1
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Rae O, Parashos P. Prevalence and morphology of different root canal systems in mandibular premolars: a cross-sectional observational study. Aust Dent J 2024; 69:112-123. [PMID: 37970986 DOI: 10.1111/adj.12994] [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] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND This study investigated the prevalence and morphology of C-shaped and non-C-shaped root canal systems in permanent mandibular first (PM1) and second (PM2) premolars using retrospective analysis of cone-beam computed tomography (CBCT) scans, and panoramic radiographs. METHODS CBCT scans from 2000 patients were screened for the presence of premolars with C-shaped canals and then assessed at three axial levels to determine the canal classification. The teeth were also assessed for Vertucci configuration, number of roots, and radicular grooves. Pre-existing panoramic radiographs were evaluated to identify features specific to PM1/2 with multiple canals or C-shaped anatomy. RESULTS A total of 1576 PM1 and 1424 PM2 from 880 patients were evaluated. The overall prevalence of C-shaped canals was 2.2% (3.3% PM1, 1.0% PM2), with 49 (5.6%) patients presenting with at least one C-shaped mandibular premolar. There were 2.3 ± 0.6 and 2.4 ± 0.5 different classifiable cross-sections per tooth for PM1 and PM2, respectively. The sudden disappearance or bifurcation of a canal on panoramic radiographs was associated with the presence of multiple canals (P < 0.001) or C-shaped anatomy (P = 0.03). CONCLUSIONS There was substantial variation in cross-sectional anatomy within and between C-shaped premolars, which will affect endodontic treatment planning. © 2023 Australian Dental Association.
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Affiliation(s)
- O Rae
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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2
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Teixeira TF, da Silva AMP, Coutinho TMDC, Marceliano EFV, Dos Santos Miranda ARL, Ferreira DDC, Provenzano JC, Marceliano-Alves MFV. Deciduous Molars Complexity Anatomy Reveled by Computed Microtomography. Eur J Dent 2023. [PMID: 37729937 DOI: 10.1055/s-0043-1772566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The aim of this study was to analyze the internal morphology of deciduous molars through the use of computed microtomography in a sample from Rio de Janeiro. MATERIAL AND METHODS Thirty maxillary and 30 mandibular deciduous molars (n = 60), divided in first and second primary molars, were scanned by computed microtomography. The teeth were evaluated for root number, root canals, Vertucci classification, root curvature, presence of lateral canals, furcation dentin thickness, structure model index (SMI), volume, and canal surface area. RESULTS The results showed 100% of maxillary molars had three roots and Vertucci type I canal was more prevalent in this group. In the mandibular ones, type IV was more frequent in the mesial root and class I in the distal root and the cavo-interradicular canal occurred in 2 specimens. Dentin thickness in the furcation region measured 1.53 and 1.59 mm in the maxillary and mandibular, respectively. Volume and area parameters varied according to the evaluated canals and SMI demonstrated that all canals had a cylindrical shape. CONCLUSION More detailed information about the internal anatomy of the primary molars has been described, which may help strategies in the preparation of these root canals.
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3
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Karobari MI, Arshad S, Noorani TY, Ahmed N, Basheer SN, Peeran SW, Marya A, Marya CM, Messina P, Scardina GA. Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review. J Clin Med 2022; 11:jcm11092287. [PMID: 35566414 PMCID: PMC9099997 DOI: 10.3390/jcm11092287] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6).
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Affiliation(s)
- Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Sohaib Arshad
- Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
| | - Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Syed Wali Peeran
- Department of Periodontics, Armed Forces Hospital Jizan, Jazan 82722, Saudi Arabia;
| | - Anand Marya
- Department of Orthodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India;
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India;
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
- Correspondence: (M.I.K.); (T.Y.N.); (G.A.S.)
