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Chan F, Brown LF, Parashos P. CBCT in contemporary endodontics. Aust Dent J 2023; 68 Suppl 1:S39-S55. [PMID: 37975281 DOI: 10.1111/adj.12995] [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
Cone-beam computed tomography (CBCT) is a three-dimensional imaging modality which can aid endodontic diagnosis and treatment planning. While there are guidelines available describing the indications, there are divergent philosophies on when this technology should be applied in clinical practice. This paper reviews the applications of CBCT including the clinical relevance of parameters which can be assessed, highlights the limitations of this technology, and provides guidance on how to maximise its clinical utility.
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Affiliation(s)
- F Chan
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - L F Brown
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Mishra A, Natanasabapathy V, Kowsky D, Sharan J, Marya A. Variation in location of the distobuccal root canal in a permanent maxillary second molar: A case report. Clin Case Rep 2023; 11:e7312. [PMID: 37151948 PMCID: PMC10160812 DOI: 10.1002/ccr3.7312] [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: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
Key Clinical Message Clinicians should be aware of the variations in the number of roots and root canals and the peculiar or eccentric location of root canals. An intraoperative CBCT can be very useful in improved visualization of the anatomical variations. Abstract This case report describes the unusual location of the distobuccal root canal in a maxillary second molar with root fusion. On access opening, three distinct root canal orifices, the mesiobuccal canal, palatal canal, and a third orifice closer to the palatal canal, were seen, giving an illusion of an additional palatal canal. An attempt was made to search for the distobuccal canal in its usual position, leading to the gouging of the pulp chamber floor. An intraoperative limited field of view cone-beam computed tomography (CBCT) revealed the root orifice adjacent to the palatal canal was the distobuccal canal. CBCT also revealed fusion of both the buccal and palatal roots in the root's coronal and middle third region, but they were not fused apically.
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Affiliation(s)
- Anisha Mishra
- Department of DentistryAll India Institute of Medical SciencesBhubaneswarIndia
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of DentistryMeenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER)ChennaiIndia
| | - Dinesh Kowsky
- Department of Conservative Dentistry and Endodontics, Faculty of DentistryMeenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER)ChennaiIndia
| | - Jitendra Sharan
- Unit of Orthodontics and Dentofacial Orthopedics, Department of DentistryAll India Institute of Medical SciencesBhubaneswarIndia
| | - Anand Marya
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Center for Transdisciplinary ResearchSaveetha Dental College, Saveetha Institute of Medical and Technical ScienceSaveetha UniversityChennaiIndia
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Alhujhuj RR, Jouhar R, Ahmed MA, Almujhim AA, Albutayh MT, Adanir N. Evaluation of Root Canal Configuration of Maxillary and Mandibular First Molar by CBCT: A Retrospective Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12092121. [PMID: 36140523 PMCID: PMC9497805 DOI: 10.3390/diagnostics12092121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/04/2022] Open
Abstract
Adequate knowledge of root canal morphology along with its probable variations is imperative to acquire successful endodontic treatment. This retrospective cross-sectional study aimed to investigate the root canal configuration of maxillary and mandibular first molar using Cone-Beam Computed Tomography (CBCT) among patients in Al-Ahsa region, Saudi Arabia. A total of 377 samples were included, out of which 123 CBCT (I-CAT Vision QTM) scans with intact all first permanent molars were selected in this study and scanned in sagittal, axial, and coronal views by using BlueSkyPlan software. The number of canals in each root and their configuration according to the Vertucci classification system was evaluated. Statistical analysis was analyzed using SPSS version 21 (IBM). Chi-square test was applied to evaluate the association of root canal morphology and mandibular and maxillary first molars with respect to gender. Out of 123 CBCT scans, 59 (48.0%) were males and 64 (52.0%) were females; the mean age was 26.95 ± 10.65 years. The mesiobuccal root of bilateral maxillary first molar had Type-I (87.0%) of Vertucci classification followed by Type-IV (9.8%). Additionally, all mesiobuccal roots (100%) of the left mandibular first molar had Type-I of Vertucci’s classification. A significant association has been observed between gender and a number of canals in bilateral maxillary first molars. Females showed a significantly higher prevalence of three-root canal configuration in maxillary first molars of both sides compared four canals found most commonly in males (p = 0.004). This study concluded that the majority of maxillary and mandibular permanent first molars had three roots and three canals with Type-I Vertucci’s classification in patients belonging to the Al-Ahsa region of the Saudi Arabia. It was also proved that gender is significantly associated with the number of canals in a bilateral maxillary molar.
