Root and canal morphology of third molar teeth

The effect of burning on dental tissue: A macroscopic and microscopic investigation

Teeth are considered unique as fingerprints for identification purposes. Their structure and resilience mean they can remain for thousands and millions of years withstanding extreme conditions, including burning. During burning, bones undergo carbonization at approximately 400°C and calcination at approximately 700°C. This study aimed to investigate the effects of carbonization and calcination on dental tissue. It involved nondestructive analyses of 58 extracted human teeth before and after burning, using x-ray diffraction, micro-CT, and high-resolution confocal microscopy. The results revealed that during carbonization, dentin volume decreased in two thirds of the sample, accompanied by crack formation and significant reduction in hydroxyapatite crystal size (p<0.001). During calcination, dentin volume decreased in all teeth, along with a significant deepening of the cracks (p<0.001), while enamel crystal size increased slightly. Initial changes in teeth occurred at lower temperatures than had once been assumed, as indicated by the cracks during carbonization, and there was up to a 36% decrease in dentin volume during calcination, which should be considered when measuring burnt teeth. The results of this research provide new insight into understanding dental tissue response to burning. Thus, dental remains may contribute to the knowledge needed to reconstruct anthropological and forensic scenarios involving burning.

Retrospective study of the morphology of third maxillary molars among the population of Lower Silesia based on analysis of cone beam computed tomography

INTRODUCTION

Understanding the anatomy of root canal systems and being aware of their variations is crucial for successful endodontic treatment. Specifically, the intricate and diverse nature of the root anatomy in maxillary third molars poses a significant challenge for dental clinicians. The study analyzed the morphology of the root canal system in maxillary third molars among residents of the Lower Silesia region in Poland using cone beam computed tomography (CBCT).

MATERIAL AND METHODS

This retrospective cross-sectional imaging study was conducted at the X-Ray Diagnostics Laboratory of the Academic Dental Polyclinic of Wroclaw Medical University, Poland. The study evaluated 316 CBCT scans and included 196 maxillary third molars. They were obtained from 118 females and 78 males over the age of 18, in the period from January to April 2022 (three consecutive months). The number of roots, root canals, and root canal configurations according to Vertucci's classification were analyzed.

RESULTS

Three-rooted maxillary molars were found most often (64.29%), followed by single-rooted (24.49%), two-rooted (7.65%), and four-rooted (3.57%) teeth. Among all the roots examined, Vertucci Type I root canals were the most prevalent. Our research found that single-rooted forms (40 teeth, 33.89% vs. 8 teeth, 10.26%, p = 0.0013) of maxillary third molars were significantly more common in females than in males. However, three-rooted forms (62 teeth, 79.49% vs. 64 teeth, 54.24%, p = 0.0013) of maxillary third molars were significantly more common in males than in females.

DISCUSSION

In the Lower Silesia region, the typical maxillary third molar in the Polish population has a three-rooted structure with Vertucci Type I root canal configuration. We noted a sex-dependent correlation in maxillary third molar morphology, with single-rooted forms more prevalent in women and three-rooted forms in men.

The Patterns of Impacted Third Molars and Their Associated Pathologies: A Retrospective Observational Study of 704 Patients

Background: The study aims to investigate parameters in patients attending Fujairah Dental Center, including assessing the prevalence of impacted teeth, determining the frequency of associated pathological conditions, and evaluating the patterns and angulations of impacted third molars. Methods: It is a retrospective descriptive study of the panoramic radiographs of patients who attended Fujairah Dental Center for dental care between January 2011 and December 2017. The minimum age for inclusion was 17 years. Clinical records were used to obtain the demographic details of patients, such as age, gender, nationality, medical history, and smoking history. Seven hundred and four panoramic radiographs and clinical records of patients were analyzed. The age range was between 17 and 112 years old, with a mean age of 34 years (S.D 13.5). Results: Of the 704 panoramic radiographs evaluated, 236 (33.6%) X-rays showed teeth impaction with a total of 562 impacted teeth in the upper and lower jaws. Five hundred and twenty-five (93.4%) were impacted third molars, and 37 (6.5%) teeth were other kinds of impacted teeth. Females showed a higher frequency of impacted teeth (62.6%) compared to males (37.4%). The highest prevalence of impacted teeth was found in the 17-25 year age group (61%), and the prevalence declined with advancing age. Impacted third molars were more likely to occur in the mandible (57.3%) than in the maxilla (42.7%). Most of the impacted third molars were in the mesioangular position, followed by the vertical position. The evaluation of the depth of impacted third molars demonstrated that level C impaction was the most frequently seen, followed by level B impaction. Impacted third-molar teeth often presented with two roots (60.7%), followed by a single root (31.3%). An evaluation of the relationship between lower third molars and the inferior dental canal (IDC) revealed that the most frequently observed relation was interrupted (61.5%), followed by a distant relation to the ID canal, and 13% were superimposed. The most common morphological pattern of roots of the impacted third molars was either straight-type or curved and dilacerated roots (5.7%). Additionally, the most noticed pathological conditions associated with impacted teeth were carious second molars adjacent to impacted third molars (42%), which was more likely to be seen in the 17-25-year age group, with females having a higher prevalence than males.

Navigating Challenges in the Management of Mandibular Third Molars With Radix Paramolaris: A Case Report

This study aims to shed light on a contemporary approach to preserving third molars instead of opting for immediate extraction. Third molars are known for their diverse shapes and unique anatomy, making root canal treatment a complex task due to limited access. However, there are situations where it is crucial to retain these molars, such as when they provide support or for self-transplantation purposes. The case report focuses on a 33-year-old female patient who presented with pulp necrosis and acute apical periodontitis in the lower right third molar. Instead of extraction, a two-visit conventional root canal treatment was planned. During the initial diagnostic radiographs, only two visible roots were observed, illustrating the typical anatomy of the third molar. However, an unforeseen additional root, referred to as radix paramolaris, was encountered in the mesiobuccal region during the access opening, presenting numerous challenges in the treatment process. Thankfully, advancements in dental technology, such as magnification aids, ultrasonic tips and flexible nickel-titanium (NiTi) rotary files, have rendered the management of such intricate cases more attainable. In conclusion, dealing with intricately curved canals in difficult-to-reach teeth like third molars has become more achievable with technological progress, although the operator's skill and experience remain crucial for effective management.