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Algarni HA, Alonazi MA, Arshad H, Zahra F, Umer F, Maqbool I, Iqbal A, Karobari MI. Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study. Eur J Med Res 2024; 29:391. [PMID: 39068434 PMCID: PMC11282603 DOI: 10.1186/s40001-024-01990-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. METHOD This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761-70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. RESULTS The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. CONCLUSION This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.
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Affiliation(s)
- Hmoud Ali Algarni
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Hamza Arshad
- Prosthodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fatima Zahra
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fahad Umer
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | | | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Department of Dental Research, CGHR, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
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Jonker CH, L'Abbé EN, van der Vyver PJ, Zahra D, Oettlé AC. A micro-computed tomographic evaluation of maxillary first molar root canal morphology in Black South Africans. J Oral Sci 2024; 66:151-156. [PMID: 38853002 DOI: 10.2334/josnusd.24-0074] [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: 06/11/2024]
Abstract
PURPOSE This study was conducted to investigate the root canal anatomy of maxillary first molars in Black South Africans. METHODS Micro-computed tomography was used to investigate 101 maxillary first molars (53 teeth from the right, 48 from the left; 50 male and 51 female teeth). The number of root canals in each tooth was determined, and the relationship between side, sex and age was analyzed using chi-squared test. To determine intra- and inter-observer reliability, Cohen's kappa coefficients were calculated. RESULTS Intra- and inter-rater agreements of 96.92% and 98.08% were achieved, respectively. Most teeth contained either three or four canals, but a second, third and fourth mesio-buccal canal was found in 60.39%, 5.94% and 0.99% of teeth, respectively. The disto-buccal and palatal roots contained predominantly single canals, but additional canals were noted in 2.97% and 1.98% of teeth. Four canals were common in females and teeth on the right side often contained a second mesio-buccal canal. However, the prevalence of a third mesio-buccal canal was higher in males than in females. CONCLUSION The teeth studied showed diversity and variations between sexes and arch sides. These findings will aid clinicians in endodontic treatment and will be applicable for educational purposes.
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Affiliation(s)
- Casper H Jonker
- Faculty of Health, Peninsula Dental School, University of Plymouth, Truro Dental Education Facility, Knowledge Spa, Royal Cornwall Hospital
- Department of Anatomy, Forensic Anthropology Research Centre, Faculty of Health Sciences, University of Pretoria
| | - Ericka N L'Abbé
- Department of Anatomy, Forensic Anthropology Research Centre, Faculty of Health Sciences, University of Pretoria
| | | | - Daniel Zahra
- Peninsula Medical and Dental Schools, Faculty of Health, University of Plymouth
| | - Anna C Oettlé
- Anatomy and Histology Department, School of Medicine, Sefako Makgatho Health Sciences University
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Alhumaidi AM, Mirza MB, Karobari MI, Abuelqomsan MA, Hashem Q, Aldaijy MT, Albarr NY, Aldaijy RT, Al Moaleem M. Classifying the internal anatomy of anterior teeth in the Yemeni population using two systems: a retrospective CBCT study. Odontology 2024:10.1007/s10266-024-00965-7. [PMID: 38935196 DOI: 10.1007/s10266-024-00965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
A precursor for effective root canal treatment (RCT) is a complete understanding of the internal anatomy of teeth. In this study, the authors aimed to classify the root canal morphology of anterior teeth in the Yemeni population and identify gender-based variations among them. In addition, the symmetry among adjacent quadrants was also evaluated. Cone beam computed tomography (CBCT) scans of 2935 anterior teeth, 1502 maxillary, and 1433 mandibular were analyzed for root canal morphology and symmetry. Comparison between groups and among different genders was done using the Chi-square test. All the maxillary teeth were single-rooted and had a predominantly 1TN1 (Vertucci Type I) canal morphology. In addition to 1TN1, the presence of 1TN1-2-1 (Vertucci type III) and 1TN1-2-1-2-1 (not classified NC according to Vertucci) morphologies were noticed in the maxillary canines. Among the mandibular anteriors, the canal morphologies identified include 1TN1 in majority of the scans followed by 1TN2-1 (Vertucci II), 1TN1-2-1, 1TN1-2 (Vertucci V), 1TN1-2-1-2 (Vertucci VII) was seen only in incisors and newer canal types like 1TN2-1-2-1 (NC Vertucci) and 1TN1-2-1-2-1 (NC Vertucci) was seen in canines and lateral incisors. Two roots were only seen in the mandibular canines and classified as 2TN1-2 (NC Vertucci). Variations in root and root canal morphologies were seen among both genders. However, the results were not significant. All the maxillary teeth except 0.8% were bilaterally symmetrical. In mandible, symmetry ranged between 84.5 and 86.5%. In conclusion, single-rooted teeth with 1TN1 classification are most commonly seen in all the anterior teeth. Gender-based differences were non-significant, and bilateral symmetry was high. Ahmed et al. classification could precisely represent the root canal morphology in two rooted teeth.
