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Çimen T, Düzgün S, Akyüz İE, Topçuoğlu HS. The effect of cone beam computerized tomography voxel size and the presence of root filling on the assessment of middle mesial canals in mandibular molar teeth. Clin Oral Investig 2024; 28:394. [PMID: 38916762 PMCID: PMC11199224 DOI: 10.1007/s00784-024-05773-5] [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: 09/06/2023] [Accepted: 06/11/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes when the mesiobuccal (MB) and mesiolingual (ML) canals have three distinct phases (unpreparation, preparation and obturation and the removal of the obturation and repreparation). METHODS Two hundred forty-two extracted human mandibular molars were collected and kept in a physiological saline solution prior to use. 0.2-, 0.28- and 0.35-mm voxel sizes CBCT (n = 242) were performed in three phases (Ph): Ph1, no MB and ML canal preparation or obturation; Ph2, after MB and ML canals preparation and obturation; and Ph3, after the removal of the obturation of MB and ML canals and canals repreparation. Images were analyzed using OnDemand3D® software. After the CBCT acquisition in Ph3, all the samples were clarified to visualize the presence of the MMC directly. A blinded, previously calibrated examiner analyzed all the images. RESULTS The MMC was detected in 15 of the 242 teeth after the clearing technique. The lowest MMC detection rate was observed at 0.35-mm voxel size regardless of the ML and MB canal condition, while the highest was observed at 0.2-mm voxel size (P < 0.05). There is no statistically significant difference between 0.2-mm and 0.28-mm voxel sizes (P > 0.05). In all voxel sizes, the highest rate of detectability of the MMC was seen in Phase 1, while the lowest was in Phase 2. CONCLUSIONS It may be appropriate to take a 0.20-mm voxel size CBCT image, especially after the removal of root canal filling. CLINICAL RELEVANCE An appropriate CBCT voxel size and the absence of root canal filling in the root canal system help to detect the missing MMC.
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Affiliation(s)
- Tansu Çimen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Melikgazi, Kayseri, 38039, Turkey.
| | - İpek Eraslan Akyüz
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Melikgazi, Kayseri, 38039, Turkey
| | - Hüseyin Sinan Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Melikgazi, Kayseri, 38039, Turkey
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Dos Santos RB, Lenz U, Griggs JA, Estrela C, Bueno MDR, Porto OCL, Della Bona A. Structural and torque changes in implant components of different diameters subjected to mechanical fatigue. Dent Mater 2024; 40:493-499. [PMID: 38176998 PMCID: PMC10942759 DOI: 10.1016/j.dental.2023.12.014] [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: 08/15/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To evaluate torque maintenance and structural damage in implant components of different diameters subjected to a fatigue challenge. METHODS Thirty 10-mm-long, morse taper connection, titanium dental implants and their corresponding one-piece abutments were divided into three groups (n = 10) according to implant diameter: 4.3 mm (I4.3), 3.5 mm (I3.5), and 2.9 mm (I2.9). The implants were placed into a load-bearing fixture simulating bone tissue (modified G10), and the abutments were screwed into the implants to a final torque of 20 Ncm for the I4.3 and I3.5 and 15 Ncm for I2.9. The torque was secured by a digital torque meter. Cone-beam computed tomography (CBCT) scans were acquired and post-processed (e-Vol DX software) for all implant/abutment sets before and after subjecting them to fatigue in 37 °C distilled water (2 million cycles, constant load and frequency). The removal torque was measured using the same digital torque meter to calculate the difference in torque before and after fatigue. RESULTS I2.9 showed substantial structural deformation compared with the other implant diameters (I3.5 and I4.3). However, the experimental groups did not show statistical differences for abutment loosening. SIGNIFICANCE Implants smaller than 3.5 mm in diameter have a higher probability of structural deformation than standard-diameter implants. The association between tomographic scans and e-Vol DX software showed satisfactory consistency with the direct assessment using the digital torque meter, offering an additional tool to evaluate implant component loosening and structural deformations.
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Affiliation(s)
| | - Ulysses Lenz
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Jason Alan Griggs
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA
| | - Carlos Estrela
- School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | - Alvaro Della Bona
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.
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Jeevanandan G, Govindaraju L, Kotian N, Maganur PC, Marwah N, Vishwanathaiah S. A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification. Int J Clin Pediatr Dent 2023; 16:376-379. [PMID: 37519969 PMCID: PMC10373759 DOI: 10.5005/jp-journals-10005-2537] [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] [Indexed: 08/01/2023] Open
Abstract
Aim The success of the pulpectomy depends on adequate access, cleaning, shaping, and good-quality obturation. Evaluating the quality of obturation is the major tool that determines the success of the procedure. The present study aimed to assess the quality of obturation in all the canals of primary teeth and suggest a new classification. Materials and methods A total of 1,000 radiographs of the pulpectomy procedure performed in primary molars were evaluated. The quality of obturation was assessed for each canal using the criteria given by Coll and Sandrian. The prevalence of each obturation criterion in every canal was represented in the form of a percentage. Results It was observed that among the mandibular primary molars, most of the mesial canals were underfilled, and in the distal canal, most of the canals were overfilled. Among the maxillary primary molars, most of the mesial canals were overfilled, more distal canals were underfilled, and with respect to palatal canals, optimal obturation was seen. Conclusion The pitfalls of the previous classification were revised, and a new classification for assessing the quality of obturation was proposed, which is arch, segment, and canal specific. Clinical significance The new classification will give a more precise assessment for the evaluation of various techniques and materials used for pulpectomy in primary teeth. How to cite this article Jeevanandan G, Govindaraju L, Kotian N, et al. A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification. Int J Clin Pediatr Dent 2023;16(2):376-379.
