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Ye L, Li S, Li C, Wang C, Wei X, Zhou W, Du Y. Pulp calcification identification on cone beam computed tomography: an artificial intelligence pilot study. BMC Oral Health 2024; 24:1132. [PMID: 39333975 PMCID: PMC11438316 DOI: 10.1186/s12903-024-04922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This study aims to verify the effectiveness of a deep neural network (DNN) in automatically identifying pulp calcification on cone beam computed tomography (CBCT) images. METHODS This study retrospectively analysed 150 CBCT images. Pulp calcification was identified and manually annotated by three endodontists with 10 years of experience. A DNN model based on the U-Net architecture was constructed to identify pulp calcification, and ten rounds of fourfold cross-validation were conducted. The model performance was evaluated using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). RESULTS The model achieved a sensitivity of 75.91 ± 2.84% in automatically identifying pulp calcification, with a specificity of 68.88 ± 2.35%, an accuracy of 72.78 ± 2.13%, and an AUC of 73.68 ± 3.09%. According to the ranking for diagnostic tests, the proposed method achieved a "good" grade for sensitivity, accuracy, and AUC and a "fair" grade for specificity. CONCLUSIONS The results indicate that the proposed method shows promise for identifying pulp calcification on CBCT images. Future research aims to expand the dataset and refine the model, thereby enhancing its clinical applicability. The integration of artificial intelligence into diagnostic and treatment systems is anticipated to increase the efficiency of diagnosing pulp calcification and assist dentists in assessing the difficulty of root canal treatment cases preoperatively. CLINICAL REGISTRATION Registration was performed on the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/ ) (Registration number: ChiCTR2300077078, 27/10/2023) and National Medical Research Registry Information System ( https://www.medicalresearch.org.cn/ , 30/10/2023) (Number: MR-44-23-039664).
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Affiliation(s)
- Li Ye
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | | | | | | | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Wu Zhou
- School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yu Du
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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Armenta HB, Mireles AGR, Martinez JS, Alvarez JP, Herrera YR, Maldonado OT, Ojeda OA, Pacheco JS, Sarabia GO, Castellanos-Juarez FX, Pacheco SS. Prevalence and Classification of C-Shaped Canal and Radix in Mandibular Molars Using Cone-Beam Computed Tomography on Mexican Population. Dent J (Basel) 2024; 12:212. [PMID: 39056999 PMCID: PMC11275415 DOI: 10.3390/dj12070212] [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: 05/29/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population.
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Affiliation(s)
- Hugo Bojorquez Armenta
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Angel Gustavo Romo Mireles
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Javier Solis Martinez
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Jesus Pescador Alvarez
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Yarely Ramos Herrera
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Omar Tremillo Maldonado
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Oscar Almeda Ojeda
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | - Jose Salas Pacheco
- Institute for Scientific Research, Juarez University, Durango 34000, Mexico; (J.S.P.); (F.X.C.-J.)
| | - Gamaliel Ortiz Sarabia
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
| | | | - Sergio Salas Pacheco
- Faculty of Dentistry, Juarez University, Durango 34070, Mexico; (H.B.A.); (A.G.R.M.); (J.S.M.); (J.P.A.); (Y.R.H.); (O.T.M.); (O.A.O.); (G.O.S.)
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Kharkar AP, Reddy KS, Banerjee S, Maheshwari Z. Coping with complexity: Navigating severe curve canals in endodontic root canal treatment: A clinical case series. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:785-788. [PMID: 39262594 PMCID: PMC11385913 DOI: 10.4103/jcde.jcde_208_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/02/2024] [Accepted: 05/16/2024] [Indexed: 09/13/2024]
Abstract
Knowledge of tooth anatomy and its variations are essential for the success of endodontic treatment. Dilacerations represent developmental anomalies marked by sudden deviations in a tooth's longitudinal axis. Common causes of treatment failures in such cases are primarily related to procedural errors such as ledging, fractured instruments, canal blockages, zipping, and elbow creations. The current case series presents three such interesting cases of endodontic management of curved root canals in mandibular molars.