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Affiliation(s)
| | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia.
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Mohammed Ali Abuelqomsan
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | - Qamar Hashem
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Dilam Road, Al-Kharj, 11942, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | - Mohammed Al Moaleem
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Karobari MI, Iqbal A, Batul R, Adil AH, Syed J, Algarni HA, Alonazi MA, Noorani TY. Exploring age and gender variations in root canal morphology of maxillary premolars in Saudi sub population: a cross-sectional CBCT study. BMC Oral Health 2024; 24:543. [PMID: 38724952 PMCID: PMC11084092 DOI: 10.1186/s12903-024-04310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In complex teeth like maxillary premolars, endodontic treatment success depends on a complete comprehension of root canal anatomy. The research on mandibular premolars' root canal anatomy has been extensive and well-documented in existing literature. However, there appears to be a notable gap in available data concerning the root canal anatomy of maxillary premolars. This study aimed to explore the root canal morphology of maxillary premolars using cone-beam computed tomography (CBCT) imaging, considering age and gender variations. METHODS From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10-20, 21-30, 31-40, 41-50, 51-60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology. RESULTS The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1-2-1 showed significant gender differences. For classifications 1MPM1 and 1MPM1-2-1, age-related changes were seen in the left and right maxillary first premolars. CONCLUSION This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Rumesa Batul
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Abdul Habeeb Adil
- Department of Dental Research, Center for Global Health Research, Saveetha Medical College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Jamaluddin Syed
- Director Research & Development, OWA Medical and Research Center, Sugarland, TX, USA
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box, Jeddah, 80209, Saudi Arabia
| | - Hmoud Ali Algarni
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Kota Bharu, Kelantan, Malaysia
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamil Nadu, India
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Rego LF, Bronzato JD, Souza APC, de-Jesus-Soares A, Frozoni M. In Vitro Evaluation of the Dynamic Cyclic Fatigue Resistance of a New TruNatomy Glider File after Different Cycles of Use. J Endod 2024; 50:619-626. [PMID: 38311114 DOI: 10.1016/j.joen.2024.01.021] [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: 08/08/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Determination of the glide path is recommended before using rotary instruments. This study aimed to evaluate the dynamic cyclic fatigue resistance of new and used glider rotary instruments in up to 6 root canals. METHODS Seventy-two TruNatomy Glider files were used for the preparation of root canals of extracted lower molars, which were then submitted to the dynamic cyclic fatigue test carried out in a curved metallic artificial canal. The instruments were divided into 4 groups (n = 18): Control group, new instruments without any use in the root canal; Group 2U, instruments used in 2 mesial canals; Group 4U, instruments used in 4 mesial canals; Group 6U, instruments used in 6 mesial canals. The time to failure (TF) of the instrument was recorded, and the number of cycles to failure (NCF) was calculated. The data were submitted to 1-way analysis of variance and to the Games-Howell test for multiple comparisons, adopting a significance level of 5%. RESULTS TF and NCF were significantly affected by the number of file uses. The Games-Howell test revealed that TF and NCF were significantly greater in the control group than in Group 4U. In Group 2U, TF and NCF were intermediate and not significantly different from the control group. Group 6U had significantly lower TF and NCF than all other groups. CONCLUSION The TruNatomy Glider can be used as a glide path for up to 2 mesial canals of mandibular molars, whereas its use on 4 or 6 root canals is not suggested.