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Affiliation(s)
- Ganesh Jeevanandan
- Department of Pedodontics, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) (Deemed to be University), Chennai, Tamil Nadu, India
| | - Lavanya Govindaraju
- Department of Pedodontics, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) (Deemed to be University), Chennai, Tamil Nadu, India
| | - Niharika Kotian
- Department of Pedodontics, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) (Deemed to be University), Chennai, Tamil Nadu, India
| | - Prabhadevi C Maganur
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan, Saudi Arabia
| | - Nikhil Marwah
- Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Satish Vishwanathaiah
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan, Saudi Arabia
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The Diagnostic Relevance and Interfaces Covered by Mach Band Effect in Dentistry: An Analysis of the Literature. Healthcare (Basel) 2022; 10:healthcare10040632. [PMID: 35455810 PMCID: PMC9026821 DOI: 10.3390/healthcare10040632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
This work surveyed how the Mach band effect was mentioned in the dental literature and provided a qualitative assessment of diagnostic relevance and interfaces covered. PubMed, Scopus, and Google Scholar were queried in mid-Jan 2022. The search string was (“mach band effect” OR “mach effect”) AND (dental OR oral OR tooth OR teeth OR maxillofacial OR orofacial). All publications returned by the searches were screened. Exclusion criteria included irrelevance (e.g., dealing with “Mach effect” that was non-radiographic or non-dental) and not written in English. Reference lists of returned publications were manually searched to identify potentially missed papers. For each included publication, the following parameters were recorded: any presentation of radiographic images showing a Mach band effect, direct investigation of the effect, relevance to which structural interfaces, diagnostic relevance, and in which parts of the publication Mach band effect was mentioned. Seventy-seven publications were included and analyzed. The majority of the publications mentioned the Mach band effect in the Discussion section about its diagnostic relevance to caries detection at the enamel-dentinal junction and the interface between restorative material and tooth structure. Eight of them presented radiographic images showing a Mach band effect. Three of them investigated the Mach band effect. Dental publications seldom covered the Mach band effect. When they covered it, most of them only mentioned it in the Discussion section without actually investigating it.
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Gregoris Rabelo LE, Bueno MDR, Costa MVCD, de Musis CR, Estrela CRDA, Guedes OA, Gavini G, Estrela C. Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts. Comput Biol Med 2021; 136:104679. [DOI: 10.1016/j.compbiomed.2021.104679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
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Machado R, Koetz R, Comparin D, Alberton LR, da Fonseca Roberti Garcia L, Xavier da Silva Neto U. Correlation among Root Canal Configuration, Quality of Filling, and Its Sealability. Eur J Dent 2021; 15:568-573. [PMID: 33622010 PMCID: PMC8382461 DOI: 10.1055/s-0041-1724158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective
This study aimed to evaluate the existence of possible correlations among root canal configuration, quality of filling, and its sealability.
Materials and Methods
Sixty human mandibular central incisors were selected for this study. The teeth were prepared with the Profile 04 system up to instrument 35/0.04 and irrigated with 2.5 mL of 2.5% sodium hypochlorite at each instrument change. Root canal filling was performed by the lateral compaction technique, using gutta-percha and an epoxy resin-based sealer (AH Plus) labeled with 0.1% Rhodamine B dye. Afterward, the specimens were submitted to fluid filtration tests to assess the sealability of the filling. Cross-sections were obtained at −3, −6, and −8 mm from the root apex and submitted to a metallographic treatment to determine the root canal configuration and the percentage of gutta-percha filled areas. The data were statistically analyzed by the Grubbs test. Pairs of correlations were analyzed by applying the Spearman test at a level of significance of 5%.
Results
No correlation was observed among the analyzed variables as follows: root canal configuration versus filling quality (Spearman’s rho = 0.031); filling quality versus sealability (Spearman’s rho = 0.219); and root canal configuration versus sealability (Spearman’s rho = 0.184).
Conclusion
The root canal configuration did not affect the quality of the filling and its sealability.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Ricardo Koetz
- Department of Endodontics, School of Dentistry, Paranaense University, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University, Francisco Beltrão, Paraná, Brazil
| | - Luiz Rômulo Alberton
- Department of Veterinary Medicine and Graduate Program in Animal Science, Paranaense University, Umuarama, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
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Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac Radiol 2021; 50:20200503. [PMID: 33400563 DOI: 10.1259/dmfr.20200503] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. METHODS 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. RESULTS For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. CONCLUSIONS Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla Faria Vasconcelos
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Biomaterials-BIOMAT, Leuven, Belgium
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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Estrela C, Costa MVC, Bueno MR, Rabelo LEG, Decurcio DA, Silva JA, Estrela CRA. Potential of a New Cone-Beam CT Software for Blooming Artifact Reduction. Braz Dent J 2020; 31:582-588. [DOI: 10.1590/0103-6440202005899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.
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Affiliation(s)
| | | | - Mike R Bueno
- Faculdade São Leopoldo Mandic, Brazil; CROIF Oral Radiology Center, Brazil
| | | | | | | | - Cyntia R A Estrela
- Universidade de Cuiabá, Brazil; Centro Universitário de Anápolis, Brazil
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9
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Zhang MM, Fang GF, Chen XT, Liang YH. Four-year Outcome of Nonsurgical Root Canal Retreatment Using Cone-beam Computed Tomography: A Prospective Cohort Study. J Endod 2020; 47:382-390. [PMID: 33130061 DOI: 10.1016/j.joen.2020.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The purpose of this prospective study was to investigate the 4-year outcome and prognostic factors of nonsurgical root canal retreatment determined by measuring the volumetric change of periapical radiolucencies on cone-beam computed tomographic (CBCT) scans. METHODS Ninety-seven endodontically treated teeth from 80 patients diagnosed as apical periodontitis and indicated for root canal retreatment were included. Retreatment was performed by 7 endodontic specialists using a standardized treatment protocol. The teeth were reexamined clinically and radiographically 48-67 months after retreatment. The volume of preoperative and postoperative periapical radiolucencies on CBCT images was independently measured by 2 examiners. Radiographic outcome is presented in 4 categories: absence, reduction, enlargement, or unchanged. Reduction or enlargement was determined when the volumetric change of radiolucency was 20% or more. Multivariate logistic regression was performed for predictor analysis. RESULTS Sixty-two teeth (63.9%) from 50 patients returned for follow-up. Fifty-eight teeth were included in the prognostic analysis, all of which were symptom free. The 4 remaining teeth that had been extracted because of fracture were excluded. The total volume of periapical radiolucencies at 4 years postoperatively decreased by 94.6% compared with that preoperatively (P < .001), with an average reduction of 83.4% (95% confidence interval, 69.2%-97.5%). The periapical radiolucencies were determined as absence in 44 teeth (75.9%), reduction in 10 teeth (17.2%), unchanged in 1 tooth (1.7%), and enlargement in 3 teeth (5.2%). Tooth type was identified as an outcome predictor (P < .05). CONCLUSIONS The 4-year outcome of endodontic retreatment is predictable, with a significant volumetric reduction in periapical radiolucencies.
