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Xu M, Ren H, Liu C, Zhao X, Li X. Systematic review and meta-analysis of root morphology and canal configuration of permanent premolars using cone-beam computed tomography. BMC Oral Health 2024; 24:656. [PMID: 38835024 DOI: 10.1186/s12903-024-04419-y] [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: 03/13/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
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Affiliation(s)
- Mengchen Xu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Huiying Ren
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Congrui Liu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Xinyu Zhao
- Department of stomatology, Jinan Hospital, Jinan, Shandong, 250013, China.
| | - Xiaoyan Li
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China.
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China.
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Šimková PG, Wurm L, Fornai C, Krenn VA, Weber GW. Shape variation in modern human upper premolars. PLoS One 2024; 19:e0301482. [PMID: 38593117 PMCID: PMC11003632 DOI: 10.1371/journal.pone.0301482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/16/2024] [Indexed: 04/11/2024] Open
Abstract
Morphological variation in modern human dentition is still an open field of study. The understanding of dental shape and metrics is relevant for the advancement of human biology and evolution and is thus of interest in the fields of dental anthropology, as well as human anatomy and medicine. Of concern is also the variation of the inner aspects of the crown which can be investigated using the tools and methods of virtual anthropology. In this study, we explored inter- and intra-population morphometric variation of modern humans' upper third and fourth premolars (P3s and P4s, respectively) considering both the inner and outer aspects of the crown, and discrete traits. We worked by means of geometric morphometrics on 3D image data from a geographically balanced sample of human populations from five continents, to analyse the shape of the dentinal crown, and the crown outline in 78 P3s and 76 P4s from 85 individuals. For the study of dental traits, we referred to the Arizona State University Dental Anthropology System integrated with more recent classification systems. The 3D shape variation of upper premolar crowns varied between short and mesio-distally broad, and tall and mesio-distally narrow. The observed shape variation was independent from the geographical origin of the populations, and resulted in extensive overlap. We noted a high pairwise correlation (r1 = 0.83) between upper P3s and P4s. We did not find any significant geographic differences in the analysed non-metric traits. Our outcomes thus suggest that geographical provenance does not play a determinant role in the shaping of the dental crown, whose genesis is under strict genetic control.
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Affiliation(s)
- Petra G. Šimková
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria
- Human Evolution and Archaeological Sciences HEAS, University of Vienna, Vienna, Austria
| | - Lisa Wurm
- Medical Technology Cluster, Business Upper Austria–OÖ Wirtschaftsagentur GmbH, Linz, Austria
| | - Cinzia Fornai
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria
- Human Evolution and Archaeological Sciences HEAS, University of Vienna, Vienna, Austria
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry–VieSID, Klosterneuburg, Austria
- Center for Clinical Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Viktoria A. Krenn
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
- Fraunhofer Austria Research GmbH, Graz, Austria
| | - Gerhard W. Weber
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria
- Human Evolution and Archaeological Sciences HEAS, University of Vienna, Vienna, Austria
- Core Facility for Micro-Computed Tomography, University of Vienna, Vienna, Austria
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Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH. Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study. Odontology 2024; 112:570-587. [PMID: 37957521 DOI: 10.1007/s10266-023-00870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P < 0.05). Younger age groups showed a higher prevalence of Vertucci Type I configuration (P < 0.05). Bilateral symmetry was seen in more than half of the maxillary premolars. There is a considerable variation in the number of roots and root canal configurations of maxillary premolars in the studied Iraqi population, with a significant difference by gender and age groups. Ahmed et al. classification provided more accurate presentation of the root and canal anatomy in maxillary premolars compared to Vertucci's classification.
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Affiliation(s)
- Abdullah Mohammed Aljawhar
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Basrah, Basrah, Iraq
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Azwatee Abdul Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayati Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Mustafa M, Batul R, Karobari MI, Alamri HM, Abdulwahed A, Almokhatieb AA, Hashem Q, Alsakaker A, Alam MK, Ahmed HMA. Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review. BMC Oral Health 2024; 24:343. [PMID: 38493123 PMCID: PMC10944621 DOI: 10.1186/s12903-024-04101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Consultant Endodontics, Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Ahmed A Almokhatieb
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Qamar Hashem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Abdullah Alsakaker
- Consultant endodontist, Department of endodontics, Prince Abdulrahman Advanced Dental Institute, Ministry of defence, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Taha NA, Makahleh N, Hatipoglu FP. Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study. BMC Oral Health 2024; 24:170. [PMID: 38308267 PMCID: PMC10837869 DOI: 10.1186/s12903-024-03934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems. METHODS 3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal's morphology were described according to Vertucci and Ahmed classifications. RESULTS Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root. CONCLUSIONS One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology. CLINICAL RELEVANCE The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.
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Affiliation(s)
- Nessrin A Taha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Box 3030, Irbid, Jordan.
| | - Nisrein Makahleh
- Dental Teaching Clinics, Jordan University of Science and Technology, Irbid, Jordan
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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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Ahmed HMA, Rossi-Fedele G, Dummer PMH. Critical analysis of a new system to classify root and canal morphology - A systematic review. AUST ENDOD J 2023; 49:750-768. [PMID: 37688283 DOI: 10.1111/aej.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/27/2023] [Accepted: 07/08/2023] [Indexed: 09/10/2023]
Abstract
A novel system to classify root and canal morphology was recently introduced (Ahmed et al. 2017). This systematic review aimed to answer the following research question: Does the Ahmed et al. system provide a more accurate and practical classification of root and canal anatomy compared to other classifications? A literature search was conducted in Google Scholar, Scopus and Wiley Online Library to identify the citation counts for the article entitled 'A new system for classifying root and root canal morphology; doi.org/10.1111/iej.12685'. After removal of duplicates and unrelated articles, 15 studies were included and analysed. All studies compared the Ahmed et al. system with the Vertucci classification. Results revealed that both systems were able to classify simple canal configurations in single-rooted anterior and premolar teeth, disto-buccal and palatal roots of maxillary molars. However, the Ahmed et al. system provided more accurate and comprehensive categorisations of single-rooted teeth with complex canal anatomy, multi-rooted maxillary and mandibular premolars and the mesio-buccal root of maxillary molars. Further evidence on the utility of the Ahmed et al. system is required using other diagnostic devices especially in molars.
