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Mantovani VDO, Gabriel AEDS, Silva RG, Savioli RN, Sousa-Neto MD, Cruz-Filho AM. Analysis of the mandibular molars root canals morphology. Study by computed tomography. Braz Dent J 2022; 33:1-8. [PMID: 36287490 PMCID: PMC9645170 DOI: 10.1590/0103-6440202205105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/23/2022] [Indexed: 05/15/2023] Open
Abstract
This study aimed to analyze the root and root canal morphology of mandibular first and second molars using CBCT images. A total of 2,400 mandibular molars exams were selected from 600 patients aged between 18 and 75 years. The number of roots, number of root canals, and root canal configuration according to the Vertucci classification were verified. Overall, 94.92% of mandibular first molars and 90.17% of mandibular second molars had two separate roots. Among the biradicular molars, the first molars showed a greater incidence of type IV canals in the mesial root and type I in the distal root. In the second molars, the most common canal form was type IV in the mesial root and type I in the distal root. In the triradicular molars, the type IV and type I configurations were the most common in the mesial root of the first molar and second molar, respectively. In both triradicular molars, there was a prevalence of type I canal in the distal and DL roots. Statistical analysis was performed at a significance level of 0.05. The number of roots was correlated with gender (Spearman test), and the canal's configuration with gender and bilaterality (Wilcoxon test). The subpopulation studied has a high incidence of bilateral symmetry and mandibular molars with two roots with two distinct mesial canals and one distal canal. The bilateral configuration is possible to estimate the number of canals, especially in images that are difficult to visualize, such as atresic canals.
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Affiliation(s)
| | | | - Ricardo Gariba Silva
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Novak Savioli
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio M Cruz-Filho
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Santos MC, Souza-Gabriel AE, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Detection of the internal anatomy of lower anterior teeth using cone-beam computed tomography. AUST ENDOD J 2021; 47:442-449. [PMID: 33650769 DOI: 10.1111/aej.12497] [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: 10/20/2020] [Revised: 01/18/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
Morphology study of root canal systems is essential for a correct diagnosis, therapy and prognosis of root canal treatment. This study aimed to analyse the dental anatomy of the lower anterior teeth, using cone-beam computed tomography (CBCT). Lower anterior teeth were classified in terms of type, number and location of root canals, evaluating the bilaterality of anatomical occurrences and determining whether the gender and age influence the findings. We analysed 749 CBCT of patients attending the School of Dentistry for different reasons. Spearman's correlations and Wilcoxon signed-rank test were used to analyse data (α = 0.05). There was no significant correlation between gender (male and female) and anatomy of the canals 33 (P = 0.162), 32 (P = 0.815), 31 (P = 0.708), 41 (P = 0.422), 42 (P = 0.382) and 43 (P = 0.063). There was a significant correlation between age and anatomy of the canals 33 (P = 0.045), 32 (P = 0.033), 31 (P = 0.022), 41 (P = 0.000), 42 (P = 0.037) and 43 (P = 0.037). There was no significant correlation between gender and patients' age (P = 0.325). There was no anatomical difference between the bilateral pairs (right and left homologous teeth) (P > 0.05). The most common anatomical configuration was single-canal teeth (85.29%), followed by the configuration in which one canal leaves the chamber, divides into two and unite again (12.88%). Anatomy of the lateral incisors and lower canines does not change with the gender of patients. However, as age rises, single canals and the incidence of division into two canals ending in a single foramen also increases.
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Affiliation(s)
- Marice C Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aline E Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio M Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo G Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Cheung AWT, Lee AHC, Cheung GSP. Clinical efficacy of activated irrigation in endodontics: a focused review. Restor Dent Endod 2021; 46:e10. [PMID: 33680899 PMCID: PMC7906851 DOI: 10.5395/rde.2021.46.e10] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.