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Alnowailaty Y, Alghamdi F. The Prevalence and Location of the Second Mesiobuccal Canals in Maxillary First and Second Molars Assessed by Cone-Beam Computed Tomography. Cureus 2022; 14:e24900. [PMID: 35698689 PMCID: PMC9185178 DOI: 10.7759/cureus.24900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/05/2022] Open
Abstract
Objective This retrospective study aimed to investigate the prevalence and location of the second mesiobuccal (MB2) canal in the mesiobuccal root of the maxillary first molar (MFM) and the maxillary second molar (MSM) through cone-beam computed tomography (CBCT) imaging. Methods One thousand two hundred CBCT images of the MFM and MSM were divided equally and analyzed. To standardize the methodology of MB2 detection, the observation and measurements were located at the pulpal floor by 1 mm apically. The distances between canals were calculated from the center point of the MB2 canal (PMB2) to the center point of both the first mesiobuccal canal (PMB1) and the palatal canal (PP). The data were provided in the form of frequencies and percentages. The chi-square test was used to analyze the differences among maxillary molars, while the significance level was set at 0.05. Results The prevalence of the MB2 canal in the MFM and MSM was 46.7% (p=0.020) and 17.7% (p=0.457), respectively. Additionally, the prevalence of the MB2 canal was more frequent in females. The average distance between PMB1 and PMB2 for MFM and MSM was 1.87±0.42 mm and 1.24±0.76 mm, respectively. Furthermore, the average distances of PMB2 and PP were 0.74±0.21 mm and 0.43±0.18 mm for MFM and MSM, respectively. Conclusion The MB2 canal was found in 386 (32.2%) of the maxillary molars. The Saudi people have a high possibility of discovering the MB2 canal. The CBCT is a useful and high-precision diagnostic tool not only for detecting but also for locating in vivo MB2 canal in the mesiobuccal root of maxillary molars.
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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: 2.0] [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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Syed G, Pullishery F, Attar A, Albalawi M, Alshareef M, Alsadeq A, Alraddadi A. Cone-beam computed tomographic evaluation of canal morphology of mesiobuccal root of maxillary molars in Saudi Subpopulation. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S410-S414. [PMID: 36110641 PMCID: PMC9469316 DOI: 10.4103/jpbs.jpbs_698_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction: The purpose of this study was to analyze the canal configuration of mesiobuccal root (MBR) of the maxillary molars in the Saudi subpopulation using cone-beam computed tomography (CBCT) and to compare if there is any gender and arch variation. Methodology: In this cross-sectional retrospective evaluation study, analysis of CBCT scans of MBRs of 400 maxillary first and second molars was done that has undergone CBCT scanning for diagnostic/treatment purposes in the private clinic of Jeddah, KSA. Statistical analysis was performed using Student's t-test and Chi-square test. Results: Type I, II, and III canal configurations have been reported to be the most common morphologies in the MBR in both first and second molars, with the incidence of 20.25% (81), 17.25% (69), and 17.25% (69), respectively. Type I canals were significantly (P < 0.001) more common in tooth #17 and #27, Type II canals were significantly (P < 0.001) more seen in tooth #26, Type 3 canals were more seen in tooth #27, but there is no statistically significant association. Supplemental canal configurations which were classified by Gulabivala as Type I, Type II, and Type IV were also seen. Furthermore, 93 additional unclassified canal configurations were also found. Conclusion: The data indicate high prevalence of MB2 canals with varying canal configurations. Preoperative CBCT imaging should always be done in tooth-like maxillary molars, to understand the complex configurations and variations and to achieve higher success while performing root canal treatment.