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Affiliation(s)
- Atharv Pramod Kharkar
- Department of Conservative Dentistry and Endodontics, ACPM Dental College, Dhule, Maharashtra, India
| | - Kranthikumar S Reddy
- Department of Conservative Dentistry and Endodontics, ACPM Dental College, Dhule, Maharashtra, India
| | - Satyabrat Banerjee
- Department of Conservative Dentistry and Endodontics, ACPM Dental College, Dhule, Maharashtra, India
| | - Zinnie Maheshwari
- Department of Conservative Dentistry and Endodontics, ACPM Dental College, Dhule, Maharashtra, India
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Chaniotis A, Sousa Dias H, Chanioti A. Negotiation of Calcified Canals. J Clin Med 2024; 13:2703. [PMID: 38731233 PMCID: PMC11084956 DOI: 10.3390/jcm13092703] [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: 03/20/2024] [Revised: 04/02/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
The gradual formation of hard tissue along the root canal walls is a natural process associated with aging, typically progressing slowly over time. In reaction to tooth wear, operative procedures, vital pulp treatments, or regenerative endodontic procedures, hard tissue may also accumulate within the pulp canal space at a slow rate. In certain cases, such as dental trauma, autotransplantation, or orthodontic treatment, this deposition of hard tissue can accelerate unexpectedly, resulting in rapid narrowing or complete closure of the root canal space. This situation is called calcific metamorphosis (CM), root canal calcification, or pulp canal obliteration (PCO). Performing conventional endodontic therapy on severely calcified canals presents significant challenges and increases the risk of procedural accidents. Calcified canals introduce such complexity that dedicated negotiation concepts and specially designed instruments have been developed to deal with the challenge. This article seeks to review the existing methods for effectively navigating calcified canals and to introduce the buckling resistance activation test (BRAT) technique.
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Affiliation(s)
| | - Hugo Sousa Dias
- Private Practice, Dentistry Department, CESPU-IUCS University, 4585-116 Gandra, Portugal;
| | - Anastasia Chanioti
- School of Dentistry, National and Kapodistrian University of Athens (NKUA), 11527 Athens, Greece;
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Liu H, Hao J, Shen Y. Endodontic Treatment of a Dilacerated Maxillary Second Premolar With a Severely Curved Root Canal: A Case Report and Literature Review. Cureus 2024; 16:e59590. [PMID: 38826877 PMCID: PMC11144437 DOI: 10.7759/cureus.59590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/04/2024] Open
Abstract
Dilaceration is a developmental anomaly characterized by a sharp change in the axial inclination between the crown and the root of a tooth. Severe root curvature in a dilacerated tooth can greatly complicate root canal treatment. This case report details the successful endodontic treatment of a dilacerated maxillary second premolar with significant root curvature. It highlights the importance of a thorough understanding of root canal anatomy and demonstrates the effectiveness of using pre-curved hand files along with heat-treated nickel-titanium rotary instruments in navigating complex root structures to achieve successful treatment outcomes.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, CAN
| | - Jing Hao
- Department of Conservative and Endodontic Dentistry, Hangzhou Stomatology Hospital, Hangzhou, CHN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
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6
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AbuMostafa A, Alrefaie MM, Abu-Mostafa N, Algahtani FN. Microcomputed tomography analysis of curved root canal preparation when coronal flaring and glide path files used with heat-treated nickel titanium rotary files. PLoS One 2024; 19:e0299896. [PMID: 38568900 PMCID: PMC10990200 DOI: 10.1371/journal.pone.0299896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/17/2024] [Indexed: 04/05/2024] Open
Abstract
The objective was to evaluate the effect of glide path and coronal flaring on the dentin volume removal and percentage of touched walls in curved canals using two heat-treated rotary files. The mesiobuccal canal of forty-eight, randomly selected, extracted mandibular molars was divided into two groups of 24 each, according to the type of instrument used (RACE EVO and EdgeSequel rotary files). Each group was further divided into three subgroups; Group (A): Control using one file shaped to 04/30, Group (B) with a glide path (EdgeGlidePath (EGP)), and Group (C): with a glide path and coronal flaring (EGP and EdgeTaper Platinum (ETP) SX file respectively). The root canals were then instrumented using the assigned instruments. The assessment was carried out using micro-CT. The comparison of the mean values of the tested groups about dentin volume removal and percentage of untouched walls did not reach statistical significance (p<0.05). Glide path and coronal flaring had an insignificant effect on the dentin volume removal and percentage of untouched walls in curved canals.