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4
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Sierra-Cristancho A, González-Osuna L, Balanta-Melo J, Cafferata EA, Rojas C, Melgar-Rodríguez S, Carvajal P, Vernal R. A micro-CT analysis of radicular dentine thickness in mandibular first premolars presenting C-shaped root canals: Identification of potential danger zones. Int Endod J 2022; 55:672-684. [PMID: 35344612 DOI: 10.1111/iej.13740] [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: 05/19/2021] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
AIM To describe the radicular dentine thickness in mandibular first premolars presenting C-shaped root canals, in order to identify the canal walls with less thickness as potential danger zones. In addition, to describe the internal and external anatomical characteristics of these teeth and to associate them to the dentine thickness. METHODOLOGY A total of 70 mandibular first premolars presenting C-shaped root canals were examined. Their internal morphology was analyzed using Vertucci´s and Fan´s criteria, and their external morphology was analyzed using the ASUDAS score. Besides, the dentine thickness around the root canals was two/three-dimensionally determined at five root planes and quantified in the distal and the mesial aspects. RESULTS According to Fan´s, ASUDAS, and Vertucci´s classifications, the most common canal configurations were category C3, grade 3, and type V, respectively. In Vertucci's type III anatomy, the mesial root wall of the lingual canal showed significantly less dentine thickness than the distal wall in the middle plane (p = 0.031). Similarly, in Vertucci's type V anatomy, significantly less dentine thickness was observed in the mesial root wall of the buccal and lingual canals in the middle plane (p < 0.001) and the buccal canal in the middle-apical plane (p = 0.014) than the distal root wall of these canals. In teeth with ASUDAS grade 3 and 4 scores, significantly less dentine thickness was observed in the mesial in comparison with the distal root wall of these canals. These differences were demonstrated in the middle and middle-apical planes (p < 0.001) of grade 3 teeth and the middle-apical plane (p < 0.001) of grade 4 teeth. In these root planes, the Ver1-AS3 and VerV-AS3 combinations presented a 4-times greater risk of presenting walls with a critical dentine thickness of 0.6 mm (OR=4, p = 0.025) than the combinations Ver1-AS2, VerV-AS2, VerV-AS4, and VerIII-AS3. CONCLUSIONS The root canal system configuration of mandibular first premolars with C-shaped canals showed a wide range of anatomical variations. The lowest dentine thickness was located in the mesial wall of the canals in the middle and apical root thirds of Vertucci´s type III and V anatomies and in teeth with deep radicular grooves scored as ASUDAS grade 3 and 4. In the middle and middle-apical planes, the presence of the combinations Ver1-AS3 and VerV-AS3 showed a high risk of presenting a critical dentine thickness of 0.6 mm. Therefore, these root canal walls with less dentine thickness represent potential instrumentation danger zones in mandibular first premolars with C-shaped canals.
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Affiliation(s)
- A Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - L González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - J Balanta-Melo
- School of Dentistry, Faculty of Health, Universidad del Valle, Cali, Colombia
| | - E A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima
| | - C Rojas
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - S Melgar-Rodríguez
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - P Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
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Al-Mahroos NE, Al-Mahroos SE, Al-Shahrani S. Management of mandibular premolars with various C-shaped root canal configurations: A case series. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_27_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Battula MS, Kaushik M, Mehra N, Singh A. Endodontic management of maxillary first molar with unusual anatomy. J Conserv Dent 2022; 25:569-572. [PMID: 36506634 PMCID: PMC9733555 DOI: 10.4103/jcd.jcd_266_22] [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: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/15/2022] Open
Abstract
This article reports nonsurgical endodontic management of bilateral maxillary first molars with an unusual morphology of a single root and a Sert and Bayirli type-IX canal configuration. A 41-year-old female reported with dull continuous pain in the maxillary left and right quadrants. On clinical examination, the maxillary first molars on both sides were carious with pulpal exposure and radiographic evaluation revealed an unusual anatomy of single root and single canal for both of them. Based on clinical and radiographic examination, tooth numbers 16 and 26 were diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Root canal treatment was initiated and cone-beam computed tomography (CBCT) imaging was advised on encountering unusual internal anatomy. The CBCT images revealed the presence single root and a Sert and Bayirli type-IX canal configuration bilaterally. Root canal treatment was performed under magnification using the dental operating microscope.
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Affiliation(s)
- Madhuri Sai Battula
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Hyderabad, Telangana, India,Address for correspondence: Dr. Madhuri Sai Battula, Army College of Dental Sciences, CRPF Road, Jai Jawahar Nagar Post, Hyderabad - 500 087, Telangana, India. E-mail:
| | - Mamta Kaushik
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Hyderabad, Telangana, India
| | - Neha Mehra
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Hyderabad, Telangana, India
| | - Ankeeta Singh
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Hyderabad, Telangana, India
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Yu YH, Kim M, Kratchman S, Karabucak B. Surgical management of lateral lesions with intentional replantation in single-rooted mandibular first premolars with radicular groove. J Am Dent Assoc 2022; 153:371-381. [DOI: 10.1016/j.adaj.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
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Rincón Rodriguez ML, Martínez-Vega RA, Duarte Monsalve ML, Moreno Monsalve JO. Reproducibilidad y validez de criterio de dos técnicas radiográficas para variaciones de premolares mandibulares comparadas con CBCT. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La existencia de variaciones anatómicas ocasiona fracasos en tratamientos endodónticos, por lo que es importante diagnosticarlas. El objetivo fue determinar la reproducibilidad y la validez de criterio de las radiografías con placa de fósforo y la radiovisografía con sensor para identificar las variaciones anatómicas detectadas por tomografía computarizada de haz cónico (CBCT) en premolares inferiores. Métodos: En 140 premolares se obtuvieron imágenes por CBCT, radiografía y radiovisografía. Se realizó lectura independiente por dos endodocistas, evaluándose la clasificación de Vertucci y las ramificaciones. Se determinó la reproducibilidad intraobservador e interobservador. Se calcularon sensibilidad, especificidad y áreas bajo la curva operador-receptor (AUC) utilizando como estándar de oro la CBCT. Resultados: La reproducibilidad intraobservador e interobservador fue mayor para radiografía. Para la Clase I de Vertucci, la radiografía presentó mayor sensibilidad (94,7%), especificidad (64,9%) y AUC (0,795) que la radiovisiografía (89,3%, 62,2% y 0,757, respectivamente), al igual que para la Clase V (Radiografía 69,2%, 93% y 0,811; Radiovisiografía 50%, 84,2% y 0,671, respectivamente). Ninguna de las técnicas aportó al diagnóstico de la Clase III (AUC <0,5). Las ramificaciones fueron infrecuentes (2,9%) y su detección fue baja (Sensibilidad 25% para radiografía y 0% para radiovisiografía). Discusión: Este es el primer estudio que evalúa la reproducibilidad y validez de estas dos técnicas radiográficas comparadas con la CBCT para la detección de variaciones anatómicas en dientes. Conclusiones: La radiografía con placa de fósforo presentó mayor reproducibilidad y validez para el diagnóstico de las Clase I y V de Vertucci, que fueron las variaciones más frecuentes.