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Affiliation(s)
- Lorena Ferreira Rego
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| | - Juliana Delatorre Bronzato
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | | | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
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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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Pires M, Martins JNR, Pereira MR, Vasconcelos I, Costa RPD, Duarte I, Ginjeira A. Diagnostic value of cone beam computed tomography for root canal morphology assessment - a micro-CT based comparison. Clin Oral Investig 2024; 28:201. [PMID: 38453706 PMCID: PMC10920457 DOI: 10.1007/s00784-024-05580-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: 07/11/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The aim of this study was to assess cone beam computed tomography (CBCT) as a root canal anatomy diagnostic tool by comparison with micro-CT gold-standard. MATERIALS AND METHODS 216 two-rooted mandibular molars were first scanned in a CBCT device (200 μm voxel size) and posteriorly in a micro-CT scanner (19.61 μm). The volumes were sequentially screened to classify main root canal anatomy according to Vertucci classification, and for the presence of lateral canals and apical deltas, in both mesial and distal roots. RESULTS Both methods revealed a higher prevalence of Vertucci Type II and IV in the mesial root, and Vertucci Type I in the distal root. The percentage of agreement for main root canal anatomy classification between CBCT and micro-CT scores was high (85.2%). CONCLUSION Sensibility to detect both lateral canals and apical deltas with CBCT was low. These results attest to the fact that minor anatomical changes might be difficult to identify with CBCT imaging, hampering its diagnostic value.
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Affiliation(s)
- Mariana Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Marinha Grande, Portugal
| | | | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, Aveiro, 3810-193, Portugal
- LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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Jonker CH, Lambourn G, Oettlé AC, Foschi F, Theye C, L’Abbé EN. A New Methodology to Determine the Orifice for Root Canal Configurations in First Permanent Molar Root and Canal Morphologies Using Micro-Computed Tomography. J Clin Med 2023; 13:71. [PMID: 38202078 PMCID: PMC10779853 DOI: 10.3390/jcm13010071] [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: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The distinction between where the pulp chamber ends and the root canal system begins is poorly defined within the existing literature. METHODS This paper aimed to describe a range of accurate methods to define the transition from pulp chamber to root canal in different first molar root morphologies using micro-focus computed tomography (micro-CT). METHODS The sample consisted of 86 mandibular and 101 maxillary first molars from the skeletal collections housed in the Department of Anatomy and Histology of the Sefako Makgatho Health Sciences University and the Pretoria Bone Collection. A stepwise approach using the cemento-enamel junction (CEJ) and dedicated landmarks was followed to create an automated cross-sectional slice. RESULTS Transition from pulp chamber to root canal could be accurately determined on maxillary and mandibular teeth. The occurrence of two separate roots in mandibular molars was 97.7%, with the remaining 2.3% having an additional disto-lingual root, with no mandibular molars displaying fused roots. In the maxillary molars, 92.1% had three separate roots and 7.9% displayed root fusion. Within this group, one tooth displayed a C-shaped root canal configuration and one a mesotaurodont-type morphology. CONCLUSION The suggested methodology to determine orifice location was found to be appropriate in all morphological types.
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Affiliation(s)
- Casper Hendrik Jonker
- Faculty of Health, Peninsula Dental School, University of Plymouth Ground, Plymouth PL6 8BT, UK; (G.L.); (F.F.)
- Truro Dental Education Facility, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, UK
| | - Guy Lambourn
- Faculty of Health, Peninsula Dental School, University of Plymouth Ground, Plymouth PL6 8BT, UK; (G.L.); (F.F.)
