1
|
Perondi I, Taschieri S, Baruffaldi M, Fornara R, Francetti L, Corbella S. The Correlation between Intraorifice Distance and the Anatomical Characteristics of the Second Mesiobuccal Canal of Maxillary Molars: A CBCT Study. Int J Dent 2024; 2024:6636637. [PMID: 38318327 PMCID: PMC10843869 DOI: 10.1155/2024/6636637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/08/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Missing anatomy is one of the main causes of endodontic failures, and accurate knowledge of teeth anatomy is a prerequisite for adequate root canal treatment. The aim of the present cone beam computed tomography (CBCT) study was to describe the anatomical characteristics of the mesiobuccal (MB) root canals of maxillary molars and to understand if a correlation exists between the position of the canal orifices and the anatomical features of the root. Methods For the purposes of the study, a total of 100 CBCT scans of maxillary molars with two MB canals were selected and studied. The features of root canal anatomy of the MB root of the same teeth were analyzed and recorded (root length, confluence, and Vertucci classification). The distance between MB1 and MB2 orifices and the palatal orifice were recorded, as well as the distance between the orifices and the line joining the palatal orifice and the others. A statistical analysis was performed by providing descriptive measures, the measure of the correlation between different parameters, and the influence of some of these measures on the presence of a confluence between MB1 and MB2. Results It resulted that the most frequent configuration is type II Vertucci. The length measured on the sagittal plane was significantly correlated to the presence of a confluence in the MB root. When the root length was higher than 14.56 mm, the confluence is three times more frequent than when the length is lower (OR = 3.635). The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for length on the sagittal plane was 0.632 (P=0.036). Conclusions The presence of a confluence between the MB canals of maxillary molars is correlated to the length of the root that could be measured on the sagittal plane and to the distance between the canal orifices. The relative position of the root canal orifices in relation to anatomic landmarks needs to be further explored.
Collapse
Affiliation(s)
- Isabella Perondi
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | - Luca Francetti
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Stefano Corbella
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
2
|
Bai B, Tang Y, Wu Y, Pei F, Zhu Q, Zhu P, Gu Y. Ex vivo detection of mandibular incisors' root canal morphology using cone-beam computed tomography with 4 different voxel sizes and micro-computed tomography. BMC Oral Health 2023; 23:656. [PMID: 37689620 PMCID: PMC10492267 DOI: 10.1186/s12903-023-03376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND In recent years, cone-beam computed tomography (CBCT) has been widely used to evaluate patients' root canal anatomy due to its high resolution and noninvasive nature. As voxel size is one of the most important parameters affecting CBCT image quality, the current study evaluated the diagnostic potential of CBCT with 4 different voxel sizes in the detection of double root canal systems and accessory canals (ACs) in permanent mandibular incisors. METHODS A total of 106 extracted mandibular permanent incisors were collected from the dental clinics, and then were scanned by using micro-CT with a voxel size of 9 μm. The teeth were then fixed in the tooth sockets of human dry mandibles and scanned by using a CBCT device with 4 different voxel sizes (300, 200, 250, and 125 μm). Four observers detected in blind the root canal morphology of the teeth according to the CBCT images, and the presence or absence of a double root canal system, and the presence or absence of ACs, were scored according to a 5-point scale, respectively. Receiver operating characteristic (ROC) analysis was performed, and DeLong test was used to compare the area under the curve (AUC) values and the micro-CT data was taken as a gold standard. RESULTS Among 106 sample teeth, 25 specimens with a double root canal system were identified by the micro-CT. ROC curve analysis of the data obtained by the four observers showed that in the detection of double root canal systems, the AUC values ranged from 0.765 to 0.889 for 300 μm voxel size, from 0.877 to 0.926 for 250 μm voxel size, from 0.893 to 0.967 for 200 μm voxel size, and from 0.914 to 0.967 for 125 μm voxel size (all p < 0.01). In general, we observed a trend that the AUC values, sensitivity, and specialty increased with the decrease in the voxel size, and significantly higher AUC values were detected in 125 μm voxel size images. In the detection of ACs, ROC curve analysis showed that among the four observers, the AUC values ranged from 0.554 to 0.639 for 300 μm voxel size, from 0.532 to 0.654 for 250 μm voxel size, from 0.567 to 0.626 for 200 μm voxel size, and from 0.638 to 0.678 for 125 μm voxel size. CBCT images at a voxel size of 125 μm had a weak diagnostic potential (AUC: 0.5-0.7, all p < 0.05) in the detection of AC, with a lower sensitivity ranging from 36.8 to 57.9% and a higher specialty ranging from 73.6 to 98.8%. CONCLUSIONS CBCT with 300 μm voxel size could only provide moderate diagnostic accuracy in the detection of a double canal system in mandibular incisors. CBCT with a voxel size of 125 μm exhibited high diagnostic value in the detection of double canal systems, while showing low but statistically significant value in the detection of ACs.
