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Swaminathan K, Padmanabhan V, Rajkumar M, Subbalekshmi T, Palanimuthu S, Haridoss S. Geographical diversity in root canal anatomy of primary molars and its clinical implications: A systematic review and meta-analysis. J Indian Soc Pedod Prev Dent 2025; 43:10-27. [PMID: 40159601 DOI: 10.4103/jisppd.jisppd_15_25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Accepted: 02/26/2025] [Indexed: 04/02/2025] Open
Abstract
BACKGROUND Anatomical variability in primary molars across geographic regions presents significant challenges in pediatric endodontics. Regional differences in root canal morphology complicate diagnosis and treatment planning, emphasizing the need for population-specific insights. OBJECTIVE This review synthesizes evidence on geographical variations in root canal anatomy, focusing on population-specific characteristics and their clinical relevance. MATERIALS AND METHODS Following PRISMA guidelines, databases including PubMed, Scopus, Web of Science, EBSCOhost, Embase, and the Cochrane Register were comprehensively searched. Studies employing advanced imaging modalities such as cone-beam computed tomography, micro-computed tomography, multidetector computed tomography, and nano-computed tomography to analyze root canal morphology were included. Observational studies describing root canal configurations and prevalence in primary molars were reviewed. A meta-analysis was performed to determine pooled prevalence rates and geographical trends for Vertucci canal configurations in maxillary and mandibular molars. RESULTS The analysis of 36 studies encompassing 4863 primary molars revealed significant regional variations. Australian maxillary molars exhibited a higher prevalence of fused roots, while Indian and Turkish mandibular molars displayed more accessory canals. Japanese molars were characterized by thinner dentin walls, reflecting population-specific trends in root canal anatomy. CONCLUSION Geographical variations in root canal morphology underscore the need for region-specific research and tailored treatment strategies in pediatric endodontics. Advanced imaging modalities play a pivotal role in improving diagnostic accuracy and optimizing clinical outcomes.
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Affiliation(s)
- Kavitha Swaminathan
- Department of Pediatric and Preventive Dentistry, Sri Ramachandra Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vaishnavi Padmanabhan
- Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - M Rajkumar
- Department of Public Health Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - T Subbalekshmi
- Department of Pediatric and Preventive Dentistry, Malabar Dental College and Research Centre, Malappuram, Kerala, India
| | | | - Selvakumar Haridoss
- Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Shanmugam Y, Raghu A, Muthu M, Swaminathan K, Haridoss S, Vignesh K, Bhattad M. Evaluation of primary teeth root canal orifices with naked eye and using magnifying loupes - An in vivo study. J Oral Biol Craniofac Res 2024; 14:600-605. [PMID: 39220757 PMCID: PMC11362793 DOI: 10.1016/j.jobcr.2024.08.001] [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: 04/08/2024] [Revised: 07/01/2024] [Accepted: 08/04/2024] [Indexed: 09/04/2024] Open
Abstract
Background Knowledge of the anatomy and morphology of root canal orifices and variations are vital elements affecting treatment outcomes. Aim The objective of this study was to evaluate variations in the number of root canal orifices and their patterns in primary teeth, as identified by both the naked eye and under magnifying loupes. Materials and methods Total of 173 primary teeth was scheduled for pulpectomy over a period of 18 months. Two examiners assessed the number and pattern of the root canal orifices. After access cavity preparation, the operator recorded the number of root canal orifices with naked eye, and examiner recorded the same using magnifying loupes (3.5×). After cleaning and shaping, the same protocol was used. Collected data were statistically analyzed using SPSS version 23.0 and compared using a paired t-test. Results The overall variation in the in the identification of root canal orifices between the naked eye and magnifying loupes (3.005 ± 0.971) was statistically significant after access cavity preparation (P ≤ 0.05). Conclusion Magnifying loupes significantly enhances the determination of the number and pattern of root canal orifices in primary teeth. Therefore, the application of magnifying loupes is essential for accurately assessing variations in root canal orifices in primary dentition.