- Truro Dental Education Facility, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, UK
| | - Anna Catherina Oettlé
- Anatomy and Histology Department, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
- Forensic Anthropology Research Centre, Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.T.); (E.N.L.)
| | - Federico Foschi
- Faculty of Health, Peninsula Dental School, University of Plymouth Ground, Plymouth PL6 8BT, UK; (G.L.); (F.F.)
- Truro Dental Education Facility, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, UK
| | - Charlotte Theye
- Forensic Anthropology Research Centre, Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.T.); (E.N.L.)
| | - Ericka Noelle L’Abbé
- Forensic Anthropology Research Centre, Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.T.); (E.N.L.)
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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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Ahmed HMA, El-Karim I, Duncan HF, Krastl G, Galler K. Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures. Clin Oral Investig 2023; 27:6357-6369. [PMID: 37870593 DOI: 10.1007/s00784-023-05284-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES This review aims to discuss the implications of anatomy of the root, pulp chamber, and canals on pulpotomy and revitalization procedures (RPs) as treatment alternatives to root canal treatment procedures. METHODS This narrative review was undertaken to address two main questions - why remove vital pulp tissue in teeth with complex canal anatomy when it can be preserved? And why replace the necrotic pulp in teeth with mature roots with a synthetic material when we can revitalize? This review also aims to discuss anatomical challenges with pulpotomy and revitalization procedures. RESULTS Maintaining the vitality of the pulp via partial or full pulpotomy procedures avoids the multiple potential challenges faced by clinicians during root canal treatment. However, carrying out pulpotomy procedures requires a meticulous understanding of the pulp chamber anatomy, which varies from tooth to tooth. Literature shows an increased interest in the application of RPs in teeth with mature roots; however, to date, the relation between the complexity of the root canal system and outcomes of RPs in necrotic multi-rooted teeth with mature roots is unclear and requires further robust comparative research and long-term follow-up. CONCLUSIONS Whenever indicated, pulpotomy procedures are viable treatment options for vital teeth with mature roots; however, comparative, adequately powered studies with long-term follow-up are needed as a priority in this area. RPs show promising outcomes for necrotic teeth with mature roots that warrant more evidence in different tooth types with long-term follow-ups. CLINICAL RELEVANCE: Clinicians should be aware of the pulp chamber anatomy, which is subject to morphological changes by age or as a defensive mechanism against microbial irritation, before practicing partial and full pulpotomy procedures. RP is a promising treatment option for teeth with immature roots, but more evidence is needed for its applications in teeth with mature roots. A universal consensus and considerably more robust evidence are needed for the standardization of RPs in teeth with mature roots.
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Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Ikhlas El-Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental, Traumatology University Hospital of Würzburg Pleicherwall, 2, 97070, Würzburg, Germany
| | - Kerstin Galler
- Department of Restorative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, van Schoor A, Uys A. Investigation of mandibular second molar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems. J Oral Sci 2023; 65:226-231. [PMID: 37532527 DOI: 10.2334/josnusd.23-0123] [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: 08/04/2023]
Abstract
PURPOSE To investigate the root and canal morphology of mandibular second molars, including anatomical variations, in a Black South African population using two classification systems. METHODS Cone-beam computed tomography images of 386 teeth were evaluated. The number of roots and canal configurations were categorized using the classifications of Vertucci (with modifications by Sert and Bayirli) and Ahmed et al. (including the modified Melton classification). Relationships between variables were assessed using Fisher's exact test (P < 0.05). RESULTS Mandibular second molars were predominantly two-rooted (91.7%). The majority of teeth had three canals including Type IV mesial (41.2%) and Type I (75.1%) distal (Ahmed et al. configuration: 2MDM M2 D1). Three or more canals were present in almost one-fifth of mesial (n = 72/386, 18.6%) and a small number of distal (n = 21/386, 5.4%) roots. Males displayed additional canals more frequently in the distal root (P = 0.02). C-shaped anatomy was found in 5.7%. Among the C-shapes, the most common was Melton's Type III in the coronal (50%), middle (81%) and apical (72%) thirds. CONCLUSION In this population, mandibular second molar teeth exhibited diverse morphology, which would have clinical significance for endodontic practitioners. The Ahmed et al. classification provided a better description than the Vertucci classification.
