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Yatabe M, Kripfgans O, Chan HL, Xu J, Cook J, Soki F. Ultrasonography as an additional tool to localize impacted canines. Oral Radiol 2024:10.1007/s11282-024-00769-z. [PMID: 39126535 DOI: 10.1007/s11282-024-00769-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
Canine impaction is a common dental anomaly that requires a multidisciplinary approach, from diagnosis to treatment. The regular two-dimensional (2D) radiographs are able to visualize if the tooth is impacted, but unable to specifically localize it, and determine if there are any root resorptions associated to it. The cone-beam computed tomography (CBCT) is able to three-dimensionally determine its location, aiding to the diagnosis and treatment plan. The major disadvantage is the amount of radiation that is added to the patient and can be even more significant in pediatric patients. The intra-oral ultrasound (io-US) is a new non-invasive and non-radiating real-time chairside imaging method that has the potential to aid in locating the impacted tooth. This paper presents 4 cases that required a CBCT for the location and treatment planning of impacted maxillary canines and were also scanned with intra-oral ultrasound. The images were then compared to the CBCT exam for validation of the new method. Through these cases, we highlight the capability of the io-US to locate the impacted canines. Other advantages of io-US might include evaluation of soft tissue thickness and vasculature that are important for surgical planning and execution.
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Affiliation(s)
- Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA.
| | - Oliver Kripfgans
- Department of Radiology, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Division of Periodontology, The Ohio State University, Columbus, OH, USA
| | - Jennifer Xu
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Jade Cook
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Fabiana Soki
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
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Paknahad M, Karimnezhand Khas R, Hasani M. Comparison of Superior Semicircular Canal Bone Thickness and Patterns in Unilateral and Bilateral Cleft Patients and Normal Controls: A CBCT Study. Cleft Palate Craniofac J 2024; 61:1172-1178. [PMID: 37073078 DOI: 10.1177/10556656231165189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Superior Semicircular Canal Dehiscence (SSCD) is a recently-defined developmental defect may be associated with several craniofacial anomalies such as Cleft Lip/Palate (CLP). The present study aimed to compare subjects with unilateral and bilateral CLP and normal controls in terms of Superior Semicircular Canal (SSC) bone thickness and pattern. A total of 238 Cone Beam Computed Tomography (CBCT) images were collected from 52 unilateral Cleft Lip and Palate (UCLP) subjects (104 temporal bones) and 38 Bilateral Cleft Lip and Palate (BCLP) (76 temporal bones) subjects and 148 healthy controls (296 temporal bones). The SSC bone thickness was measured twice and validated by a maxillofacial radiologist. The samples were then classified into five categories based on bone thickness: papyraceous or thin, normal, thick, pneumatized, and dehiscence. After all, the UCLP, BCLP, and normal control groups were compared concerning the SSC pattern and thickness. The results revealed no significant difference among the three groups regarding the SSC pattern and thickness based on gender. The SSC patterns (P value = .001) and SSC thickness (0.01) were strongly correlated to the cleft type. The thinnest bone thickness and the highest incidence of SSCD were observed among the subjects with BCLP. The results showed a significant association between the SSC patterns and SSC thickness and the study groups.
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Affiliation(s)
- Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahvash Hasani
- Oral & Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Mareque-Bueno MS, Nagendrababu V, Dummer PMH, Ruíz-Piñón M, Arias-Moliz T, Uroz-Torres D, Garrido-Parada S, Martín-Biedma B, Castelo-Baz P. A retrospective clinical study to compare the ability of cone-beam computed tomographic images and periapical radiographs to reveal cracked teeth, split teeth, and teeth with vertical root fractures. J Am Dent Assoc 2024; 155:614-623.e2. [PMID: 38795077 DOI: 10.1016/j.adaj.2024.04.009] [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: 02/27/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND This retrospective clinical study aimed to compare the sensitivity of cone-beam computed tomographic (CBCT) images and periapical (PA) radiographs to reveal cracked teeth, split teeth, and teeth with vertical root fractures (VRFs). METHODS The authors included 98 patients (98 teeth) diagnosed with a longitudinal tooth fracture (LTF) (cracked tooth, split tooth, VRF) through direct visualization after extraction and with comprehensive clinical and radiographic records. They collected demographic, clinical, and radiographic data. The authors evaluated PA radiographs and CBCT images to identify fractures, fracture lines, and the different patterns of bone loss associated with these teeth. They used the McNemar test to compare PA radiographs and CBCT scans when assessing bone loss. They used the Fisher test to determine statistical relationships between fracture types and demographic, clinical, and radiologic traits. They used an analysis of variance test to compare patient age with fracture types. RESULTS CBCT images were significantly more effective (P < .05) in detecting bone loss patterns associated with LTFs than with PA radiographs, with 71% of cases detected via CBCT images compared with 42% via radiographs. Mean age was significantly greater (P < .05) in patients with teeth with VRFs than in patients with split teeth. A significant relationship was observed between the type of fracture and the following variables: root canal treatment (split, VRF, P = .002), deep probing depth (≥ 5 mm) (VRF, P = .026), and having more than 8 teeth extracted from the mouth (VRF, P = .032). Overall, there was a significant difference (P < .001) between the visualization of fracture lines (45% on PA radiographs, 65% on CBCT images). CONCLUSIONS CBCT scans provided more information on LTFs than PA radiographs, particularly in the identification of periradicular bone changes. PRACTICAL IMPLICATIONS CBCT imaging can assist in making the clinical diagnosis of LTFs through observation of bone loss patterns, providing more information than PA radiographs.
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Carney KA, Colloc TNE, Kilgariff JK. Management of rarely seen internal tunnelling root resorption associated with a maxillary permanent incisor. Br Dent J 2024; 236:955-961. [PMID: 38942857 PMCID: PMC11213701 DOI: 10.1038/s41415-024-7504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 06/30/2024]
Abstract
This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.
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Affiliation(s)
- Kirsty A Carney
- Post Dental Core Training Fellow, Dundee Dental Hospital and Research School, Dundee, Scotland, UK.
| | - Thibault N E Colloc
- Clinical Lecturer and Honorary Specialty Registrar in Endodontics, Dundee Dental Hospital and Research School, Dundee, Scotland, UK
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and Research School, Dundee, Scotland, UK
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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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Boveda C, Kishen A, Millan B, Camejo MV, Gomez-Sosa JF. Pericervical Dentin Metrics in Mandibular First Molars Determined with Digital Periapical Radiography and Cone-beam Computed Tomography. J Endod 2024; 50:637-643. [PMID: 38360092 DOI: 10.1016/j.joen.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Pericervical root dentin is decisive for the long-term mechanical integrity of root-filled teeth. Current treatment protocol does not include a customized step to determine the pretreatment residual pericervical root dentin. OBJECTIVE To determine and compare the residual root dentin and canal width using digital periapical radiography (DPR) and cone-beam computed tomography (CBCT) at the apical limit of the pericervical area (PCA) in mandibular first molars. METHODS DPR and CBCT images of 60 patients with age between 22 and 76 years were used to determine (a) the mesiodistal widths of the root canal (pericervical dimensions [PCL]-C) and the root (PCL-R) of mandibular first molars at the apical limit of the PCA and (b) the intracanal distance from the apical limit of the PCA to the radiographic apex (intracanal distance [ICD]). The correlation between the PCL and ICD measurements obtained from DPR and CBCT were evaluated. RESULTS Values between 0.10-0.80 mm and 0.00-1.10 mm were obtained for PCL-C using DPR and CBCT respectively (95% CI). The PCL values between 0.90-2.30 mm and 0.00-2.30 mm were obtained from DPR and CBCT respectively (95% CI). The ICD ranged between 4.6-12.3 mm in DPR and 4.40-12.0 mm in CBCT (95% CI). The comparative analysis showed differences from -0.9 to 0.5 mms for PCL and -2.00 to 1.5 mms for ICD between DPR and CBCT techniques respectively. CONCLUSION The PCL and ICD determined from DPR and CBCT provided the pericervical dentin metrics that could be utilized clinically as a guideline for decision-making in endodontic treatment.
