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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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Ghoncheh Z, Kaviani H, Soleimani S, Nasri S, Malekpour F, Afkhami F. Assessment of the diagnostic accuracy of strip and furcal perforations in different sizes by cone beam computed tomography. Oral Radiol 2023; 39:654-660. [PMID: 36961620 DOI: 10.1007/s11282-023-00681-y] [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: 02/23/2022] [Accepted: 03/04/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE Root perforation is an adverse event that may accidentally occur during root canal treatment and can adversely affect the treatment plan and tooth prognosis. This study aimed to assess the accuracy of cone beam computed tomography (CBCT) for detecting the strip and furcal perforations with different sizes. METHODS The mesiolingual canals of 155 extracted human mandibular first molars were instrumented and randomly divided into four experimental groups and one control group (n = 31). Furcal (in the pulp chamber floor) and strip perforations with 0.5, 1, 1.5, and 2 mm in diameter were manually created. The teeth were randomly mounted in bovine ribs and scanned using CBCT. Two radiologists unaware of the study groups observed the images and reported the greatest perforation diameter. The inter-observer agreements were calculated. The diagnostic accuracy was compared for furcal and strip perforations with different sizes. RESULTS The inter-observer agreement for detecting furcal and strip perforations with different sizes were good. The diagnostic accuracy was 100% for the absence of perforation in each group. CONCLUSIONS CBCT can detect the absence of perforation with high accuracy. The diagnostic accuracy of CBCT in the presence of strip and furcal perforation with different sizes was not significant.
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Affiliation(s)
- Zahra Ghoncheh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Kaviani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Fatemeh Malekpour
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Afkhami
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Adibi A, Sobhnamayan F, Ostovar Zijerdi N, Tajik M, Paknahad M. Comparison of the Accuracy of CBCT Images and Apex Locator in Detection of External Root Resorption with Perforation. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:445-451. [PMID: 36718169 PMCID: PMC9883623 DOI: 10.30476/dentjods.2021.91056.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/11/2021] [Accepted: 08/30/2021] [Indexed: 06/18/2023]
Abstract
STATEMENT OF THE PROBLEM Perforation within external root resorption (ERR) lesions dra-matically affects the prognosis of the involved roots. Failure to diagnose perforation under-mines treatment; therefore, early detection of these lesions is of great importance. The cone-beam computed tomography (CBCT) images and electronic apex locators (EAL) are reliably used to detect root perforations. PURPOSE In this in vitro study, we compared the EAL findings with the results obtained by the CBCT images for the detection of perforations within ERR lesions. MATERIALS AND METHOD This cross sectional study included 160 extracted anterior human teeth. The teeth were categorized into four groups including teeth with intact root, teeth with ERR, teeth with ERR and 0.5 mm perforation, and teeth with ERR with 1 mm perforation. The presence of perforations was compared by CBCT images and root EAL. RESULTS The sensitivity of CBCT scans in detecting 0.5 mm and 1 mm root perforations was 100% and 97.5%, respectively, while the sensitivity of the EAL was 10% and 27.5% in de-tecting 0.5 mm and 1 mm root perforations, respectively( with the ±0.5mm range of error). For detecting intact and teeth with ERR, the specificity of CBCT scans was 100% and 95%, respectively, and for EAL, it was 100% for both. Poor agreement was found between the two techniques (kappa=-0.025). CONCLUSION CBCT scans were more sensitive and specific than EAL scans for detecting perforations in non-obturated root canals in this study.
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Affiliation(s)
- Afsoon Adibi
- Dentist, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Sobhnamayan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Tajik
- Postgraduate Student, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Paknahad
- Oral and Dental Disease Research Center Dept. of Oral and maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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ORHAN AI, TUFENKCİ P, ONCU A, SEVGI S, CELİKTEN B, ORHAN K. CBCT Visualization of Furcation Perforation Repair Materials Using Different Voxel Sizes. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.954463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Huamán SD, Brito Aragão MG, Dias Moreno AP, Mussolino de Queiroz A, Bezerra da Silva RA, Garcia de Paula-Silva FW, Bezerra da Silva LA. Accuracy of Conventional Periapical Radiography in Diagnosing Furcation Repair after Perforation Treatment. J Endod 2020; 46:827-831. [PMID: 32307135 DOI: 10.1016/j.joen.2020.03.004] [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: 08/06/2019] [Revised: 02/06/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Periapical radiography (PR) is a diagnostic tool to be used by professionals in clinical practice. The method presents limitations, and doubts still exist about its value to evaluate furcation perforation and the reparative process of hard or soft tissues after treatment. Thus, the aim of this study was to evaluate the accuracy of PR as a diagnostic method to detect both resorption of the furcation area after induced experimental perforation and repair after perforation treatment using histopathological findings as a gold standard. METHODS Thirty teeth of beagle dogs with furcation perforation were filled with Biodentine (Septodont, Saint-Maur-des-Fossés, France), ProRoot White mineral trioxide aggregate (Dentsply Tulsa Dental Specialties, Tulsa, OK), or gutta-percha and examined using PR and histology. Sensitivity, specificity, predictive values, and accuracy were calculated. RESULTS PR detected repair and reabsorption of furcation perforation in 55% and 48% of the teeth, respectively. Histologic analysis showed furcation perforation in 66% and 21% of the teeth, respectively. Sensitivity and specificity of PR for the detection of repair were 0.84 and 1, respectively, whereas for resorption detection, the values were 0.43 and 0.65, respectively. Diagnostic accuracy for PR was 0.89 and 0.72 for repair and resorption of furcation perforation, respectively. PR showed more accurate diagnostic (true positives + true negatives/total) in repair detection compared with resorption of furcation perforation. CONCLUSIONS We conclude that PR is not adequate in detecting resorption progress after the treatment of furcation perforation, and we encourage the use of digital imaging when suspicious of a possible unsuccessful result after furcation perforation treatment.
