance to root surface. The two shortest distances were 0.27 and 0.41 mm.
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Affiliation(s)
- Gabriela Martin
- Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Cordoba, Argentina.,Division of Endodontics, Department of Oral Rehabilitation, Faculty of Dentistry, National University of Córdoba, Cordoba, Argentina.,Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Dentistry, National University of North East, Argentina
| | - Georgette Arce Brissón
- Division of Endodontics, Department of Oral Rehabilitation, Faculty of Dentistry, National University of Córdoba, Cordoba, Argentina
| | - Binwen Chen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Cecilia Noemí de Caso
- Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Cordoba, Argentina.,Division of Endodontics, Department of Oral Rehabilitation, Faculty of Dentistry, National University of Córdoba, Cordoba, Argentina
| | - Ana Cecilia Boetto
- Division of Endodontics, Department of Oral Rehabilitation, Faculty of Dentistry, National University of Córdoba, Cordoba, Argentina
| | - María Inés Jacobo
- Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Cordoba, Argentina
| | - Romina Higa
- Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Cordoba, Argentina
| | - Silvia Marta Braschi
- Department of Endodontics, Postgraduate Program of Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Cordoba, Argentina
| | | | - Andrés Monsalvo
- Division of Biomedical Engineering, Raomed Technology and Health Institute, Córdoba, Argentina
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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Four-Rooted Maxillary First Molars: A Systematic Review and Meta-Analysis. Int J Dent 2021; 2021:8845442. [PMID: 33542735 PMCID: PMC7843171 DOI: 10.1155/2021/8845442] [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: 04/28/2020] [Revised: 11/08/2020] [Accepted: 12/17/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives The majority of human maxillary first molars is usually described as having three roots, but different morphologies were documented in several studies and case reports. One very rare and less investigated anatomical anomaly is the occurrence of four radicular structures in the upper first molars. This communication aimed to define the prevalence of four-rooted maxillary first molars on a meta-analytical basis. The external and internal morphology of these teeth was described by the collection of published case reports. Materials and Methods Six electronic databases were accessed to collect case reports dealing with four-rooted maxillary first molars, as well as population-based cone-beam computed tomography (CBCT) studies. Afterward, the publications were selected according to predefined inclusion/exclusion criteria and evaluated using the Joanna Briggs Institute Critical Appraisal tool. The teeth of the chosen case reports were then independently analyzed by two dental professionals according to different dental classifications. Furthermore, the population studies were meta-analyzed to calculate the global and regional prevalence of four-rooted maxillary molars. Results Included were forty-nine population-based CBCT studies containing 26663 maxillary first molars. Upon these data, the global incidence of four-rooted maxillary molars was meta-analytically determined as 0.047% (95%-CI:0.011-0.103%). In combination with the case reports, it was pointed out that this anomaly is distributed worldwide. Furthermore, forty-eight case reports were included containing fifty-three maxillary molars with four roots. The analyzed teeth exhibited Versiani´s pulpal chamber floor Types A and B. The majority of four-rooted maxillary first molars were classified as Type I regarding Christie's configuration. But, also 7.54% of the altered teeth could not be described by this classification. 62.34% exhibited four root canals, but also variations with five, six, or seven canals were identified. Furthermore, a significant difference was found in the occurrence rate between male and female patients. Conclusion Due to the worldwide occurrence, dental professionals should be aware of this rare anomaly to avoid treatment errors, especially during endodontic or surgical therapies.