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Affiliation(s)
- Ammar AbuMostafa
- Department of Restorative Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed M. Alrefaie
- Department of Restorative Dentistry, Ministry of Health, Riyadh Third Cluster, Riyadh, Kingdom of Saudi Arabia
| | - Nedal Abu-Mostafa
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Fahda N. Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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7
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Chrostek E, Peralta S, Fiani N. Morphological study of pulp cavity anatomy of canine teeth in domestic cats using micro-computed tomography. Front Vet Sci 2024; 11:1373517. [PMID: 38523713 PMCID: PMC10957770 DOI: 10.3389/fvets.2024.1373517] [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: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
An understanding of the pulp cavity anatomy of individual teeth is essential for success during endodontic therapy. The objective of this study was to document pulp cavity anatomy and summarize numerical data of maxillary and mandibular canine teeth of domestic cats using micro-computed tomography (micro-CT). Thirty-nine canine teeth from eleven domestic cat cadaveric specimens were extracted and prepared for scanning. Segmentation of the pulp cavity was performed using the Avizo (v2022.2) software package. The morphological features of the pulp cavity including overall shape, configuration, presence of apical deltas and lateral canals was recorded. A quantitative analysis was performed on thirty-one teeth to explore associations between pulp cavity volume and length, apical delta length, maximum apical delta foramina number and cusp-to-tip length using a linear mixed model. Correlation between pertinent continuous variables was assessed using a Pearson's correlation test. Most pulp cavities exhibited varying curvature and ranged from a cylindrical configuration in the coronal third to an ovoid configuration in the middle to apical third. A ribbon-like flattened canal was observed in 6/31 teeth (19%). All canine teeth depicted an apical delta with various configurations except for two teeth that showed a single canal exiting at the apex. In 15/31 teeth (48%), the primary root canal within the apical delta could be clearly identified and in 16/31 (52%) the primary root canal was indiscernible. The results showed that the pulp cavities of maxillary canine teeth were significantly larger and longer and the cusp-to-tip length was longer, when compared to mandibular teeth. The apical delta length was negatively correlated to the volume of the pulp cavity. No specimens depicted lateral canals. This study revealed that the anatomy of the canine tooth pulp cavity in cats can vary considerably and should be a consideration when performing thorough debridement, shaping and obturation of the endodontic system.
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Affiliation(s)
| | | | - Nadine Fiani
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
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Huang D, Wang X, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen X, Li J, Ye L, Cheng L, Xu X, Hu T, Wu H, Guo B, Su Q, Chen Z, Qiu L, Chen W, Wei X, Huang Z, Yu J, Lin Z, Zhang Q, Yang D, Zhao J, Pan S, Yang J, Wu J, Pan Y, Xie X, Deng S, Huang X, Zhang L, Yue L, Zhou X. Expert consensus on difficulty assessment of endodontic therapy. Int J Oral Sci 2024; 16:22. [PMID: 38429281 PMCID: PMC10907570 DOI: 10.1038/s41368-024-00285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/19/2024] [Indexed: 03/03/2024] Open
Abstract
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
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Affiliation(s)
- Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Xinmei Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Geriatric dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Guo
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qin Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jinhua Yu
- Department of Endodontics, School and Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Zhengmei Lin
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Shuang Pan
- Department of Endodontics, Schoolof Stomatology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Jiayuan Wu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Yihuai Pan
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Xie
- Department of Cariology and Endodontics, Xiangya Stomatological School, Central South University, Changsha, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaojing Huang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Almnea RA, Mohammad Al Ageel Albeaji S, Ali Alelyani A, AlHarith D, Saeed Alshahrani A, Al Malwi AA, Alobaid MA, Al Moaleem MM. Comparative Analysis of Three Nickel-Titanium Rotary Files in Severely Curved L-Shaped Root Canals: Preparation Time, Aberrations, and Fracture Rates. Clin Cosmet Investig Dent 2024; 16:1-9. [PMID: 38384359 PMCID: PMC10878313 DOI: 10.2147/ccide.s452742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