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Affiliation(s)
- Carlos Boveda
- Faculty of Dentistry, Universidad Central de Venezuela, Caracas, Venezuela.
| | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Health System, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Beatriz Millan
- Faculty of Dentistry, Universidad Central de Venezuela, Caracas, Venezuela
| | - María V Camejo
- Faculty of Dentistry, Universidad Central de Venezuela, Caracas, Venezuela
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Liu J, Zhao X, Liu Y, Dong N, Zhang X. Prevalence and anatomic associations of middle mesial canals and isthmi in mandibular first molars: A CBCT-based study in a Northern Chinese population. AUST ENDOD J 2024; 50:69-77. [PMID: 37902140 DOI: 10.1111/aej.12807] [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: 08/25/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 10/31/2023]
Abstract
This study investigated the prevalence of the middle mesial canal (MMC) and isthmus in a northern Chinese subpopulation using cone-beam computed tomography (CBCT). CBCT images of 1060 mandibular first molars (MFMs) were analysed. Data analysis was performed using the chi-square test, t-test, and multiple logistic regression analysis (p < 0.05). The prevalence of MMC and isthmus was 15.2% and 40.6%, respectively. The average dentinal thickness in the danger zone was 1.61 ± 0.14 mm. Patients younger than 40 years were two times more likely to have MMC (odds ratio [OR] = 2.204). Additionally, for every 1 mm reduction in the MB-ML orifice distance, the likelihood of detection of MMC in MFM nearly doubled (OR = 1.738). Furthermore, MFMs with MB-ML isthmus were five times more likely to exhibit MMC than those without it (OR = 4.756). The findings revealed that the prevalence of MMC and isthmus in MFMs is high and suggested that anatomical and demographic variables can serve as valuable indicators for clinicians in anticipating their presence.
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Affiliation(s)
- Jiaojiao Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiangyu Zhao
- Department of Oral Emergency, Shenyang Stomatological Hospital, Shenyang, China
| | - Ying Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Nannan Dong
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiaodong Zhang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Mustafa M, Batul R, Karobari MI, Alamri HM, Abdulwahed A, Almokhatieb AA, Hashem Q, Alsakaker A, Alam MK, Ahmed HMA. Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review. BMC Oral Health 2024; 24:343. [PMID: 38493123 PMCID: PMC10944621 DOI: 10.1186/s12903-024-04101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Consultant Endodontics, Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Ahmed A Almokhatieb
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Qamar Hashem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Abdullah Alsakaker
- Consultant endodontist, Department of endodontics, Prince Abdulrahman Advanced Dental Institute, Ministry of defence, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Kim YM, Choi HK, Kim JE, Han JJ, Huh KH. Multislice computed tomography demonstrating mental nerve paresthesia caused by periapical infection: A case report. Imaging Sci Dent 2024; 54:115-120. [PMID: 38571774 PMCID: PMC10985528 DOI: 10.5624/isd.20230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 04/05/2024] Open
Abstract
Components derived from an infected lesion within the bone can spread through various passages in the mandible, particularly via the mental foramen. Radiologically, the spread of infection is typically nonspecific and challenging to characterize; however, multislice computed tomography (MSCT) can effectively detect pathological changes in soft tissues and the bone marrow space. This report describes the case of a 55-year-old woman who experienced mental nerve paresthesia due to a periapical infection of the right mandibular second premolar. MSCT imaging revealed increased attenuation around the periapical lesion extending into the mandibular canal and loss of the juxtamental foraminal fat pad. Following endodontic treatment of the tooth suspected to be the source of the infection, the patient's symptoms resolved, and the previous MSCT imaging findings were no longer present. Increased bone marrow attenuation and obliteration of the fat plane in the buccal aspect of the mental foramen may serve as radiologic indicators of inflammation spreading from the bone marrow space.
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Affiliation(s)
- Yong-Min Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ho-Keun Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Joon Han
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Ferrari CH, de Carvalho LS, Rocha CT, Abu Hasna A. Correlation between Tooth Position Parameters and Apical Fenestration: A Cone-Beam Computed Tomography Study. Methods Protoc 2024; 7:14. [PMID: 38392688 PMCID: PMC10893403 DOI: 10.3390/mps7010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to assess the relationship between apical fenestration-a defect in the alveolar bone involving the root apex-and tooth position in all tooth groups, excluding the third molars, utilizing cone-beam computed tomography (CBCT) images. A total of 800 CBCT scans (400 maxillary and 400 mandibular) from patients undergoing various treatments were examined by a single professional (radiologist and endodontist). Statistical analyses, including the chi-square test or Fisher's exact test, were conducted using R software 2.7.3 (R Foundation, Vienna, Austria). Results indicated a significant association (p ≤ 0.05) between apical fenestration and tooth position. In the upper teeth, apical fenestrations were notably present in the mesio-buccal (17.17%) and disto-buccal (11.07%) roots of the first molars. Conversely, apical fenestrations in the lower teeth were relatively less frequent. The study revealed a negative correlation between apical fenestration and mesial inclination, rotation, and extrusion in the upper teeth. However, a positive correlation was observed between apical fenestration and lingual inclination in the upper teeth. In conclusion, this study illuminates the distribution of apical fenestration and its correlation with tooth positions, offering insights into factors influencing this defect in dental anatomy. The findings enhance our understanding of nuanced relationships between tooth position and apical fenestration in the upper and lower dental arches.
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Affiliation(s)
- Carlos Henrique Ferrari
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, SP, Brazil (C.T.R.)
| | - Lara Steffany de Carvalho
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, SP, Brazil;
| | - Caroline Trefiglio Rocha
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, SP, Brazil (C.T.R.)
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, SP, Brazil (C.T.R.)
- School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador
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Ríos-Osorio N, Quijano-Guauque S, Briñez-Rodríguez S, Velasco-Flechas G, Muñoz-Solís A, Chávez C, Fernandez-Grisales R. Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications. Restor Dent Endod 2024; 49:e1. [PMID: 38449497 PMCID: PMC10912545 DOI: 10.5395/rde.2024.49.e1] [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: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024] Open
Abstract
The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.
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Affiliation(s)
- Néstor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sara Quijano-Guauque
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sandra Briñez-Rodríguez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Gustavo Velasco-Flechas
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | | | - Carlos Chávez
- Postgraduate Endodontics Department, IMED, Guadalajara, México
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12
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Behrouzi E, Abesi F, Ghorbani H, Gholinia H. Association between gubernacular canals characteristics and teeth eruption status: a cone-beam computed tomography study. J Clin Exp Dent 2024; 16:e145-e150. [PMID: 38496806 PMCID: PMC10943672 DOI: 10.4317/jced.61169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/18/2023] [Indexed: 03/19/2024] Open
Abstract
Background There have been few studies that have evaluated the imaging characteristics of the gubernacular canal. Additionally, it is important to understand the role of this structure and its relationship with tooth erupt. Therefore, the objective of this study was to investigate the association between gubernacular canal features and teeth eruption status on cone-beam computed tomography (CBCT) images. Material and Methods In this cross-sectional study, 150 CBCT images were obtained from patients referred to a maxillofacial radiology clinic in Babol, northern Iran, in 2021. Eruption status (normal, delayed, and impacted) and the presence of the gubernacular canal were recorded. If the gubernacular canal was detected, its opening site in the alveolar crest (buccal, lingual, and central) and its attachment site to the dental follicle (usual, unusual) were further assessed. Results Gubernacular canal was observed in 133 (88.7%) of the total 150 CBCT images. Also, 41 cases (27.3%) had impacted teeth. The detection rate of the gubernacular canal in the normal, delayed, and impacted eruption of teeth was 92.1% (n=93), 75.0% (n=6), and 82.9% (n=34), respectively (p=0.135). Opening the gubernacular canal in the alveolar crest was not associated with teeth eruption status. Also, unusual attachment sites of the gubernacular canal to dental follicles were mostly seen in abnormal eruptions. Conclusions According to the findings, observing the presence of the gubernacular canal on CBCT may not help anticipate teeth eruption problems. Key words:Gubernacular canal, Cone-beam computed tomography, Tooth eruption.
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Affiliation(s)
- Emad Behrouzi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Farida Abesi
- Dental Materials Research Center, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Hakimeh Ghorbani
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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13
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Jain A, Shil M, Sreepradha C, Rai S, Kaur I, Banka A. A Review on Cone-Beam Computed Tomography and its Application in Dentistry. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S38-S40. [PMID: 38595423 PMCID: PMC11000885 DOI: 10.4103/jpbs.jpbs_741_23] [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: 08/25/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 04/11/2024] Open
Abstract
Cone-beam computed tomography (CBCT), which has benefits over traditional radiography in this age of cutting-edge technology, has become increasingly popular in oral radiology. The utilization of CBCT is experiencing significant growth in several dental specialties, mainly for diagnostic purposes and treatment planning. Image acquisition and 3D imaging have helped the clinical use of cone-beam technology. The equipment has a user-friendly interface, minimum image distortion, and images compatible with many planning and simulation software applications. The present literature review aims to discuss CBCT and its various applications in dentistry.