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Affiliation(s)
- Ming-Ming Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Gao-Feng Fang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiao-Tong Chen
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China; Department of Stomatology, Peking University International Hospital, Beijing, China.
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10
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Baxter S, Schöler C, Dullin C, Hülsmann M. Sensitivity of conventional radiographs and cone-beam computed tomography in detecting the remaining root-canal filling material. J Oral Sci 2020; 62:271-274. [PMID: 32493862 DOI: 10.2334/josnusd.19-0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study aimed to compare the sensitivity of radiographs and flat-panel volume-computed tomography (fpVCT) in detecting the remaining root-canal filling material. Thirty-two root canals in extracted human mandibular molars were prepared and obturated with gutta-percha and sealer. The filling material was removed, and the teeth were split longitudinally. Radiographs and fpVCT scans were obtained and digitized. Virtual images were developed using reconstruction software and then superimposed, and the remaining filling material was outlined. Direct observation of the split root halves using flatbed scans served as a control. The presence and extension of the remaining filling material were evaluated. Statistical analysis was conducted using chi-squared test (P < 0.05). A total of 116 remnants were detected in the flatbed scans, 81 in the fpVCT scans, and 90 in the radiographs, with no significant difference between the radiograph (78%) and fpVCT (70%) results (P = 0.18). In the fpVCT scans, 42% of the remnants exhibited the same dimensions as the control, whereas 27% appeared larger and 30% appeared smaller. In the radiographs, the dimensions of the remnants were identical to the control in 64% of cases, smaller in 29%, and larger in 7%. FpVCT did not exhibit better performance than dental radiographs in detecting the remaining root-canal-filling material: the extension of remnants was indicated correctly in the fpVCT in fewer than 50% of the samples.
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Affiliation(s)
- Steffi Baxter
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen
| | - Christian Schöler
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen
| | | | - Michael Hülsmann
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen
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Torres FFE, Jacobs R, EzEldeen M, de Faria-Vasconcelos K, Guerreiro-Tanomaru JM, Dos Santos BC, Tanomaru-Filho M. How image-processing parameters can influence the assessment of dental materials using micro-CT. Imaging Sci Dent 2020; 50:161-168. [PMID: 32601591 PMCID: PMC7314609 DOI: 10.5624/isd.2020.50.2.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose The aim of this study was to evaluate the influence of voxel size and different post-processing algorithms on the analysis of dental materials using micro-computed tomography (micro-CT). Materials and Methods Root-end cavities were prepared in extracted maxillary premolars, filled with mineral trioxide aggregate (MTA), Biodentine, and Intermediate Restorative Material (IRM), and scanned using micro-CT. The volume and porosity of materials were evaluated and compared using voxel sizes of 5, 10, and 20 µm, as well as different software tools (post-processing algorithms). The CTAn or MeVisLab/Materialise 3-matic software package was used to perform volume and morphological analyses, and the CTAn or MeVisLab/Amira software was used to evaluate porosity. Data were analyzed using 1-way ANOVA and the Tukey test (P<0.05). Results Using MeVisLab/Materialise 3-matic, a consistent tendency was observed for volume to increase at larger voxel sizes. CTAn showed higher volumes for MTA and IRM at 20 µm. Using CTAn, porosity values decreased as voxel size increased, with statistically significant differences for all materials. MeVisLab/Amira showed a difference for MTA and IRM at 5 µm, and for Biodentine at 20 µm. Significant differences in volume and porosity were observed in all software packages for Biodentine across all voxel sizes. Conclusion Some differences in volume and porosity were found according to voxel size, image-processing software, and the radiopacity of the material. Consistent protocols are needed for research evaluating dental materials.
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Affiliation(s)
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mostafa EzEldeen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria-Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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12
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Comparative evaluation of three obturation techniques in primary incisors using digital intra-oral receptor and C.B.C.T-an in vitro study. Clin Oral Investig 2018; 23:689-696. [PMID: 29744724 DOI: 10.1007/s00784-018-2484-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/02/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Successful pulpectomy in primary teeth depends on quality of obturation. It can be evaluated using digital intra-oral receptor (D.I.O.R) and cone beam computed tomography (C.B.C.T). The purposes of this study were to compare 3 different obturation techniques such as lentulospiral, insulin syringe, and endodontic plugger in primary incisors and to evaluate its quality of obturation using D.I.O.R and C.B.C.T technique. MATERIALS AND METHODS Thirty-three extracted primary incisors were biomechanically prepared and obturated with zinc oxide eugenol cement by 3 different obturation techniques. The obturation was evaluated for length of obturation and voids using D.I.O.R and C.B.C.T methods. RESULTS There was a statistically significant difference between all the groups in length of obturation (P = 0.02) in both D.I.O.R and C.B.C.T. Significant differences (P = 0.03) were present in number of voids among 3 obturation techniques in C.B.C.T. Statistically more voids were observed with D.I.O.R in lentulospiral (P = 0.04) group and in insulin syringe (P = 0.02) group. CONCLUSIONS Acceptable result was obtained with lentulospiral in length of obturation compared to insulin syringe and endodontic plugger technique. Insulin syringe technique resulted in increased underfilling with least number of voids. More number of voids were seen in middle one-third and least number of voids were observed at apical one third of the root among all the 3 techniques of obturation. The study concluded that void identification is improved with D.I.O.R compared to C.B.C.T. CLINICAL RELEVANCE Lentulospiral reported effective length of obturation, while insulin syringe with least number of voids. D.I.O.R (2-Dimensional) is efficient in detecting voids compared to C.B.C.T (3-Dimensional) in obturated primary teeth.