Background This simulated study of 30 severely curved L-shaped root canals aimed to compare preparation time, aberrations, width measurements, and fractured files of three nickel-titanium (Ni-Ti) files, namely, ProTaper, ProTaper Next (PTN), and WaveOne (WO). Methods Thirty simulated L-curved root canals of resin blocks were randomly divided into three groups. The canals were prepared to a tip size of 25 using ProTaper, PTN, and WO rotary file systems. Pre- and post-operative views for each sample were captured by a professional camera at a standardized distance and position. Blue India ink was injected into the pre-operative canals, and red India ink was injected into the post-operative canals to give a clear superimposition image. Five points were assessed through the halfway of the canal to the orifice (area between the beginning of curvature and apical end point). Preparation time, aberrations, width measurements, and fractured files were recorded and analyzed. Results Mean preparation time was longest in ProTaper (4.89±0.68 minutes). PTN and WO were the fastest in preparing the canals (about 3 minutes). A statistically significant difference was found between WO and ProTaper & PTN and ProTaper (p=0.000), while the difference was non-significant (p > 0.05) between WO and PTN. Nine aberrations consisting of three zips, one ledge and one outer widening were related to ProTaper, while WO recorded a ledge and fractured file, but for PTN system, it verified an outer widening and ledge. Only one WO file fractured, with no deformation observed in the other instruments. No significance was recorded among the width measurements in the different levels. Conclusion ProTaper next achieved faster cutting than the ProTaper and WO file systems. PTN maintained the best apical termination position and produced the least canal aberration, followed by WO and ProTaper.
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Affiliation(s)
- Raid Abdullah Almnea
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | | | - Ahmed Ali Alelyani
- Restorative Department, Endodontic Division, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Dalia AlHarith
- Department of Restorative Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdulmajeed Saeed Alshahrani
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Ahmed Abdullah Al Malwi
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A Alobaid
- Restorative Dental Science Department & Department of Dental Education, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia
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10
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Liu H, Hieawy A, Shen Y. Endodontic Treatment of Two Calcified Mandibular Central Incisors: A Case Report. Cureus 2024; 16:e53066. [PMID: 38410353 PMCID: PMC10896276 DOI: 10.7759/cureus.53066] [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: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
Treating calcified root canals presents significant challenges, as incorrect approaches can result in treatment failure or lead to complications. The necessity for advanced diagnostic and therapeutic tools is often paramount in these situations. This case report demonstrates the successful treatment of two calcified mandibular central incisors, followed up for a period of up to six years. It emphasizes the effectiveness of integrating cone-beam computed tomography, dental operating microscopes, and ultrasonic instruments in the treatment of such challenging cases.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, University of British Columbia, Vancouver, CAN
| | - Ahmed Hieawy
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
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11
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Liu H, Shen Y. Endodontic Treatment of a Maxillary First Molar With Two Separate Palatal Roots: A Case Report. Cureus 2024; 16:e51907. [PMID: 38333498 PMCID: PMC10850443 DOI: 10.7759/cureus.51907] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Maxillary first molars exhibit considerable anatomical variation, with a single palatal root being the most common occurrence, while two palatal roots are notably less frequent. This case report details the endodontic treatment of a maxillary first molar with two separate palatal roots. It highlights the critical importance of recognizing these anatomical variations and their unique challenges during endodontic procedures. This report emphasizes the essential role of advanced diagnostic methods, such as cone-beam computed tomography, and the use of microscopic techniques in identifying and treating such cases.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vacnouver, CAN
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12