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Affiliation(s)
- Arvind Jain
- Department of Conservative Dentistry and Endodontics, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Malabika Shil
- Oral and Maxillofacial Radiologist, Nidaan Diagnostic Centre, Pune, Maharashtra, India
| | - C Sreepradha
- Department of Oral Medicine and Radiology, GDCRI, Bellary, Karnataka, India
| | - Sajni Rai
- Department of Prosthodontics, Crown and Bridge, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Mangalore, Karnataka, India
| | - Impreet Kaur
- Pedodontics and Preventive Dentistry, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Aanchal Banka
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, KIIT University, Patia, Bhubaneswar, India
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14
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Heller ZA, Hogge M, Ragan MR, Portnof JE. Applications of Cone Beam Computed Tomography Scans in Dental Medicine and Potential Medicolegal Issues. Dent Clin North Am 2024; 68:55-65. [PMID: 37951637 DOI: 10.1016/j.cden.2023.07.009] [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: 11/14/2023]
Abstract
A cone beam central tomography (CBCT) scan produces images in orthogonal and non-orthogonal with great spatial resolution. When a dental health care practitioner (DHP) orders a CBCT scan, they should consider if it is truly indicated, as CBCT scans carry up to four times the dosage of radiation compared to panoramic radiographs. Any diagnostic imaging obtained of a patient should include a formal interpretive report commenting on the findings within the imaging. Ordering of limited field of view (FOV) CBCT scans and failing to report on abnormal findings present outside of the region of interest (ROI) is a potential medicolegal issue.
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Affiliation(s)
- Zachary A Heller
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA.
| | - Maritzabel Hogge
- Department of Maxillofacial Medicine, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Michael R Ragan
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Jason E Portnof
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA; Private Practice, 9980 North Central Park Boulevard, Suite 113, Boca Raton, FL 33428, USA
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15
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Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. Saudi Dent J 2023; 35:780-784. [PMID: 38025595 PMCID: PMC10658366 DOI: 10.1016/j.sdentj.2023.07.005] [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: 04/09/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. AIM To understand the importance of root morphology in endodontic treatment. METHODOLOGY A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. RESULTS CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. CONCLUSION The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.
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Affiliation(s)
- Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudia Arabia
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16
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Yazdizadeh M, Alavinezhad P, Sadrishahrezaei A, Sharifishoshtari S. Root canal morphology of mandibular first molars: Comparison of the diagnostic accuracy of cone-beam computed tomography and the sectioning technique. Dent Res J (Isfahan) 2023; 20:103. [PMID: 38020262 PMCID: PMC10630543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 05/21/2023] [Accepted: 07/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background A successful endodontic treatment requires a comprehensive knowledge of the root canal morphology. This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) and the sectioning technique for the assessment of mandibular first molar (MFM) root canal morphology. Materials and Methods In this in vitro, experimental study, 48 eligible MFMs were mounted in 12 blocks (groups of 4) made of acrylic resin and sheep bone powder and underwent CBCT. Next, the teeth were mounted in transparent self-cure acrylic blocks, and their roots were sectioned at three points with 3 mm intervals. Images underwent multiplanar reconstruction in NNT Viewer software and were analyzed by one radiologist with the cooperation of an endodontist. The sections were also evaluated by an endodontist under a stereomicroscope (gold standard). The frequency and percentage of single-canal, and two-canal roots were determined by each technique. The agreement between CBCT and the Gold standard was analyzed by calculating the kappa coefficient (P < 0.05). Results The diagnostic accuracy of CBCT for the assessment of the MFM root canal morphology was 80% on the mesial surface, 99% in the distal surface, and 96% in total. In the mesial surface, 94.2% of two-canal roots and 66.7% of single-canal roots were correctly detected by CBCT. These values were 100% and 97.4% in the distal surface, and 95.2% and 95.8% in total, respectively. A significant agreement was noted between CBCT and the Gold standard with κ =0.412 for the mesial, 0.939 for the distal, and 0.907 for the total surfaces (P < 0.001). Conclusion CBCT can be reliably used for the assessment of the complex root canal morphology of MFMs when other modalities fall short.
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Affiliation(s)
- Mohammad Yazdizadeh
- Department of Endodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parniyan Alavinezhad
- Department of Endodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abtin Sadrishahrezaei
- Department of Endodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sanaz Sharifishoshtari
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ahmed J, Gupta A, Shenoy N, Sujir N, Muralidharan A. Prevalence of Incidental Maxillary Sinus Anomalies on CBCT Scans: A Radiographic Study. Diagnostics (Basel) 2023; 13:2918. [PMID: 37761284 PMCID: PMC10528184 DOI: 10.3390/diagnostics13182918] [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: 08/18/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant (p = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.
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Affiliation(s)
| | | | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal 575001, Karnataka, India; (J.A.); (A.G.); (N.S.); (A.M.)
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Mathew AI, Lee SC, Ha WN, Rossi-Fedele G, Doğramacı EJ. Cone-beam computed tomography-Predictors and characteristics of usage in Australia and New Zealand, a multifactorial analysis. AUST ENDOD J 2023; 49:247-255. [PMID: 35830370 DOI: 10.1111/aej.12663] [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: 01/18/2022] [Revised: 06/19/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Cone-beam computed tomography (CBCT) is an increasingly used imaging modality. This study aimed to identify the factors that predict its usage amongst endodontists in Australia and New Zealand and describe usage characteristics. Data were collected via an online questionnaire, with analysis including descriptive statistics, cross-tabulation and multifactorial modelling. Ninety-four endodontists completed the questionnaire who were using CBCT for 7 years (median), over half had a CBCT unit in practice, with most prescribing up to 10 scans/month and 55 using a small field of view. Sixty-eight participated in >5 h of CBCT education/year and a third received a specialist-prepared report. The number of prescriptions/month was significantly associated with on-site CBCT units (Exp B: 8.53; 95% CI: 1.46-49.86, p < 0.05) and the number of years of CBCT usage by participants (Exp B: 1.46; 95% CI: 1.17-1.84, p = 0.001). CBCT imaging in endodontics is a useful diagnostic aid to decision making and treatment planning, with widespread acceptance and usage.
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Affiliation(s)
- Abhishek Isaac Mathew
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Silvia C Lee
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - William Nguyen Ha
- Sydney Dental School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Esma J Doğramacı
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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19
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Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: A narrative review. Saudi Dent J 2023; 35:468-475. [PMID: 37520597 PMCID: PMC10373078 DOI: 10.1016/j.sdentj.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This review aimed to assess the incidence, anatomical characteristics, identification, and clinical management using conventional techniques and advanced tools to manage MMCs successfully. Methods Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references. Results The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures. Conclusion The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
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Affiliation(s)
- Raghavendra Penukonda
- Department of Endodontics, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Harshada Pattar
- Department of Oral Pathology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Phrabhakaran Nambiar
- Head of the Department, Department of Oral Biology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
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20
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Tartuk GA, Kaya S. Incidence of missed middle mesial canal in endodontically treated mandibular molar teeth: A cone-beam computed tomography study. Niger J Clin Pract 2023; 26:756-759. [PMID: 37470649 DOI: 10.4103/njcp.njcp_743_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background In endodontic treatment, the aim is to completely determine, shape, and fill all root canals in a three-dimensional way. Missed canals lead to treatment failure. In mandibular molars, there may be an extra canal called the middle mesial canal between the mesiobuccal and mesiolingual canals. Aim The aim of this study was to evaluate the prevalence of missed middle mesial canals in root canal-treated mandibular molar teeth. Materials and Methods In this study, cone-beam computed tomography (CBCT) images of 1054 patients were analyzed. We identified 121 endodontically treated mandibular molars and evaluated the prevalence of missed canals. Results Although 33.05% of the root canal-treated teeth did not have a middle mesial canal, this canal was detected in the other 66.94%; 97.53% of teeth with a middle mesial canal could not be detected by clinicians. Conclusion Clinicians performing endodontic treatment of mandibular molar teeth should not ignore the presence of the middle mesial canal. Thus, it is very important for clinicians to have sufficient information about the localization, morphology, and variations of the middle mesial canal.