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Survival of Endodontically Treated Roots/Teeth Based on Periapical Health and Retention: A 10-year Retrospective Cohort Study. J Endod 2017; 43:2001-2008. [DOI: 10.1016/j.joen.2017.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/12/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022]
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Rahimi S, Ghasemi N, Razi T, Rezaiepour A. Quality of the calcium-enriched mixture apical plug in simulated apexification model; Effect of different mixing and placement methods. J Clin Exp Dent 2017; 9:e1237-e1241. [PMID: 29167715 PMCID: PMC5694154 DOI: 10.4317/jced.53236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 09/06/2017] [Indexed: 11/05/2022] Open
Abstract
Background Presence of voids at root canal wall‒apical seal material interface gives rise to the entrapment of toxins and microorganisms, which might have a relationship with post treatment disease. The present study was carried out to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) methods of Calcium-enriched Mixture (CEM) cement on the number and dimensions of voids in the apical plug in simulated apexification models. Material and Methods A total of 80 human maxillary central incisors with mature apices were selected. After simulation of the open apices, the teeth were divided into 4 groups (n=20) based on the mixing and placement techniques of CEM cement: group 1, manual mixing‒manual placement; group 2, manual mixing‒manual placement in association with indirect ultrasonic technique; group 3, ultrasonic mixing‒manual placement; and group 4, ultrasonic mixing‒manual placement in association with indirect ultrasonic technique. The samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. After placement the apical plugs, a wet piece of cotton was placed on canal orifices, followed by dressing with Cavit. The samples were incubated at 37°C and 100% relative humidity for 7 days. Then the voids between the material and root canal walls were counted with the CBCT technique. The void dimensions were scored with the following scoring system: score 1, no voids; score 2, the void size less than half of the size of the evaluated cross-section; score 3, the void size larger than half of the size of the evaluated cross-section. Statistical analyses were carried out with chi-squared and Fisher's exact tests. Statistical significance was defined at P<0.05. Results The maximum (7) and minimum (2) number of voids were detected in groups 1 and 2, respectively. The difference between these two groups was statistically significant (p<0.05). The differences in the number of voids between groups with similar mixing technique and different mixing techniques (i.e. groups 1 and 3 and groups 2 and 4) were not significant (p>0.05). Void dimensions in all the study groups were in score 2 category and no score 3 was recorded in the study groups. Conclusions Under the limitations of the present study, manual placement in association with indirect ultrasonic technique was a proper technique to improve the quality of apical plug, considering the decrease in the number of voids. Key words:Apical plug, CEM cement, void.
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Affiliation(s)
- Saeed Rahimi
- Professor, Dental and Periodontal Research Center, Department of Endodontics, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
| | - Negin Ghasemi
- Assistant Professor, Dental and Periodontal Research Center, Department of Endodontics, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
| | - Tahmineh Razi
- Assistant Professor, Department of Radiology, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
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Gandhi M, Tandon S, Vijay A, Kalia G, Rathore K. Clinical Assessment of Various Obturating Techniques for Primary Teeth: A Comparative Study. J Clin Diagn Res 2017; 11:ZC48-ZC51. [PMID: 28893042 DOI: 10.7860/jcdr/2017/25818.10194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 03/15/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lifelong preservation of tooth in a healthy state is the ultimate goal of dentistry. Premature loss of primary teeth is common due to caries, dental trauma or other causes. As the primary teeth are the best space maintainers, teeth with infected pulps should be retained until exfoliation, whenever possible. AIM The purpose of this in vivo study was to evaluate and compare the efficacy of different obturating methods used in primary teeth. MATERIALS AND METHODS Forty one patients aged four to nine years with a total of 60 teeth were selected. Out of the 60 teeth, 32 were primary mandibular first molars and 28 were primary mandibular second molars, the sample was randomly divided into three groups. Disposable syringe, lentulo spiral and past inject were used for obturation. Postoperative evaluation was done for; quality of canal obturation, presence of voids using postoperative radiographs following obturation of teeth. The data were analysed to assess the success rate of the three methods used for obturation using Chi-square test. RESULTS Among the three groups of the study, past inject exhibited the maximum number of optimally filled canals. Maximum number of underfilled canals was found with lentulospiral, and the maximum number of overfilled canals was seen with disposable syringe. Least number of voids was observed in canals filled with the past inject technique and disposable syringe. CONCLUSION The results suggest that the most successful technique for obturation of primary teeth was past inject.
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Affiliation(s)
- Mahima Gandhi
- Resident, Department of Paediatric and Preventive Dentistry, Gdc Jaipur, Jaipur, Rajasthan, India
| | - Sandeep Tandon
- Senior Professor and Head, Department of Paediatric and Preventive Dentistry, Gdc Jaipur, Rajasthan, India
| | - Akshat Vijay
- Senior Resident, Department of Orthopaedics, Jhalawar Medical College, Kota, Rajasthan, India
| | - Garima Kalia
- Resident, Department of Paediatric and Preventive Dentistry, Gdc Jaipur, Rajasthan, India
| | - Khushboo Rathore
- Resident, Department of Paediatric and Preventive Dentistry, Gdc Jaipur, Rajasthan, India
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Česaitienė G, Česaitis K, Junevičius J, Venskutonis T. The Reliability of Panoramic Radiography Versus Cone Beam Computed Tomography when Evaluating the Distance to the Alveolar Nerve in the Site of Lateral Teeth. Med Sci Monit 2017; 23:3247-3252. [PMID: 28674379 PMCID: PMC5507794 DOI: 10.12659/msm.902083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to compare the reliability of panoramic radiography (PR) and cone beam computed tomography (CBCT) in the evaluation of the distance of the roots of lateral teeth to the inferior alveolar nerve canal (IANC). MATERIAL AND METHODS 100 PR and 100 CBCT images that met the selection criteria were selected from the database. In PR images, the distances were measured using an electronic caliper with 0.01 mm accuracy and white light x-ray film reviewer. Actual values of the measurements were calculated taking into consideration the magnification used in PR images (130%). Measurements on CBCT images were performed using i-CAT Vision software. Statistical data analysis was performed using R software and applying Welch's t-test and the Wilcoxon test. RESULTS There was no statistically significant difference in the mean distance from the root of the second premolar and the mesial and distal roots of the first molar to the IANC between PR and CBCT images. The difference in the mean distance from the mesial and distal roots of the second and the third molars to the IANC measured in PR and CBCT images was statistically significant. CONCLUSIONS PR may be uninformative or misleading when measuring the distance from the mesial and distal roots of the second and the third molars to the IANC.