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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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Machado R, Pamplona GF, de Souza Júnior C, Nascimento J, Back EDEE, Comparin D, Ignácio SA, Reinke SMG, Kovalik AC, da Silva Neto UX. Clinical determination of anatomical diameter in different dental groups correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis: an observational clinical study. Sci Rep 2023; 13:16215. [PMID: 37758735 PMCID: PMC10533535 DOI: 10.1038/s41598-023-41967-9] [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: 05/17/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this observational clinical study (OCS) was to determine the clinical anatomical diameter (CAD) in several dental groups, thus correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis. Three-hundred fifty-nine teeth/584 vital or necrotic root canals from patients of both genders and different ages composed the sample. After performing the necessary previous procedures, K-Flexofiles were used to determine the CAD. Then, the gender and age of the patients, as well as the pulpoperiradicular diagnosis of the teeth were tabulated to conduct the statistical analysis (p < 0.05). Of the 359 teeth/584 root canals evaluated, 208/342 were from women (mean age 38.85 ± 13.42 years) and 151/242 were from men (mean age 45.41 ± 14.90 years). Statistically significant differences between the CAD means of root canals from women and men were not identified (p = 0.411). The analysis of the correlation between the CAD and age also showed a total independence (p = 0.271). Teeth with pulp necrosis and asymptomatic apical periodontitis diagnosed radiographically (TPNAAPDR) had a significantly larger CAD mean than teeth with pulp necrosis and no asymptomatic apical periodontitis diagnosed radiographically (TPNNAAPDR) and teeth with vital pulp and normal apical tissues (TVPNAT) (p = 0.0297); and the last two did not differ statistically (p > 0.05). The largest CAD mean was observed in single canals of maxillary central incisors. The lowest values of this variable were identified in the mesiobuccal and mesial canals of maxillary and mandibular first molars, respectively. The CAD of the root canals was influenced only by the root canal/tooth and pulpoperiradicular diagnosis.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil.
| | - Gabriel Filipe Pamplona
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | | | - Jaqueline Nascimento
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | | | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University-UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Biostatistics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Stella Maria Glaci Reinke
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | - Ana Cristina Kovalik
- Department of Periodontics, School of Dentistry, Regional University of Blumenau-FURB, Blumenau, Santa Catarina, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
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Madfa AA, Almansour MI, Al-Zubaidi SM, Alghurayes AH, AlDAkhayel SD, Alzoori FI, Alshammari TF, Aldakhil AM. Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population. Heliyon 2023; 9:e19477. [PMID: 37681163 PMCID: PMC10481312 DOI: 10.1016/j.heliyon.2023.e19477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023] Open
Abstract
Background The goal of the present research was to employ CBCT imaging to assess the root and canal anatomy of maxillary second molars in a population from the Hail province of Saudi. The effects of gender and side were taken into account. Methods The investigation included a sample size of 499 completely developed right and left untreated maxillary second molars obtained from 250 Saudi people. The root morphology of each tooth was evaluated. The examination also included an analysis of the canal morphology for each tooth, utilizing Vertucci's categorization. The effect of genders as well as sides was recorded. Results were analyzed using the Chi-square test. Results 464 teeth had three roots (93.0%), whereas 20 teeth (4.0%) had two roots. One root was recorded in 7 (1.4%) of the study sample, whilst 8 (1.6%) had four roots. Although there were no significant differences between the left and right sides (p = .075), gender had a significant influence on the number of roots (p = .030). 240 M (48.1%) had three canal orifices, and 247 (49.5%) had four root canal orifices. Eight molars (1.6%) had two canal orifices, while one and five canal orifices were found in 3 (0.6%) and one (0.2%), respectively. Gender had a significant impact on the number of root canal orifices (p = .039). The observed differences in the orifices of the root canals between the left and right sides were not statistically significant (p = .059). The prevalence of MB2 in maxillary second molars was found to be 49.7%. In the mesiobuccal root, the Vertucci type I configuration had the highest canal frequency (50.3%), followed by the Vertucci types II (14.4%), IV (13.8%), V (12.0%), and III (7.6%), and VI (1.8%). The prevalence of Vertucci type I canal configurations was found to be higher in the distobuccal root (99.4%) and palatal root (98.2%) of maxillary second molars. Conclusions Significant variations in root canal anatomy were observed within the Saudi population. The majority of the subjects from Saudi Arabia in this study exhibited the presence of maxillary second molars with three roots. Approximately half of the sample under investigation exhibited the presence of the four canals.