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Thanaruengrong P, Kulvitit S, Navachinda M, Charoenlarp P. Prevalence of complex root canal morphology in the mandibular first and second premolars in Thai population: CBCT analysis. BMC Oral Health 2021; 21:449. [PMID: 34530811 PMCID: PMC8444426 DOI: 10.1186/s12903-021-01822-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Mandibular premolars demonstrate high variability in root canal morphology, especially mandibular first premolars. The purposes of this study were to determine the prevalence of root canal configurations of mandibular premolars according to Vertucci classification in a Thai population. Methods Total of 1159 CBCT images of Thai patients who received radiographic imaging at the Department of Radiology, Faculty of Dentistry, Chulalongkorn University in 2017–2018 was evaluated. The data were reported using descriptive statistics and the relationship between the prevalence of the root canal complexities and sex was analyzed using the chi-squared test. Results The most common root canal configuration was Vertucci type I, with a 63.1% and 98% prevalence in the mandibular first and second premolars, respectively. More than 98% of mandibular premolars had a single root. The prevalence of a bifurcation was 28.5% and 1.5% in the mandibular first and second premolars, respectively. The prevalence of a trifurcation was 3.2% in the mandibular first premolar. A C-shaped root canal was observed at 23.7% and 0.7% in the mandibular first and second premolars, respectively. The level of branching was mostly found at the middle 1/3 of the root. Bilateral appearance of the same root canal configuration was identified in 80.3% and 95.9% in the mandibular first and second premolars, respectively. There was no relationship between sex and the prevalence of a bifurcation, trifurcation, or C-shaped root canal. Conclusion Mandibular first premolars have more root canal complexities than mandibular second premolars. Horizontal tube shift x-ray technique, CBCT, dental operating microscope, and knowledge of root canal configurations have an important role in root canal identification in mandibular premolar with suspected complex root canal morphology. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01822-7.
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Affiliation(s)
- Paramee Thanaruengrong
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Sirinya Kulvitit
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand.
| | - Mettachit Navachinda
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Pornkawee Charoenlarp
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
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Martins JN, Zhang Y, von Zuben M, Vargas W, Seedat HC, Santiago F, Aguilar RR, Ragnarsson MF, Plotino G, Parashos P, Ounsi HF, Nole C, Monroe A, Kottoor J, Gonzalez JA, Flynn D, Chaniotis A, Cassim I, Boveda C, Berti L, Altaki Z, Alkhawas MBA, Alfawaz H, Silva EJL, Versiani MA. Worldwide Prevalence of a Lingual Canal in Mandibular Premolars: A Multicenter Cross-sectional Study with Meta-analysis. J Endod 2021; 47:1253-1264. [DOI: 10.1016/j.joen.2021.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/08/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
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Sierra-Cristancho A, González-Osuna L, Poblete D, Cafferata EA, Carvajal P, Lozano CP, Vernal R. Micro-tomographic characterization of the root and canal system morphology of mandibular first premolars in a Chilean population. Sci Rep 2021; 11:93. [PMID: 33420202 PMCID: PMC7794380 DOI: 10.1038/s41598-020-80046-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
This study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.