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Wu L, Ha WN, Decurcio DA, Estrela C, Rossi-Fedele G. Comparison of Curvature Severity Between Sagittal and Coronal Planes of Mesiobuccal Canals in Permanent Maxillary First Molars Using Multiple Complexity-risk Criteria: A CBCT Cross-sectional Study of a Brazilian Subpopulation. J Endod 2023; 49:1682-1689.e4. [PMID: 37816431 DOI: 10.1016/j.joen.2023.09.015] [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: 08/11/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION This study aimed to compare the curvature severity of mesio-buccal (MB) canals between sagittal and coronal planes using cone-beam computed tomography. METHODS In a Brazilian subpopulation, untreated MB1 (n = 141) and MB2 (n = 72) with single curvatures in sagittal and coronal planes were measured to determine their angle and radius (r), plus the prevalence of S-shaped canals was recorded. Curvature severity was defined according to the American Association of Endodontists Case Difficulty Assessment form (AAE) and EndoApp (EA), as well as their modified versions that consider angle and radii (AAE-r, EA-r). Data were converted into mean angle and r, percentage of canals >30°, AAE, EA, AAE-r and EA-r categories. The influence of r on case severity was assessed. Statistical analysis was performed using t-tests and chi-squared tests. The level of significance was set as P ≤ .05. RESULTS For single curvatures, significantly higher mean degrees (SD) angles were found in the sagittal views in both canals (MB1 sagittal: 35 [11]; MB1 coronal: 13 [13]; MB2 sagittal: 29 [14]; MB2 coronal: 22 [15] [P < .05]). A greater percentage of angles >30° (MB1: 56.7% vs 6.4%; MB2: 44.4% vs 22.2%) in sagittal planes compared to coronal planes was also found. Conversely, a higher prevalence of S-shaped canals (MB1: 33.3% vs 7.1% MB2: 31.9% vs 15.3%) was observed in coronal planes. Significant differences between AAE and AAE-r were present with greater case severity when radii were considered (P < .05). CONCLUSIONS Sagittal planes were associated with more severe single curvatures, while coronal planes had a greater prevalence of S-shaped canals.
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Affiliation(s)
- Lee Wu
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
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Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: A narrative review. Saudi Dent J 2023; 35:468-475. [PMID: 37520597 PMCID: PMC10373078 DOI: 10.1016/j.sdentj.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This review aimed to assess the incidence, anatomical characteristics, identification, and clinical management using conventional techniques and advanced tools to manage MMCs successfully. Methods Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references. Results The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures. Conclusion The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
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Affiliation(s)
- Raghavendra Penukonda
- Department of Endodontics, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Harshada Pattar
- Department of Oral Pathology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Phrabhakaran Nambiar
- Head of the Department, Department of Oral Biology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
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Herbst SR, Herbst CS, Schwendicke F. Preoperative risk assessment does not allow to predict root filling length using machine learning: A longitudinal study. J Dent 2023; 128:104378. [PMID: 36442583 DOI: 10.1016/j.jdent.2022.104378] [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: 07/07/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES First we aimed to identify significant associations between preoperative risk factors and achieving optimal root filling length (RFL) during orthograde root canal treatments (RCT) and second to predict successful RFL using machine learning. METHODS Teeth receiving RCT at one university clinic from 2016-2020 with complete documentation were included. Successful RFL was defined to be 0-2mm of the apex, suboptimal RFL >2mm or beyond the apex. Logistic regression (logR) was used for association analyses; logR and more advanced machine learning (random forest (RF), support vector machine (SVM), decision tree (DT), gradient boosting machine (GBM) and extreme gradient boosting (XGB)) were employed for predictive modeling. RESULTS 555 completed RCT (343 patients, female/male 32.1/67.9%) were included. In our association analysis (involving the full dataset), unsuccessful RFL was more likely in undergraduate students (US): OR 2.74, 95% CI [1.61, 4.75], p < 0.001), teeth with indistinct canal paths (OR 11.04, [2.87, 44.88], p < 0.001), root canals reduced in size (OR 2.56, [1.49, 4.46], p < 0.01), retreatments (OR 3.13, [1.6, 6.41], p < 0.001). Subgroup analyses revealed that dentists were more successful in mitigating risks than undergraduate students. Prediction of RFL on a separate testset was limitedly possible regardless of the machine learning approach. CONCLUSIONS Achieving RFL is depending on the operator and several risk factors. The predictive performance on the technical outcome of a root canal treatment utilizing ML algorithms was insufficient. CLINICAL SIGNIFICANCE Preoperative risk assessment is a relevant step in endodontic treatment planning. Single radiographic risk factors were significantly associated with achieving (or not achieving) optimal RFL and showed higher predictive value than a more complex risk assessment form.
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Affiliation(s)
- S R Herbst
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - C S Herbst
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - F Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
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