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A Comparison of Endodontic Treatment Factors, Operator Difficulties, and Perceived Oral Health-related Quality of Life between Elderly and Young Patients. J Endod 2021; 47:1844-1853. [PMID: 34499888 DOI: 10.1016/j.joen.2021.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The purpose of this study was to compare endodontic treatment factors, treatment difficulties, and oral health-related quality of life (OHRQOL) between elderly and young patients. METHODS A total of 150 adults, 75 elderly (≥65 years) and 75 young patients (18-64 years), were recruited. Operators enumerated difficulties associated with communication, diagnosis, rubber dam application, access cavity preparation, canal localization, working length determination, instrumentation, and obturation after root canal treatment. The number of treatment visits, maxillary first molars with a second mesiobuccal canal, and the technical quality of the root filling were registered. Patients filled out questionnaires on pain, attendance of regular dental visits, esthetics, and masticatory function and the Oral Health Impact Profile-14. RESULTS Significantly more elderly had necrotic pulp (P < .001) and needed root canal treatment on teeth with full-coverage crown/bridge abutment (P < .001). It was significantly difficult to perform access cavity preparation and localize root canals on the elderly and on teeth with a full-coverage crown/bridge abutment. In regression analysis, the elderly presented with difficulties only during canal localization (P < .05). Second mesiobuccal canals were obturated in 43.5% of the young patients and 23.1% of the elderly patients. There were no significant differences in the number of treatment visits or the technical quality of root filling between the 2 groups. There were no significant differences in pain sensation, esthetics, masticatory function, or regular dental visits between the 2 groups. Elderly patients reported a significantly better OHRQOL (P < .05). Patients experiencing pain, patients needing treatment on anteriors/premolars, and females reported a significantly poorer OHRQOL (P < .05). CONCLUSIONS The elderly presented with treatment difficulty during canal localization and had better OHRQOL compared with young patients.
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Mouzinho-Machado S, Rosado LDPL, Coelho-Silva F, Neves FS, Haiter-Neto F, de-Azevedo-Vaz SL. Influence of Voxel Size and Filter Application in Detecting Second Mesiobuccal Canals in Cone-beam Computed Tomographic Images. J Endod 2021; 47:1391-1397. [PMID: 34166686 DOI: 10.1016/j.joen.2021.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study assessed the influence of voxel size and filter application in detecting second mesiobuccal (MB2) canals in cone-beam computed tomographic (CBCT) images. METHODS Using the OP300 CBCT system (Instrumentarium, Tuusula, Finland) and 3 voxel size protocols (80 μm, 125 μm, and 200 μm), we scanned 40 first molars: 20 with an MB2 canal and 20 without. All molars received silver palladium pins on the palatal root, whereas the non-MB2 molars were also filled with gutta-percha. Five oral radiologists assessed the presence of an MB2 canal under 3 filter application conditions: without filter, with sharpen 1 × filter, and with sharpen 2 × filter. Intra- and interobserver reproducibility was evaluated using the weighted kappa index. We compared the area under the receiver operating characteristic curves with SPSS Statistics v.20.0 (IBM Corp, Armonk, NY) using 2-way analysis of variance and the Tukey post hoc test with 5% significance level. RESULTS Our analysis found median intra- and interobserver agreement values of 0.70 and 0.56, respectively. The 80-μm voxel with sharpen 1 × filter image group had the highest sensitivity, accuracy, and negative predictive values. As for specificity and positive predictive, the 80-μm voxel group without filter application presented the highest values. The areas under the receiver operating characteristic curve were higher in the 80-μm groups than in the 125-μm and 200-μm voxel size groups (P < .05). We found no differences among the filters used (P = .22) or for the filter-voxel size interactions (P = .88). CONCLUSIONS A smaller voxel size increased the accuracy in detecting MB2 canals, whereas the enhancement filters did not.
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Affiliation(s)
- Sâmia Mouzinho-Machado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lucas de Paula Lopes Rosado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fernanda Coelho-Silva
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Division of Oral Radiology, Department of Propedeutics and Integrated Clinic, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
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Ptak DM, Finkelman MD, Amato RB. The Association between Choice of Diagnostic Imaging Modality and Long-term Treatment Outcomes for Patients Undergoing Nonsurgical Root Canal Treatment on Maxillary First Molars. J Endod 2020; 47:572-576. [PMID: 33285204 DOI: 10.1016/j.joen.2020.11.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/22/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Radiography has played a fundamental role in the advancement of nonsurgical root canal therapy (NSRCT), allowing for more accurate diagnosis and treatment. Typically, providers choose to perform NSRCT using periapical (PA) radiographs alone or, often in more difficult cases, in conjunction with cone-beam computed tomographic (CBCT) imaging. This study aimed to evaluate the outcomes of NSRCT based on imaging modality selection for the initial treatment of maxillary first molars. METHODS A retrospective chart review was conducted using 1385 cases of NSRCT on maxillary first molars. Charts were reviewed for patient demographics and treatment outcomes. Based on the imaging modality used, patients were stratified into 2 groups (PA radiographs alone or PA radiographs + CBCT imaging). Those who required additional treatment(s) after the completion of NSRCT were classified as having "posttreatment disease." Statistical analysis was performed to assess the differences between groups. RESULTS After the completion of primary endodontic therapy, 5.8% (n = 81) of the entire sample had posttreatment disease. CBCT imaging was used in 13.4% (n = 185) of NSRCTs. Although not significant, cases that were difficult enough to require the use of CBCT imaging had a higher rate of posttreatment disease compared to those that could be completed with PA radiographs alone (8.6% vs 5.4%, P > .05). Results from a multivariable logistic regression model showed that the need for CBCT imaging had a nonsignificant positive association with posttreatment disease (P > .05). CONCLUSIONS The decision to use CBCT imaging appears to serve as a proxy for case complexity and the associated increase in risk of posttreatment disease. This is important to keep in mind when assessing treatment prognosis.