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Affiliation(s)
- Amelia Wan Tin Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Angeline Hui Cheng Lee
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gary Shun Pan Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Paula-Silva FWG, Arnez MFM, de Campos Chaves Lamarque G, Petille R, Ribeiro-Santos FR, de Sena MF, Nelson-Filho P, da Silva LAB. Osteoclast formation, inflammation, and matrix metalloproteinase-9 are downregulated in bone repair following root canal treatment in dogs teeth. Clin Oral Investig 2021; 25:4699-4707. [PMID: 33449195 DOI: 10.1007/s00784-021-03784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/06/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the inflammatory infiltrate, osteoclast formation, and expression of MMP-9 during the healing phase following root canal treatment in teeth with apical periodontitis. MATERIALS AND METHODS Apical periodontitis was induced in dogs teeth, and root canal treatment was performed in a single visit or using calcium hydroxide as intracanal medication. One hundred and eighty days following treatment the presence of inflammation was examined, and the tissues were stained to detect osteoclasts by means of a tartrate resistant alkaline phosphatase (TRAP) assay. Synthesis of MMP-9 was detected using Western blotting and immunohistochemistry. RESULTS Teeth with apical periodontitis that had root canal therapy performed in a single visit presented a higher synthesis of MMP-9 compared with root canal treatment using calcium hydroxide. Treatment with calcium hydroxide resulted in a reduced amount of inflammatory cells and MMP-9 positive cells. Osteoclast formation, the number of MMP-9 positive osteoclasts and cementocytes, was reduced following root canal treatment, regardless of the root canal treatment protocol used. CONCLUSION Root canal treatment reduced the amount of inflammatory cells and osteoclasts in periapical area. The use of calcium hydroxide as intracanal medication resulted in a lower synthesis of MMP-9, though the number of osteoclasts and MMP-9 positive osteoclasts were similar between the groups. CLINICAL RELEVANCE Periapical bone repair following root canal treatment is impacted by therapy performed either in single visit or using calcium hydroxide dressing measured by inflammatory cell recruitment, osteoclast formation, and MMP-9 synthesis.
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Affiliation(s)
| | - Maya Fernanda Manfrin Arnez
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Renato Petille
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fernanda Regina Ribeiro-Santos
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- Universidade de Pernambuco, Arco Verde, PE, Brazil
| | - Marina Fernandes de Sena
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Silva LABD, Linhares ML, Silva RABD, Nelson-Filho P, Lucisano MP, Pucinelli CM, Carvalho FKD, Cohenca N. Negative Pressure Irrigation Presents Mineralizing Potential in Dogs' Immature Teeth with Periapical Lesion. Braz Dent J 2020; 31:37-43. [PMID: 32159704 DOI: 10.1590/0103-6440201802764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/18/2019] [Indexed: 11/21/2022] Open
Abstract
The objective of this in vivo study was to assess the effect of the root canal irrigation by negative and positive apical pressure on the expression of molecules that are an indicative of cell differentiation with mineralizing phenotype in teeth of dogs with incomplete rhizogenesis and induced periapical lesion. A total of 30 teeth (60 roots) were distributed into 3 groups (n=20): EndoVac®, Conventional and Control. After 90 days, the routine histotechnical procedures were performed and the sections were submitted to immunohistochemical technique for the staining of osteopontin (OPN), alkaline phosphatase (ALP) and the RUNX2 transcription factor in the apical and periapical regions of the roots. A semi-quantitative analysis of the positive immunostaining was performed and the intensity of the expression was classified in absent (0), mild (1), moderate (2), or intense (3). Scores data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. RUNX2 immunostaining revealed that in the negative pressure group there was a significantly stronger (p<0.05) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to detect a statistically significant difference between the groups (p>0.05). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p<0.05), and the negative pressure group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation presents mineralizing potential in immature teeth with apical periodontitis.
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Affiliation(s)
- Léa Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Raquel Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marília Pacífico Lucisano
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Carolina Maschietto Pucinelli
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Fabrício Kitazono de Carvalho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Nestor Cohenca
- Department of Pediatric Dentistry, University of Washington and Private Practice Limited to Endodontics in Everett WA, USA
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