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Khorasani M, Nabavi S, Hamedi A, Jafarzadeh H. Endodontic Treatment of C-shaped Mandibular Premolars: A Case Report and Review of Literature. IRANIAN ENDODONTIC JOURNAL 2021; 16:244-253. [PMID: 36704776 PMCID: PMC9735311 DOI: 10.22037/iej.v16i4.34187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 01/28/2023]
Abstract
Our article aimed to present a curious case of a mandibular premolar with a C-shaped root canal and to review the available literature on this anatomical variation. Mandibular premolar teeth account for the greatest endodontic challenges in the course of treatment on account of the morphological variations in their root canal systems, including extra root(s)/canal(s) or a C-shaped configuration. A 20-year-old female patient was referred to the Department of Endodontics of Mashhad Faculty of Dentistry, suffering from abscess, and pain while chewing. On examination the culprit was found to be the left mandibular first premolar. Following special tests and periapical radiography, we found an amalgam restoration proximate to the non-vital pulp chamber, as well as an unusually complex root canal anatomy with periapical radiolucency. A non-surgical root canal treatment with the aid of a dental operating microscope was considered as the treatment plan. Clinicians should always anticipate the presence of a C-shaped configuration in mandibular premolars, and make use of all the available tools to locate and treat such cases. A substantial knowledge of root canal anatomy would be prudent to ensure a successful outcome ensuing surgical and non-surgical root canal treatments.
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Affiliation(s)
- Monire Khorasani
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saideh Nabavi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Saideh Nabavi, Dental Research Center, Vakilabad Blvd, Mashhad, Iran
| | - Ali Hamedi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Jafarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Cone-beam computed tomography classification of the mandibular second molar root morphology and its relationship to panoramic radiographic appearance. Oral Radiol 2020; 37:494-501. [PMID: 33048311 DOI: 10.1007/s11282-020-00486-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aimed to clarify the relationship between the panoramic radiographic appearance and the longitudinal cone-beam computed tomography (CBCT) classification of root configurations of the mandibular second molar. METHODS Panoramic radiographs of 1058 mandibular second molars were classified into five types according to the number and configuration of the roots. These molars were also examined with CBCT at four levels between the pulp chamber and the root apex, and axial images perpendicular to the root axis were categorized into three patterns: single (fused root with small grooves on both buccal and lingual sides or a round root with one canal); double (two separate roots with a trabecular appearance between them); and C-shaped (root with a deep groove opening only on the lingual or buccal side relative to the opposite side). Based on these patterns and their scan levels, the CBCT root morphology appearance in each tooth unit was classified into seven groups. Relationships were investigated between these seven CBCT groups and the five panoramic root types. RESULTS In panoramic types 1 and 2 (with separate roots), 85% had roots with a double pattern (groups II and III) on the CBCT images. In panoramic types 3 and 4 (with fused roots), 85% had C-shaped CBCT patterns at the lower scan levels. CONCLUSIONS When panoramic images show fused root types, CBCT examinations should be planned to clarify the root canal configuration.
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Taurodontism and C-shaped anatomy: is there an association? Oral Radiol 2020; 37:443-451. [PMID: 32803678 DOI: 10.1007/s11282-020-00476-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/08/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate the relation between taurodontism and C-shaped configuration, as well as the prevalence and classification according to sex, left/right position, and arc length in the mandibular premolar and molar teeth using cone beam computed tomography (CBCT). METHODS The presence of taurodontism and C-shaped configuration were evaluated using CBCT scans and classified by two independent radiologists. The sex, location in the jaw (left-right), and mandibular arc length measurements were recorded. The Chi-square test was used to determine the presence of taurodontism and C-shape configuration according to sex, left/right location, and independent-sample t tests were used to assess the relation between the arc length. RESULTS The prevalence of taurodontism was significantly higher in the female population, whereas the C-shaped configuration was more frequent in males (p < 0.05). In both sexes, the most common type was hypotaurodont (7.5%). In the molars, the prevalence was significantly higher in second molars, and the most common C-shaped configuration type was C3 (39.3%). The prevalence was significantly higher in the first premolar, with C2 (22.4%) being the most frequent type in the premolars (p < 0.05). The arc length and location in the jaw were not significantly affected (p > 0.05). CONCLUSIONS A high correlation was revealed between taurodontism and complicated C-shape canal configurations. Practitioners should be very careful about the presence of C-shape morphology in taurodontism treatment, and various types of C-shaped morphology ranging from coronal to the apical direction.