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Affiliation(s)
- Gabrielė Česaitienė
- Clinical Department of Dental and Oral Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kęstutis Česaitis
- Clinical Department of Dental and Maxillofacial Orthopedics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jonas Junevičius
- Clinical Department of Dental and Maxillofacial Orthopedics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tadas Venskutonis
- Clinical Department of Dental and Oral Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Song D, Zhang L, Zhou W, Zheng Q, Duan X, Zhou X, Huang D. Comparing cone-beam computed tomography with periapical radiography for assessing root canal obturation in vivo using microsurgical findings as validation. Dentomaxillofac Radiol 2017; 46:20160463. [PMID: 28332866 DOI: 10.1259/dmfr.20160463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The aim of this study was to verify whether there is a difference in the in vivo performance characteristics of CBCT and periapical radiography (PR) in assessing the apical extension of root canal obturation (RCO) and to evaluate the ability of CBCT in void detection using microsurgical findings as validation. METHODS This study included 323 tooth roots that required surgical treatment and for which pre-existing periapical radiographs and CBCT images were available. Three calibrated observers individually analyzed the periapical radiographs, CBCT images and photomicrographs of each root. Performance characteristics of CBCT and PR were compared in terms of their evaluation of the apical extension of the RCOs. The ability of CBCT to detect voids in the RCOs was evaluated using microsurgical findings as validation. Kappa values were used for intraobserver/interobserver agreement. RESULTS Perfect intraobserver/interobserver agreement (1.0) was achieved when using photomicrography. The two agreements of PR were superior to those of CBCT when CBCT was used to detect voids (p < 0.05). The sensitivity of CBCT [0.86, 95% confidence interval (CI) 0.76-0.93] was superior to that of PR (0.66, 95% CI 0.54-0.76) in detecting overextension (p < 0.005). CBCT showed a poor sensitivity (0.24, 95% CI 0.19-0.30) and specificity (0.67, 95% CI 0.54-0.78) in void detection. CONCLUSIONS CBCT was better than PR for evaluating the apical extension of RCOs. CBCT, with its poor sensitivity and specificity, might both overestimate and underestimate the proportion of voids in RCOs. CBCT was not suitable for evaluating the quality of RCOs.
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Affiliation(s)
- Dongzhe Song
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lan Zhang
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,2 Department of Conservative Dentistry and Endodontics, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Wei Zhou
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qinghua Zheng
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xingyu Duan
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,2 Department of Conservative Dentistry and Endodontics, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Dingming Huang
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,2 Department of Conservative Dentistry and Endodontics, West China College of Stomatology, Sichuan University, Chengdu, China
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Ghasemi N, Janani M, Razi T, Atharmoghaddam F. Effect of different mixing and placement methods on the quality of MTA apical plug in simulated apexification model. J Clin Exp Dent 2017; 9:e351-e355. [PMID: 28298973 PMCID: PMC5347280 DOI: 10.4317/jced.53410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/18/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND It is necessary apical plug material to exhibit proper adaptation with the root canal walls. Presence of voids at the interface between the root canal wall and this material result in micro leakage, which might have a relationship with post treatment disease. The aim of the present study was to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) method of Mineral Trioxide Aggregate (MTA) on the void count and dimension in the apical plug in natural teeth with simulated open apices. MATERIAL AND METHODS Eighty human maxillary central incisors were selected. After simulation of the open apex model, the teeth were assigned to 4 groups based on the mixing and placement techniques of MTA: group 1, manual mixing and manual placement; group 2, manual mixing and manual placement in association with indirect ultrasonic; group 3, ultrasonic mixing and and manual placement; and group 4, ultrasonic mixing and manual placement in association with indirect ultrasonic. The prepared samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. In group 1, after mixing, the material was condensed with a hand plugger. In group 2, after mixing, the ultrasonic tip was contacted with the hand plugger for 2 seconds. In groups 3 and 4, mixing was carried out with the ultrasonic tip for 5 seconds and in groups 3 and 4, similar to groups 1 and 2, respectively, the materials were placed as apical plugs, measuring 3 mm in length. A wet cotton pellet was placed at canal orifices and dressed with Cavit. After one week, the cone beam computed tomography (CBCT) technique was used to count the number of voids between the material and root canal walls. The void dimensions were determined using the following scoring system: score 1, absence of voids; score 2, the void size less than half of the dimensions of the evaluated cross-section; score 3, the void size larger than half of the dimensions of the evaluated cross-section. Chi-squared and Fisher's exact tests were used for statistical analyses. Statistical significance was set at P<0.05. RESULTS The maximum (13) and minimum (3) number of voids were detected in groups 2 and 3, respectively. There were no significant differences between groups 1 and 3 in the number of voids (p >0.05). Evaluation of void dimensions showed no score 3 in any of the study groups and the dimensions of all the voids conformed to score 2. CONCLUSIONS Under the limitations of the present study, use of ultrasonic mixing and manual placement techniques resulted in a decrease in the number of voids in the apical plug. Key words:Apical plug, MTA, ultrasonic, void.