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Affiliation(s)
- Alfredo Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - Luis González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Daniela Poblete
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Emilio A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Paola Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Carla P Lozano
- Oral Biology and Biochemistry Laboratory, Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile. .,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
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12
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Lobo NS, Wanderley VA, Nejaim Y, Gomes AF, Zaia AA. Assessment of Ramifications in the Apical Region of Root Canals: A Micro-CT Study in a Brazilian Population. Braz Dent J 2020; 31:505-510. [PMID: 33146334 DOI: 10.1590/0103-6440202003430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023] Open
Abstract
The present study used microcomputed tomography (micro-CT) images to assess the prevalence, number, and location of apical ramifications (ARs) in the root canals of different dental groups in a Brazilian population. Three hundred and sixty-seven extracted human teeth, totaling 475 roots, were scanned by micro-CT at 19.6 µm spatial resolution. The obtained images were evaluated by two observers in consensus, and a descriptive analysis was performed to verify the prevalence, number, and location of ARs in each dental group. Chi-square test was used to compare the prevalence of ARs in different types of roots, and one-way analysis of variance compared the number of ARs in the apical 1 mm, 2 mm, and 3 mm of the root. Significance level was established at 5% (α=0.05). ARs were present in 253 (53.3%) of the 475 roots evaluated. A total of 607 ARs were detected, with the vast majority (530) located at one and two millimeters from the main foramen. The highest prevalence of ARs was observed in maxillary canines (65%); maxillary premolars - single-rooted (83.3%), buccal root (80%), and palatine root (73.3%); mandibular premolars (64.2%); mesiobuccal root of maxillary molars (76.6%); and mesial root of mandibular molars (66.6%). For the Brazilian population, most of the ARs are located in the apical 1 and 2 mm of the root, with greater prevalence in the posterior teeth and maxillary canines. These findings suggest the need for additional attention while planning endodontic treatments, including strategies to effectively clean and fill the apical region.
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Affiliation(s)
- Natalia Siqueira Lobo
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Victor Aquino Wanderley
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Yuri Nejaim
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alexandre Augusto Zaia
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Root Canal Treatment of Mandibular Second Premolars with Three Root Canals-Report of Four Rare Cases. BALKAN JOURNAL OF DENTAL MEDICINE 2020. [DOI: 10.2478/bjdm-2020-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: The aim of root canal treatment is the thorough cleaning, shaping and obturation of the root canals. Variations in root canal anatomy increase the difficulty of the root canal treatment and therefore the possibility of failure. The mandibular premolars often present complex anatomy and the existence of mandibular second premolars with three root canals is very scarce. This report presents the successful endodontic management of four mandibular second premolars with three root canals.
Cases Report: In all cases working length was estimated using the working length radiograph and an apex locator. Canal orifices were enlarged with Gates-Glidden drills and manual instrumentation performed with Stainless Steel reamers and Hedstroem files, using either step-back or crown-down technique. Sodium hypochlorite (NaOCl) 2.5% was used as an irrigant. Root canal obturation were then performed using the cold lateral condensation technique with gutta-percha points and Roth’s 801 canal sealer. The cases were scheduled for clinical and radiographic follow-up examination. Clinically in all follow-up examinations the teeth were asymptomatic. For the three cases with periapical lesions, post treatment radiographs, demonstrated periapical healing. Additionally, in the case without periapical lesion, the 9 months recall radiograph revealed healthy periapical conditions.
Conclusions: Mandibular premolars should never be underestimated and the clinician should always be alerted for anatomic variations.
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Milanovic I, Milovanovic P, Antonijevic D, Dzeletovic B, Djuric M, Miletic V. Immediate and Long-Term Porosity of Calcium Silicate-Based Sealers. J Endod 2020; 46:515-523. [PMID: 32094001 DOI: 10.1016/j.joen.2020.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 01/05/2020] [Accepted: 01/08/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Open pores between endodontic sealer and root canal walls present potential niches for bacterial growth and migration pathways. The aim was to assess the internal and external porosity of calcium silicate-based sealers and to ascertain the long-term effect of storage in simulated body fluid on sealer porosity. METHODS Sixteen single-rooted teeth were filled with gutta-percha and 1 of 4 root canal sealers: BioRoot RCS, EndoSequence BC, MTA Fillapex, or AH Plus. Obturated roots, stored in Hank's balanced salt solution, were scanned after 7 days and after 6 months by using micro-computed tomography at an isotropic resolution of 9.9 μm. Total, open, and closed porosity were calculated in the coronal, middle, and apical thirds. Data were statistically analyzed by using general linear model and paired t test (α = 0.05). RESULTS Significantly higher percentage of open than closed porosity was found in all groups. Initially, significantly greater open and total porosity were found for MTA Fillapex than for AH Plus. After 6 months, the percentage of open and total porosity increased in BioRoot RCS and MTA Fillapex and decreased in AH Plus and EndoSequence BC. Both initially and after storage, coronal region of all sealers had significantly greater total porosity than middle and apical regions, which were comparable. CONCLUSIONS None of the root fillings were void-free, with predominant open porosity persisting after long-term storage.