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Affiliation(s)
- G A Tartuk
- Department of Endodontics, Diyarbakir Oral and Dental Health Hospital, Diyarbakır, Turkey
| | - S Kaya
- Department of Endodontics, Dicle University, Diyarbakır, Turkey
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Karobari MI, Iqbal A, Syed J, Batul R, Adil AH, Khawaji SA, Howait M, Khattak O, Noorani TY. Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study. BMC Oral Health 2023; 23:291. [PMID: 37189077 DOI: 10.1186/s12903-023-03002-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The clinician should have complete knowledge of the normal anatomy of the root as well as complexities in the root canal configuration for a better outcome, as missed or improper handling of the canal system can lead to the failure of an entire endodontic procedure. The present study aims to assess the morphology of roots and canals in permanent mandibular premolars in the Saudi subpopulation with a new classification system. METHODS The present study includes 1230 mandibular premolars (645 first premolars and 585-second premolars) from 500 CBCT images of the patients, including retrospective data. iCAT scanner system (Imaging Sciences International, Hatfield, PA, USA) was used to obtain the images; scanning of 8 × 8 cm images was performed at 120 KVp and 5-7 mA with a voxel size of 0.2 mm. The new method of classification presented by Ahmed et al. 2017 was used to record and classify the root canal morphology, followed by recording the differences regarding the age and gender of the patients. Comparison of canal morphology in lower permanent premolars and its association with gender and age of the patients was done by Chi-square test/ Fisher exact test; the significance level was set at 5% (p ≤ 0.05). RESULTS The left mandibular 1st and 2nd premolars with one root were 47.31%, with two roots were 2.19%. However, three roots (0.24%) and C-shaped canals (0.24%) were reported only in the left mandibular 2nd premolar. The right mandibular 1st and 2nd premolars with one root were 47.56%, with two roots were 2.03%. The overall percentage of the number of roots and canals in the first and second premolars 1 PM 1 (88.38%), 2 PM 1 B 1 L 1 (3.5%), 2 PM B 1 L 1 (0.65%), 1 PM 1-2-1 (3.08%), 1 PM 1-2 (3.17%), 1 PM 1-2-1-2 (0.24%), 3 PMMB 1 DB 1 L1 (0.48%). However, the C-shaped canals (0.40%) were reported in right and left mandibular second premolars. No statistically significant difference was reported between mandibular premolars and gender. A statistically significant difference was reported between mandibular premolars and the age of the study subjects. CONCLUSION Type I (1 TN 1) was the major root canal configuration in permanent mandibular premolars, which was higher among males. The CBCT imaging provides thorough details about the root canal morphology of lower premolars. These findings could support diagnosis, decision-making, and root canal treatment, for dental professionals.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Department of Conservative Dentistry & Endodontics, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Jamaluddin Syed
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Abdul Habeeb Adil
- Department of Community Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Sara Akili Khawaji
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Osama Khattak
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
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Wang Y, Xia W, Yan Z, Zhao L, Bian X, Liu C, Qi Z, Zhang S, Tang Z. Root canal treatment planning by automatic tooth and root canal segmentation in dental CBCT with deep multi-task feature learning. Med Image Anal 2023; 85:102750. [PMID: 36682153 DOI: 10.1016/j.media.2023.102750] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
Accurate and automatic segmentation of individual tooth and root canal from cone-beam computed tomography (CBCT) images is an essential but challenging step for dental surgical planning. In this paper, we propose a novel framework, which consists of two neural networks, DentalNet and PulpNet, for efficient, precise, and fully automatic tooth instance segmentation and root canal segmentation from CBCT images. We first use the proposed DentalNet to achieve tooth instance segmentation and identification. Then, the region of interest (ROI) of the affected tooth is extracted and fed into the PulpNet to obtain precise segmentation of the pulp chamber and the root canal space. These two networks are trained by multi-task feature learning and evaluated on two clinical datasets respectively and achieve superior performances to several comparing methods. In addition, we incorporate our method into an efficient clinical workflow to improve the surgical planning process. In two clinical case studies, our workflow took only 2 min instead of 6 h to obtain the 3D model of tooth and root canal effectively for the surgical planning, resulting in satisfying outcomes in difficult root canal treatments.
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Affiliation(s)
- Yiwei Wang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Wenjun Xia
- Shanghai Xuhui District Dental Center, Shanghai 200031, China
| | - Zhennan Yan
- SenseBrain Technology, Princeton, NJ 08540, USA
| | - Liang Zhao
- SenseTime Research, Shanghai 200233, China
| | - Xiaohe Bian
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Chang Liu
- SenseTime Research, Shanghai 200233, China
| | - Zhengnan Qi
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Shaoting Zhang
- Shanghai Artificial Intelligence Laboratory, Shanghai 200232, China; Centre for Perceptual and Interactive Intelligence (CPII), Hong Kong Special Administrative Region of China.
| | - Zisheng Tang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China.
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Abesi F, Yousefi MJ, Zamani M. Prevalence and anatomical characteristics of maxillary sinus septa: a systematic review and meta-analysis of cone-beam computed tomography studies. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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Wahane KD, Bansod AV, Mattigatti S, Mahaparale R, Rote YB, Wanjari MB. Cone-Beam Computed Tomography (CBCT) Analysis of an Unusual Configuration of the Upper First Molar With a C-shaped Canal With Apically Fused Roots: A Case Report. Cureus 2023; 15:e36474. [PMID: 37090297 PMCID: PMC10115750 DOI: 10.7759/cureus.36474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Lack of identification of the root canal results in root canal treatment failure, one of the most frequent causes of root canal treatment failure. To successfully treat root canals, it is crucial to have a detailed understanding of root canal configuration, including distinguishing traits and anatomical differences. The root canal in the C form arrangement is among the most important anatomical variances. Because of its distinctive highlight, the existence of fins or webs linking the different root canals - the C-shaped form of root canal has proven challenging to detect and manage. Any molar region may have this root canal arrangement, including the mandibular first molar, first premolar, and maxillary molars. Above all, mandibular second molars are where it is most usually discovered. This report discusses the uncommon maxillary first molar with an apically merged root. The importance of comprehending canal variations, which are C-shaped root canals, should be critically evaluated in light of the rise in the root canal treatment failure rate for the upper molars.
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Affiliation(s)
- Kapil D Wahane
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Anand V Bansod
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Sudha Mattigatti
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Rushikesh Mahaparale
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Yuvraj B Rote
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to Be University (KIMSDU), Karad, IND
| | - Mayur B Wanjari
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Johri S, Verma P, Tikku AP, Bains R, Kohli N. Effect of amniotic membrane and platelet-rich fibrin membrane on bone healing post endodontic surgery: An ultrasonographic, randomized controlled study. J Tissue Eng Regen Med 2022; 16:1208-1222. [PMID: 36401577 DOI: 10.1002/term.3362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/21/2022]
Abstract
The use of membrane barriers and bone grafting materials in endodontic surgery promotes healing by regeneration rather than repair by scar tissue. Due to its valuable regenerative and therapeutic properties, the human amniotic membrane can support ideal periapical rehabilitation and promote better healing after surgery. The current trial aimed to evaluate the amniotic membrane's healing potential and compare it with platelet-rich fibrin using color doppler sonography. The current study is a randomized, double-blinded, parallel-group, single-center study. Thirty-four systematically healthy individuals requiring endodontic surgery who fulfilled all inclusion and exclusion criteria were selected and randomly placed in two groups. Surgical curettage of the bony lesion was performed and filled with hydroxyapatite graft. Amniotic membrane (Group 1) and platelet-rich fibrin (Group 2) were placed over the bony crypt, and the flap was sutured back. The lesion's surface area and vascularity were the parameters assessed with ultrasound and color doppler. and observations: The groups found a significant difference in mean vascularity at 1 month and mean vascularity change from baseline to 1 month (p < 0.05). Mean surface area had no statistically significant difference between the groups. However, in terms of the percentage change in surface area, a significant difference was found from baseline to 6 months (p < 0.05). Amniotic membrane was a significantly better promoter of angiogenesis than platelet-rich fibrin in the current trial. The osteogenic potential of both materials was similar. However, the clinical application, availability, and cost-effectiveness of amniotic membrane support it as a promising therapeutic alternative in clinical translation. Further large-scale trials and histologic studies are warranted.
