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Khademi A, Saatchi M, Sheikhi M, Soltani MM, Moradi S. In Vitro Diagnostic Accuracy and Agreement of Dental Microscope and Cone-Beam Computed Tomography in Comparison with Microcomputed Tomography for Detection of the Second Mesiobuccal Canal of Maxillary First Molars. SCANNING 2022; 2022:1493153. [PMID: 36263096 PMCID: PMC9553662 DOI: 10.1155/2022/1493153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The percentage of failure of endodontically treated maxillary molars is relatively high; one main reason is that the second mesiobuccal canal (MB2) is missing. Some techniques have been proposed for detection of the MB2. This study was aimed at assessing the diagnostic accuracy and agreement of the dental microscope and cone-beam computed tomography (CBCT) in comparison with microcomputed tomography (micro-CT) for detection of the MB2 of maxillary first molars in vitro. MATERIALS AND METHODS This in vitro, experimental study evaluated 71 permanent maxillary first molars that were stored in 100% humidity at room temperature. The teeth were mounted in 9 silicone dental arches to the level of their cementoenamel junction (8 teeth in each arch). The blocks underwent CBCT in a XG3D scanner. Access cavity was then prepared, and the teeth were inspected by a surgical microscope for negotiation of the MB2. Also, micro-CT images were obtained from the teeth to serve as the gold standard. CBCT and micro-CT images were observed by two examiners twice with a 2-week interval. RESULTS The frequency of the MB2 detected by dental microscope was significantly lower than micro-CT (P < 0.001) and CBCT (P = 0.008); no significant difference existed between micro-CT and CBCT in this respect. The sensitivity, specificity, positive predictive value, and negative predictive value of CBCT for detection of MB2 were 92.6%, 100%, 100%, and 81%, respectively. CONCLUSION CBCT is superior to the dental microscope for detection of the MB2 of maxillary first molars and can be used for this purpose in the clinical setting with adequate accuracy.
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Affiliation(s)
- Abbasali Khademi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan Po. Code: 8174673461, Iran
| | - Masoud Saatchi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan Po. Code: 8174673461, Iran
| | - Mahnaz Sheikhi
- Department of Oral and Maxillofacial Radiology, Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan Po. Code: 8174673461, Iran
| | - Mohammad Mehdi Soltani
- Department of Prosthodontics, School of Dentistry, Azad University of Isfahan, Isfahan Po. Code: 8155139998, Iran
| | - Samane Moradi
- Department of Endodontics, School of Dentistry, Qom University of Medical Sciences, Qom Po. Code: 3716993456, Iran
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Al-Alawi H, Al-Nazhan S, Al-Maflehi N, Aldosimani MA, Zahid MN, Shihabi GN. The prevalence of radix molaris in the mandibular first molars of a Saudi subpopulation based on cone-beam computed tomography. Restor Dent Endod 2020; 45:e1. [PMID: 32110531 PMCID: PMC7030963 DOI: 10.5395/rde.2020.45.e1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 11/11/2022] Open
Abstract
Objectives The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). Results Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. Conclusions The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.
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Affiliation(s)
- Hassan Al-Alawi
- Dental Department, Ministry of Health Endodontist, Huraymala General Hospital, Riyadh, Saudi Arabia
| | - Saad Al-Nazhan
- Department of Restorative Dentistry-Endodontics, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Nassr Al-Maflehi
- Department of Preventive Dental Sciences-Biostatistics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mazen A Aldosimani
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Nabil Zahid
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, Al Kharj, Saudi Arabia
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Chuppani Dastgerdi A, Navabi M, Rakhshan V. Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study. Restor Dent Endod 2020; 45:e7. [PMID: 32110536 PMCID: PMC7030962 DOI: 10.5395/rde.2020.45.e7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/22/2019] [Accepted: 09/17/2019] [Indexed: 11/12/2022] Open
Abstract
Objectives This study was performed to assess the anatomy of mandibular first molars. Materials and Methods In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0–2, 2–4, and 4–6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ2 test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.
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Affiliation(s)
| | - Manizheh Navabi
- Department of Removable Prosthodontics, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Vahid Rakhshan
- Department of Dental Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
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Hosseinpour S, Kharazifard MJ, Khayat A, Naseri M. Root Canal Morphology of Permanent Mandibular Premolars in Iranian Population: A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:150-6. [PMID: 27471522 PMCID: PMC4947835 DOI: 10.7508/iej.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/01/2016] [Accepted: 01/15/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION It is essential for clinicians to have knowledge about root canal configuration, although its morphology varies largely in different ethnicities and even in different individuals within the same ethnic group. The current study reviewed the root canal configuration of root canals in mandibular first and second premolars among Iranian population based on independent epidemiological studies. METHODS AND MATERIALS A comprehensive search was conducted on retrieved articles related to root canal configuration and prevalence of each types of root canal in mandibular premolars based on Vertucci's classification. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. RESULTS In eleven studies conducted in eight provinces, 1644 mandibular first premolars and 1268 second premolars were investigated. Within mandibular first premolars, 70.9% were Vertucci's type I, followed by 10.4% type III, 7.18% type IV, 5.23% type II and 5.16% type V. In addition, among mandibular second premolars, 82.86% were type I, 6.25 type III, 5.32% type II, 4.27% type IV, and 0.69% type V. CONCLUSION These results highlight the necessity of searching for additional possible root canals by clinicians. Moreover, these results indicated the ethnical characteristics of Iranian population regarding the morphology of mandibular premolars compared to other populations.