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Affiliation(s)
- Ivana Milanovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Antonijevic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Dzeletovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Miletic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
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Abstract
Purpose: To determine the three-dimensional (3D) tooth morphology of all primary molars and to identify and consolidate positional factors that could potentially have an effect on tooth preparation. Study design: Thirty-one non-carious primary molars were scanned using micro-CT and reconstructed using 3D analysis software. Each pulp horn to its respective cusp tip distance (PHCD) was measured as well as the distances from the pulp chamber to the mesial, distal, lingual and buccal surfaces. One-way ANOVA and post-hoc t-tests were used for data analysis. Results: The mesio-buccal and disto-buccal PHCD was significantly shorter than the mesio-lingual and disto-lingual PHCDs in maxillary second primary molars (P < 0.05). Mesial, distal and lingual walls were thinner than the buccal walls of mandibular molars while in maxillary molars; the mesial and distal walls were thinner than the palatal and buccal walls (P < 0.05). Conclusions: First primary molars have thinner tooth structure surrounding the pulp than second primary molars in the same arch with the exception of the buccal walls of all molars and lingual walls of maxillary molars. The mesial and distal walls are thinner than the buccal walls of all molars and lingual walls in maxillary molars.
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Casadei BDA, Lara-Mendes STDO, Barbosa CDFM, Araújo CV, de Freitas CA, Machado VC, Santa-Rosa CC. Access to original canal trajectory after deviation and perforation with guided endodontic assistance. AUST ENDOD J 2019; 46:101-106. [PMID: 31267636 DOI: 10.1111/aej.12360] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 11/28/2022]
Abstract
Procedural accidents are eventualities that may occur during endodontic treatment because of lack of attention to detail or even unforeseeable situations. Knowledge of the root canal anatomy and its variations is a prerequisite for successful endodontic treatment. This case report describes an endodontic treatment where there was an intercurrence, generating deviation and perforation, which was solved with the aid of guided endodontics. A 37 years old, ASA1, was referred to the clinic for localisation and treatment of a calcified canal of the second right upper premolar. The tomographic images revealed the presence of only one canal and deviation with apical perforation. With the help of CBCT and CAD/CAM, it was possible to perform the guided access technique even after deviation and root perforation. Once again, this technique proved to be safe and predictable, allowing for a favourable prognosis in the long term.
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Affiliation(s)
- Bruna de Athayde Casadei
- Department of Endodontics, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte (SLM-Belo Horizonte), Belo Horizonte, Brazil
| | | | - Camila de Freitas M Barbosa
- Department of Endodontics, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Campinas (SLM-Campinas), Campinas, Brazil
| | - Christiane Valente Araújo
- Department of Endodontics, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte (SLM-Belo Horizonte), Belo Horizonte, Brazil
| | - Cristina Almeida de Freitas
- Department of Endodontics, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte (SLM-Belo Horizonte), Belo Horizonte, Brazil
| | - Vinícius C Machado
- Department of Radiology, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte (SLM-Belo Horizonte), Belo Horizonte, Brazil
| | - Caroline C Santa-Rosa
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Guerreiro D, Shin JM, Pereira M, McDonald NJ. Radicular Groove Accessory Canal Morphology in Mandibular First Premolars: Micro-computed Tomographic Study. J Endod 2019; 45:554-559. [PMID: 30827771 DOI: 10.1016/j.joen.2018.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/17/2018] [Accepted: 12/30/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the morphologic features of radicular groove accessory canals (RGACs) in mandibular first premolars and their relationship to root anatomy by micro-computed tomographic imaging. METHODS A total of 154 single-rooted mandibular first premolars with radicular grooves were selected. The teeth were scanned by micro-computed tomographic imaging, and the following parameters were recorded: (1) the presence of RGACs, (2) the origin of RGACs, (3) the position of the RGAC foramen in the groove in relation to root length, (4) the foramen diameter, (5) the type of groove present according to the Arizona State University dental anthropology scoring system (ASUDAS), and (6) the type of anatomy present according to Vertucci's classification. The data were recorded and statistically analyzed using the chi-square test (P < .05). RESULTS The incidence of RGACs in the teeth was 49.9%. The average distance from the cementoenamel junction plane to the RGAC foramen was 8.83 ± 2.53 mm, and the majority of the RGAC foramina were located in the middle third. Regarding the severity of the groove, the presence of RGACs was significantly higher for groups ASUDAS 3 and 4 compared with ASUDAS 1 and 2 (85.7% and 14.3%, respectively). The presence of at least 1 RGAC was greatest for Vertucci type V (46%) and for more complex types (46%) when compared with Vertucci types I and III. CONCLUSIONS Mandibular first premolars with radicular grooves often present with RGACs. An association between the internal and external anatomy and the presence of RGACs was detected in this study.