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Affiliation(s)
- Saumya Johri
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Promila Verma
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Aseem Prakash Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Rhythm Bains
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Neera Kohli
- Department of Radiodiagnosis, King George's Medical University, Lucknow, India
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External Cervical Resorption: A Volumetric Analysis on Evolution of Defects Over Time. J Endod 2022; 49:36-44. [DOI: 10.1016/j.joen.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
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Boubaris M, Cameron A, Love R, George R. Sphericity of periapical lesion and its relation to the novel CBCT periapical volume index. J Endod 2022; 48:1395-1399. [PMID: 36087762 DOI: 10.1016/j.joen.2022.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to assess the sphericity of periapical lesions and its relation to the cone beam computed tomography periapical volume index (CBCTPAVI). METHODS 261 periapical lesions were assessed using cone beam computed tomography images from InteleViewerTM. Three-dimensional analysis of the lesions was conducted using analytical imaging software Mimics ResearchTM. Lesion volume and surface area measurements were determined using the semi-automatic segmentation technique and these measurements were then used to determine lesion sphericity and CBCTPAVI score. One-way analysis of variance with post-hoc Tuckey test was used to assess for differences in sphericity among CBCTPAVI groups. RESULTS The mean sphericity of periapical lesions was 62%. Periapical lesions with larger CBCTPAVI scores were significantly less spherical than lesions with smaller CBCTPAVI scores. CONCLUSIONS Periapical lesions of endodontic origin are mostly semi-spherical in their spread and as CBCTPAVI score increases, sphericity decreases, indicating that larger lesions expand less uniformly compared with smaller lesions. Clinicians should be aware that lesions of increased volume, have less sphericity, and are thus elongated or stretched in one or more anatomical plane. This information will assist clinicians in planning and performing periapical surgery and may aid in differential diagnosis of radiolucent jaw lesions.
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Affiliation(s)
- Matthew Boubaris
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Andrew Cameron
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Robert Love
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Roy George
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
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Setzer FC, Kratchman SI. Present Status and Future Directions - Surgical Endodontics. Int Endod J 2022; 55 Suppl 4:1020-1058. [PMID: 35670053 DOI: 10.1111/iej.13783] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.
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Affiliation(s)
- F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - S I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Palczewska-Komsa MP, Gapiński B, Nowicka A. The Influence of New Bioactive Materials on Pulp–Dentin Complex Regeneration in the Assessment of Cone Bone Computed Tomography (CBCT) and Computed Micro-Tomography (Micro-CT) from a Present and Future Perspective—A Systematic Review. J Clin Med 2022; 11:jcm11113091. [PMID: 35683478 PMCID: PMC9181092 DOI: 10.3390/jcm11113091] [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: 03/18/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
The present paper is the first article providing a systematic literature review on the visualization of tertiary dentin influenced by modern bioactive materials in CBCT and micro-CT. Six database searches of studies on tertiary dentin visualization using CBCT produced 622 records in total, and the search of the studies on tertiary dentin using micro-CT produced 502 records in total. The results were thoroughly selected considering the inclusion criteria, and five research papers using CBCT and nine research papers using micro-CT for visualization of tertiary dentin were eventually qualified for the analysis. All the non-randomized and randomized studies presented good and high levels of quality evidence, respectively. Among the bioactive materials used, the most frequently analysed were: MTA, Biodentine dentin matrix hydrogel, Pro Root MTA, and EndoSequence root repair material. The highest thickness of the tertiary dentin was achieved after the use of MTA material in both imaging techniques. The remaining parameters had different results, taking into account the CBCT and micro-CT analysis. The possibilities of the qualitative and quantitative assessment of the particular parameters of tertiary dentin using CBCT and micro-CT techniques were presented and analysed. CBCT and micro-CT analyses can be useful in the assessment of tertiary dentin formed beneath the bioactive material applied during vital pulp treatment. The research argues that the presented results differ depending on the material applied to the pulp, the study duration (4–6 weeks), difference in teeth, species (rats, human), as well as the applied technique and differences in computer software used for the analysis.
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Affiliation(s)
- Mirona Paula Palczewska-Komsa
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland;
- Correspondence:
| | - Bartosz Gapiński
- Division of Metrology and Measurement Systems, Institute of Mechanical Technology, Poznan University of Technology, Jana Pawła II 24, 60-965 Poznań, Poland;
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland;
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Sharaan MES, Abdulla AY, Ragab MH. Assessment of the relationship of the distance between mandibular first and second molars with the inferior alveolar canal and cortical bone plate in an Egyptian subpopulation: a CBCT study. Braz Oral Res 2022; 36:e033. [PMID: 35352763 DOI: 10.1590/1807-3107bor-2022.vol36.0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of the current cone beam computed tomography (CBCT) study was to evaluate the proximity of mandibular first and second molar roots to the inferior alveolar canal (IAC) and mandibular cortex in an Egyptian subpopulation. Scans of 120 patients (480 molars, 960 roots) were obtained from the College of Dentistry database at the Suez Canal University, Egypt. Buccal and lingual bone plates and root thickness were measured at the specified resected root end 3 mm from the radiographic apex, and so was the proximity of the root apices to the IAC. Measurements of the right and left mandibular first and second molars were recorded for each root. Three examiners performed the measurements separately. ANOVA was used to compare the different roots. Bonferroni's post-hoc test was used for pair-wise comparisons when ANOVA was significant. The significance level was set at p ≤ 0.05. The findings displayed a closer proximity of the mandibular second molar apices to the IAC, as compared to the mandibular first molars. The mesial roots were at a shorter distance than the distal ones. Moreover, the mandibular second molars revealed the thickest total bone width including the root. So, it is beneficial for endodontists to be aware of the relation of the mandibular first and second molars to the surrounding cortical bone plates and the IAC before starting either nonsurgical or surgical endodontic treatment.
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Affiliation(s)
| | - Asmaa Yousry Abdulla
- Suez Canal University, College of Dentristry, Department of Oral Radiology, Ismailia,m Egypt
| | - Msi Hamdy Ragab
- Suez Canal University, College of Dentistry, Department of Endodontics, Ismailia, Egypt
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Dhillon JK, Ghosh S, Mathur VP. Root canal morphology of primary molars - A cone beam computed tomography (CBCT) study. Indian J Dent Res 2022; 33:14-17. [PMID: 35946238 DOI: 10.4103/ijdr.ijdr_748_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone-beam computed tomography (CBCT). Methods A retrospective cross-sectional study was performed, where CBCT scans of children less than 10 years of age taken for valid diagnostic purposes previously were considered and images were analyzed. The number of roots, root canals, and variations in morphology were recorded. Left-right symmetry was also noted. Results A total of 433 deciduous maxillary and mandibular primary molars were studied. It was observed that two separate roots with three separate canals were common in primary mandibular first molars, whereas two separate roots with two canals in each root were common in mandibular second primary molars. In primary maxillary molars, three separate roots with one canal each were the most common. Maxillary first molars (17.21%) and 17.35% second molars had fused distobuccal and palatal roots. It was observed that primary maxillary molars showed more left-right symmetry (86.7% in first molars and 82.7% in second molars) compared to primary mandibular molars (54.05% in first molars and 68% in second molars). Conclusions It was concluded that in both primary maxillary first and second molars, three separate roots, a mesiobuccal root, a distobuccal root, and a palatal root with one canal in each root, were the most common. Two separate roots with three separate canals were the most common in primary mandibular first molars, whereas two separate roots with two canals each in both roots were more common in mandibular second primary molars.
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Affiliation(s)
- Jatinder K Dhillon
- Department of Pediatric Dentistry, College of Dental Medicine, Nova Southeastern University, Florida, USA
| | - Sujoy Ghosh
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Vijay P Mathur
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research (CDER), All India Institute of Medical Sciences, New Delhi, India
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Iqbal A, Khattak O, Issrani R, Alonazi MA, Ali AH. Cone Beam Computed Tomography Evaluation of Root Morphology of the Premolars in Saudi Arabian Subpopulation. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Sharma G, Abraham D, Gupta A, Aggarwal V, Mehta N, Jala S, Chauhan P, Singh A. Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review. Imaging Sci Dent 2022; 52:1-9. [PMID: 35387097 PMCID: PMC8967488 DOI: 10.5624/isd.20210195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023] Open
Affiliation(s)
- Garima Sharma
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Dax Abraham
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Alpa Gupta
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Vivek Aggarwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Namrata Mehta
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Sucheta Jala
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Parul Chauhan
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Arundeep Singh
- Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Faridabad, Haryana, India
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Kalaitzoglou ME, Angelopoulos C, Lyroudia K, Lambrianidis T. Frequency of root fenestration in a Greek subpopulation: A cone beam computed tomography clinical study. AUST ENDOD J 2021; 47:580-591. [PMID: 34190384 DOI: 10.1111/aej.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/28/2021] [Accepted: 04/13/2021] [Indexed: 12/29/2022]
Abstract
This cone beam computed tomography (CBCT) study aimed to assess the root fenestration (RF) frequency in healthy, intact teeth and analyse their features in a Greek subpopulation. 432 CBCT scans were examined. 5486 teeth were evaluated for RF prevalence. RF prevalence and distribution were recorded for each jaw, tooth group, as well as patient age and sex. RF symmetry, distribution to the affected root surface and the effects of age and sex were evaluated. The prevalence of RF ranged from 0.57% (central incisors) to 7.18% (first premolars) and from 0.48% (second premolars) to 10.79% (lateral incisors) for the maxilla and the mandible, respectively. No symmetrical occurrence of RF was detected. Most RF patients presented one or two defects in both jaws. Types I and IV were the most prevalent in the maxilla, while Types III, II and V were the most prevalent in the mandible. No statistical difference was detected between different sexes and age groups (P > 0.05).