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Affiliation(s)
- Sepanta Hosseinpour
- Students' Research Office, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | - Akbar Khayat
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Canada;
| | - Mandana Naseri
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Abraham SB, Gopinath VK. Root canal anatomy of mandibular first premolars in an Emirati subpopulation: A laboratory study. Eur J Dent 2016; 9:476-482. [PMID: 26929684 PMCID: PMC4745227 DOI: 10.4103/1305-7456.172618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: The purpose of this study was to determine the root canal anatomy of mandibular first premolar teeth in an Emirati subpopulation using a decalcification and clearing method. Materials and Methods: One hundred permanent mandibular first premolar teeth extracted for orthodontic purposes from an Emirati subpopulation from the United Arab Emirates were used for this study. They were subjected to decalcification and clearing. The tooth length, the canal orifice shape, mesial invagination, canal pattern, the location of apex, presence of lateral canals, and intercanal communications were determined. Results: The most common canal pattern was the Vertucci Type I (65%) followed by Type V (14%) and Type IV (13%). The most common type of canal orifice seen was the oval shape (36%) followed by the round shape (25%). Mesial invaginations were seen in 44% of the teeth. The mean tooth length was 19.9 mm, and apical deltas were seen in 24% of teeth. Conclusion: The Vertucci Type I canal pattern was the most prevalent in the mandibular first premolars while the occurrence of multiple canals was noted in 35% of this population.
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Affiliation(s)
- Sheela Balu Abraham
- Department of General and Specialist Dental Practice, College of Dental Medicine, Sharjah, UAE
| | - Vellore Kannan Gopinath
- Department of General and Specialist Dental Practice, College of Dental Medicine, Sharjah, UAE
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Abstract
OBJECTIVE The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. MATERIALS AND METHODS Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. RESULTS The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. CONCLUSION A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars.
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Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St. George Hospital compound, D Mello Road, Near GPO, Fort. Mumbai, Maharashtra, India
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St. George Hospital compound, D Mello Road, Near GPO, Fort. Mumbai, Maharashtra, India
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Singh S, Pawar M. Root canal morphology of South asian Indian mandibular premolar teeth. J Endod 2014; 40:1338-41. [PMID: 25043328 DOI: 10.1016/j.joen.2014.03.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 03/07/2014] [Accepted: 03/25/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study was to study the root canal morphology of South Asian Indian mandibular premolars using a tooth clearing technique. METHODS Two hundred mandibular premolar teeth were collected from different dental schools and clinics in India. After pulp tissue removal and root canal staining with Indian ink, the specimens were decalcified with 5% nitric acid, dehydrated in ethyl alcohol, and subsequently cleared in methyl salicylate. RESULTS Of the 200 mandibular premolars, 100 were first premolars and 100 were second premolars. Of the first premolars, 94% had a single root, whereas 6% were 2 rooted. Seventy-six percent had a single canal, 22% had 2 canals, and 2% had 3 canals. Eighty-two percent had a single apical foramen, 16% had 2 foramens, and 2% teeth had 3 apical foramens. Eighty percent of teeth had type I, 6% had type II, 10% had type IV, 2% had type V, and 2% teeth had type IX root canal anatomy. Of the 100 second premolars, 92% had a single root, whereas 8% teeth were 2 rooted and fused. Fifty-eight percent of teeth had a single canal, and 42% had two canals. Eighty-eight percent had a single apical foramen, and 12% had 2 foramens. Sixty-six percent had type I, 30% had type II, and 4% had type V root canal anatomy. CONCLUSIONS A high prevalence of 2 canals was noted in the first and second premolars. Also, 20% of first premolars and 34% of second premolars had a root canal anatomy other than type I.
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Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St George Hospital Compound, Mumbai, India.
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St George Hospital Compound, Mumbai, India
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Bardauil MRRDS, Moura Netto CD, Moura AAMD. Evaluation of the maxillary premolar roots dissociation using radiographic holders with conventional and digital radiography. Braz Oral Res 2010; 24:284-9. [PMID: 20877964 DOI: 10.1590/s1806-83242010000300005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 05/31/2010] [Indexed: 11/22/2022] Open
Abstract
This in vivo study evaluated the dissociation quality of maxillary premolar roots combining variations of vertical and horizontal angulations by using X-ray holders (Rinn -XCP), and made a comparison between two types of intraoral radiography systems - conventional film (Kodak Insight, Rochester, USA) and digital radiography (Kodak RVG 6100, Kodak, Rochester, USA). The study sample was comprised of 20 patients with a total of 20 maxillary premolars that were radiographed, using the paralleling angle technique (GP), with a 20º variation of the horizontal angle (GM) and 25º variation of the horizontal angle combined with 15º vertical angle (GMV). Each image was independently analyzed by two experienced examiners. These examiners assigned a score to the diagnostic capability of root dissociation and the measurement of the distance between the apexes. Statistical data was derived using the Wilcoxon Signed Rank test, Friedman and T test. The means of the measured distances between buccal and lingual root apexes were greater for the GMV, which ranged from 2.3 mm to 3.3 mm. A statistically significant difference was found between GM and GMV when compared to GP with p < 0.01. An established best diagnostic dissociation roots image was found in the GMV. These results support the use of the anterior X-ray holders which offer a better combined deviation (GMV) to dissociate maxillary premolar roots in both radiography systems.
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Miguens SAQ, Veeck EB, Fontanella VRC, da Costa NP. A Comparison between Panoramic Digital and Digitized Images to Detect Simulated Periapical Lesions Using Radiographic Subtraction. J Endod 2008; 34:1500-3. [DOI: 10.1016/j.joen.2008.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Revised: 09/07/2008] [Accepted: 09/08/2008] [Indexed: 11/28/2022]
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