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Affiliation(s)
- Negin Ghasemi
- Assistant Professor, Department of Endodontics, Dental and Periodontal Research Center, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
| | - Maryam Janani
- Assistant Professor, Department of Endodontics, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
| | - Tahmineh Razi
- Assistant Professor, Department of Radiology, Dental Faculty, Tabriz University (Medical Sciences), Tabriz, Iran
| | - Faezeh Atharmoghaddam
- Student of Dentistry, Dental Faculty, Tabriz University, (Medical Sciences), Tabriz, Iran
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Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study. Clin Oral Investig 2016; 21:643-652. [PMID: 27522217 DOI: 10.1007/s00784-016-1931-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The objectives of the study were to evaluate the radiographic technical quality of root canal treatment before and after the implementation of a nickel-titanium rotary (NiTiR) preparation followed by a matching-taper single-cone (mSC) obturation and to detect the procedural errors associated with this technique. MATERIALS AND METHODS A random sample of 535 patients received root canal treatment at the Department of Conservative Dentistry and Periodontology at the University of Würzburg: 254 teeth were treated in 2002-2003 by using stainless steel instruments (SSI) for preparation and a lateral compaction (LC) technique (classic group (CG)). Two hundred eighty-one teeth were root filled in 2012-2013 employing NiTiR instruments for the root canal shaping and a mSC technique (advanced group (AG)). The quality assessments were based on the radiographic criteria of the European Society of Endodontology. The presence of voids was recorded separately for the apical, central and cervical thirds of the root canals. Procedural errors, such as ledges, apical transportations, perforations and fractured instruments, were detected. The root canal fillings in the CG and AG were compared using chi-squared and Fisher's exact tests. Multivariable logistic regression was performed to investigate the association between the independent variables (patient age, tooth type and type of treatment) and the dependent variables (density and length). RESULTS Adequate length was achieved significantly more often in the AG compared to the CG for molars (p = 0.017), mandibular teeth (p = 0.013) and primary root canal treatments (p = 0.024). No significant difference was detected between the AG and CG regarding adequate length in general (p = 0.051) or adequate overall quality of root canal filling (p = 0.1). In the AG, a significant decrease in procedural errors was evident (p = 0.019) and decreases in the densities of the root canal fillings in the cervical (p = 0.01) and central (p = 0.01) thirds of the root canals were also observed. Moreover, root canals in elderly patients exhibited fewer voids (p = 0.009). CONCLUSIONS Rotary root canal preparation followed by a matching-taper single-cone filling technique provides a reliable shaping of the root canal, with fewer procedural errors and a more acceptable filling quality in terms of length and homogeneity in the apical third. Less favourable results were achieved in the central and cervical parts of the root canals. CLINICAL RELEVANCE The matching-taper single-cone technique seems to effectively obturate well-tapered root canals after adequate rotary instrumentation. Irregularly shaped canals require additional lateral or warm vertical condensation to avoid voids.
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The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics: A Systematic Review and Analysis by a Hierarchical Model of Efficacy. J Endod 2015; 41:1008-14. [DOI: 10.1016/j.joen.2015.02.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/05/2015] [Accepted: 02/14/2015] [Indexed: 01/21/2023]
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Venskutonis T, Plotino G, Juodzbalys G, Mickevičienė L. The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature. J Endod 2014; 40:1895-901. [PMID: 25287321 DOI: 10.1016/j.joen.2014.05.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/16/2014] [Accepted: 05/12/2014] [Indexed: 01/26/2023]
Abstract
INTRODUCTION To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. METHODS Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. RESULTS Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. CONCLUSIONS Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available.
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Affiliation(s)
- Tadas Venskutonis
- Department of Dental and Oral Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gianluca Plotino
- Department of Endodontics, 'Sapienza' University of Rome, Rome, Italy.
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Lina Mickevičienė
- Department of Dental and Oral Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Møller L, Wenzel A, Wegge-Larsen AM, Ding M, Væth M, Hirsch E, Kirkevang LL. Comparison of images from digital intraoral receptors and cone beam computed tomography scanning for detection of voids in root canal fillings: an in vitro study using micro-computed tomography as validation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:810-8. [DOI: 10.1016/j.oooo.2013.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 02/19/2013] [Accepted: 03/05/2013] [Indexed: 11/16/2022]
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Vizzotto MB, Silveira PF, Arús NA, Montagner F, Gomes BPFA, Silveira HEDD. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J 2013; 46:870-6. [DOI: 10.1111/iej.12075] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 01/24/2013] [Indexed: 12/13/2022]
Affiliation(s)
- M. B. Vizzotto
- Department of Surgery and Orthopedics; Federal University of Rio Grande do Sul; Porto Alegre; RS; Brazil
| | - P. F. Silveira
- Department of Surgery and Orthopedics; Federal University of Rio Grande do Sul; Porto Alegre; RS; Brazil
| | - N. A. Arús
- Department of Surgery and Orthopedics; Federal University of Rio Grande do Sul; Porto Alegre; RS; Brazil
| | - F. Montagner
- Department of Conservative Dentistry; Federal University of Rio Grande do Sul; Porto Alegre; RS; Brazil
| | - B. P. F. A. Gomes
- Department of Restorative Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba; SP; Brazil
| | - H. E. D. da Silveira
- Department of Surgery and Orthopedics; Federal University of Rio Grande do Sul; Porto Alegre; RS; Brazil
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Bodanezi A, Munhoz EA, Capelozza ALÁ, Bernardineli N, Moraes IGD, Garcia RB, Bramante CM. Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth. J Appl Oral Sci 2013; 20:404-9. [PMID: 23032200 PMCID: PMC3881829 DOI: 10.1590/s1678-77572012000400003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 10/01/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. MATERIAL AND METHODS The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05). RESULTS Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings. CONCLUSIONS The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.
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Affiliation(s)
- Augusto Bodanezi
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil.