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Affiliation(s)
- Diogo Guerreiro
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan.
| | - Jae M Shin
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Mário Pereira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Neville J McDonald
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
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Plascencia H, Cruz Á, Palafox-Sánchez CA, Díaz M, López C, Bramante CM, Moldauer BI, Ordinola-Zapata R. Micro-CT study of the root canal anatomy of maxillary canines. J Clin Exp Dent 2017; 9:e1230-e1236. [PMID: 29167714 PMCID: PMC5694153 DOI: 10.4317/jced.54235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/06/2017] [Indexed: 11/07/2022] Open
Abstract
Background This study aimed to describe the anatomy of maxillary canines from a Western Mexican sub-population using micro-computed tomography (micro-CT). Material and Methods Maxillary canines (n=32) were scanned at 19.6µm voxel resolution. Number and location of canals, the distance between the cemento-enamel junction and apex, occurrence of accessory and lateral canals, presence of oval canals, number of foraminas as well as two- (area, perimeter, roundness, aspect ratio, major and minor diameters) and three-dimensional (volume, surface area, and SMI) analysis were performed. Data of two-dimensional analyses at 5 different apical levels was statistically compared using Kruskal-Wallis tests (α=0.05). Results Overall, 31 specimens had one root with a main canal (Vertucci type I). Mean distance from the apex to the cemento-enamel junction was 16.32±2.27. Apical foraminas were present in 14 specimens (43.75%). No statistical differences were found in the two-dimensional analyses between the foramen and the 1 and 2mm apical levels (P >0.05). Conclusions Maxillary canines presenting one root canal were present in a high percentage of cases (96%). The prevalence of long oval canals was <12% at the apical third and at least 37% of the sample showed more than one point of exit in the last apical 3mm. Key words:Maxillary canine, micro-computed tomography, root canal anatomy.
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Affiliation(s)
- Hugo Plascencia
- DDS, Endodontic Postgraduate Program, CUCS-CUAltos, University of Guadalajara, Mexico
| | - Álvaro Cruz
- DDS, MSc, PhD, Endodontic Postgraduate Program and Research Institute in Biomedical Sciences, CUCS, University of Guadalajara, Mexico
| | - Claudia-Azucena Palafox-Sánchez
- DDS, MSc, PhD, Research Institute in Biomedical Sciences, Department of Medical Clinics, CUCS, University of Guadalajara, Mexico
| | - Mariana Díaz
- DDS, Endodontic Postgraduate Program, CUCS-CUAltos, University of Guadalajara, Mexico
| | - Claudia López
- Postgraduate Student, Endodontic Postgraduate Program, CUAltos, University of Guadalajara, Mexico
| | - Clovis-Monteiro Bramante
- DDS, MSc, PhD, Department of Endodontics, Dental School of Bauru, University of Sao Paulo, Bauru, Brazil
| | - Bertram I Moldauer
- DDS, MS, Adjunct Assistant Professor in Endodontics and Surgical Course Co-Director, Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, Florida
| | - Ronald Ordinola-Zapata
- DDS, MSc, PhD, Department of Endodontics, Dental School of Bauru, University of Sao Paulo, Bauru, Brazil
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Zoya-Farook A, Abhishek P, Shahabadi A. Cone-beam Computed Tomographic Evaluation and Endodontic Management of a Mandibular First Premolar with Type IX Canal Configuration: Case Report. J Endod 2017; 43:1207-1213. [DOI: 10.1016/j.joen.2017.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/30/2016] [Accepted: 01/08/2017] [Indexed: 11/25/2022]
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Ordinola-Zapata R, Martins JNR, Bramante CM, Villas-Boas MH, Duarte MH, Versiani MA. Morphological evaluation of maxillary second molars with fused roots: a micro-CT study. Int Endod J 2017; 50:1192-1200. [DOI: 10.1111/iej.12752] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- R. Ordinola-Zapata
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
- Bender Division of Endodontics; Albert Einstein Medical Center; Philadelphia PA USA
| | - J. N. R. Martins
- Department of Endodontics; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisboa Portugal
| | - C. M. Bramante
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - M. H. Villas-Boas
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - M. H. Duarte
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - M. A. Versiani
- Department of Restorative Dentistry; Ribeirão Preto Dental School; University of São Paulo; Ribeirão Preto Brazil
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Kato A, Ziegler A, Utsumi M, Ohno K, Takeichi T. Three-dimensional imaging of internal tooth structures: Applications in dental education. J Oral Biosci 2016. [DOI: 10.1016/j.job.2016.05.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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22
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Ordinola-Zapata R, Bramante CM, Versiani MA, Moldauer BI, Topham G, Gutmann JL, Nuñez A, Duarte MAH, Abella F. Comparative accuracy of the Clearing Technique, CBCT and Micro-CT methods in studying the mesial root canal configuration of mandibular first molars. Int Endod J 2016; 50:90-96. [PMID: 26659613 DOI: 10.1111/iej.12593] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 12/02/2015] [Indexed: 11/30/2022]
Abstract
AIMS To compare the accuracy of the clearing technique and cone beam computed tomography (CBCT) in the assessment of root canal configurations using micro-computed tomography (micro-CT) imaging system as the reference standard. METHODOLOGY Thirty-two mesial roots of mandibular first molars, selected on the basis of micro-CT scans (voxel size: 19.6 μm) and presenting several canal configurations, were evaluated using 2 CBCT scanners (voxels sizes: 120 μm and 150 μm) followed by the clearing technique. Two examiners analysed the data from each method and classified the anatomical configuration of the mesial canal according to Vertucci's system. Data were compared using Fisher's exact and chi-square tests. Reliability for each assessment was verified by the kappa test, and significance level was set at 5%. RESULTS Kappa value indicated a high level of agreement between the examiners. Detection of type I configurations was significantly lower in cleared teeth (P < 0.05), whilst type II root canals were detected in all specimens by both tests (P > 0.05). In mesial roots with variable anatomical configurations, CBCT and the clearing method were significantly less accurate than the reference standard (P < 0.05). CONCLUSION Within the tooth population studied, accuracy of identifying mesial root canal configuration was influenced greatly by the evaluation method and the type of anatomy. Detection of type I configurations in cleared teeth was significantly lower, whilst type II configurations were detected in all specimens by both methods. In mesial roots with variable anatomical configurations, neither CBCT nor clearing methods were accurate for detecting the actual root canal anatomy.