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Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Nawar NN, Abdelfattah RA, Kataia M, Saber SM, Kataia EM, Kim HC. Effect of Proximal Caries-driven Access on the Biomechanical Behavior of Endodontically Treated Maxillary Premolars. J Endod 2023; 49:1337-1343. [PMID: 37517584 DOI: 10.1016/j.joen.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION This study investigated the effects from the carious cavity and access from it on the fracture resistance of endodontically treated maxillary premolars using finite element analysis (FEA). METHODS A maxillary premolar was used to compare 3 types of access cavity related to having a proximal carious defect: caries-driven access (CDA), conservative access that has a mesial component (MCA), as well as traditional access with the same mesial component (MTA). Cyclic loading was simulated on the occlusal surface, and number of cycles until failure (NCF) was compared with the intact tooth model (IT). Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (vM) and maximum principal stresses (MPS), with emphasis on pericervical region as a specific area of interest. RESULTS Maximum vM registered on the IT was 6.14 MPa. CDA provided the highest NCF with 92.28% of the IT, followed by MCA (84.90%) and MTA (83.79%). The vM and MPS analysis showed that the stress values and patterns are affected more by the proximity of the occlusal load to the tooth/restoration interface. Concerning the pericervical region, maximum vM was registered for IT (4.11 MPa), followed by CDA (4.85 MPa) and then MCA (8.13 MPa) and MTA (8.61 MPa), whereas the MPS analysis revealed that CDA showed the highest magnitude of tensile stresses. CONCLUSIONS A proximal CDA benefits the mechanical properties of maxillary premolars; however, its impact on the biological aspect should be assessed to provide a ruling for/against it.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | | | - Mohamed Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt
| | - Engy Medhat Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Restorative and Dental Materials Department, National Research Centre, Doki, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Mirah MA, Bafail A, Baik A, Abu Zaid B, Hakeem M, Ghabbani H. Root Canal Morphology of Premolars in Saudis. Cureus 2023; 15:e45888. [PMID: 37885565 PMCID: PMC10599201 DOI: 10.7759/cureus.45888] [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: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
AIM This study aimed to evaluate root number and morphological variations of the root canal system in maxillary and mandibular premolars among the Saudi subpopulation. METHODOLOGY A total of 500 cone-beam computed tomography (CBCT) images were assessed, including 2442 maxillary and mandibular premolars. The evaluation encompassed the number of roots and canals and their configuration based on the Vertucci classification. Gender differences were considered, along with the position of premolars and unilateral or bilateral symmetry. RESULTS Maxillary first premolars predominantly exhibited two roots (82.6%), followed by one root (16.3%) and three roots (0.97%), with a majority having two root canals (83.6%). Regarding maxillary second premolars, the most common morphology was one root (66.6%), with two root canals (40.5%) observed more frequently than one root canal (38.1%). Mandibular first and second premolars mainly featured one root (84.8% and 96.1%, respectively) with one root canal (70.8% and 90.2%, respectively), whereas two root canals were less prevalent (2.3% and 1.8%, respectively). Three canals and three roots were rarely found in mandibular premolars (0.3%). Regarding maxillary premolars, males exhibited significantly higher type IV and mandibular type I root configurations compared with females. Conversely, regarding mandibular premolars, females showed significant mandibular type V and higher type I root configurations compared with males. CONCLUSION CBCT imaging facilitated precise assessment of root morphology and root canal configurations in maxillary and mandibular premolars. The present findings can aid dentists in diagnosing, evaluating case difficulty, and devising effective root canal treatments, particularly in patients from Saudi Arabia.
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Affiliation(s)
- Mahir A Mirah
- Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madinah, SAU
| | - Arwa Bafail
- Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madinah, SAU
| | - Abdulmajeed Baik
- Internship Program, College of Dentistry, Taibah University, Madinah, SAU
| | - Basim Abu Zaid
- Internship Program, College of Dentistry, Taibah University, Madinah, SAU
| | - Muhannad Hakeem
- Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madinah, SAU
| | - Hani Ghabbani
- Endodontic Department, King Faisal Specialist Hospital and Research Centre, Madinah, SAU
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Erkan E, Olcay K, Eyüboğlu TF, Şener E, Gündoğar M. Assessment of the canal anatomy of the premolar teeth in a selected Turkish population: a cone-beam computed tomography study. BMC Oral Health 2023; 23:403. [PMID: 37337200 DOI: 10.1186/s12903-023-03107-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Teeth may have additional roots and a different number of root canals. Overlooked root canals may cause endodontic failure. The aim of this study was to investigate the prevalence of root canals and the number of roots of premolars in a selected Turkish population. MATERIALS AND METHODS A total of 2,570 teeth from 1,438 patients were evaluated. The cone-beam computed tomography scans of 1,055 maxillary and 1,515 mandibular premolars were examined. RESULTS Type IV root canal morphology was observed most frequently in maxillary first premolars (77%), and the rates of single and double channel formations were very similar (51% and 49%, respectively). Of the second maxillary premolars, 57.4% had Type I morphology, and 89.9% of the teeth were single-rooted, while 68.6% had a single root canal. The most common formation was Type I (85%) among mandibular first premolars, and a single root was observed in 95.6% of these teeth. In addition, 87% of the mandibular first premolars had a single root canal. The second mandibular premolars mostly had Type I (95.4%) formation, and 99.3% of the teeth were single-rooted, while 96.9% had a single root canal. CONCLUSION According to our findings, 51% of maxillary first premolars had a single root, 79.4% had two root canals, and 77% had Type IV (77%) formation. Maxillary second premolars mostly had Type I formation. In addition, a single root and single root canal formation were most common. Mandibular first premolars generally had a single root and single root canal formation, but 13% had two root canals, and 6.4% had Type V formation. More than 95% of mandibular second premolars had Type I formation.
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Affiliation(s)
- Erhan Erkan
- Department of Endodontics, School of Dentistry, Medipol Mega Dental Hospital, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe No: 1, Bagcilar, Istanbul, 34214, Turkey.
| | - Keziban Olcay
- Department of Endodontics School of Dentistry, Istanbul University-Cerrahpasa, Kocamustafapasa Cad. No: 34/E, Cerrahpasa, Fatih, Istanbul, 34098, Turkey
| | - Tan Fırat Eyüboğlu
- Department of Endodontics, School of Dentistry, Istanbul Medipol University, Ataturk Blvd., No: 27, Unkapanı, Fatih, Istanbul, 34083, Turkey
| | - Elif Şener
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Erzene Mah. Ankara Cad. No: 172/109, Bornova, Izmir, 35040, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, School of Dentistry, Medipol Mega Dental Hospital, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe No: 1, Bagcilar, Istanbul, 34214, Turkey
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Saber SM, Elashiry MM, Sadat SMAE, Nawar NN. A microcomputed tomographic analysis of the morphological variabilities and incidence of extra canals in mandibular first molar teeth in an Egyptian subpopulation. Sci Rep 2023; 13:8985. [PMID: 37268728 DOI: 10.1038/s41598-023-36005-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
A well-protected microbial habitat may be present in the root and canal morphology, which is varied and complicated. Before initiating effective root canal treatment, a detailed knowledge of the root and canal anatomical variances in each tooth is a must. This study aimed to investigate the root canal configuration, apical constriction anatomy, location of the apical foramen, dentine thickness, and prevalence of accessory canals in mandibular molar teeth in an Egyptian subpopulation using micro-computed tomography (microCT). A total of 96 mandibular first molars were scanned using microCT, and 3D reconstruction was performed using Mimics software. The root canal configurations of each of the mesial and distal root were classified with two different classification systems. The prevalence and dentin thickness around middle mesial and middle distal canals were investigated. The number, location and anatomy of major apical foramina and the apical constriction anatomy analysed. The number and location of accessory canals were identified. Our findings showed that two separate canals (15%) and one single canal (65%) were the most common configuration in the mesial and distal roots, respectively. More than half of the mesial roots had complex canal configurations and 51% had middle mesial canals. The single apical constriction anatomy was the most common for both canals followed by the parallel anatomy. Disto-lingual and distal locations of the apical foramen are the most common location for both roots. Mandibular molars in Egyptians show a wide range of variations in root canal anatomy with high prevalence of middle mesial canals. Clinicians should be aware of such anatomical variations for successful root canal treatment procedures. A specific access refinement protocol and appropriate shaping parameters should be designated for each case to fulfil the mechanical and biological objectives of root canal treatment without compromising the longevity of treated teeth.
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Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt.
- The Center for Innovative Dental Sciences, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt.