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Nagahara T, Takeda K, Wada K, Shirawachi S, Iwata T, Kurihara H, Shiba H. A mandibular second molar with a middle mesial root canal. Clin Case Rep 2020; 8:1015-1020. [PMID: 32577255 PMCID: PMC7303868 DOI: 10.1002/ccr3.2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 11/17/2022] Open
Abstract
The present case report describes the clinical detection and root canal management of a rare middle mesial canal of a Japanese mandibular second molar by troughing preparation using an operating microscope and cone-beam computed tomography.
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Affiliation(s)
| | - Katsuhiro Takeda
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Satomi Shirawachi
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tomoyuki Iwata
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hidemi Kurihara
- Department of Periodontal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Shiba
- Department of Biological EndodonticsGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Kato A, Hishikawa T, Inagaki K, Yamamoto G, Mitani A, Honda M. Evaluation of root morphology of maxillary and mandibular second molars lost due to periodontitis. J Periodontal Res 2020; 55:753-761. [PMID: 32449986 DOI: 10.1111/jre.12764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/13/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Little is known about the anatomical characteristics of root morphology in molars lost due to periodontal reason. The aim of this study was to study root morphology in maxillary and mandibular molars lost due to periodontitis by investigating the frequency of root fusion, classifying fusion types, and measuring radicular groove depth by micro-computed tomography. MATERIAL AND METHODS Ninety-eight posterior teeth were collected from 87 Japanese patients during the study period. Of these, maxillary (N = 36) and mandibular (N = 22) second molars lost most frequently were assessed for root fusion and morphology. RESULTS The 36 maxillary second molars included nine (25%) teeth with a single root, 14 (39%) with two roots, and 13 (36%) with three roots. Of the 23 maxillary second molars with fused (1 and 2) roots, there were 11 (48%), 2 (9%), 1 (4%), 1 (4%), 3 (13%), and 5 (22%) teeth with root types 1-6, respectively. The 22 mandibular second molars comprised 14 (64%) teeth with a single root, 7 (32%) with two roots, and one (4%) with three roots. Of the 14 mandibular second molars with a fused (1) root, 12 (86%) had a C-shaped root and two (14%) had a non-C-shaped root. CONCLUSION We observed a higher frequency of root fusion in the present study compared with that reported by previous studies using randomly selected second molars.
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Affiliation(s)
- Akiko Kato
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Toshimitsu Hishikawa
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Koji Inagaki
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.,Department of Dental Hygiene, Aichi Gakuin University Junior College, Nagoya, Japan
| | - Genta Yamamoto
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masaki Honda
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Adıgüzel M, Ahmetoğlu F, Eldeniz AÜ, Tekin MG, Göğebakan B. Comparison of cytotoxic effects of calcium silicate-based materials on human pulp fibroblasts Mehmet. J Dent Res Dent Clin Dent Prospects 2019; 13:241-246. [PMID: 32190206 PMCID: PMC7072094 DOI: 10.15171/joddd.2019.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background. This study aimed to compare the in vitro cytotoxicity of Theracal LC, BiodentineTM, iRoot BP Plus, and MTA
Angelus on human pulp fibroblasts (HPF).
Methods. Fifteen discs from each calcium silicate-based material were prepared in sterile Teflon molds. After setting, the
fabricated discs were eluated with a culture medium for 24 h. HPF cells were plated onto 24-well plates at 5×103
cells/well,
and the cells were exposed to the material eluates. The cell viability was evaluated with MTT assay at three different times
(24, 48, and 72 h). Data were statistically analyzed. The apoptotic/necrotic status of HPF cells exposed to material eluates
was determined by flow cytometry.
Results. The differences between the effects of Theracal LC, BiodentineTM, MTA Angelus, and iRoot BP Plus on HPF cells
were found to be statistically significant (P<0.05). Theracal LC was found to be more cytotoxic considering other vital pulp
capping materials at 24- (28.3%), 48- (44.9%), and 72-hour (49.2%) intervals. On the other hand, BiodentineTM showed the
least cytotoxic effects (97.1%, 130.0%, and 103.7%, respectively) According to flow cytometry results, Theracal LC material
increased apoptosis/necrosis ratios compared to the other materials.
