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Algarni HA, Alonazi MA, Arshad H, Zahra F, Umer F, Maqbool I, Iqbal A, Karobari MI. Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study. Eur J Med Res 2024; 29:391. [PMID: 39068434 PMCID: PMC11282603 DOI: 10.1186/s40001-024-01990-6] [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: 06/05/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. METHOD This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761-70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. RESULTS The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. CONCLUSION This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.
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Affiliation(s)
- Hmoud Ali Algarni
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Meshal Aber Alonazi
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Hamza Arshad
- Prosthodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fatima Zahra
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Fahad Umer
- Operative Dentistry and Endodontics, Dental Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | | | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Department of Dental Research, CGHR, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
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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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Korsós SA, Staszyk C, Boone M, Josipovic I, Vogelsberg J, Vlaminck L. Micro-CT and histological examination of accessory canals in 34 equine cheek teeth. Front Vet Sci 2024; 11:1396871. [PMID: 38659446 PMCID: PMC11039908 DOI: 10.3389/fvets.2024.1396871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Accessory canals and apical deltas have been extensively studied in human dentistry. Their clinical role as a difficult to clean reservoir for bacteria during endodontic treatments has been well described. Many papers describe in detail the pulp anatomy of equine dentition but little attention has been given to their apical ramifications. The goal of this paper is to describe the presence and anatomy of these accessory canals and apical deltas in healthy equine cheek teeth and discuss their possible relevance in the light of equine endodontics. To accomplish this, 15 maxillary and 19 mandibular healthy cheek teeth were collected ranging from Triadan 06 s to 11 s with eruption ages from 4 to 9 years. Their root anatomy was documented in detail based on micro computed tomography images. A subset of 3 teeth also underwent histological examination. Accessory canals were found in all but two teeth examined. Up to 44 accessory canals per tooth have been found with locations ranging from the root furcation down to the apex of the root and with highly variable diameters. Apical deltas in different stages of development were found in 84% of the roots. The presence of accessory canals identified on microCT images could be confirmed using histological examination although some of them were obliterated by reparative dentin. Accessory canals can be found in most equine cheek teeth and add complexity to their endodontic anatomy. This could have important implications for their treatment in case of pulp pathology. In humans, failure to remove bacterial biofilm from such canals has been associated with failure of endodontic treatment. Research on diseased equine teeth is required to gain a better understanding of their clinical relevance in horses.
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Affiliation(s)
- Szabolcs A. Korsós
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Carsten Staszyk
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Matthieu Boone
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Iván Josipovic
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Jörg Vogelsberg
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lieven Vlaminck
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Pires M, Martins JNR, Pereira MR, Vasconcelos I, Costa RPD, Duarte I, Ginjeira A. Diagnostic value of cone beam computed tomography for root canal morphology assessment - a micro-CT based comparison. Clin Oral Investig 2024; 28:201. [PMID: 38453706 PMCID: PMC10920457 DOI: 10.1007/s00784-024-05580-y] [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: 07/11/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The aim of this study was to assess cone beam computed tomography (CBCT) as a root canal anatomy diagnostic tool by comparison with micro-CT gold-standard. MATERIALS AND METHODS 216 two-rooted mandibular molars were first scanned in a CBCT device (200 μm voxel size) and posteriorly in a micro-CT scanner (19.61 μm). The volumes were sequentially screened to classify main root canal anatomy according to Vertucci classification, and for the presence of lateral canals and apical deltas, in both mesial and distal roots. RESULTS Both methods revealed a higher prevalence of Vertucci Type II and IV in the mesial root, and Vertucci Type I in the distal root. The percentage of agreement for main root canal anatomy classification between CBCT and micro-CT scores was high (85.2%). CONCLUSION Sensibility to detect both lateral canals and apical deltas with CBCT was low. These results attest to the fact that minor anatomical changes might be difficult to identify with CBCT imaging, hampering its diagnostic value.