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt.
| | - Mohamed Mohamed Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University in Egypt, Cairo, Egypt
- Department of Endodontics, Dental College of Georgia, Augusta University, Cairo, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt
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Karobari MI, Iqbal A, Syed J, Batul R, Adil AH, Khawaji SA, Howait M, Khattak O, Noorani TY. Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study. BMC Oral Health 2023; 23:291. [PMID: 37189077 DOI: 10.1186/s12903-023-03002-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The clinician should have complete knowledge of the normal anatomy of the root as well as complexities in the root canal configuration for a better outcome, as missed or improper handling of the canal system can lead to the failure of an entire endodontic procedure. The present study aims to assess the morphology of roots and canals in permanent mandibular premolars in the Saudi subpopulation with a new classification system. METHODS The present study includes 1230 mandibular premolars (645 first premolars and 585-second premolars) from 500 CBCT images of the patients, including retrospective data. iCAT scanner system (Imaging Sciences International, Hatfield, PA, USA) was used to obtain the images; scanning of 8 × 8 cm images was performed at 120 KVp and 5-7 mA with a voxel size of 0.2 mm. The new method of classification presented by Ahmed et al. 2017 was used to record and classify the root canal morphology, followed by recording the differences regarding the age and gender of the patients. Comparison of canal morphology in lower permanent premolars and its association with gender and age of the patients was done by Chi-square test/ Fisher exact test; the significance level was set at 5% (p ≤ 0.05). RESULTS The left mandibular 1st and 2nd premolars with one root were 47.31%, with two roots were 2.19%. However, three roots (0.24%) and C-shaped canals (0.24%) were reported only in the left mandibular 2nd premolar. The right mandibular 1st and 2nd premolars with one root were 47.56%, with two roots were 2.03%. The overall percentage of the number of roots and canals in the first and second premolars 1 PM 1 (88.38%), 2 PM 1 B 1 L 1 (3.5%), 2 PM B 1 L 1 (0.65%), 1 PM 1-2-1 (3.08%), 1 PM 1-2 (3.17%), 1 PM 1-2-1-2 (0.24%), 3 PMMB 1 DB 1 L1 (0.48%). However, the C-shaped canals (0.40%) were reported in right and left mandibular second premolars. No statistically significant difference was reported between mandibular premolars and gender. A statistically significant difference was reported between mandibular premolars and the age of the study subjects. CONCLUSION Type I (1 TN 1) was the major root canal configuration in permanent mandibular premolars, which was higher among males. The CBCT imaging provides thorough details about the root canal morphology of lower premolars. These findings could support diagnosis, decision-making, and root canal treatment, for dental professionals.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Department of Conservative Dentistry & Endodontics, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Jamaluddin Syed
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Abdul Habeeb Adil
- Department of Community Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Sara Akili Khawaji
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Osama Khattak
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
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Saber SM, Seoud MAE, Sadat SMAE, Nawar NN. Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study. BMC Oral Health 2023; 23:217. [PMID: 37061674 PMCID: PMC10105946 DOI: 10.1186/s12903-023-02939-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND This study was using Cone beam computed tomography (CBCT) to examine the anatomical variations in mandibular second molars in an Egyptian sub-population. METHODS A total of 350 CBCT images (215 females and 135 males, aged 15-65 years) of mandibular second molars were evaluated. Samples were evaluated in terms of: number of roots, number of root canals, roots' cross section as well as prevalence and configurations of C-shaped canals. Statistical analysis was done to highlight differences between different categories and their prevalence among genders (significance level was set at p < 0.05). Data were presented as frequency and percentage values and were analyzed using chi square test followed by pairwise comparisons utilizing multiple Fisher's exact tests with Bonferroni correction. The significance level was set at p < 0.05 within all tests. RESULTS Of the 350 mandibular second molars evaluated, 87.2% were non-C-shaped while 12.8% were C-shaped with no gender-based statistically significant differences (χ2 = 0.19, p = 0.656). Most samples had three root canals (80%) followed by two (16%), then one (3.2%), and finally four (0.8%) root canals. Among the non-C-shaped molars, presence of two roots was most common (83.4%) followed by presence of a single root (16.2%), and only one sample (0.2%) had three roots, and this had no correlation with gender (χ2 = 1.86, p = 0.431). In the mesial roots Type IV Vertucci was the most common configuration found (68.8%), while Type I was the most prevalent in the distal roots (91.8%). The long oval configuration was the most commonly found cross section in mesial roots while "oval" was the most prevalent in distal roots. CONCLUSION Egyptian sub-population shows highly variable morphological features in mandibular second molars, hence, CBCT is highly recommended on case-to-case conditions.
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Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
- Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mohammed Abou El Seoud
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, Cairo, Egypt.
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Nawar NN, Elkholy MMA, Ha WN, Saber SM, Kim HC. Optimum shaping parameters of the middle mesial canal in mandibular first molars: A finite element analysis study. J Endod 2023; 49:567-574. [PMID: 36965769 DOI: 10.1016/j.joen.2023.03.007] [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: 12/30/2022] [Revised: 01/27/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION This study investigated the effect of shaping parameters of two different configurations of middle mesial canals (MMC) on the biomechanical behavior and life span of a mandibular first molar using finite element analysis (FEA). METHODS A mandibular molar with an independent MMC and another with a confluent MMC were scanned via micro-CT, and FEA models were produced. For each tooth, an intact model and 5 experimental models were produced differed by parameters of how MMC was shaped: unshaped MMC, 25/.04, 25/.06, 30/.04, and 30/.06. Cyclic loading of 50 N was applied on the occlusal surface in vertical and oblique scenarios, and the number of cycles until failure (NCF) was compared to the intact models. In addition, mathematical analyses evaluated the stress distribution patterns and calculated maximum von Mises and maximum principal stresses. RESULTS For both the independent and confluent MMC models, shaping the MMC reduced the NCF. The lifelog percentage of models was inversely proportional with radicular shaping parameters during the vertical and oblique loading scenarios. The shaping size of 30/.06 resulted in lower lifelog percentage than the cases with shaping size of 25/.04 in both of the independent and confluent MMC models. For all models, oblique loading reduced NCF more than vertical loading. CONCLUSION Shaping the MMC should be kept as conservative as 25/.04. Also, whether the MMC is independent or confluent is a deciding factor in whether to increase the apical diameter or the root canal taper when larger shaping parameters are needed.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Mostafa M A Elkholy
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Prevalence of Second Root and Root Canal in Mandibular and Maxillary Premolars Based on Two Classification Systems in Sub-Population of Northern Region (Saudi Arabia) Assessed Using Cone Beam Computed Tomography (CBCT): A Retrospective Study. Diagnostics (Basel) 2023; 13:diagnostics13030498. [PMID: 36766603 PMCID: PMC9914268 DOI: 10.3390/diagnostics13030498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The objective of this paper is to assess the prevalence of a second canal in maxillary and mandibular premolars based on two classification systems of root canal morphology using Cone beam computed tomography (CBCT) images. A total of 286 CBCT scans from the archive of the Radiology department of a hospital were assessed for the presence of a second canal in maxillary and mandibular premolars. The canal configuration and its assessment was undertaken using Vertucci and Ahmed's classification. A Chi-square test was used to test the significance of the difference between gender and age. A total of 286 premolars were examined (217 mandibular premolars and 69 maxillary premolars); of these, 173 teeth (60.5%) were from males and 113 were from females (39.5%). Some 62% of maxillary left first premolars had two roots, followed by maxillary right first premolars (47%), and then maxillary left second premolars (30%) and maxillary right ones (27%), respectively. Type IV Vertucci were seen in maxillary premolars, while type I were ordinarily seen in the included mandibular premolars. Surprisingly, Vertucci type III was only found in mandibular left first premolars at a frequency of 2%. One orifice with two separate canals and two orifices of two distinct canals with two portals of exit were predominantly noticed with maxillary first premolars (2 FP B1 P1) in 73% and 81%, respectively, followed by (1 FP 2) 19%. The prevalence of a second canal in maxillary and mandibular premolars was low in the investigated premolars in comparison to the premolars that had just one root and canal, as assessed based on Vertucci and Ahmed's root canal system classification.