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Zogheib C, Naaman A, Sigurdsson A, Medioni E, Bourbouze G, Arbab-Chirani R. Comparative micro-computed tomographic evaluation of two carrier-based obturation systems. Clin Oral Investig 2012; 17:1879-83. [DOI: 10.1007/s00784-012-0875-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 10/23/2012] [Indexed: 01/22/2023]
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Demiralp KÖ, Kamburoğlu K, Güngör K, Yüksel S, Demiralp G, Uçok O. Assessment of endodontically treated teeth by using different radiographic methods: an ex vivo comparison between CBCT and other radiographic techniques. Imaging Sci Dent 2012; 42:129-37. [PMID: 23071962 PMCID: PMC3465754 DOI: 10.5624/isd.2012.42.3.129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 06/11/2012] [Accepted: 06/30/2012] [Indexed: 12/13/2022] Open
Abstract
Purpose To compare different radiographic methods for assessing endodontically treated teeth. Materials and Methods Root canal treatments were applied in 120 extracted mandibular teeth, which were divided into four groups: (1) ideal root canal treatment (60 teeth), (2) insufficient lateral condensation (20 teeth), (3) root canals filled short of the apex (20 teeth), (4) overfilled root canal treatment (20 teeth). The teeth were imaged using intraoral film, panoramic film, digital intraoral systems (CCD and PSP), CCD obtained with portable X-ray source, digital panoramic, and CBCT images obtained at 0.3 mm3 and 0.2 mm3 voxel size. Images were evaluated separately by three observers, twice. Kappa coefficients were calculated. The percentage of correct readings obtained from each modality was calculated and compared using a t-test (p<0.05). Results The intra-observer kappa for each observer ranged between 0.327 and 0.849. The inter-observer kappa for each observer for both readings ranged between 0.312 and 0.749. For the ideal root canal treatment group, CBCT with 0.2 mm3 voxel images revealed the best results. For insufficient lateral condensation, the best readings were found with periapical film followed by CCD and PSP. The assessment of teeth with root canals filled short of the apex showed the highest percentage of correct readings by CBCT and CCD. For the overfilled canal treatment group, PSP images and conventional periapical film radiographs had the best scores. Conclusion CBCT was found to be successful in the assessment of teeth with ideal root canal treatment and teeth with canals filled short of the apex.
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Affiliation(s)
- Kemal Özgür Demiralp
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Decurcio DA, Bueno MR, de Alencar AHG, Porto OCL, Azevedo BC, Estrela C. Effect of root canal filling materials on dimensions of cone-beam computed tomography images. J Appl Oral Sci 2012; 20:260-7. [PMID: 22666847 PMCID: PMC3894773 DOI: 10.1590/s1678-77572012000200023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 08/02/2011] [Indexed: 11/21/2022] Open
Abstract
Objective To evaluate the discrepancy of root canal filling (RCF) measurements obtained
from original root specimens and cone-beam computed tomography (CBCT) images. Material and Methods Seventy-two human maxillary anterior teeth were prepared up to an ISO #50 K-File
1 mm short of the apical foramen. Thus, the teeth were randomly divided into 8
groups, according to the root canal filling material: Sealapex®,
Sealapex®+gutta-percha points, Sealer 26®, Sealer
26®+gutta-percha points, AH PlusTM, AH PlusTM+gutta-percha points,
Grossman Sealer, and Grossman Sealer+gutta-percha points. After root canal
preparation and RCF, CBCT scans were acquired and the specimens were sectioned in
axial, sagittal and coronal planes. The RCF measurements were obtained in
different planes and thicknesses to determine the discrepancy between the original
root specimens (using a digital caliper) and the CBCT images (using the scanner's
proprietary software). One-way analysis of variance and Tukey tests were used for
statistical analyses. The significance level was set at α=5%. Results Measurements of the different endodontic filling materials were 9% to 100%
greater on the CBCT images than on the original root specimens. Greater RCF
dimensions were found when only sealers were used, with statistically significant
difference among the groups. Conclusions RCF dimensions were greater on CBCT images than on the original root specimens,
especially when only sealer was used.
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Important technical parameters are not presented in reports of intraoral digital radiography in endodontic treatment: recommendations for future studies. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:251-8.e1-6. [DOI: 10.1016/j.oooo.2012.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Revised: 01/20/2012] [Accepted: 02/22/2012] [Indexed: 01/08/2023]
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Zogheib C, Naaman A, Medioni E, Bourbouze G, Chirani RA. The quality of Thermafil obturations with different final apical tapers: a three-dimensional microcomputed tomographic comparative study. J Contemp Dent Pract 2012; 13:322-6. [PMID: 22918004 DOI: 10.5005/jp-journals-10024-1145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study is to evaluate the influence of final canal taper on the sealing ability of Thermafil by using microcomputed tomography (micro-CT). MATERIALS AND METHODS Fifty-four single-rooted teeth were instrumented to apical size 40 taper 4, 6 and 8%. Teeth were divided into three groups. All teeth were filled with Thermafil (Dentsply,Tulsa Dental Products). Using micro-CT, roots were scanned and volume measurements of voids at 1, 3 and 5 mm from the apex were calculated using specialized CT software. Measurements were analyzed statistically with ANOVA followed by Bonferroni multiple comparison correction. RESULTS Data analysis showed that 0.08 preparations provided better results than 0.06 and 0.04% tapered samples especially at 1 mm from the apex. Mean percentage of voids were significantly higher with Thermafil taper 0.06% (p = 0.05). None of the root canals filled teeth were gap free. Root canal preparations with bigger taper exhibited less voids than smaller tapered preparations. CLINICAL SIGNIFICANCE In our daily practice, enlarging the apical third (last 3 mm) of root canals to an 8% taper gives a better sealing ability and thus long-term success for our root canal obturations.
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Affiliation(s)
- Carla Zogheib
- Department of Endodontics, School of Dentistry Saint-Joseph University, 1104 2020 Beirut, Libanon.