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Affiliation(s)
- Ahmed A. Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Moazzy I. Almansour
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Saad M. Al-Zubaidi
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | | | | | - Fatemah I. Alzoori
- College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Taif F. Alshammari
- College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Abrar M. Aldakhil
- College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
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Buchanan GD, Gamieldien MY, Fabris-Rotelli I, Van Schoor A, Uys A. Root and canal morphology of maxillary second molars in a Black South African subpopulation using cone-beam computed tomography and two classifications. AUST ENDOD J 2023; 49 Suppl 1:217-227. [PMID: 36420941 DOI: 10.1111/aej.12720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/18/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
This study investigated the root and canal morphology of maxillary second molars in a Black South African population using high-resolution cone-beam computed tomography. In total, 386 maxillary second molar teeth were evaluated and described according to the classifications of Vertucci (with the additions of Sert and Bayirli), as well as Ahmed et al. Root number, fusions and canal morphology were recorded. Relationships between morphology, sex and age were assessed using Fisher's exact test (p < 0.05). Maxillary second molars were predominantly three-rooted (96.1%), with root fusion observed in 14%. No relationships between sex, age and canal morphology were found. Additional canals were observed in 67.4% of mesiobuccal roots. The Ahmed et al. classification provided a better overall description of the morphology. In this population, maxillary second molar teeth exhibited a diversity of root and canal morphology. Complex variations may render endodontic management more difficult and increase the possibility of missed anatomy.
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Affiliation(s)
- Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mohamed Yasin Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Inger Fabris-Rotelli
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
| | - Albert Van Schoor
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Andre Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ahmed HMA, Nagendrababu V, Duncan HF, Peters OA, Dummer PMH. Developing a consensus-based glossary of controversial terms in Endodontology. Int Endod J 2023; 56:788-791. [PMID: 37300405 DOI: 10.1111/iej.13918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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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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Usta SN, Solana C, Ruiz-Linares M, Baca P, Ferrer-Luque CM, Cabeo M, Arias-Moliz MT. Effectiveness of conservative instrumentation in root canal disinfection. Clin Oral Investig 2023; 27:3181-3188. [PMID: 36867258 PMCID: PMC10264279 DOI: 10.1007/s00784-023-04929-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The impact of conservative instrumentation on the disinfection of root canals with different curvatures has not yet been determined. This ex vivo study aimed to evaluate and compare the effect of conservative instrumentation with TruNatomy (TN) and Rotate and a conventional rotary system, ProTaper Gold (PTG), on root canal disinfection during chemomechanical preparation of straight and curved canals. MATERIALS AND METHODS Ninety mandibular molars with straight (n = 45) and curved (n = 45) mesiobuccal root canals were contaminated with polymicrobial clinical samples. Teeth were divided into three subgroups (n = 14) according to the file systems and the curvature. Canals were instrumented with TN, Rotate, and PTG, respectively. Sodium hypochlorite and EDTA were used as irrigants. Intracanal samples were taken before (S1) and after (S2) instrumentation. Six uninfected teeth were used as negative controls. The bacterial reduction between S1 and S2 was measured by ATP assay, flow cytometry, and culture methods. Kruskal-Wallis and ANOVA tests were followed by the Duncan post hoc test (p < 0.05). RESULTS Bacterial reduction percentages were similar for the three file systems in straight canals (p > 0.05). However, PTG showed a lower reduction percentage of intact membrane cells in flow cytometry than TN and Rotate (p = 0.036). For the curved canals, no significant differences were obtained (p > 0.05). CONCLUSION Conservative instrumentation of straight and curved canals using TN and Rotate files resulted in similar bacterial reduction compared to PTG. CLINICAL RELEVANCE The disinfection efficacy of conservative instrumentation is similar to conventional instrumentation in straight and curved root canals.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Etlik, Keçiören, 06018 Ankara Turkey
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Monica Cabeo