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Chourasia HR, Odabi AI, Owis AA, Dahas ZA, Bokhari AM, Mashyakhy M, Jabali AH. Evaluation of Root Canal Morphology of Maxillary Second Premolars and Its Relation to Maxillary Sinus in a Saudi Arabian Population. J Contemp Dent Pract 2023; 24:35-41. [PMID: 37189010 DOI: 10.5005/jp-journals-10024-3456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM This study aimed to evaluate the root canal anatomy of maxillary second premolars, and its relation to the maxillary sinus in a Saudi Arabian population using cone-beam computed tomography. MATERIALS AND METHODS Records of 301 patients (602 Teeth) were obtained from a Cone-beam Computed Tomography Database of the College of Dentistry, Jazan University from February 2020 to January 2022. The number of roots, root canals, and the relationship between the root apices of maxillary second premolars and the floor of the maxillary sinuses were studied. The data was recorded, tabulated, and statistically analyzed. RESULTS A majority of maxillary second premolars were single-rooted (78.74%), followed by double-rooted (20.76%) and three-rooted (0.5%). Two canals (59.1%) were seen in the majority of the examined teeth, followed by one canal (40.4%) and three canals (0.5%). The roots of the maxillary second premolars were predominantly (69.17%) outside the sinus. Nineteen percent of roots were in contact with the floor of the maxillary sinus with no significant difference between buccal and palatal roots, and around twelve percent (11.73%) of roots were inside the maxillary sinus. CONCLUSIONS The root canal system morphology of maxillary second premolars showed a wide range of anatomical variations in the Saudi Arabian population with a predominance of single roots. Most of the roots were located outside the sinus followed by in contact and then inside the sinus. Three-rooted second premolars were exceedingly rare. CLINICAL SIGNIFICANCE The cognizance of maxillary second premolar root canal anatomy and its relation to maxillary sinus would be a valuable affirmation for dentists of different nationalities treating the Saudi Arabian population to ensure a successful endodontic treatment.
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Affiliation(s)
- Hemant Ramesh Chourasia
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia, Phone: +966509795107, e-mail:
| | - Ali I Odabi
- Dental Department, Sabya General Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Alhassan A Owis
- Resident in Endodontic, King Abdulaziz University Dental Hospital, Saudi Arabia
| | - Zarah A Dahas
- Resident in Endodontic, King Faisal Specialist Hospital & Research Centre, Saudi Arabia
| | - Ahmed M Bokhari
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Ahmad H Jabali
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, van Schoor A, Uys A. A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems. J Oral Sci 2022; 64:300-306. [PMID: 36089376 DOI: 10.2334/josnusd.22-0239] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans. METHODS Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05). RESULTS Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al. 1MP1) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created. CONCLUSION Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.
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Affiliation(s)
- Glynn D Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria.,Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Mohamed Y Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Inger Fabris-Rotelli
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria
| | - Albert van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Andre Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
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Versiani MA, Carvalho KKT, Martins JNR, Custódio ALN, Castro MAA, Akaki E, Silva-Sousa YTCS, Sousa-Neto MD. Effects of root canal enlargement on unprepared areas and coronal dentine thickness of three-rooted maxillary first premolars with different root configurations: a stepwise micro-CT study. Int Endod J 2022; 55:1262-1273. [PMID: 35993556 DOI: 10.1111/iej.13818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations. METHODOLOGY Thirty three-rooted maxillary first premolars with 3 root configurations (n=10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2), and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels, and minimal dentine thickness. Statistic analyses were performed with one-way ANOVA post hoc Tukey tests and paired sample t-test at a significance level of 5%. RESULTS No statistical differences were observed among groups regarding the morphometric parameters and static voxels (p > 0.05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p < 0.05), while no differences were observed in the other roots (p > 0.05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction of dentine thickness was higher in the buccal roots than in the palatal root (p < 0.05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3. CONCLUSIONS Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.
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Affiliation(s)
- Marco A Versiani
- Dental Specialty Centre, Brazilian Military Police, Minas Gerais, Brazil.,Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Kleber K T Carvalho
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jorge N R Martins
- Centro de Estudo de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Portugal
| | - Antonio L N Custódio
- Department of Morphology, Biologic Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Maurício A A Castro
- Department of Clinic, Pathology and Dental Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Emílio Akaki
- Department of Dentistry, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Brazil
| | - Yara T C S Silva-Sousa
- Department of Endodontics, Faculty of Dentistry, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Diab H, Al-Sheeb F, Diab A, Marouf N, Al Obaid M, Lari M. A Cone-Beam Computed Tomography (CBCT) Study of Root Anatomy, Canal Morphology and Bilateral Symmetry of Permanent Maxillary Premolar Teeth Among the Qatari Subpopulation. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2204260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives:
The study aims to evaluate the root anatomy, canal morphology, and symmetry of maxillary premolars teeth in a Qatari subpopulation using cone-beam computed tomography (CBCT).
Materials and Methods:
544 CBCT images of Qatari patients were analyzed by two endodontists. Tooth position, number of roots, canal configuration, and number of canals per root were investigated. A chi-square test was used to evaluate the association between gender and the number of roots. The interexaminer and intraexaminer were performed and documented.
Results:
The most common root anatomy and canal morphology observed in maxillary first premolars (MFP) were two roots (70.6%) with a single canal per root, while in maxillary second premolars (MSP), there was one root (84.3%) with a single canal (83%).
Type I Vertucci morphology was predominated in all roots of two-rooted MFP (97%), three-rooted MFP (100%), single-rooted MSP (42%), and two-rooted MSP (100%). The Chi-square test showed an association between gender and number of roots in both MFP and MSP, with a higher number of roots seen in men(P<0.05).
A symmetrical pattern was observed in the number of roots and canals in both maxillary premolars. But the symmetry for the type of canal configuration is higher in MFP (78%) than MSP (54%).
Conclusion:
In the Qatari subpopulation, most MFP had two roots with a predominance of type I Vertucci, while MSP had one root with type I. Contralateral MSP showed more diversity in canal configuration that should be considered during root canal treatment. CBCT is an effective diagnostic tool to investigate root anatomy and canal morphology.
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Olczak K, Pawlicka H, Szymański W. Root and canal morphology of the maxillary second premolars as indicated by cone beam computed tomography. AUST ENDOD J 2022; 49:92-103. [PMID: 35502481 DOI: 10.1111/aej.12624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 01/22/2023]
Abstract
The aim was to evaluate the morphology of maxillary second premolars. The root canal configurations were classified according to Vertucci and a new system by Ahmed et al. based on CBCT images. In addition, the number of roots and the level where they bifurcated were identified, and morphological measurements were performed based on anatomical landmarks. Single-rooted forms were most common. Bifurcation occurred most often in the middle part of the root. The most common canal configuration was type I according to Vertucci and code 1 SP1 according to the new classification. The measurements showing the results were as follows (mm): palatal cusp/buccal cusp/the lowest point of the occlusal surface to pulp chamber ceiling 6.18/6.54/4.77; the ceiling of the pulp chamber was found at the CEJ in 92.28% of the specimens. The maxillary second premolars tended to be single-rooted and with one root canal.