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da Silveira PF, Vizzotto MB, Liedke GS, da Silveira HLD, Montagner F, da Silveira HED. Detection of vertical root fractures by conventional radiographic examination and cone beam computed tomography - anin vitroanalysis. Dent Traumatol 2012; 29:41-6. [DOI: 10.1111/j.1600-9657.2012.01126.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liang YH, Yuan M, Li G, Shemesh H, Wesselink PR, Wu MK. The ability of cone-beam computed tomography to detect simulated buccal and lingual recesses in root canals. Int Endod J 2012; 45:724-9. [DOI: 10.1111/j.1365-2591.2012.02025.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Liang YH, Li G, Shemesh H, Wesselink PR, Wu MK. The association between complete absence of post-treatment periapical lesion and quality of root canal filling. Clin Oral Investig 2012; 16:1619-26. [PMID: 22228024 PMCID: PMC3501171 DOI: 10.1007/s00784-011-0671-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 12/21/2011] [Indexed: 02/04/2023]
Abstract
AIM The technical quality of a root canal treatment is clinically judged by the apical extension and homogeneity of the filling material imaged by periapical radiographs (PA). The aim of this experiment was to evaluate the association between the technical quality of the root canal filling and treatment outcome. MATERIALS AND METHODS In 234 teeth (268 roots) that underwent root-canal treatment, the quality of the root canal filling as well as the outcome of the treatment were assessed with both PA and cone-beam computed tomography (CBCT) 2 years after treatment. Satisfactory root filling on PA was defined as 0-2 mm within the radiographic apex without voids; on CBCT scans, the apical end of the canal replaced the radiographic apex. The outcome predictors were analyzed using multivariate logistic regression. RESULTS At recall, periapical radiolucent areas were absent in 198 (74%) roots on PA and 164 (61%) roots on CBCT scans. The presence of preoperative periapical radiolucency and the quality of root filling and coronal restoration were identified by both PA and CBCT as outcome predictors (p < 0.01). Complete absence of post-treatment periapical radiolucency was observed in CBCT scans in 81% and 49% of satisfactory and unsatisfactory root fillings, respectively, as compared to 87% and 61% revealed by PA. CONCLUSION Satisfactory root fillings were associated with a favorable outcome, confirmed by both PA and CBCT. CLINICAL RELEVANCE The outcome of root canal treatment is improved once the filling is 0-2 mm from the apex, and no voids could be detected. Technical skills and performance of root canal filling procedures should be emphasized, and suitable methods should be developed in order to achieve more compacted filling materials without voids and at the correct length.
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Affiliation(s)
- Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
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Influence of apical taper on the quality of thermoplasticized root fillings assessed by micro-computed tomography. Clin Oral Investig 2011; 16:1493-8. [DOI: 10.1007/s00784-011-0638-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 11/08/2011] [Indexed: 10/15/2022]
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Liang YH, Li G, Wesselink PR, Wu MK. Endodontic Outcome Predictors Identified with Periapical Radiographs and Cone-beam Computed Tomography Scans. J Endod 2011; 37:326-31. [DOI: 10.1016/j.joen.2010.11.032] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 11/24/2010] [Accepted: 11/30/2010] [Indexed: 11/28/2022]
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Zaslansky P, Fratzl P, Rack A, Wu MK, Wesselink PR, Shemesh H. Identification of root filling interfaces by microscopy and tomography methods. Int Endod J 2011; 44:395-401. [PMID: 21219359 DOI: 10.1111/j.1365-2591.2010.01830.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To assess differences in observed cross-sectional areas of root canals and filling materials, as imaged by three microscopy and two tomography methods. METHODOLOGY Six roots filled with laterally compacted Gutta-percha and AH26 were scanned with phase-contrast enhanced microtomography in a synchrotron facility. Reconstructed virtual slices were compared with sections of both wet and acrylic-embedded roots, evaluated also by light and electron microscopy (EM) and laboratory-based microtomography (μCT). The different contrasts of Gutta-percha, voids, sealer and root dentine were identified and correlated. Inner canal border, outer Gutta-percha rim and the external margin of a void were manually delineated, and the enclosed areas were repeatedly measured by three observers. Interobserver and interimaging method differences were tested by 2-way anova with Bonferroni adjustments (P < 0.05). Percentages of Gutta-percha-filled canal areas (PGP) were determined. RESULTS Phase-contrast enhanced microtomography revealed internal interfaces and detailed 3D volumes of accentuated voids as well as micrometre-sized particles and gaps within the treated roots. Overestimates in the cross-sectional areas were obtained by light microscopy, whereas underestimates were obtained by μCT and EM. Differences exceeded 40%; however, PGP values by all methods were within 5% for the same slice. Differences between observers were sometimes significant, but they were not method related (<3%). CONCLUSIONS Phase-contrast enhanced microtomography is a powerful non-destructive ex vivo investigation method for studying the interfaces within root canals and filling materials at a micrometre resolution. The method does not require damage-prone sectioning/polishing during sample preparation procedures. Caution should be used when quantifying the extent of Gutta-percha in root fillings by measurements using μCT, light and EM.
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Affiliation(s)
- P Zaslansky
- Department of Biomaterials, Max-Planck Institute of Colloids and Interfaces, Potsdam, Germany.
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Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G. Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. J Forensic Sci 2010; 56 Suppl 1:S77-82. [PMID: 21182523 DOI: 10.1111/j.1556-4029.2010.01633.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Secondary dentine is responsible for a decrease in the volume of the dental pulp cavity with aging. The aim of this study is to evaluate a human dental age estimation method based on the ratio between the volume of the pulp and the volume of its corresponding tooth, calculated on clinically taken cone beam computed tomography (CBCT) images from monoradicular teeth. On the 3D images of 111 clinically obtained CBCT images (Scanora(®) 3D dental cone beam unit) of 57 female and 54 male patients ranging in age between 10 and 65 years, the pulp-tooth volume ratio of 64 incisors, 32 canines, and 15 premolars was calculated with Simplant(®) Pro software. A linear regression model was fit with age as dependent variable and ratio as predictor, allowing for interactions of specific gender or tooth type. The obtained pulp-tooth volume ratios were the strongest related to age on incisors.
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Affiliation(s)
- Hazha Star
- Forensic Odontology Department, Katholieke Universiteit Leuven, Belgium
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Bodanezi A, Munhoz EDA, Bernardineli N, Capelozza ALA, de Moraes IG, Bramante CM. Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids. Braz Dent J 2010; 21:142-7. [PMID: 20640361 DOI: 10.1590/s0103-64402010000200009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 03/16/2010] [Indexed: 11/21/2022] Open
Abstract
The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5% significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.
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Affiliation(s)
- Augusto Bodanezi
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil.
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