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Affiliation(s)
- Stephanie Díaz Huamán
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| | - Maria Gerusa Brito Aragão
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ana Paula Dias Moreno
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Léa Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Enhancing the three-dimensional visualization of a foreign object using Mimics software. Radiol Case Rep 2019; 14:1545-1549. [PMID: 31719943 PMCID: PMC6838482 DOI: 10.1016/j.radcr.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/20/2022] Open
Abstract
A patient was referred to the Oral and Maxillofacial Imaging Division and the attending dental specialist suspected a foreign object at the anterior region of the maxilla. The region was scanned using Kodak 9000 3D cone-beam computed tomography (CBCT) extraoral imaging system (Carestream Health, Inc.) to determine the type and morphometric characteristic of foreign object. The CBCT images failed to determine the identity and nature of the foreign object. CBCT images were then exported to the Materialise Interactive Medical Image Control System (Mimics) software to evaluate whether this software can help in enhancing the visualization of the foreign object in the maxillofacial region. The findings showed that there was an improved visualization of the foreign body and the type of the object could be determined with certainty. The object was identified as an endodontic file and was clearly visible when visualized as a reconstructed 3D model in Mimics software. Although the identification of abnormalities has been dramatically improved using 3D scans, the visualization can be further enhanced using image processing software like Mimics.
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Shokri A, Jamalpour MR, Khavid A, Mohseni Z, Sadeghi M. Effect of exposure parameters of cone beam computed tomography on metal artifact reduction around the dental implants in various bone densities. BMC Med Imaging 2019; 19:34. [PMID: 31035955 PMCID: PMC6489302 DOI: 10.1186/s12880-019-0334-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to assess the effect of exposure parameters such as milliampere (mA) and field of view (FOV) of cone beam computed tomography (CBCT) on a metal artifact of dental implants placed in different bone densities. Methods A total of 27 bone blocks with different densities (nine were type 1, nine were types 2 and 3, and nine were type 4) were used in this in vitro, experimental study. These blocks were placed in mandibular wax models. The blocks were scanned after drilling (hole preparation) and after implant placement using Cranex3D imaging system with a 4 × 6 cm2and 6 × 8 cm2 FOV and 4 and 10 mA. Gray value of the bone blocks was recorded before and after placement of implants. Results In general, irrespective of bone density, the amount of artifacts was lower in small FOV compared to large FOV (P < 0.05). Change of mA had no effect on metal artifacts (P > 0.05). Artifacts in type 4 bone were greater than in other bone types (P < 0.05). Difference between type 1 and types 2 and 3 was not significant (P > 0.05). Conclusion According to the results of this study, Peri-implant artifacts were seen in all bone types; the amount of artifacts in type 4 bone was higher than that in other types. Size of FOV and bone density affect the metal artifacts around dental implants; so that a smaller FOV can be used to decrease metal artifacts.
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Affiliation(s)
- Abbas Shokri
- Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Dental Implant Research Center, Department of Oral and Maxillofacial Surgery, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Atefeh Khavid
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Zeinab Mohseni
- Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Eskandarloo A, Arabi R, Bidgoli M, Yousefi F, Poorolajal J. Association between Marginal Bone Loss and Bone Quality at Dental Implant Sites Based on Evidence from Cone Beam Computed Tomography and Periapical Radiographs. Contemp Clin Dent 2019; 10:36-41. [PMID: 32015639 PMCID: PMC6974999 DOI: 10.4103/ccd.ccd_185_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess bone quality in patient's preoperative cone beam computed tomography (CBCT) and their relation with marginal bone loss at implant placement sites over follow-up periods. MATERIALS AND METHODS In this retrospective cross-sectional study, 100 implants were evaluated. The implants had been placed in the maxillary and mandibular edentulous areas. Bone quality at implant placement sites was measured on preoperative CBCTs and then classified by two observers according to Lekholm and Zarb classification. Marginal bone height was then measured on periapical radiographs obtained at baseline and then 6, 12, 18, 24, and 30 months' follow-up periods from a reference point (implant shoulder) to the bone-implant interface. The relation between bone quality and bone loss was assessed. ANOVA was used to compare mean difference among groups and Pearson correlation coefficient to assess the correlation between observers. All statistical analyses were performed at 0.05 significance level using Stata 11 software (StataCorp, College Station, TX, USA). RESULTS Of 100 implants, 48 were placed in the maxilla and 52 in the mandible. There was no significant difference between bone quality and the mean bone loss at follow-up periods. Using Pearson's correlation coefficient, it was shown that with an increase in bone quality, marginal bone loss was decreased at follow-up periods. CONCLUSIONS The results confirmed that during the follow-up periods, less bone loss was observed in implant areas with higher bone quality and CBCT is a reliable tool for assessing bone quality at implant placement sites and estimation of subsequent treatment prognosis.