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Affiliation(s)
- Katarzyna Olczak
- Department of Endodontics, Medical University of Lodz, Lodz, Poland
| | - Halina Pawlicka
- Department of Endodontics, Medical University of Lodz, Lodz, Poland
| | - Witold Szymański
- Institute of Materials Science and Engineering, Lodz University of Technology, Lodz, Poland
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Fournier G, Maret D, Duchesne S, Telmon N, Diemer F, Savall F. Root and canal morphology of the permanent teeth in medieval and current French population. Arch Oral Biol 2022; 140:105452. [DOI: 10.1016/j.archoralbio.2022.105452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/22/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
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22
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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23
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Correlations between additional roots in maxillary second molars, maxillary first premolars, mandibular first molars and mandibular first premolars: a retrospective cone-beam computed tomography analysis. Odontology 2022; 110:584-595. [DOI: 10.1007/s10266-022-00687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, van Schoor A, Uys A. Root and canal morphology of the permanent anterior dentition in a Black South African population using cone-beam computed tomography and two classification systems. J Oral Sci 2022; 64:218-223. [DOI: 10.2334/josnusd.22-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Glynn D. Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Mohamed Y. Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria
| | - Inger Fabris-Rotelli
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria
| | - Albert van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
| | - Andre Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria
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Kartik SN, Shetty K, Vergis BA, Natarajan S, D'Souza JL. Analysis of root morphology and internal anatomy of 400 maxillary first premolars using cone-beam computed tomography in an Indian Dravidian subpopulation: An ex vivo study. J Conserv Dent 2022; 25:487-491. [PMID: 36506628 PMCID: PMC9733556 DOI: 10.4103/jcd.jcd_158_22] [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: 03/17/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 12/15/2022] Open
Abstract
Background There have been numerous cone-beam computed tomography (CBCT) studies done over the years to analyze the canal configurations among various racial and ethnic population groups. Several of these studies have highlighted a certain consistency in the incidence of particular features within these population subsets. Aim The study aimed to analyze the root morphology and canal configurations of the maxillary first premolar (Mx1PM) in the Indian Dravidian subpopulation using CBCT. Setting and Design This study involved a retrospective analysis of 200 CBCT scans, which included 400 Mx1PM. Methods The CBCT images were evaluated, and the number of roots and canal configurations was recorded as per the Vertucci's classification. Statistical Analysis Variations in the number of roots and canal anatomies were statistically interpreted using the Chi-square test of association with the significance level set at P < 0.05. Results Among the 400 Mx1PM studied, 116 (29%) teeth displayed single roots and 284 (71%) showed the presence of two roots. The single-rooted premolars revealed a varied canal configuration with a predominance of Vertucci's Type II configuration in around 53.4% of the Mx1PM. The two-rooted premolars revealed 100% Type I canal configuration. Conclusion The Mx1PM studied predominantly showed the two-rooted morphology with independent canals in each root. There was no significant difference between the teeth on either side of the same arch. The CBCT is an excellent nondestructive modality that can help us study the internal anatomy of pulp space accurately.
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Affiliation(s)
- S. Nath Kartik
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Karthik Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India,Address for correspondence: Dr. Karthik Shetty, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore. Affiliated to Manipal Academy of Higher Education, Karnataka, India. E-mail:
| | - Bettina Ashwini Vergis
- Department of Conservative Dentistry and Endodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Janina Loren D'Souza
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Karnataka, India
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Nino-Barrera J, Alzate-Mendoza D, Olaya-Abril C, Gamboa-Martinez LF, Guamán-Laverde M, Lagos-Rosero N, Romero-Diaz AC, Duran N, Vanegas-Hoyose L. Atypical Radicular Anatomy in Permanent Human Teeth: A Systematic Review. Crit Rev Biomed Eng 2022; 50:19-34. [PMID: 35997108 DOI: 10.1615/critrevbiomedeng.2022043742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of the present study is to classify and quantify the anatomical variations of teeth in terms of form and number of root canals reported in human teeth employing the classification systems proposed previously. An electronic (PubMed) and manual search were performed to identify case reports noting any of the anatomical variations. Each alteration was studied independently. The electronic search was performed using the following keywords: anatomical aberration, root canal, permanent Dentition, case report, c-shaped canal, dens invaginatus, palato-radicular groove, palato-radicular groove, palato-gingival groove, radix entomolaris, dental fusion, dental gemination, taurodontism, dilaceration. The initial search revealed 1497 papers, of which 938 were excluded after analyzing the titles and abstracts. Therefore, 559 potential papers were considered. Of those, 140 articles did not meet the inclusion criteria. For the final revision, 419 papers were considered. We found that the mandibular first premolar had the highest prevalence of C-shaped canals. Dens invaginatus was more frequently found in the mandibular lateral incisor. Taurodontism was more prevalent in the maxillary first molar and in the mandibular first molar. Dilaceration was not clearly associated with a particular tooth. The classifications systems used in this review allowed for the better understanding and analysis of the many anatomical variations present in teeth. The variations in shape most found were dens invaginatus and radix entomolaris. The most frequently reported anatomical variation was in the number of canals.
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Affiliation(s)
- Javier Nino-Barrera
- Faculty of Dentistry, School of Endodontics, Universidad Nacional de Colombia, Bogota, Colombia; Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia; Research Group on Biomechanics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Diana Alzate-Mendoza
- Program Director, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | - Carolina Olaya-Abril
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | | | - Mishell Guamán-Laverde
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
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Canal Configuration of Maxillary Premolars in Cukurova Population: A CBCT Analysis. BALKAN JOURNAL OF DENTAL MEDICINE 2021. [DOI: 10.2478/bjdm-2021-0023] [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: Aim of this study was to evaluate the anatomy of root-canal systems and numbers of permanent maxillary premolars’ roots and canals, using cone beam computed tomography scans.
Material and Methods: In this retrospective and observational study, maxillary right/left and first/second premolars of patients who were screened with cone beam computed tomography for various reasons in a Turkish dental school, were examined. Evaluated parameters were age, gender, canal configuration (Vertucci classification) and numbers of roots and canals. Chi-square test was used for statistical analysis. The level of significance was set at p<0.05.
Results: A total of 1086 maxillary premolars including 555 first premolars and 531 second premolars were examined in 331 patients (186 female, 145 male). Presence of two roots was shown in 75% of first premolars. 76.3% of second premolars were found to have a single root. Most common canal configuration was type IV (73.2%) for first premolars and type II (32.4%) for second premolars. There was a significant relationship between gender and numbers of first and second premolars’ roots and canals.
Conclusions: High heterogeneity of maxillary premolar root-canal system anatomy should be considered during endodontic treatment.