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Affiliation(s)
- Yamuna Shanmugam
- Department of Pediatric and Preventive Dentistry,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Aksshaya Raghu
- Department of Pediatric and Preventive Dentistry,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - M.S. Muthu
- Centre for Early Childhood Caries and Research (CECCRe) Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Adjunct Research Associate (ARA), Ajman University, United Arab Emirates
| | - Kavitha Swaminathan
- Department of Pediatric and Preventive Dentistry,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Selvakumar Haridoss
- Department of Pediatric and Preventive Dentistry,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - K.C. Vignesh
- Department of Pediatric and Preventive Dentistry,Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Mayur Bhattad
- Dept of Pedodontics and Preventive Dentistry, Dr HSRSM Dental College and Hospital, Hingoli, Maharashtra, India
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Zhu Z, Fu G. Research on NiTi instruments combined with ultrasonic irrigation and multiantibiotic paste in root canal therapy of periapical inflammation in deciduous teeth. Exp Ther Med 2024; 28:346. [PMID: 39006454 PMCID: PMC11240859 DOI: 10.3892/etm.2024.12635] [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: 11/29/2023] [Accepted: 03/20/2024] [Indexed: 07/16/2024] Open
Abstract
Pain often occurs after root canal treatment due to unavoidable mechanical or chemical damage. The purpose of the present study was to investigate the efficacy of a nickel-titanium (NiTi) device combined with ultrasonic irrigation and multiple antibiotic creams in the treatment of periapical inflammation of deciduous teeth, so as to improve the understanding of root canal treatment and optimize clinical practice. Evaluation of efficacy was conducted using X-rays and the Visual Analog Scale. This treatment significantly reduced pain and also improved patient compliance and treatment outcomes. The findings of the present study may have scientific and clinical significance for optimizing root canal treatment in pediatric dentistry and requires further in-depth research in clinical practice. These outcomes may provide potential new ideas and directions for improving patients' quality of life and the efficacy of clinical treatment and have further impacts on future related research and medical practice.
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Affiliation(s)
- Zongxia Zhu
- Oral & Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, Sichuan 646000, P.R. China
- Department of Pediatric Dentistry and Children's Stomatology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Guangli Fu
- Department of Pediatric Dentistry and Children's Stomatology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Ahmed HMA, Ibrahim N, Mohamad NS, Nambiar P, Muhammad RF, Yusoff M, Dummer PMH. Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration. Int Endod J 2021; 54:1056-1082. [PMID: 33527452 DOI: 10.1111/iej.13486] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/15/2022]
Abstract
Adequate knowledge and accurate characterization of root and canal anatomy is an essential prerequisite for successful root canal treatment and endodontic surgery. Over the years, an ever-increasing body of knowledge related to root and canal anatomy of the human dentition has accumulated. To correct deficiencies in existing systems, a new coding system for classifying root and canal morphology, accessory canals and anomalies has been introduced. In recent years, micro-computed tomography (micro-CT) and cone beam computed tomography (CBCT) have been used extensively to study the details of root and canal anatomy in extracted teeth and within clinical settings. This review aims to discuss the application of the new coding system in studies using micro-CT and CBCT, provide a detailed guide for appropriate characterization of root and canal anatomy and to discuss several controversial issues that may appear as potential limitations for proper characterization of roots and canals.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N S Mohamad
- Centre of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM) Selangor Branch, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
| | - P Nambiar
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Malaysia
| | - R F Muhammad
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - M Yusoff
- Department of Geology, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Bovino M, Santos LDS, Cavalcante LLFDA, Lima CCB, Lima MDDMD, Moura MSD, Macêdo PDTSD, Moura LDFADD. Dentin Thickness of Pulp Chamber Floor in Primary Molars: Evaluation by Cone-Beam Computed Tomography. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Yu Y, Zhou X, Zheng LW. [Advanced research on root canal therapy for primary teeth]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:205-210. [PMID: 32314896 DOI: 10.7518/hxkq.2020.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Primary tooth root canal therapy is a treatment performed on primary teeth diagnosed with pulpitis or periapical periodontitis. This procedure requires perfect instrumentation, disinfection, and filling of root canals to eliminate infection, control inflammation, relieve pain, prevent pathological effects on inherited permanent tooth, and prolong primary tooth preservation. This paper reviews the research history on primary tooth root canal treatment and summarizes the progress on primary tooth root canal treatment, including anatomical morphology, root canal preparation, root canal disinfection, root canal filling, and application of antibiotics.
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Affiliation(s)
- Yi Yu
- 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
| | - Xin Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li-Wei Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Ahmed HMA, Musale PK, El Shahawy OI, Dummer PMH. Application of a new system for classifying tooth, root and canal morphology in the primary dentition. Int Endod J 2019; 53:27-35. [DOI: 10.1111/iej.13199] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/05/2019] [Indexed: 12/23/2022]
Affiliation(s)
- H. M. A. Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur Malaysia
| | - P. K. Musale
- “Little Ones Big Smiles” Laser and Microscope Integrated Paediatric Dentistry Pune India
| | - O. I. El Shahawy
- Department of Paediatric Dentistry Faculty of Dentistry Cairo University Cairo Egypt
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
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