Conclusion. Based on the results of the present study, BiodentineTM, MTA Angelus, and iRoot BP Plus can be classified as
biocompatible materials in vital endodontic treatments. However, the Theracal LC materials should be used carefully due to
their cytotoxic effects.
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Affiliation(s)
- Mehmet Adıgüzel
- Department of Endodontics, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | | | - Ayçe Ünverdi Eldeniz
- Department of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | | | - Bülent Göğebakan
- Department of Biology and Genetics, Mustafa Kemal University, Hatay, Turkey
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Unusual Maxillary First Molars with C-Shaped Morphology on the Same Patient: Variation in Root Canal Anatomy. Case Rep Dent 2019; 2019:1857289. [PMID: 31772783 PMCID: PMC6854219 DOI: 10.1155/2019/1857289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 11/18/2022] Open
Abstract
A maxillary first molar should be considered a four-canal tooth until proved otherwise; however, a clinician should also be aware of the possibility of the presence of C-shaped root canal configuration with or without possibility of splitting into two or three canals. The two clinical cases reported in this paper describe the endodontic treatment of two maxillary first molars, on the same patient, with uncommon anatomy: the first case is about a maxillary first molar with only one C-shaped root and one oval canal with a large buccolingual diameter, a C1 type according to Fan's classification; the second case, about the contralateral maxillary first molar, is probably the first case documented of a maxillary first molar with a C-shaped root canal and C-shaped root with complete fusion of the three roots, having a C3 configuration.
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Martins JNR, Mata A, Marques D, Caramês J. Prevalence of C-shaped mandibular molars in the Portuguese population evaluated by cone-beam computed tomography. Eur J Dent 2019; 10:529-535. [PMID: 28042270 PMCID: PMC5166311 DOI: 10.4103/1305-7456.195175] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: The purpose of this study was to evaluate the prevalence of first and second C-shaped mandibular molars in a Western European population of Portuguese Caucasians. Materials and Methods: Patients having both routine panoramic radiograph and presurgical cone-beam computed tomography (CBCT) exams were selected. The CBCT examination was performed at five different axial levels and the mandibular molars were classified as C-shape according to the Fan criteria. Differences between genders, age groups, left and right side, type of tooth, and root concavity side were determined. The molars were classified as nonfused roots (NFRI–II), FRI–III, or single root with single canal (SS) groups, using the panoramic radiograph. The prevalence of C-shaped anatomy was calculated to each group. Results: A total of 1783 teeth (695 first molars and 1088 second molars) from 792 patients were included in the study. The prevalence of C-shaped configurations was 0.6% and 8.5% to mandibular first and second molars, respectively. The differences between gender, teeth, and root concavity direction were considered statistically significant (P < 0.05). The FR had a significantly higher rate of C-shapes when compared to NFR (P < 0.05). Intrarater reliability was 93.6%. Conclusions: The FR radiographic appearance may be considered a predictor of this anatomy. Second mandibular molars and females had a higher incidence ratio. Apparently, the mandibular C-shaped anatomy is more common in the population of this study than that has been previously reported for the European population.