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Affiliation(s)
- Mariana Pires
- 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 Bioquímica 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
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Marinha Grande, Portugal
| | | | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, Aveiro, 3810-193, Portugal
- LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica 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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Bago I, Đurin A, Kanižaj D, Vuletić LB, Zdrilić IV, Anić I. The efficacy of a novel SWEEPS laser-activated irrigation compared to ultrasonic activation in the removal of pulp tissue from an isthmus area in the apical third of the root canal. Lasers Med Sci 2023; 38:189. [PMID: 37599293 DOI: 10.1007/s10103-023-03857-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
This study aimed to evaluate the efficacy of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS) in the removal of remaining pulp tissue from the root canal isthmus area in lower molars and compare it with ultrasonically activated irrigation (UAI) and conventional needle irrigation (NI). Forty-one lower molars with isthmuses between mesial canals were included in the study. The teeth were randomly distributed into experimental groups (n = 12/each) based on the final irrigation protocol (SWEEPS, UAI, or NI) and a control group (C) (n = 5). The traditional access cavity of the mesial part of each tooth was made in all samples. The mesial root canals in the experimental groups were instrumented with a Wave One Gold Primary (25/.07) file using 3% sodium hypochlorite (NaOCl) while the distal canal served as a control for the presence of pulp tissue. No treatment was performed in the C group. Sections from the isthmus region were processed for histopathology to measure the remaining pulp tissue (RPT). The results were analyzed using analysis of variance and the Kruskal-Wallis test (α = 0.05). There were no significant differences in the relative surface area of root canals and isthmus among the groups (p > 0.05). Samples in the SWEEPS group had significantly less RPT than UAI, NI, and C (p = 0.003, 0.014, 0.003, respectively). There were no significant differences between the UAI and NI (p = 0.583). SWEEPS was the most efficient in debridement of the root canal isthmus area. UAI and NI showed similar but lower efficiency.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia.
| | - Adriana Đurin
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
| | - Debora Kanižaj
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
| | | | - Ivana Vidović Zdrilić
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
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Barbosa AFA, Lima COD, Sassone LM, Fares RD, Fidalgo TKDS, Silva EJNL. Effect of passive ultrasonic irrigation on hard tissue debris removal: a systematic review and meta-analysis. Braz Oral Res 2021; 35:e123. [PMID: 34878078 DOI: 10.1590/1807-3107bor-2021.vol35.0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/15/2021] [Indexed: 12/22/2022] Open
Abstract
Accumulated hard tissue debris (AHTD) in root canal irregularities may negatively impact adequate root canal disinfection. In light of this, the efficacy of passive ultrasonic irrigation (PUI) to reduce AHTD has been largely studied in in vitro studies, which have adopted different analytic methods of varying accuracy to determine the extent of AHTD more correctly. Therefore, the aim of this study was to compare how well PUI and non-activated irrigation (NAI) systems perform in reducing AHTD during final irrigation protocols, based exclusively on studies whose analyses used microCT scanning. A systematic search of the studies published up to April 2020 was performed using MeSH terms and free terms, in the following databases: PubMed, Scopus, Web of Science, BVS (Lilacs and BBO) and Embase. The inclusion criteria consisted of laboratory studies that evaluated the amount of AHTD, and compared PUI with NAI protocols using microCT analysis. The risk of bias in the selected studies was assessed critically by two reviewers. A meta-analysis was performed using the RevMan software program (P<0.05), and included studies providing the standardized mean difference (SMD), using a fixed effect model, and adopting a confidence interval of 95%. In all, 3495 studies were identified, three of which met the inclusion criteria. All three were considered as having a low risk of bias. The meta-analysis comparing the ability of PUI and NAI protocols to remove hard tissue debris showed a higher percentage of AHTD reduction (P<0.01) for PUI, with a confidence interval of 1.41 [0.79, 2.02]. The heterogeneity among the studies was 82% (I2). Considering the limitations of the present study, this systematic review and meta-analysis showed that PUI was more effective than NAI in removing hard tissue debris, based exclusively on studies that used microCT scanning to provide a more precise analysis of the two techniques used. The findings presented in the present study reinforce the concept that PUI can increase residue removal and improve the cleanliness of the root canal in endodontic treatments.
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Affiliation(s)
- Ana Flávia Almeida Barbosa
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Luciana Moura Sassone
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | - Raissa Dias Fares
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Universidade do Estado do Rio de Janeiro - UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil
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