Collapse
Affiliation(s)
- Bingbing Bai
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Ying Tang
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Yihan Wu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Fan Pei
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Qi Zhu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Peng Zhu
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Yongchun Gu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China.
| |
Collapse
|
3
|
de Lima JP, Mazzi-Chaves JF, de Sousa-Neto MD, Candemil AP. Could Low-dose Cone-beam CT be Used for Endodontic Intraoperative Diagnosis? J Endod 2023; 49:1161-1168. [PMID: 37451335 DOI: 10.1016/j.joen.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) allows three-dimensional evaluation and has high diagnostic accuracy of endodontic conditions. Considering that the most indicated protocol for endodontics should have smaller field-of-view and higher spatial resolution, a higher radiation dose may be associated. Thus, this study evaluated the accuracy of an optimized CBCT protocol for the detection of intraoperative endodontic complications. METHODS An image phantom was custom-made with a human mandible covered with Mix-D and forty mandibular first molars. The teeth were subdivided into 4 groups of endodontic complications which were simulated. All teeth were individually inserted into the left second molar socket of the phantom and CBCT images were acquired with OP 300 unit adjusted to a field-of-view of 6 × 4 cm, 90kVp, and 2 dose protocols: low and high. Furthermore, a titanium implant, a tooth with endodontic treatment, and a cobalt-chromium post were inserted into the empty sockets adjacent to the teeth of interest and additional images were acquired. Four endodontists evaluated the images and indicated the presence of endodontic complications on a 5-point scale. Sensitivity, specificity, and area under the receiver operating characteristic curve were obtained. The different groups were compared by ANOVA and Tukey tests (α = 0.05). RESULTS In most conditions, irrespective of the presence of metallic materials, the values of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve did not differ significantly (P > .05) between the dose protocols. CONCLUSIONS Optimized CBCT protocols should be considered for the detection of intraoperative endodontic Diagnostic complications.
Collapse
Affiliation(s)
- João Pedro de Lima
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião de Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
4
|
Pertek Hatipoğlu F, Mağat G, Hatipoğlu Ö, Taha N, Alfirjani S, Abidin IZ, Lehmann AP, Alkhawas MBAM, Buchanan GD, Kopbayeva M, Surendar S, Javed MQ, Madfa AA, Donnermeyer D, Krmek SJ, Bhatti UA, Palma PJ, Brochado Martins JF. Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis. J Endod 2023; 49:549-558. [PMID: 36863567 DOI: 10.1016/j.joen.2023.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence. METHODS Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. RESULTS In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P < .05). MMC prevalence ranged from 1% to 23%, and the overall prevalence was 7% (95% confidence interval [CI]: 5%-9%). No significant differences were found between the left and right M1M (odds ratio = 1.09, 95% CI: 0.93, 1.27; P > .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). CONCLUSIONS The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral.
Collapse
Affiliation(s)
| | - Güldane Mağat
- Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey.
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya
| | | | - Anna Paulina Lehmann
- Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań, Poznań, Poland
| | | | - Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Maira Kopbayeva
- Kazakh National Medical University Asfendiyarov, Almaty, Kazakhstan
| | - Sugumaran Surendar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Saudi Arabia; Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry and Endodontics, Riphah International University, Pakistan
| | - Paulo J Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Filipe Brochado Martins
- Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Barros-Costa M, Ferreira MD, Costa FF, Freitas DQ. Middle mesial root canals in mandibular molars: prevalence and correlation to anatomical aspects based on CBCT imaging. Dentomaxillofac Radiol 2022; 51:20220156. [PMID: 35926079 PMCID: PMC9717399 DOI: 10.1259/dmfr.20220156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/13/2022] [Accepted: 07/22/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To determine the prevalence of middle mesial root canal (MMC) in a Brazilian subpopulation, verify whether its presence is related to anatomical characteristics of the tooth, and propose a classification using cone-beam computed tomography (CBCT). METHODS CBCT scans of 284 patients were evaluated by 2 radiologists to determine the presence of the MMC in mandibular first and second molars. Subsequently, the mesiodistal and buccolingual measurements of the mesial roots were obtained; the measurements between the root canals, and from MMC to the mesiobuccal canal and to the mesiolingual canal were also obtained. The MMC was classified according to its relationship with mesiobuccal and mesiolingual canals. The data were analyzed using χ2 and Fisher's exact test, multiple logistic regression analysis, Student's t-test, κ and intraclass correlation coefficient (p < 0.05). RESULTS The intraexaminer agreements for the presence of the MMC and the measurements were considered almost perfect (0.953 and 0.999, respectively). Of 216 mandibular first molars, 11.1% had the MMC, and of 228 mandibular second molars, only 1.75% had the MMC. The presence was significant higher in the mandibular first molar (p < 0.0001). The buccolingual measurement and the measurement between mesiobuccal and mesiolingual canals were higher in teeth with MMC (p = 0.024 and p = 0.005, respectively). It was possible to classify the configuration of MCC into four types: independent (60.7%), confluent (14.3%), mesiolingual confluent (14.3%), and mesiobuccal confluent (10.7%). CONCLUSIONS The prevalence of MMC is more pronounced in mandibular first molars and anatomical measurements, such as greater measurement between mesiobuccal and mesiolingual canals, may alert clinicians to its presence. It was found four types of configurations of MMC.
Collapse
Affiliation(s)
- Matheus Barros-Costa
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Matheus Diniz Ferreira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Felipe Ferreira Costa
- Department of Oral Diagnosis, São Paulo Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| |
Collapse
|
6
|
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
| |
Collapse
|
7
|
Aminoshariae A, Azarpazhooh A, Diogenes AR, Fouad AF, Glickman GN, Kishen A, Letra AM, Levin L, Roda RS, Setzer FC, Tay FR, Hargreaves KM. Insights into the September 2021 Issue of the JOE. J Endod 2021; 47:1337-1339. [PMID: 34429215 DOI: 10.1016/j.joen.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Amir Azarpazhooh
- Faculty of Dentistry University of Toronto, Toronto, Ontario, Canada
| | - Anibal R Diogenes
- University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
| | - Ashraf F Fouad
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Anil Kishen
- Faculty of Dentistry University of Toronto, Toronto, Ontario, Canada
| | - Ariadne M Letra
- University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | | | | | - Frank C Setzer
- University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
| | | |
Collapse
|