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Affiliation(s)
| | - António Mata
- Department of Biology, New York University, New York, USA.,Department of Oral Biology, School of Dental Medicine, Lisbon University, Lisbon, Portugal.,Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062)- Evidence Based Dentistry Center, Lisbon University, Lisbon, Portugal
| | - Duarte Marques
- Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062)- Evidence Based Dentistry Center, Lisbon University, Lisbon, Portugal.,Department of Anatomy and Physiology, School of Dental Medicine, Lisbon University, Lisbon, Portugal
| | - João Caramês
- Department of Implantology, School of Dental Medicine, Lisbon University, Lisbon, Portugal
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Martins JNR, Marques D, Silva EJNL, Caramês J, Mata A, Versiani MA. Prevalence of C‐shaped canal morphology using cone beam computed tomography – a systematic review with meta‐analysis. Int Endod J 2019; 52:1556-1572. [DOI: 10.1111/iej.13169] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- J. N. R. Martins
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
| | - D. Marques
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry Grande Rio University Rio de JaneiroBrazil
| | - J. Caramês
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- Instituto de Implantologia LisboaPortugal
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - A. Mata
- Faculdade de Medicina Dentária Universidade de Lisboa Lisboa
- LIBPhys‐FCT UID/FIS/04559/2013 Lisboa Portugal
| | - M. A. Versiani
- Dental Specialty Center Brazilian Military Police Minas Gerais Brazil
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Marcano-Caldera M, Mejia-Cardona JL, Blanco-Uribe MDP, Chaverra-Mesa EC, Rodríguez-Lezama D, Parra-Sánchez JH. Fused roots of maxillary molars: characterization and prevalence in a Latin American sub-population: a cone beam computed tomography study. Restor Dent Endod 2019; 44:e16. [PMID: 31149614 PMCID: PMC6529798 DOI: 10.5395/rde.2019.44.e16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population. Materials and Methods A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion. Results Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped. Conclusion Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.
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Affiliation(s)
- Maytté Marcano-Caldera
- Postgraduate Endodontics Program. Autonomous University of Manizales, Manizales, Colombia
| | | | | | | | | | - Jose Hernán Parra-Sánchez
- Math and Statistics Department. National University of Colombia, Campus Palogrande, Manizales, Colombia
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C-shaped canals in first and second mandibular molars from Brazilian individuals: A prevalence study using cone-beam computed tomography. PLoS One 2019; 14:e0211948. [PMID: 30759126 PMCID: PMC6373947 DOI: 10.1371/journal.pone.0211948] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 01/24/2019] [Indexed: 01/28/2023] Open
Abstract
Introduction The study aimed to evaluate, through in vivo tomographic analysis, the prevalence of C-shaped canals in mandibular first and second molars of Brazilian individuals, analyzing its frequency by thirds of the roots, and in contralateral teeth. Methods Images of 801 mandibular molars (379 first molars and 422 second molars) from 334 Brazilian individuals (142 men and 192 women) were identified through 1544 cone beam computed tomography (CBCT) exams, obtained from a private oral radiologic clinic. The cross-sectional configurations were analyzed to determine the frequency of C-shaped canals at three different axial levels and classified in categories by three experienced endodontists independently. Results The incidence of C-shaped canals was 181 (23%). Considering the type of tooth, 91 (24.01%) were identified in the first molars, and 90 (21.32%) were found in the second molars. The incidence was significantly higher in female individuals (P < 0.05) for both first and second molars. The most common C-shaped canal configurations were: C1 (89.01% for first molars and 90% second molars), followed by C2 (8.79% for first molars and 6.66% for second molars) and C4 (2.19% for the first molars and 3.33% for the second molars). Bilateral C-shaped canals were significantly higher than unilateral for both first and second molars (P < 0.01). Conclusions The prevalence of C-shaped canals in mandibular molars of the Brazilian individuals was higher than previously reported for both mandibular first (24.01%) and second molars (21.32%). The incidence was significantly higher in female individuals and the coronal portion of the roots. The classic C-shaped format “C1” was the most frequent anatomical configuration. Furthermore, the prevalence of bilateral C-shaped canals was higher for the first molar (61.70%) and lower for the second molar (38.29%).