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Olczak K, Pawlicka H, Szymański W. Root form and canal anatomy of maxillary first premolars: a cone-beam computed tomography study. Odontology 2021; 110:365-375. [PMID: 34714481 PMCID: PMC8930800 DOI: 10.1007/s10266-021-00670-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/17/2021] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the root and canal morphology of permanent maxillary first premolars in a Polish population using cone-beam computed tomography scanning (CBCT) and to compare the classifications by Vertucci and Ahmed et al. Images of 350 maxillary first premolars were analyzed. Scans were obtained from 226 patients: 131 women and 95 men. The root canal configurations were classified according to Vertucci and a new system by Ahmed et al. In addition, the number of roots and the level where roots bifurcated were identified. The results were submitted to statistical analysis. Most maxillary first premolars had two roots (69.1%). Most bifurcations were located in the coronal part of the root (44.2%) and the least in the apical part (15.3%). Bifurcation in the coronal part of the root was observed more often in the teeth of men than women. In turn, bifurcation in the central or apical part was significantly more common in women than in men. The most common canal configuration of the maxillary first premolars was type IV (78.2%) according to Vertucci and 2FPB1P1 (65.4%) according to the new classification. Among the remaining cases, almost all types of canals described by Vertucci, and many combinations of codes given in the new classification were demonstrated. The maxillary first premolars displayed a wide range of root and canal anatomical variations. The new system for classifying canal morphology based on Ahmed et al. is more accurate than the Vertucci classification.
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Affiliation(s)
- Katarzyna Olczak
- Department of Endodontics, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Halina Pawlicka
- Department of Endodontics, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Witold Szymański
- Institute of Materials Science and Engineering, Lodz University of Technology, Stefanowskiego 1/15, 90-924 Lodz, Poland
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Al-Zubaidi SM, Almansour MI, Al Mansour NN, Alshammari AS, Alshammari AF, Altamimi YS, Madfa AA. Assessment of root morphology and canal configuration of maxillary premolars in a Saudi subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2021; 21:397. [PMID: 34389013 PMCID: PMC8364052 DOI: 10.1186/s12903-021-01739-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to use CBCT to look into the root canal morphology of maxillary premolars in a Saudi Arabian subpopulation and associate the results to existing canal morphology classifications. METHODS The sample size for this analysis was 500 right and left untreated maxillary first and second premolars with fully formed roots from 250 Saudi residents (125 male and 125 female). The following observations were made using CBCT on the teeth related: (1) The number and morphology of roots; (2) The canal morphology for each root according to Vertucci's classification. The frequency and similarities between the right and left sides, as well as between females and males, were studied. The Chi-square test was used to assess the results. RESULTS Of the 500 maxillary first premolars studied, 199 teeth had one root (39.8%), whilst 293 (58.6%) were two-rooted. Three-rooted maxillary first premolars were found in 8 (1.6%). For maxillary second premolars, 416 premolars had one root (83.2%), whilst 79 (15.8%) had two roots and the rest 5 (1.0%) were three roots. There were significant differences of number of root were found between groups (p > 0.05). For maxillary first premolar, Type IV was the most frequent, accounting for 57.8% of the sample (n = 289), followed by type II (32.8%, n = 164). For maxillary second premolar, Type I was mainly occurrence 302 (60.4%), followed by Type II (16.4%, n = 82). CONCLUSIONS The majority of maxillary first premolars had two roots and two root canals, while one root and one root canal was the most common anatomical configuration for maxillary second premolars. Additional canal forms do occur on occasion, and clinicians should pay close attention to them.
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Affiliation(s)
- Saad M Al-Zubaidi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
| | - Moazzy I Almansour
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | | | | | - Ahad F Alshammari
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Yazeed S Altamimi
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
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A Microcomputed Tomographic Evaluation of Root Canal Morphology of Maxillary Second Premolars in a Pakistani Cohort. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11115086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study aimed to investigate variations in the root canal morphology of maxillary second premolar (MSP) teeth using microcomputed tomography (micro-CT). Sixty (N = 60) human extracted MSPs were collected and prepared for micro-CT scanning. The duration for scanning a single sample ranged between 30 and 40 min and a three-dimensional (3-D) image was obtained for all the MSPs. The images were evaluated by a single observer who recorded the canal morphology type, number of roots, canal orifices, apical foramina(s), apical delta(s), and accessory canals. The root canal configuration was categorized in agreement with Vertucci’s classification, and any configuration not in agreement with Vertucci’s classification was reported as an “additional canal configuration”. Descriptive statistics (such as mean percentages) were calculated using SPSS software. The most common types agreeing with Vertucci’s classification (in order of highest to lowest incidence) were types I, III, V, VII, II, and VI. The teeth also exhibited four additional configurations that were different from Vertucci’s classification: types 2-3, 1-2-3, 2-1-2-1, and 1-2-1-3. A single root was found in 96.7% and the majority of the samples demonstrated two canals (73.3%). Further, 80% of the teeth showed one canal orifice. The number of apical foramina’s in the teeth was variable, with 56.7% having solitary apical foramen. The accessory canal was found in 33.3%, and apical delta was found in only 20% of the samples. Variable morphology of the MSPs was detected in our study. The canal configuration most prevalent was type 1; however, the results also revealed some additional canal types.
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Ahmed HMA, Ibrahim N, Mohamad NS, Nambiar P, Muhammad RF, Yusoff M, Dummer PMH. Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration. Int Endod J 2021; 54:1056-1082. [PMID: 33527452 DOI: 10.1111/iej.13486] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/15/2022]
Abstract
Adequate knowledge and accurate characterization of root and canal anatomy is an essential prerequisite for successful root canal treatment and endodontic surgery. Over the years, an ever-increasing body of knowledge related to root and canal anatomy of the human dentition has accumulated. To correct deficiencies in existing systems, a new coding system for classifying root and canal morphology, accessory canals and anomalies has been introduced. In recent years, micro-computed tomography (micro-CT) and cone beam computed tomography (CBCT) have been used extensively to study the details of root and canal anatomy in extracted teeth and within clinical settings. This review aims to discuss the application of the new coding system in studies using micro-CT and CBCT, provide a detailed guide for appropriate characterization of root and canal anatomy and to discuss several controversial issues that may appear as potential limitations for proper characterization of roots and canals.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N S Mohamad
- Centre of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM) Selangor Branch, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
| | - P Nambiar
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Malaysia
| | - R F Muhammad
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - M Yusoff
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Root and Root Canal Morphology Classification Systems. Int J Dent 2021; 2021:6682189. [PMID: 33679981 PMCID: PMC7910041 DOI: 10.1155/2021/6682189] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction While there are many root morphology classification systems with their own distinct advantages, there are many shortcomings that come along with each system. Objectives The aim of this review was to compare the various root and root canal morphology classifications, their advantages, limitations, and clinical and research implications. Data Sources and Selection. An extensive literature search was conducted on PubMed and Scopus to identify the published data on root and root canal classification systems published until 1 May 2020 using keywords, root canal classification system, classification systems for root canals, and root morphology. The related literature was reviewed and then summarized. Data Synthesis. Several studies have analysed and detailed root and root canal classifications and further added new subsystems, works of Weine et al. (1969) and Vertucci et al. (1974). Besides, Sert and Bayirli (2004) added supplementary types to Vertucci's classification system. A new classification was most recently introduced by Ahmed et al. (2017) involving the use of codes for tooth numbering, number of roots, and canal configuration. Conclusions Weine et al. classified only single-rooted teeth, without considering multirooted teeth and complex configurations. Vertucci's classification included complex configurations, with Sert and Bayirli adding further complex supplemental types. Ahmed et al.'s classification simplifies classifying root and canal morphology while overcoming the limitations of several previous classification systems making it beneficial for implementation in dental schools.