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Affiliation(s)
- Devon M Ptak
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, Massachusetts.
| | - Matthew D Finkelman
- Division of Biostatistics and Experimental Design, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Robert B Amato
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
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Al-Saedi A, Al-Bakhakh B, Al-Taee RG. Using Cone-Beam Computed Tomography to Determine the Prevalence of the Second Mesiobuccal Canal in Maxillary First Molar Teeth in a Sample of an Iraqi Population. Clin Cosmet Investig Dent 2020; 12:505-514. [PMID: 33235509 PMCID: PMC7678691 DOI: 10.2147/ccide.s281159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/29/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose This study aimed to determine the prevalence of the second mesiobuccal canal in maxillary first molar teeth in a sample of population from Basrah city in the south of Iraq. Patients and Methods Cone-beam computed tomography (CBCT) images of 353 Iraqi patients from Basrah city were included in the study. These images revealed 691 maxillary first molars, but only 655 of them were included. The images were obtained using a Gendex (GXDP-7000) CBCT machine (Hatfield, PA, USA) and studied for the prevalence of second mesiobuccal canal in the mesiobuccal root canal configuration, according to Vertucci’s classification, by scrolling through the images. Pearson’s chi-square tests were used to correlate canal type distribution to gender and age. The distributions of canal type on the right and left sides were assessed using the Kendal tau correlation coefficient. A P-value <0.001 was considered highly significant. For intra-examiner reliability analysis, Cohen’s kappa test was used. Results The second mesiobuccal canal was identified in 81.68% of the Iraqi population sample. The most common type was type II (44.58%), followed by type IV (31.30%). Type I occurred in 18.32% of cases. Other types were less frequent. Conclusion The second mesiobuccal canal occurred in most of the examined samples of the Iraqi population (81.68%), with the most common type being type II, followed by type IV.
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Affiliation(s)
- Aqeel Al-Saedi
- Oral Diagnosis Department, College of Dentistry, University of Basrah, Basrah, Iraq
| | - Bahaa Al-Bakhakh
- Conservative Dentistry Department, College of Dentistry, University of Basrah, Basrah, Iraq
| | - Riad G Al-Taee
- Oral and Maxillofacial Surgery Department, College of Dentistry, University of Basrah, Basrah, Iraq
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Zhuk R, Taylor S, Johnson JD, Paranjpe A. Locating the MB2 canal in relation to MB1 in Maxillary First Molars using CBCT imaging. AUST ENDOD J 2020; 46:184-190. [DOI: 10.1111/aej.12414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ruvim Zhuk
- Department of Endodontics University of Washington Seattle Washington USA
| | - Stuart Taylor
- Department of Oral Radiology University of Washington Seattle Washington USA
| | - James D. Johnson
- Department of Endodontics University of Washington Seattle Washington USA
| | - Avina Paranjpe
- Department of Endodontics University of Washington Seattle Washington USA
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Camargo RV, Mazzi-Chaves JF, Leoni GB, Vasconcelos KF, Lamira A, Jacobs R, Sousa-Neto MD. Quantitative Assessment of 2-dimensional Parameters in Tomographic Images by Using Different Segmentation Methods. J Endod 2020; 46:694-699. [DOI: 10.1016/j.joen.2020.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 01/14/2020] [Accepted: 01/19/2020] [Indexed: 10/24/2022]
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Mohara NT, Coelho MS, de Queiroz NV, Borreau MLS, Nishioka MM, de Jesus Soares A, Frozoni M. Root Anatomy and Canal Configuration of Maxillary Molars in a Brazilian Subpopulation: A 125-μm Cone-Beam Computed Tomographic Study. Eur J Dent 2019; 13:82-87. [PMID: 31170761 PMCID: PMC6635971 DOI: 10.1055/s-0039-1688736] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objective
Knowledge of internal anatomy of the teeth is of great importance in endodontics, leading to success in root canal therapy (RCT). The aim of this study was to assess the root anatomy and canal configuration of maxillary molars in a Brazilian subpopulation using tomographic images using a voxel size of 125 μm.