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Affiliation(s)
- Maria-Elpida Kalaitzoglou
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis & Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Kleoniki Lyroudia
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Lambrianidis
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Choi YJ, Lee C, Jeon KJ, Jang JT, Han SS. Canal configuration and root morphology of mandibular premolars using cone-beam computed tomography in a Korean population. Clin Oral Investig 2021; 26:3325-3332. [PMID: 34846559 DOI: 10.1007/s00784-021-04313-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate the anatomy of mandibular premolars from two perspectives-the canal configuration and radicular grooves-using cone-beam computed tomography (CBCT) in a large Korean population. MATERIALS AND METHODS CBCT images of mandibles acquired from March 2018 to December 2019 for dental treatment were randomly selected. In each image, the root canal of premolars was classified into 8 types according to the canal merging or diverging pattern and the number of apical foramens. The presence and the location of radicular grooves were also assessed. Statistical analysis was performed. RESULTS A total of 1463 first and 1448 s premolars from 732 patients (390 males, 342 females, mean age of 36.1 years) were evaluated. A single canal with one foramen predominated in both first (85.7%) and second (99.5%) premolars, while complete or partial multi-canals accounted for 14.3% and 0.5% of first and second premolars, respectively. The prevalence of radicular grooves was significantly higher in first premolars (13.2%) than in second premolars (0.5%) and in males (4.3%, n = 119) than in females (2.5%, n = 73). CONCLUSIONS Although most premolars were complete single canals, the first premolars showed a relatively higher number of complex canals compared to the second premolar. In addition, radicular grooves in mandibular premolars were significantly more common in male patients. CLINICAL RELEVANCE When planning the endodontic treatment of mandibular premolars, clinicians should be aware of their morphologic complexity, especially in the first premolar of male patients.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Ji-Taek Jang
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
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Baruwa AO, Martins JNR, Pereira B, Meirinhos J, Ordinola-Zapata R, Souza EM, Ginjeira A. Prevalence of periapical lesions, root canal treatments and restorations in teeth adjacent to implant- or tooth-supported crowns: A multi-centre cross-sectional study. Int Endod J 2021; 55:30-37. [PMID: 34676902 DOI: 10.1111/iej.13651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/14/2022]
Abstract
AIM To describe the prevalence of periapical lesions, root canal treatments and coronal restorations on teeth adjacent to either implant- or natural tooth-supported crowns using cone-beam computed tomography (CBCT) assessment compared to nonadjacent teeth. METHODOLOGY A total of 1249 CBCT volumes were screened by five pre-calibrated observers in 11 health centres. A step-by-step screening protocol was implemented and reviewed every 3 months, and mandatory setting characteristics were established for all CBCT scans using dedicated visualization software. Intra- and inter-rater reliability tests were conducted. The prevalence of periapical lesions, root canal treatments and coronal restorations was recorded on both teeth adjacent and nonadjacent to implant- (predictor 1) or natural tooth-supported crowns (predictor 2). A binary logistic model (Generalizing Estimating Equations test) was used to verify whether the prevalence of periapical lesion, root canal filling and the tooth restorative status are altered when the assessed tooth is adjacent or not to an implant-supported crown (predictor 1); or to a natural tooth-supported crown (predictor 2). Odds ratio and confidence intervals for the dependent variables at both predictors were obtained. The significance level was set at .05. RESULTS A global sample of 22 899 teeth was included. Compared to nonadjacent teeth, the prevalence of periapical lesion, root canals treatments and restorative procedures when adjacent to implant-supported crowns was 10.7%, 19.6% and 22.9% higher, respectively, and when adjacent to tooth-supported crowns was 19.3%, 35.6% and 37.4% higher respectively. These results were significant only for variables root canal filling and coronal restoration (p < .0001). Odds ratio to present root canal treatment is 2.57 times higher (CI 1.95-3.39, p = .0001) when the tooth is adjacent to implant-supported crown and 4.39 times (CI 3.49-5.53, p = .0001) when adjacent to tooth-supported crown, whilst for restorative procedure, the odds are, respectively, 1.63 (CI 1.29-2.06, p = .0001) and 2.30 (CI 1.92-2.76, p = .0001). CONCLUSIONS Teeth adjacent to both implant- and natural tooth-supported crowns were associated with a higher frequency of root canal filling and coronal restorations.
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Affiliation(s)
- Abayomi O Baruwa
- 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 Bioquimica 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
| | - Beatriz Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - João Meirinhos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Ronald Ordinola-Zapata
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Erick M Souza
- Departmento de Odontologia II, Universidade Federal do Maranhão, São Luís, Brazil
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Grupo de Investigação em Bioquimica 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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de Oliveira Pinto MG, Melo SLS, Suassuna FCM, Marinho LE, Leite JBDS, Batista AUD, Bento PM, Melo DP. Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images. Dentomaxillofac Radiol 2021; 50:20200563. [PMID: 33565884 DOI: 10.1259/dmfr.20200563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception. METHODS Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05. RESULTS The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe". CONCLUSION Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.
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Affiliation(s)
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical & Diagnostic Sciences, School of Dentistry, Oregon Health & Science University, Portland, USA
| | | | - Luiz Eduardo Marinho
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | | | | | - Patrícia Meira Bento
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | - Daniela Pita Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
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Cunliffe J, Al-Hadidi A, Sawair FA, Mahasneh SA. Comparison of imaging modalities in the diagnosis of external cervical resorption (ECR): an in-vitro study. Odontology 2021; 110:157-163. [PMID: 34448951 DOI: 10.1007/s10266-021-00651-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/18/2021] [Indexed: 01/25/2023]
Abstract
External cervical resorption is a pathological condition affecting the cervical margins of teeth. Due to the increased prevalence and the area it affects, it can be easily misdiagnosed. The ability of clinicians to diagnose ECR and subcategorise the lesions using periapical radiographs and cone beam-CT scans has not been investigated in-depth. This study aims to assess if diagnostic ability to detect ECR lesions with the two modalities was different and if there was a change in the diagnosis when CBCT was used. A human skull, including the mandible was used for this study. The teeth were randomly allocated to the different subcategories, then pre and post-preparation radiographs with CBCT were taken. Statistical analysis was done using IBM SPSS version 16.0 (SPSS Inc., Chicago, IL, USA). The study sample was composed of 60 participants, the overall sensitivity of intraoral radiographs was significantly lower than CBCT. When the participants were told the radiograph and the CBCT were of the same tooth 60% said they would change their diagnosis. The use of intraoral radiographs alone might not be enough to identify and correctly diagnose ECR lesions. CBCT can give a better idea about the nature and the extent of the lesion.
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Affiliation(s)
- Joanne Cunliffe
- Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - Abeer Al-Hadidi
- School of Dentistry, The University of Jordan, Amman, 11942, Jordan
| | - Faleh A Sawair
- School of Dentistry, The University of Jordan, Amman, 11942, Jordan
| | - Sari A Mahasneh
- Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, M13 9PL, UK. .,School of Dentistry, The University of Jordan, Amman, 11942, Jordan.