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Salas H, Torres J, Pauro J, Ahmed HMA. A new coding system for root and canal morphology - an online survey from Peru. Int Endod J 2021; 54:147-149. [PMID: 33351981 DOI: 10.1111/iej.13439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- H Salas
- School of Dentistry, Catholic University of Santa Maria, Arequipa, Perú
| | - J Torres
- Postgraduate School, Stomatology Second Speciality, Universidad Privada San Juan, Bautista Lima, Perú
| | - J Pauro
- Private Practice of Endodontics, Tacna, Perú
| | - H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Qiao X, Xu T, Chen L, Yang D. Analysis of Root Canal Curvature and Root Canal Morphology of Maxillary Posterior Teeth in Guizhou, China. Med Sci Monit 2021; 27:e928758. [PMID: 33439855 PMCID: PMC7812699 DOI: 10.12659/msm.928758] [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] [Indexed: 11/09/2022] Open
Abstract
Background We investigated the root canal curvature and morphology of maxillary posterior teeth in Guizhou, China, to provide references for clinical practice. Material/Methods We collected 274 maxillary posterior teeth in Guizhou Province, China. The root canal curvature was observed by X-ray film measurement. Two hundred teeth were selected to make transparent tooth models, and root canal configuration was recorded according to Vertucci classification criteria. The position of the MB2 root canal orifice and the mesiobuccal root canal configuration were observed by micro-computed tomographic (micro-CT) scanning. The t test and the chi-square test were used for statistical analysis. Results The root canals of the maxillary posterior teeth showed more significant curvature in the mesiodistal direction than in the buccolingual direction (P<0.05). The MB2 root canal of maxillary molars showed severe bending in the mesiodistal direction: 25.16±6.6 degrees and 28.05±8.65 degrees in first and second molars, respectively. The detection rate of MB2 was 48% in maxillary first molars and 32% in maxillary second molars. The results of micro-CT showed that the vertical distances between the MB2 and MB-P line were 0.64±0.34 mm and 0.57±0.28 mm in first and second molars, respectively. Conclusions The root canal morphology and curvature of maxillary posterior teeth varied greatly in the Guizhou population, which increases the difficulty of treatment. It is necessary for clinicians to gain understanding of the root canal and to improve the success rate of root canal therapy.
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Affiliation(s)
- Xin Qiao
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Tingting Xu
- Hospital/School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China (mainland)
| | - Liang Chen
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China (mainland).,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China (mainland).,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China (mainland)
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Evaluation of Palatal Furcation Groove and Root Canal Anatomy of Maxillary First Premolar: A CBCT and Micro-CT Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8862956. [PMID: 33506045 PMCID: PMC7814948 DOI: 10.1155/2021/8862956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/17/2022]
Abstract
Objectives This study is aimed at investigating the root and root canal morphology by cone beam computed tomography (CBCT) and palatal furcation groove of the buccal root by microcomputed tomography (micro-CT) of maxillary first premolars in a Chinese subpopulation. Methods This study assessed CBCT images of 440 patients aged 14-80 years. Based on Vertucci's classification, the number of roots and the canal configuration were determined. Forty-eight maxillary first premolars with furcation grooves were analyzed by micro-CT in patients aged 18-25 years. Results Based on the CBCT assay, 70.22% and 29.32% of maxillary first premolars were 1 root and 2 roots, respectively. The configuration indicated statistical difference (P < 0.05) between male and female patients. The most common canal type was type IV and was found in 44.32% of cases, followed by type I in 27.84%, and then type II in 20.57%. Root bifurcations had 40.13% prevalence which was distributed more in the middle third than in the cervical and the apical third. For the micro-CT study, 95.83% of the furcation groove configuration was found in the bifurcated maxillary first premolars. The length varied from 1.02 to 7.63 mm. The mean depth of this groove was 0.57 mm in the root coronal, 0.47 mm in the root middle, and 0.22 mm in the root apical level. Palatal dentin width was smaller than 1 mm. Conclusion The anatomy of the root and root canal system and the irregular wall width of maxillary first premolars with furcation grooves may help dentists to understand the anatomical morphology and improve the outcomes of endodontic treatment.
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Sierra-Cristancho A, González-Osuna L, Poblete D, Cafferata EA, Carvajal P, Lozano CP, Vernal R. Micro-tomographic characterization of the root and canal system morphology of mandibular first premolars in a Chilean population. Sci Rep 2021; 11:93. [PMID: 33420202 PMCID: PMC7794380 DOI: 10.1038/s41598-020-80046-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
This study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.
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Affiliation(s)
- Alfredo Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - Luis González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Daniela Poblete
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Emilio A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Paola Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Carla P Lozano
- Oral Biology and Biochemistry Laboratory, Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile. .,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
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Gill G, Malik S, Singla R, Jain N, Kumar T, Arora S. Evaluation of root canal anatomy of maxillary premolars in a North Indian subpopulation using cone-beam computed tomography. ENDODONTOLOGY 2021. [DOI: 10.4103/endo.endo_128_21] [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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Karobari MI, Noorani TY, Halim MS, Ahmed HMA. Root and canal morphology of the anterior permanent dentition in Malaysian population using two classification systems: A CBCT clinical study. AUST ENDOD J 2020; 47:202-216. [DOI: 10.1111/aej.12454] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Mohmed Isaqali Karobari
- Conservative Dentistry Unit School of Dental Sciences Universiti Sains Malaysia Health campus, Kota Bharu, Kelantan, Malaysia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit School of Dental Sciences Universiti Sains Malaysia Health campus, Kota Bharu, Kelantan, Malaysia
- Conservative Dentistry Unit Hospital Universiti Sains Malaysia Health campus, Kota Bharu, Kelantan, Malaysia
| | - Mohamad Syahrizal Halim
- Conservative Dentistry Unit School of Dental Sciences Universiti Sains Malaysia Health campus, Kota Bharu, Kelantan, Malaysia
- Conservative Dentistry Unit Hospital Universiti Sains Malaysia Health campus, Kota Bharu, Kelantan, Malaysia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur Malaysia
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Wolf TG, Kozaczek C, Campus G, Paqué F, Wierichs RJ. Root Canal Morphology of 116 Maxillary Second Premolars by Micro-Computed Tomography in a Mixed Swiss-German Population with Systematic Review. J Endod 2020; 46:1639-1647. [PMID: 32822696 DOI: 10.1016/j.joen.2020.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/15/2020] [Accepted: 08/10/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this investigation was to examine the root canal system morphology of maxillary second premolars (Mx2Ps) of a Swiss-German population by means of micro-computed tomography and provide systematic review of the root canal configuration (RCC) literature of Mx2Ps. METHODS The RCC, main foramina as well as accessory canals and foramina frequency of 116 Mx2Ps, were investigated by means of micro-computed tomography and 3-dimensional software imaging. The RCC from the coronal to apical thirds of the root as well as the main foramina number were described by using a four-digit system code. The literature review follows the PRISMA guideline analyzing randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies on RCC in Embase, grey literature, PubMed, and Scopus. RESULTS Most frequently observed RCCs of Mx2Ps were 1-1-1/1 (35.3%), 1-1-1/2 (21.6%), and 2-1-1/1 (14.7%). Another 11 less frequent RCCs were observed. All Mx2Ps had 1 root. One main foramen was observed in 59.5% and two in 37.9%. Accessory foramina were observed in 46.6%. Thirty-one percent of the Mx2Ps showed accessory canals. One connecting canal between the buccal and palatal was observed in 12.1%. CONCLUSIONS Detailed RCC information of Mx2Ps in a Swiss-German population and the results of a systematic literature review of different populations and research methods used to investigate root canal morphology and configuration of Mx2Ps are given. Within the limitations of the study, a high RCC, connecting and accessory canals variability occur in maxillary second premolars.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Christoph Kozaczek