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Affiliation(s)
- R Ordinola-Zapata
- Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.,Advanced Education in General Dentistry Program, Larkin Community Hospital, Miami, FL, USA
| | - C M Bramante
- Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M A Versiani
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - B I Moldauer
- Advanced Education in General Dentistry Program, Larkin Community Hospital, Miami, FL, USA
| | - G Topham
- Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain
| | - J L Gutmann
- Department of Endodontics, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, TX, USA
| | - A Nuñez
- Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain
| | - M A Hungaro Duarte
- Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - F Abella
- Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain
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23
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Middle mesial canals in mandibular first molars: A micro-CT study in different populations. Arch Oral Biol 2016; 61:130-7. [DOI: 10.1016/j.archoralbio.2015.10.020] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 09/26/2015] [Accepted: 10/21/2015] [Indexed: 11/21/2022]
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24
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De-Deus G, Belladonna FG, Silva EJNL, Marins JR, Souza EM, Perez R, Lopes RT, Versiani MA, Paciornik S, Neves ADA. Micro-CT Evaluation of Non-instrumented Canal Areas with Different Enlargements Performed by NiTi Systems. Braz Dent J 2015; 26:624-9. [DOI: 10.1590/0103-6440201300116] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the percentage of non-instrumented area of root canals prepared with different enlargements using single-file reciprocating systems (Reciproc and WaveOne) and a conventional multi-file rotary (BioRaCe) system by micro-computed tomographic analysis. Thirty mesial roots of mandibular molars with moderate curvature (10° to 20°) presenting a type II Vertucci canal configuration and similar internal volume were chosen and scanned at an isotropic resolution of 14.16 µm. The sample was assigned to 3 groups (n=10) according to the system used for root canal preparation: Reciproc, WaveOne, and BioRaCe groups. Second and third scans were taken after the canals were prepared with instruments sizes 25 and 40, respectively. The recorded images of the surface area voxels of the canals, before and after preparation were examined from the furcation level to the apex to quantify the non-instrumented surface. Statistical data were compared using GLM for repeated-measures with a significance level set at 5%. Instrumentation systems did not influence the percentage of untouched root canal surfaces (p=0.690) whilst a significant reduction in the percentage of static voxels was observed after the enlargement of the root canal (p=0.010) in all groups (p=0.507). None of the systems was able to prepare the entire surface area of the mesial root canal of mandibular molars. The increased final apical size resulted in a significant positive effect on the shaping ability of the tested systems.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sidnei Paciornik
- PUC-RIO - Pontifícia Universidade Católica do Rio de Janeiro, Brazil
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Filpo-Perez C, Bramante CM, Villas-Boas MH, Húngaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod 2014; 41:231-6. [PMID: 25447505 DOI: 10.1016/j.joen.2014.09.024] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 09/15/2014] [Accepted: 09/27/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the morphologic aspects of the root canal anatomy of the distal root of a mandibular first molar using micro-computed tomographic analysis. METHODS One-hundred distal roots of mandibular first molars were scanned using a micro-computed tomographic device at an isotropic resolution of 19.6 μm. The percentage frequency distribution of the morphologic configuration of the root canal was performed according to the Vertucci classification system. Two-dimensional parameters (area, perimeter, roundness, aspect ratio, and major and minor diameters) and the cross-sectional shape of the root canal were analyzed in the apical third at every 1-mm interval from the main apical foramen in roots presenting Vertucci types I and II configurations (n = 79). Data were statistically compared using the Kruskal-Wallis and Dunn tests with a significance level set at 5%. RESULTS Seventy-six percent of the distal roots had a single root canal. Two, three, and four canals were found in 13%, 8%, and 3% of the sample, respectively. In 13 specimens, the configuration of the root canal did not fit into Vertucci's classification. Overall, 2-dimensional parameter values significantly increased at the 3-mm level (P < .05). The prevalence of oval canals was higher at the 1-mm level and decreased at the 5-mm level in which long oval and flattened canals were more prevalent. CONCLUSIONS The distal roots of the mandibular first molars showed a high prevalence of single root canals. The prevalence of long oval and flattened canals increased in the coronal direction. In 13% of the samples, canal configurations that were not included in Vertucci's configuration system were found.