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Boubaris M, Chan KL, Zhao W, Cameron A, Sun J, Love R, George R. A Novel Volume-based Cone-beam Computed Tomographic Periapical Index. J Endod 2021; 47:1308-1313. [PMID: 33984376 DOI: 10.1016/j.joen.2021.04.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/04/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the variations in the volume of periapical lesions scored using a cone-beam computed tomographic periapical index (CBCTPAI) and to develop a new volume-based periapical index. METHODS Cone-beam computed tomographic images were obtained from InteleViewer (Intelerad Medical Systems Incorporated, Montreal, Canada). Teeth with a periapical radiolucency or with a history of endodontic treatment were included in this study. Using 3-dimensional medical imaging processing software (Mimics Research; Materialise NV, Leuven, Belgium), the maximum diameter of 273 periapical lesions and their corresponding CBCTPAI score was determined. The software was then used to determine the volume of the lesions using a semiautomatic segmentation technique. RESULTS There was a substantial variation in the volume for CBCTPAI scores 3, 4, and 5, which was demonstrated by the variance and range, thus making it difficult to use the current CBCTPAI as a method to predict volume and treatment outcomes. A new index, the cone-beam computed tomographic periapical volume index (CBCTPAVI), was developed using partition classification analysis. The results for the new index demonstrated high levels of sensitivity, specificity, precision, and area under the curve, all at 0.90 or more, except 1 sensitivity for CBCTPAVI 1 at 0.875. Overall, the accurate classification rate was 98.169%, and the root mean square error rate was low at 0.07. CONCLUSIONS The proposed CBCTPAVI will allow clinicians to classify lesions based on their true 3-dimensional size, accurately assess healing of lesions, and predict treatment outcomes.
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Affiliation(s)
- Matthew Boubaris
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Keen Long Chan
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Wei Zhao
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Andrew Cameron
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Australia
| | - Robert Love
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Roy George
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.
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Conejo J, Dayo AF, Syed AZ, Mupparapu M. The Digital Clone: Intraoral Scanning, Face Scans and Cone Beam Computed Tomography Integration for Diagnosis and Treatment Planning. Dent Clin North Am 2021; 65:529-553. [PMID: 34051929 DOI: 10.1016/j.cden.2021.02.011] [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: 10/21/2022]
Abstract
The purpose of this article is to synthesize different technologies that are available for the creation of a virtual patient, "the digital clone" because the data can be used for diagnosis as well as treatment planning. The role of facial scans, 3-dimensional intraoral scans as well as the cone beam computed tomography in the creation of a digital clone is discussed in detail. A step-by-step guide is created for the reader for integration of the intraoral scan data with the cone beam computed tomography Dicom data to create a digital clone.
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Affiliation(s)
- Julian Conejo
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Suite #350, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Adeyinka F Dayo
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, 240 S 40th Street, Philadelphia, PA 10104, USA
| | - Ali Z Syed
- Admitting & Oral and Maxillofacial Radiology Clinics, Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Medicine & Diagnostic Sciences, CWRU School of Dental Medicine, Office # 245 C, 9601 Chester Avenue, Cleveland, OH 44106, USA
| | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, 240 S 40th Street, Suite 214, Philadelphia, PA 19104, USA.
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Bahmani A, Karkehabadi H, Shokri A, Farhadian M. Performance of Bioceramic-based Root Filling Material with Artifact Reduction Properties in the Detection of Vertical Root Fractures Using Cone-beam Computed Tomography. Open Dent J 2021. [DOI: 10.2174/1874210602115010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Introduction:
In Cone-beam Computed Tomography (CBCT) images, metallic artifacts by root filling materials reduce the quality of images. It seems that bioceramic sealers produce fewer artifacts than gutta-percha. In this situation, the possibility of VRF detection could increase, and therefore, flap and exploratory surgery would not be needed. The purpose of this study was to evaluate the performance of a bioceramic-based root filling material in the detection of Vertical Root Fractures (VRF) in CBCT imaging.
Materials and Methods:
This study was conducted at the dental school from March to August 2019, and 100 healthy human mandibular premolar teeth were obtained and randomly divided into two equal groups. The teeth were filled with either AH26 and gutta-percha or bioceramic root filling materials. VRF was induced on half of the decoronated teeth in each group using a Global Testing Machine, and the others were considered control. CBCT imaging was performed by the Cranex 3D machine. Comparisons of the 2 groups were made using the Mann-Whitney test.
Results:
There was a significant difference between the two groups of bioceramic and gutta-percha in the measured indices, including sensitivity (P=0.017), specificity (P=0.018), positive predictive value (P=0.018), negative predictive value (P=0.018), and accuracy (P=0.011). The Area Under Curve (AUC) also showed a significant difference between the two groups (P=0.011). According to Kappa test results, no significant difference was obtained between the findings of the two observers.
Conclusion:
Different root filling materials showed a different extent of artifact in CBCT images. Bioceramic root filling material induces fewer artifacts in CBCT images, and the diagnostic value of VRF in CBCT images in the root canals filled with it is greater than those filled with AH26 and gutta-percha.
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Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, Silva MAG. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51:55-62. [PMID: 33828962 PMCID: PMC8007395 DOI: 10.5624/isd.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45–0.72), sensitivity (0.6–0.67), and specificity (0.23–0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68–0.77, 0.67–083, and 0.53–087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
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Affiliation(s)
- Mariana Rodrigues Oliveira
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Aline Ferreira Caetano
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Rogério Ribeiro de Paiva
- Department of Oral Radiology, School of Dentistry, Anápolis University Centre, Anápolis, Goiás, Brazil
| | - José Valladares-Neto
- Department of Oral Rehabilitation, Division of Orthodontics, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Yang Y, Wu B, Zeng J, Chen M. Classification and morphology of middle mesial canals of mandibular first molars in a southern Chinese subpopulation: a cone-beam computed tomographic study. BMC Oral Health 2020; 20:358. [PMID: 33302951 PMCID: PMC7726862 DOI: 10.1186/s12903-020-01339-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/22/2020] [Indexed: 01/21/2023] Open
Abstract
Background Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs). Methods CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (< 40 years old) and group B (≥ 40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P < 0.05 was considered statistically significant. Results In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P < 0.05). The curvature in the mesiodistal direction was 29.39 ± 8.53° in group A and 26.06 ± 8.50° in group B, and this difference was also significant (P < 0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P > 0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy. *Yeqing Yang and Buling Wu have contribute equally to this article.
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Affiliation(s)
- Yeqing Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Buling Wu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Junkai Zeng
- Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ming Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. .,School of Stomatology, Southern Medical University, Guangzhou, China.
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Chen YT, Hsu TY, Liu H, Chogle S. Factors Related to the Outcomes of Cracked Teeth after Endodontic Treatment. J Endod 2020; 47:215-220. [PMID: 33275995 DOI: 10.1016/j.joen.2020.11.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/27/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cracked teeth are a common clinical finding; however, their presence renders diagnosis and prognosis unreliable. The purpose of this research was to assess the correlations of multiple factors on the prognosis of cracked teeth that had undergone endodontic treatment. METHODS A total of 3680 patients who received endodontic treatment by an advanced postdoctoral education program in endodontics with follow-up records of at least 1 year were assessed. From this sample, 62 patients met the inclusion criteria and were included in the final analysis. The factors being evaluated included demographics, clinical symptoms and signs, radiographic findings, and restoration type. Statistical analysis was then completed using the chi-square and Fisher exact tests. RESULTS The mean follow-up period was 23.3 months, with an overall tooth success rate of 75.8%. The success rates differed significantly when the patient had an existing preoperative periapical lesion, lacked a proper permanent restoration on the treated tooth, or had a post placed after root canal treatment. Data analysis showed that restoring the tooth after endodontic treatment was the single most important factor for prognosis. In fact, the endodontically treated teeth with definitive full-coverage restorations had a 2-year success rate of 93.6%. CONCLUSION Full-coverage restorations should be considered an important part of the treatment plan for cracked teeth treated endodontically.
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Affiliation(s)
- Yen-Tung Chen
- Department of Endodontics, Boston University, Boston, Massachusetts
| | - Tun-Yi Hsu
- Department of Endodontics, Boston University, Boston, Massachusetts
| | - Hongsheng Liu
- Department of Endodontics, Boston University, Boston, Massachusetts
| | - Sami Chogle
- Department of Endodontics, Boston University, Boston, Massachusetts.