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
| | - Maria Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Al-Qudah AA, Bani Younis HAB, Awawdeh LA, Daud A. Root and canal morphology of third molar teeth. Sci Rep 2023; 13:6901. [PMID: 37106025 PMCID: PMC10140078 DOI: 10.1038/s41598-023-34134-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch. However, the anatomy of third molars has been described as unpredictable. To date, there has been little published work on root and canal morphology of third molars, with an adequate sample size. The aim of this study was to investigate root and canal morphology of third molars. Maxillary and mandibular third molars were gathered from dental surgeries within north Jordan. Following access cavity preparation, pulp tissue was removed and root canals stained. Teeth were subject to examination after rendering them clear by immersion in methyl salicylate, and the following features evaluated: (1) number of roots; (2) number and type of root canals; (3) number and position of lateral canals; and (4) presence of inter-canal communications. Out of the examined 592 maxillary third molars, 69.9% had three roots, 10.81% had one, 9.79% had two, 9.12% had four, and 0.34% had five roots. Most had three (52.36%) and four canals (28.2%) with less frequency of two (11.48%), one (5.91%) and five canals (2.03%). Of the 639 mandibular third molars, 89.76% had two roots, 7.35% had three, 2.5% had one, and 0.47% had four roots. Most had three (55.71%) and two canals (29.42%) with less frequency of four (13.61%), one (1.09%) and five canals (0.15%). The majority of maxillary third molars had 3 roots, while the majority of mandibular third molars had two. Overall, nearly half of the maxillary and mandibular third molars had three canals. New canal configurations, not previously described in the literature nor included in Vertucci's classifications, were identified in both maxillary and mandibular third molars.
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Affiliation(s)
- Aladdin Ahmad Al-Qudah
- Department of Conservative Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
| | - Hamzeh A Barakat Bani Younis
- Department of Conservative Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Lama Adel Awawdeh
- Department of Conservative Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Alaa Daud
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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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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Vhorkate K, Banga K, Pawar AM, Mir S, Arora S, Wahjuningrum DA, Bhardwaj A, Luke AM. Location angle of second mesio-buccal canal in maxillary molars of an Indian population: an in vivo retrospective CBCT evaluation and proposal of a new classification. PeerJ 2022; 10:e14234. [PMID: 36248703 PMCID: PMC9559056 DOI: 10.7717/peerj.14234] [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: 06/22/2022] [Accepted: 09/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population. Methods Three-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using 3D Slicer. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MB-MB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (-0.1° to -1.9°), II (-2° to -4°), III (>-4°). On the data tabulated a new Banga Vhorkate and Pawar's (BVP's) angular classification for maxillary molars was proposed. Results The existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1-MB2 in maxillary 1st molar is seen to be 3.12-3.31 mm and this distance in maxillary 2nd molar is 2.8-3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06-5.22 mm in maxillary first molars and 4.9-5.8 mm in maxillary second molars. Conclusion Accurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal.
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Affiliation(s)
- Kishor Vhorkate
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Kulvinder Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Shugufta Mir
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Universitas Airlingga, Faculty of Dental Medicine, Surabaya City, East Java, Indonesia
| | - Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Sciences & Hospital, Rau, Indore, India
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman, United Arab Emirates,Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman, United Arab Emirates
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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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Carrion SJ, Coelho MS, Soares ADJ, Frozoni M. Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e37. [DOI: 10.5395/rde.2022.47.e37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/11/2022]
Affiliation(s)
| | - Marcelo Santos Coelho
- Department of Endodontic, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
| | | | - Marcos Frozoni
- Department of Endodontic, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
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