Materials and Methods
This in vivo retrospective study assessed 651 cone-beam computed tomographic scans from 328 maxillary first molars and 323 maxillary second molars. The images were assessed by two endodontists and an oral radiologist. Only permanent molars with fully developed roots and with no signs of RCT were included.
Results
Maxillary first and second molars presented three separated roots in 99.39 and 90.09% of the cases, respectively. The presence of mesiolingual canals in the mesiobuccal roots was 64.22% for maxillary first molars and 33.56% for maxillary second molars. Distobuccal canals in the maxillary first and second molars presented Vertucci's Type I configuration in 99.39 and 99.66%, respectively, and palatal canals in the maxillary first and second molars presented Vertucci's Type I configuration in 99.69 and 99.68%, respectively. Maxillary second molars were more subjected to anatomical variations than first molars. Female patients presented higher prevalence of mesiolingual canals in the maxillary second molars.
Conclusions
The most prevalent morphology in the maxillary first and second molars was three root canals. The presence of only one or two roots is more likely to occur in the maxillary second molars than in the maxillary first molars. Mesiolingual canals in mesiobuccal roots are more frequent in the maxillary first molars than in the maxillary second molars, and the occurrence of two distobuccal or two palatal canals is rare.
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Affiliation(s)
- Nelson Tsutomu Mohara
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
| | - Marcelo Santos Coelho
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
| | | | | | | | | | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
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Su CC, Huang RY, Wu YC, Cheng WC, Chiang HS, Chung MP, Cathy Tsai YW, Chung CH, Shieh YS. Detection and location of second mesiobuccal canal in permanent maxillary teeth: A cone-beam computed tomography analysis in a Taiwanese population. Arch Oral Biol 2019; 98:108-114. [DOI: 10.1016/j.archoralbio.2018.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 11/24/2022]
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Liu J, Que KH, Xiao ZH, Wen W. Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature. World J Clin Cases 2019; 7:79-88. [PMID: 30637256 PMCID: PMC6327126 DOI: 10.12998/wjcc.v7.i1.79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/26/2018] [Accepted: 12/01/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.
CASE SUMMARY The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively. Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography (CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope (DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition, each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.
CONCLUSION Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.
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Affiliation(s)
- Jie Liu
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Ke-Hua Que
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Zuo-Hui Xiao
- Department of Geriatric Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
- Laboratory of Biomedical Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Wen Wen
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin 300070, China
- Department of Stomatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China
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Coelho MS, Lacerda MFLS, Silva MHC, Rios MDA. Locating the second mesiobuccal canal in maxillary molars: challenges and solutions. Clin Cosmet Investig Dent 2018; 10:195-202. [PMID: 30288125 PMCID: PMC6159800 DOI: 10.2147/ccide.s154641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The second mesiobuccal canal in mesiobuccal roots in maxillary molars is a common finding in root canal treatments. Failure on the location of these canals is associated with a high rate of unsuccessful treatments of maxillary molars. Its prevalence has been assessed in several in vitro and in vivo studies, presenting variations according to the methodology applied, along with the population of interest. While the anatomy of these teeth is well defined in micro-computed tomography studies, the clinical management is a great challenge for the practitioner. The use of a dental operating microscope has rendered a better clinical outcome when considering the location and treatment of this canal. On the other hand, cone-beam computed tomography use is still controversial in the efficacy of MB2 canal location. The association of a dental operating microscope with troughing performed with ultrasonic tips is an essential step in this location. Moreover, sodium fluorescein might be applied for root canal location. Due to the high rate of unsuccessful cases when the MB2 canal is not initially found, several cases are performed aiming to address the cases of missed MB2 canals. Therefore, the clinician should discuss the best possible approach, whether surgical or clinical. This article presents an overview of the importance of the MB2 canal on the outcomes of root canal treatments of maxillary molars. Solutions based in current literature will be presented accordingly.
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