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Bhatt M, Coil J, Chehroudi B, Esteves A, Aleksejuniene J, MacDonald D. Clinical decision-making and importance of the AAE/AAOMR position statement for CBCT examination in endodontic cases. Int Endod J 2020; 54:26-37. [PMID: 32964475 DOI: 10.1111/iej.13397] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
AIM To compare conventional radiographic and cone beam computed tomography (CBCT) findings with reference to the American Association of Endodontics and American Academy of Oral and Maxillofacial Radiology (AAE/AAOMR) joint position statement and to determine the effect of the CBCT on the initial diagnoses and treatment plans in a single-centre Postgraduate Endodontic Programme. METHODOLOGY The clinical CBCT scans of patients, treated at the Endodontic Department of the University of British Columbia, were reviewed for CBCT referrals by comparing them with corresponding radiographs. The features considered were periapical lesions, missed/extra canals, root fractures, complex anatomy, calcified canals and root resorption of tooth/teeth in question. Reasons for the CBCT prescriptions were assigned to 3 groups: to formulate the primary diagnosis, to confirm the diagnosis achieved by clinical examination and conventional radiographs, and to assist in treatment planning. Variables were compared statistically using chi-square and McNemar tests. RESULTS A total of 128 CBCT examinations were performed on 110 patients. No CBCT examination was performed more than once on the same tooth. Overall, 76% of CBCT examinations were performed on previously root filled teeth. CBCT images revealed a significantly higher incidence of periapical lesions (P = 0.002), missed canals (P < 0.001), vertical root fractures (P = 0.004) and complex anatomy (P = 0.008) than periapical radiographs. CBCT was prescribed most frequently to assist surgical treatment planning (62%) rather than for generating a diagnosis (9%) or confirming diagnoses (29%). Both the diagnosis (P = 0.001) and the treatment plan (P = 0.005) initially made by examining periapical radiographs were altered significantly by the subsequent CBCT examination by revealing information such as new periapical lesions, missed canals or involvement of buccal or lingual cortical bone. CONCLUSION CBCT examinations were prescribed mainly to assist treatment planning rather than for diagnosis. The majority of CBCT examinations were performed on previously root filled teeth. The additional information obtained from CBCT scans resulted in the alteration of the initial diagnoses as well as subsequent treatment plans in 59 out of 128 cases.
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Affiliation(s)
- M Bhatt
- Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - J Coil
- Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - B Chehroudi
- Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - A Esteves
- Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - J Aleksejuniene
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - D MacDonald
- Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.,Division of Oral and Maxillofacial Radiology, Department of Oral, Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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Abstract
Abstract
Background
Endodontic disease can adversely affect the quality of life and therefore early diagnosis and consequent timely treatment is of paramount importance for the Endodontist. Radiology is an essential component in treatment planning, disease monitoring and assessment of treatment outcome. Periapical radiographs and panoramic radiography are frequently utilised but they provide only two-dimensional representation of three-dimensional structures. The advent of cone beam computed tomography (CBCT) offers three-dimensional accuracy of the hard tissue images with a reasonable cost and this has revolutionised imaging of the dentomaxillofacial structures. This imaging system has been seen to overcome some limitations of conventional radiography, as brought out in this review. The improvement in the accuracy is, however, accompanied at the cost of increased radiation exposure to the patient. Nevertheless, smaller areas of exposure are normally appropriate for endodontic imaging, and adjustment in the exposure parameters can further moderate the effective dose (Loubele et al. 37(6):309-18, 2008).
Aims and objectives
The aim of this review is to present the pertinent literature on the various applications of cone beam computed tomography in the field of endodontics.
Methods
Literature was electronically searched on the following sources; Medline and Keats Library. Further, a manual search was performed on the following journals: International Endodontic Journal, Journal of Endodontics, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, Endodontology, Journal of Dental Research, European Journal of Oral Sciences & Odontology and Dentomaxillofacial Radiology. A preliminary search was performed to gain an idea of the available literature using keywords ‘Cone Beam Computed Tomography’ to view the volume of the literature evident and identify questions to be addressed in this review. The initial search showed 243 potential articles. After scrutinising the titles and abstracts of the retrieved articles, 70 relevant studies were reviewed in full text. Furthermore, ‘published guidelines on the use of CBCT’ were also searched so as to include the results as an additional source material. All the articles eligible to be included in the review were in the English language and ranged from the year 1960 to the present. Also all the studies reviewed were based on the various uses of cone beam computed tomography in the field of endodontics. The keywords used to search were ‘Cone Beam Computed Tomography (CBCT)’, ‘Conventional radiography’, ‘Applications of CBCT in endodontics’, ‘CBCT and tooth morphology’, ‘CBCT and apical periodontitis’, ‘CBCT and vertical root fractures’, ‘CBCT and resorption’, ‘CBCT and pre-surgical assessment’, ‘CBCT and dento-alveolar trauma’ and ‘CBCT and endodontic outcome’.
Results
Every case is unique and CBCT should be considered only after studying each case individually. CBCT imaging needs to be adopted or used where information from conventional imaging systems is either inadequate for the management of endodontic problems or inconclusive. Having said that, it is safe to state that 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 and enhanced resolution would be available.
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Martins JN, Kishen A, Marques D, Nogueira Leal Silva EJ, Caramês J, Mata A, Versiani MA. Preferred Reporting Items for Epidemiologic Cross-sectional Studies on Root and Root Canal Anatomy Using Cone-beam Computed Tomographic Technology: A Systematized Assessment. J Endod 2020; 46:915-935. [DOI: 10.1016/j.joen.2020.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/27/2020] [Accepted: 03/15/2020] [Indexed: 01/15/2023]
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Mechanical Properties of CoCr Dental-Prosthesis Restorations Made by Three Manufacturing Processes. Influence of the Microstructure and Topography. METALS 2020. [DOI: 10.3390/met10060788] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study is to compare the mechanical properties of three different dental restorations’ manufacturing processes (CADCAM milling, casting and laser sintering) generated by only one laboratory scanner focusing on marginal fit analysis and their mechanical properties. A chrome-cobalt (Cr-Co) alloy from the same batch was used for three different methods to make an implant abutment. This simulates a maxillary right first molar that was fixed in a hemi-maxillary stone model. Five scans were performed by each tested framework. Nine frameworks were manufactured for each manufacture procedure. Field-Emission Scanning Electron Microscope (FE-SEM) direct vision was used to marginal gap measurement in five critical points for each specimen. In order to fix the samples in the microscope chamber, the restorations were submitted at a compression load of 50 N. The samples always have the same orientation and conditions. The resolution of the microscope is 4 nm and it is equipped by J image software. The microstructure of the samples was also determined with the FE-SEM equipped with EDS-microanalysis. Roughness parameters were measured using White Light Interferometry (WLI). The arithmetical mean for the Ra and Rq of each sample was calculated. The samples were mechanically characterized by means of microhardness and flexural testing. Servo-hydraulic testing machine was used with cross-head rate of 1 mm/min. Two-way ANOVA statistical analysis was performed to determine whether the marginal discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values were: from 50.53 ± 10.30 µm for the samples produced by CADCAM to 85.76 ± 22.56 µm for the samples produced by the casting method. Laser sintering presents a marginal gap of 60.95 ± 20.66 µm. The results revealed a statistically significant difference (p-value < 0.005) in the mean marginal gap between the CADCAM systems studied. The higher flexure load to fracture for these restorations were for CADCAM restoration and the lower was for the casting samples. For these restorations, CADCAM Restoration yielded a higher flexure load to fracture and Casting ones yielded the lower. Porosity and microstructure play a very important role in the mechanical properties.
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Digital Determination of Curvature of Root Canals of Extracted Teeth. ACTA MEDICA BULGARICA 2020. [DOI: 10.2478/amb-2020-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction: Determination of the curvature of root canals at present is accomplished by complicated or expensive methods. Therefore, there is a need to develop a new digital method by which this curvature can be determined quickly, easily and accurately.
The aim of this in-vitro study is to determine the angles of curvature of the root canals of extracted teeth by comparing a new digital method of measurement with an established digital method.
Material and Methods: Forty-eight (48) root canals of extracted teeth were studied to achieve the goal. In all roots, curvature is measured by three methods: Method 1 – new digital photographic method and special Software (Screen Protractor); Method 2 – a new digital radiography method and special software (Screen Protractor); Method 3 – approved method, digital by X-ray and special Software (Durr dental).
Results: The mean degrees of the measured curvature of the root canals in all three groups are similar and are about 22°. There are no statistically significant differences between them (p > 0.05).
Conclusion: This shows that the new digital photographic and x-ray methods for measuring root curvature can accurately determine the curve angle for extracted teeth.
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Mena Álvarez J, Zubizarreta Macho Á. Applications of CBCT in Endodontics. Oral Dis 2020. [DOI: 10.5772/intechopen.89956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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