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Roy A, Astekar M, Bansal R, Gurtu A, Kumar M, Agarwal LK. Racial predilection of C-shaped canal configuration in the mandibular second molar. J Conserv Dent 2019; 22:133-138. [PMID: 31142981 PMCID: PMC6519192 DOI: 10.4103/jcd.jcd_369_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The purpose of this article is to determine the racial predilection of C-shaped canal configuration in a mandibular second molar. Background: Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of root canal treatment outcome. C-shaped canal configuration is such an aberrant morphology of molar teeth that vary in different population and is commonly seen in a mandibular second molar. Thus, knowledge of racial predilection of C-shaped canal configuration in different population for early diagnosis is obligatory. Materials and Methods: An exhaustive search was undertaken to identify published research articles related to C-shaped canal configuration in mandibular second molars. Forty-three research articles were analyzed which included 12,481 mandibular second molars. Chi-square test using value of P < 0.05 was performed to assess the statistical significance of this anomalous anatomic variation among the different population. Results: Statistical test revealed a significant variation between the Asian and nonAsian population. The highest incidence of racial predilection was observed in China (Asia) with 93.1%, and the minimum was observed in America with 2.7%. Conclusion: This research reported that racial predilection of C-shaped canal configuration in mandibular second molar varies significantly.
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Affiliation(s)
- Aishwarya Roy
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rashmi Bansal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Anuraag Gurtu
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Mrityunjay Kumar
- Department of Anaesthesiology, Critical Care and Pain Management, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Lalit Kumar Agarwal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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A cone-beam computed tomography study of C-shaped root canal systems in mandibular second premolars in a Taiwan Chinese subpopulation. J Formos Med Assoc 2018; 117:1086-1092. [DOI: 10.1016/j.jfma.2017.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 10/17/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022] Open
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Study of Internal Morphology of Root-Canal Treated Single-Rooted Mandibular Second Molars in a Greek Population. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: To determine the prevalence of single-rooted mandibular second molars in a Greek population and examine their internal morphology with the aid of intraoral periapical radiography.
Material and Methods: Clinical records of 531 root-canal treated permanent single-rooted mandibular second molars were collected from the Postgraduate Clinic of the Department of Endodontology, Dental School, Aristotle University of Thessaloniki, Greece and from private dental clinics in the same city. The clinical records, along with the radiographic examination, were evaluated to determine the overall frequency of single-rooted mandibular second molars together with the number of root canals and their course. The root canals were categorized using Vertucci’s classification with the addition of 3 further types where appropriate.
Results: Out of 531 mandibular second molars; 102 (19.2%) presented a single root; 427 (80.4%) presented two roots; 2 (0.4%) presented three roots. In a total of 102 single-rooted mandibular second molars 31 (30.3%) presented with Type I, 18 (17.6%) with Type II, 14 (13.7%) with Type IV, 7 (7%) with 3 additional root canal types and 32 (31.4%) with a C-shaped root canal system.
Conclusions: One out five mandibular second molars was single-rooted in a Greek population. The internal morphology of these teeth can be very complex with regard to the numbers and courses of root canals.
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Lim A, Le Clerc J. Endodontic treatment of a hypertaurodontic mandibular left second molar in a patient with many taurodonts combined with multiple pulp stones. AUST ENDOD J 2018; 45:414-419. [DOI: 10.1111/aej.12291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Adrian Lim
- UFR Odontologie Univ Rennes 1 Rennes France
- Pôle Odontologie CHU Rennes Rennes France
| | - Justine Le Clerc
- UFR Odontologie Univ Rennes 1 Rennes France
- Pôle Odontologie CHU Rennes Rennes France
- ISCR – UMR CNRS 6226 Univ Rennes 1 Rennes France