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Affiliation(s)
- Carolina Filpo-Perez
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Clovis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marcelo Haas Villas-Boas
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marco Aurélio Versiani
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ronald Ordinola-Zapata
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil.
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26
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Ordinola-Zapata R, Monteiro Bramante C, Gagliardi Minotti P, Cavalini Cavenago B, Gutmann JL, Moldauer BI, Versiani MA, Hungaro Duarte MA. Micro-CT evaluation of C-shaped mandibular first premolars in a Brazilian subpopulation. Int Endod J 2014; 48:807-13. [DOI: 10.1111/iej.12380] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- R. Ordinola-Zapata
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - C. Monteiro Bramante
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - P. Gagliardi Minotti
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - B. Cavalini Cavenago
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
| | - J. L. Gutmann
- Department of Endodontics; Baylor College of Dentistry; Texas A&M University System Health Science Center; Dallas TX USA
| | - B. I. Moldauer
- Advanced Education in General Dentistry Program; Larkin Community Hospital; Miami FL USA
| | - M. A. Versiani
- Department of Endodontics; Ribeirão Preto Dental School; University of São Paulo; Ribeirão Preto Brazil
| | - M. A. Hungaro Duarte
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
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Abarca J, Zaror C, Monardes H, Hermosilla V, Muñoz C, Cantin M. Morphology of the Physiological Apical Foramen in Maxillary and Mandibular First Molars. INT J MORPHOL 2014; 32:671-677. [PMID: 25937698 DOI: 10.4067/s0717-95022014000200048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3-5 mm from the apex were sectioned and prepared for analysis at 40× magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24-0.33 mm in maxillary first molars and between 0.25-0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully.
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Affiliation(s)
- J Abarca
- Alumno Programa Magister en Odontología, Universidad de La Frontera, Temuco, Chile ; Facultad de Odontología, Universidad San Sebastián, Puerto Montt, Chile
| | - C Zaror
- Departamento de Odontopediatría y Ortodoncia, Facultad de Odontología, Universidad de la Frontera, Temuco, Chile
| | - H Monardes
- Facultad de Odontología, Universidad San Sebastián, Santiago, Chile
| | - V Hermosilla
- Alumna Programa de Postítulo en Endodoncia, Facultad de Odontología, Universidad San Sebastián, Santiago, Chile
| | - C Muñoz
- Alumna Programa de Postítulo en Endodoncia, Facultad de Odontología, Universidad San Sebastián, Santiago, Chile
| | - M Cantin
- Programa de Doctorado en Ciencias Morfológicas. CIMA Research Group, Facultad de Odontología, Universidad de la Frontera, Temuco, Chile ; Center of Research in Biomedical Science, Universidad Autónoma de Chile, Temuco, Chile
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Endodontic and clinical considerations in the management of variable anatomy in mandibular premolars: a literature review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:512574. [PMID: 24895584 PMCID: PMC4034431 DOI: 10.1155/2014/512574] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/16/2014] [Indexed: 12/16/2022]
Abstract
Mandibular premolars are known to have numerous anatomic variations of their roots and root canals, which are a challenge to treat endodontically. The paper reviews literature to detail the various clinically relevant anatomic considerations with detailed techniques and methods to successfully manage these anomalies. An emphasis and detailed description of every step of treatment including preoperative diagnosis, intraoperative identification and management, and surgical endodontic considerations for the successful management of these complex cases have been included.
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Chen J, Li X, Su Y, Zhang D, Wen X, Nie X, An J, Liu L, Deng M. A micro-computed tomography study of the relationship between radicular grooves and root canal morphology in mandibular first premolars. Clin Oral Investig 2014; 19:329-34. [DOI: 10.1007/s00784-014-1242-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
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Root anatomy and root canal configuration of human permanent mandibular premolars: a systematic review. ANATOMY RESEARCH INTERNATIONAL 2013; 2013:254250. [PMID: 24455268 PMCID: PMC3881342 DOI: 10.1155/2013/254250] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 11/17/2022]
Abstract
Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24%) while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.
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