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Affiliation(s)
- Amir Eskandarloo
- Department of Radiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Arabi
- Department of Periodontology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Bidgoli
- Department of Periodontology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faezeh Yousefi
- Department of Radiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Department of Epidemiology and Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
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Yin SH. [Current situation and strategy on perforation repair]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:469-474. [PMID: 30465337 DOI: 10.7518/hxkq.2018.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Perforations are common complications of root canal therapy. In clinic, perforations that were improperly and untimely repaired can seriously affect the prognosis of teeth after root canal treatment. At present, the status of perforation repair in our country is worrisome. This paper focused on the progress of perforation repair in the country by discussing the current situation of repair methods and materials. This review aims to improve knowledge and aid clinical doctors in the sophistication of perforation repair in order to improve the retention rate of root-canal-treated teeth.
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Affiliation(s)
- Shi-Hai Yin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Hourfar J, Bister D, Lisson JA, Ludwig B. Incidence of pulp sensibility loss of anterior teeth after paramedian insertion of orthodontic mini-implants in the anterior maxilla. Head Face Med 2017; 13:1. [PMID: 28061791 PMCID: PMC5217250 DOI: 10.1186/s13005-016-0134-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this retrospective investigation was to evaluate the incidence of loss to pulp sensibility testing (PST) of maxillary front teeth after paramedian (3 to 5 mm away from the suture) orthodontic mini-implant (OMI) insertion in the anterior palate. METHODS A total of 284 patients (102 males, 182 females; mean age was 14.4 years (±8.8) years at time of OMI-Insertion) with a total of 568 OMIs (1.7 mm diameter, length 8 mm) were retrospectively investigated. A binomial regression analysis was performed to explore covariates, such as age, gender, inclination of upper central incisors, dentition status and insertion position of OMIs that could have contributed to loss of sensibility. Statistical significance was set at p < 0.05. RESULTS Loss of response to PST was encountered during retention in 3 out of 284 patients and the respective OMIs had been placed at height of the second rugae (R-2). Affected teeth were a right canine, a left lateral and a left central incisor. Subsequent root canal treatment was successful. Results of the binomial regression analysis revealed that the covariate insertion position (R-2) of OMIs (p = 0.008) had statistically significant influence on loss of response to PST. CONCLUSIONS (1) Although there was no radiographic evidence for direct root injury, the proximity of the implants to the anterior teeth was nevertheless statistically related to loss of PST. (2) In all cases of PST loss OMIs were inserted at the second rugae. Therefore OMIs should be placed either more posteriorly, at the third rugae or in the median plane. (3). Loss of PST was not increased for patients with palatal OMI (0.18%) compared to samples without OMI (0.25%).
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust and King's College Dental Institute, London, UK
| | - Jörg A Lisson
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany
| | - Björn Ludwig
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany. .,Private Practice, Am Bahnhof 54, 56841, Traben-Trarbach, Germany.
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Identification of the Procedural Accidents During Root Canal Preparation Using Digital Intraoral Radiography and Cone Beam Computed Tomography. ACTA MEDICA MARISIENSIS 2016. [DOI: 10.1515/amma-2016-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Crown or root perforation, ledge formation, fractured instruments and perforation of the roots are the most important accidents which appear during endodontic therapy. Our objective was to evaluate the value of digital intraoral periapical radiographs compared to cone beam computed tomography images (CBCT) used to diagnose some procedural accidents. Material and methods: Eleven extracted molars were used in this study. A total of 18 perforations and 13 ledges were created artifically and 10 instruments were fractured in the root canals. Digital intraoral periapical radiographs from two angles and CBCT scans were made with the teeth fixed in position. The images were evaluated and the number of detected accidents were stated in percentages. Statistical analysis was performed using the chi square-test. Results: On digital periapical radiographs the evaluators identified 12 (66.66%) perforations, 10 (100 %) separated instruments and 10 (76.9%) created ledges. The CBCT scans made possible the recognition of 17 (94.66 %) perforations, 9 (90 %) separated instruments and 13 (100%) ledges. The totally recognized accidental procedures showed significant differences between the two groups. (p<0.05) Conclusion: Digital periapical radiographs are the most common imaging modalities used during endodontic treatments. Though, the CBCT allows a better identification of the procedural accidents.
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