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Newe A, Becker L. Three-Dimensional Portable Document Format (3D PDF) in Clinical Communication and Biomedical Sciences: Systematic Review of Applications, Tools, and Protocols. JMIR Med Inform 2018; 6:e10295. [PMID: 30087092 PMCID: PMC6103636 DOI: 10.2196/10295] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/07/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background The Portable Document Format (PDF) is the standard file format for the communication of biomedical information via the internet and for electronic scholarly publishing. Although PDF allows for the embedding of three-dimensional (3D) objects and although this technology has great potential for the communication of such data, it is not broadly used by the scientific community or by clinicians. Objective The objective of this review was to provide an overview of existing publications that apply 3D PDF technology and the protocols and tools for the creation of model files and 3D PDFs for scholarly purposes to demonstrate the possibilities and the ways to use this technology. Methods A systematic literature review was performed using PubMed and Google Scholar. Articles searched for were in English, peer-reviewed with biomedical reference, published since 2005 in a journal or presented at a conference or scientific meeting. Ineligible articles were removed after screening. The found literature was categorized into articles that (1) applied 3D PDF for visualization, (2) showed ways to use 3D PDF, and (3) provided tools or protocols for the creation of 3D PDFs or necessary models. Finally, the latter category was analyzed in detail to provide an overview of the state of the art. Results The search retrieved a total of 902 items. Screening identified 200 in-scope publications, 13 covering the use of 3D PDF for medical purposes. Only one article described a clinical routine use case; all others were pure research articles. The disciplines that were covered beside medicine were many. In most cases, either animal or human anatomies were visualized. A method, protocol, software, library, or other tool for the creation of 3D PDFs or model files was described in 19 articles. Most of these tools required advanced programming skills and/or the installation of further software packages. Only one software application presented an all-in-one solution with a graphical user interface. Conclusions The use of 3D PDF for visualization purposes in clinical communication and in biomedical publications is still not in common use, although both the necessary technique and suitable tools are available, and there are many arguments in favor of this technique. The potential of 3D PDF usage should be disseminated in the clinical and biomedical community. Furthermore, easy-to-use, standalone, and free-of-charge software tools for the creation of 3D PDFs should be developed.
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Affiliation(s)
- Axel Newe
- Chair of Medical Informatics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,NewTec GmbH, Pfaffenhofen an der Roth, Germany
| | - Linda Becker
- Chair of Health Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Amoroso-Silva P, De Moraes IG, Marceliano-Alves M, Bramante CM, Zapata RO, Hungaro Duarte MA. Analysis of mandibular second molars with fused roots and shallow radicular grooves by using micro-computed tomography. J Conserv Dent 2018; 21:169-174. [PMID: 29674819 PMCID: PMC5890407 DOI: 10.4103/jcd.jcd_74_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: This study aimed to describe the morphological and morphometric aspects of fused mandibular second molars with radicular shallow grooves using micro-computed tomography (CT). Materials and Methods: Eighty-eight mandibular second molars with fused roots were scanned in a micro-CT scanner at a voxel size of 19.6 μm. After reconstruction, only molars without C-shaped roots and presenting shallow radicular grooves were selected. 30 molars were chosen for further analysis. Canal cross-sections were classified according to Fan's modified classification (C1, C2, C3, and C4) and morphometric parameters at the apical region, examination of accessory foramina and tridimensional configuration were evaluated. Results: Three-dimensional reconstructions indicated a higher prevalence of merging type (n = 22). According to Fan's modified classification, the C4 configuration was predominant in the 3 apical mm. Roundness median values revealed a more round-shaped canals at 3 mm (0.72) than at 2 (0.63) and 1 (0.61) mm from the apex. High values of major and minor diameters were observed in the canals of these evaluated sections. In addition, few accessory apical foramina were observed at 1 and 2 mm from the apex. The average distance between last accessory foramina and the anatomic apex was 1.17 mm. A less complex internal anatomy is found when a mandibular second molar presents fused roots with shallow radicular grooves. The merging type canal was frequently observed. Moreover, the C4 configuration was predominant at a point 3 mm from the apex and presented rounded canals, large apical diameters, and few accessory foramina. The cervical and middle thirds presented C3 and C1 canal configurations most frequently. Conclusion: A minor morphological complexity is found when fused mandibular second molars present shallow radicular grooves.