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - Frank Paqué
- Division of Preventive Dentistry, Periodontology, and Cariology, Department of Endodontology, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Ahmed HMA, Che Ab Aziz ZA, Azami NH, Farook MS, Khan AA, Mohd Noor NS, Ayoub AA, Imran ZA, Halim MS, Pai ARV, Kacharaju KR, Mohammad N, Nagendrababu V, Nabhan MS, Dummer PMH. Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia. Int Endod J 2020; 53:871-879. [PMID: 32003029 DOI: 10.1111/iej.13271] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/29/2020] [Indexed: 12/23/2022]
Abstract
AIM To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice. METHODS One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05). RESULTS A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P < 0.001). Overall, 97% of students reported the new system helped their understanding of root and canal morphology compared with the Vertucci classification (P < 0.001). Over 97% of students recommended the use of the new system in teaching, pre-clinical courses and clinical practice (P < 0.001). Except for two schools, no significant difference was detected between the responses of students for all questions at the different schools (P > 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05). CONCLUSIONS The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Z A Che Ab Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N H Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - M S Farook
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - A A Khan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N S Mohd Noor
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - A A Ayoub
- Comprehensive Care Centre of Studies, Faculty of Dentistry, University Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Z A Imran
- Endodontic Unit, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia
| | - M S Halim
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - A R V Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Melaka-Manipal Medical College (MMMC), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - K R Kacharaju
- Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Jenjarom, Selangor, Malaysia
| | - N Mohammad
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Selangor, Malaysia
| | - V Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - M S Nabhan
- Department of Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Buchanan GD, Gamieldien MY, Tredoux S, Vally ZI. Root and canal configurations of maxillary premolars in a South African subpopulation using cone beam computed tomography and two classification systems. J Oral Sci 2020; 62:93-97. [PMID: 31996533 DOI: 10.2334/josnusd.19-0160] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This cone beam computed tomography (CBCT) study aimed to describe the maxillary premolar anatomy of a South African subpopulation using two classification systems. A total of 601 premolars were evaluated. For each tooth, the root number and canal configurations were described using the classification systems devised by Vertucci (1984) and Ahmed et al. (2017). Correlations between root number and sex were determined using the chi-squared test (P = 0.05). Two roots were present in approximately half of all maxillary first premolars (54.1%, n = 171/316). The majority of maxillary second premolars displayed one root (78.2%, n = 223/285). Single-rooted maxillary second premolars were more common in females (P < 0.05). The Vertucci type IV configuration was most prevalent in the maxillary first premolars. In contrast, maxillary second premolars showed a greater tendency toward Vertucci's type I configuration. The classification proposed by Ahmed et al. indicated the most prevalent maxillary first premolar configuration to be 2MP B1P1. The most common configuration among the maxillary second premolars was 1 MP1. Diverse root and canal anatomical presentations were found in this subpopulation. Both classification systems adequately describe maxillary premolar anatomy; however, the system proposed by Ahmed et al. may more accurately describe complex teeth.
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Affiliation(s)
- Glynn D Buchanan
- Department of Odontology, School of Dentistry, University of Pretoria
| | - Mohamed Y Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, University of Pretoria
| | - Sheree Tredoux
- Department of Odontology, School of Dentistry, University of Pretoria
| | - Zunaid I Vally
- Department of Odontology, School of Dentistry, University of Pretoria
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Root Canal Anatomy of Maxillary First Premolar by Microscopic Computed Tomography in a Chinese Adolescent Subpopulation. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4327046. [PMID: 31828103 PMCID: PMC6881762 DOI: 10.1155/2019/4327046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/27/2019] [Accepted: 09/14/2019] [Indexed: 02/08/2023]
Abstract
Objectives To investigate the root morphology and root canal anatomy of maxillary first premolar using microscopic computed tomography (micro-CT). Methods 324 maxillary first premolars were collected and scanned. The root and canal diameter, canal wall thickness, root taper, and cross-sectional shapes were determined in the single root with 1 canal (SR1C), single root with 2 canals (SR2C), and 2 roots with 2 canals (2R2C) by micro-CT. Results The results showed that single-rooted maxillary premolars were more common than other types. The incidence of SR1C, SR2C, and 2R2C reached 25%, 26.39%, and 26.39%, respectively. Root and canal diameters and canal wall thickness were decreased from coronal third to apical foramen. The three parameters and canal taper showed increases from buccal and palatal (BP) to mesiodistal (MD) aspects. The root canal tapers were smallest of the middle third level. The findings showed the different variations in 2R2C teeth. The root canal cross-sectional morphology in maxillary first premolars is complicated, including round, oval, long oval, flat canal, and irregular canal shapes. The distribution varied in different aspects. Conclusion Root canal morphology showed a wide variation and complicated structure. The single-rooted teeth were more common in the Chinese adolescent population, and the majority of maxillary first premolars have two canals.
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Borghesi A, Michelini S, Zigliani A, Tonni I, Maroldi R. Three-rooted maxillary first premolars incidentally detected on cone beam CT: an in vivo study. Surg Radiol Anat 2019; 41:461-468. [PMID: 30721338 DOI: 10.1007/s00276-019-02198-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/30/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE To explore the incidence and analyze the morphology of three-rooted maxillary first premolars (MFPs) incidentally detected on cone beam computed tomography (CBCT) scans. METHODS Of 1328 patients who underwent CBCT scans of the maxilla, only patients with three-rooted MFPs were selected. Morphological features, including the lengths and diameters of palatal, mesiobuccal (MB) and distobuccal (DB) roots, the positions of bucco-palatal (B-P) bifurcations, the distances between root canal bifurcations and cementoenamel junctions (CEJs) and the distances between the apical thirds of the roots, were measured. The canal configuration and the visibility of root canals were also evaluated. RESULTS A total of 16/1328 (1.2%) patients had one or two three-rooted MFPs, and a total of 22/2656 (0.8%) three-rooted MFPs were enrolled. The lengths and diameters of palatal roots were significantly greater than those of other roots. The positions of B-P bifurcations were located mainly at the middle third of the root. The median distances between root canal bifurcations and CEJs were 3 mm for B-P bifurcations and 5.2 mm for MB-DB bifurcations. The distance between MB and DB roots was significantly shorter than the distances between other root pairs. All teeth had a type VIII canal configuration. Palatal roots exhibited the best visibility of root canals, whereas the worst visibility was observed within DB roots. A gender-related relationship was observed only for the lengths of the roots. CONCLUSIONS The occurrence of three-rooted MFPs is not unusual; therefore, preoperative CBCT evaluation could be suggested whenever endodontic procedures are planned on an MFP.
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Affiliation(s)
- Andrea Borghesi
- Department of Radiology, Medical School, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | - Silvia Michelini
- Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Angelo Zigliani
- Department of Radiology, Medical School, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Ingrid Tonni
- Dental School, Dental Clinic, University of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, Medical School, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
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