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Affiliation(s)
- Pablo Amoroso-Silva
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Ivaldo Gomes De Moraes
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Marilia Marceliano-Alves
- Department of Endodontics, Faculty of Dentistry, Estacio De Sa University, Rio De Janeiro, Rio De Janeiro, Brazil
| | - Clovis Monteiro Bramante
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Ronald Ordinola Zapata
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
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Gharechahi M, Dastmalchi P. Cutaneous Sinus Tract from Mandibular Second Molar with C-shaped Canal System and Improper Former Root Canal Treatment: A Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 57:183-7. [PMID: 27665696 DOI: 10.2209/tdcpublication.2015-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Here, we report the diagnosis and treatment of an extraoral cutaneous sinus tract originating in a mandibular second molar with a C-shaped root canal system. The patient was referred to our department by a dermatologist after a series of unsuccessful treatments, including antibiotics. Diffuse radiolucency on a preoperative radiograph revealed that earlier root canal treatment had been only partially successful. Consequently, we performed retreatment of the root canal comprising removal of the former restoration and gutta-percha, cleaning and shaping, and passive irrigation with sodium hypochlorite. The patient responded well, and the cutaneous lesion completely resolved uneventfully within 1 month postoperatively. Preoperative recognition and thorough knowledge of the root canal anatomy and conventional methods of obturation are necessary in performing successful endodontic treatment.
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Affiliation(s)
- Maryam Gharechahi
- Department of Endodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences
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Ahmed HMA, Dummer PMH. A new system for classifying tooth, root and canal anomalies. Int Endod J 2017; 51:389-404. [DOI: 10.1111/iej.12867] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 10/09/2017] [Indexed: 01/30/2023]
Affiliation(s)
- H. M. A. Ahmed
- Department of Restorative Dentistry; Faculty of Dentistry; 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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Worldwide Prevalence of Mandibular Second Molar C-Shaped Morphologies Evaluated by Cone-Beam Computed Tomography. J Endod 2017; 43:1442-1447. [DOI: 10.1016/j.joen.2017.04.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 01/02/2023]
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Gok T, Capar ID, Akcay I, Keles A. Evaluation of Different Techniques for Filling Simulated C-shaped Canals of 3-dimensional Printed Resin Teeth. J Endod 2017; 43:1559-1564. [PMID: 28756962 DOI: 10.1016/j.joen.2017.04.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/27/2017] [Accepted: 04/29/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to compare the ability of different root canal filling methods on the C1 root canal anatomy using 3-dimensional (3D) printer technology. METHODS Mandibular molars were scanned with cone-beam computed tomographic (CBCT) imaging. A mandibular molar tooth with a C1 root canal configuration was selected according to images obtained from CBCT technology. The root canals were shaped with ProTaper Universal rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland) and hand files. After the root canal shaping procedure, the tooth was scanned with micro-computed tomographic imaging, and 80 replicas of the tooth were produced with a 3D printer. Replicas were assigned into 4 groups (n = 20) and were filled using one of the following techniques: a core carrier system (GuttaCore [GC]; Dentsply Tulsa Dental Specialties, Tulsa, OK), a continuous wave obturation system (Elements Free [CW]; Kerr/SybronEndo, Orange, CA), a cold lateral compaction technique (CLC), or the injectable cold filling method (GuttaFlow Bioseal [GFB]; Coltène/Whaledent AG, Altstatten, Switzerland). All specimens were sectioned horizontally at 2, 4, 6, 8, and 10 mm from the apices of the specimens. The sections were examined at 32× magnification under a stereomicroscope, and the percentage areas of gutta-percha, sealer, and voids were measured. Statistical analysis of data was performed using multivariate analysis of variance and Tukey honestly significant difference tests (P < .05). RESULTS The CW group had the highest mean percentages for void and the least mean percentages for gutta-percha at 2-mm sections (P < .05). A pairwise comparison between the groups showed significantly less void in the CLC and GFB groups and more void in the CW and GC groups at 2 mm (P < .05). In the total area, the CLC and GFB groups showed a significantly lower percentage of gutta-percha and more sealer compared with the other groups (P < .05), and there was no significant difference between the CLC and GFB groups (P > .05). CONCLUSIONS At the apical part of the canal, the cold lateral compaction and cold injectable filling techniques were more successful compared with the warm gutta-percha filling techniques in C1 root canal configuration.
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Affiliation(s)
- Tuba Gok
- Department of Endodontics, Faculty of Dentistry, İzmir Katip Celebi University, İzmir, Turkey.
| | | | - Ilgin Akcay
- Department of Endodontics, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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