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Sheth K, Banga KS, Pawar A, Wahjuningrum DA, Karobari MI. Distolingual root prevalence in mandibular first molar and complex root canal morphology in incisors: a CBCT analysis in Indian population. Sci Rep 2024; 14:443. [PMID: 38172235 PMCID: PMC10764885 DOI: 10.1038/s41598-024-51198-1] [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: 06/04/2023] [Accepted: 01/02/2024] [Indexed: 01/05/2024] Open
Abstract
Cone-beam computed tomography was used to understand the possible correlation between the prevalence of distolingual root (DLR) in permanent mandibular first molars (MFMs) and the associated complicated mandibular incisor's root canal morphology (MIs) in an Indian population. A total of 400 scans were evaluated for MFMs and MIs. The prevalence of DLRs and root canal anatomy of MIs were assessed based on Vertucci's classification, and then the sample were grouped according to age, sex and side. Statistical analysis was used to evaluate the possible correlation between the presence of DLRs in the first molar and root canal morphology of incisors. Chi square test was used to evaluate the correlation between the root canal configurations of MIs with the existence of DLRs in MFMs. There was no statistically significant difference between sexes or ages for the prevalence of DLRs in the first molars (p > 0.05), which was 6.62%, with the right side having a greater frequency of DLRs (7.8%) than the left (5.5%). Vertucci Type I canal configuration was most common for the mandibular central (66.75%) and lateral incisors (58.62%). Vertucci Type III was the most common complicated canal morphology, followed by Types V, II, and IV for MIs, with no statistically significant difference in the studied sample's age and sex. (p < 0.05). No association was observed between the presence of DLRs in first molars and complicated root canal configurations in MIs. Taken together, the possibility of complicated root canal configuration in MIs was lesser in the presence of DLRs in MFMs among the Indian population.
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Affiliation(s)
- Komal Sheth
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
| | - K S Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
| | - Ajinkya Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai Central, Mumbai, 400 008, India
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mohmed Isaqali Karobari
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India.
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Cameron AB, Abdelhamid HMHAS, George R. CBCT Segmentation and Additive Manufacturing for the Management of Root Canals with Ledges: A Case Report and Technique. J Endod 2023; 49:1570-1575. [PMID: 37582414 DOI: 10.1016/j.joen.2023.08.002] [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: 06/19/2023] [Revised: 08/06/2023] [Accepted: 08/06/2023] [Indexed: 08/17/2023]
Abstract
Cone-beam computed tomography (CBCT) assessment of a ledge could be useful to a clinician; however, using this information effectively during a treatment procedure can be challenging. Advanced additive manufacturing technologies combined with semi-automated segmentation of root canals can help simulate the ledge and help in management of these iatrogenic complications. A patient presented after unsuccessful root canal treatment with a ledge on the left mandibular first molar. A CBCT was taken, and the images imported into a segmentation software (Mimics, Materialise). The canal was isolated, and segmentation performed along with the other structures of the tooth. A 3-dimensional digital model of the internal structures of the canal were used to design a mock-up which was additively manufactured. This was used as a preclinical guide to simulate the procedure, precurve the file, and manage the canal. This novel technique using virtual modeling from CBCT data post ledge formation allowed for successful and quick management of a tooth with ledges.
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Affiliation(s)
- Andrew B Cameron
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Menzies Health Institute Queensland Disability & Rehabilitation Center, Gold Coast, Australia
| | | | - Roy George
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia.
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Al-Maswary AA, Almadhoon HW, Elkhateb A, Hamdallah A, Halboub E. The global prevalence of middle mesial canal in mandibular first and second molars assessed by cone beam computed tomography: A systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00236-4. [PMID: 37116828 DOI: 10.1016/j.joen.2023.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND This meta-analysis sought to identify the in vivo prevalence and influencing factors of middle mesial canal (MMC) in mandibular first and second molars based on cone-beam computed tomography (CBCT) scans. METHODS MEDLINE/PubMed, Web of Science, Scopus, SciELO, Google Scholar databases/search engines were searched in period between 15th and 21st November 2022, to retrieve the in vivo CBCT-based studies that assessed the prevalence of MMC in mandibular first and/or second molars. The studies were strictly assessed using pre-defined inclusion and exclusion criteria for relevancy and eligibility through screening the title and abstract, and then assessed through reading the full texts using the same criteria. Subsequently, the fulfilled studies were assessed qualitatively using the Newcastle-Ottawa Quality Assessment Scale, and quantitatively using meta-analysis to calculate the pooled prevalence rates of MMC. The publication bias was assessed using funnel plot and Egger's test. RESULTS Out of 1,122 studies, 33 studies comprised 13,349 and 7,624 mandibular first and second molars, respectively, were eligible for inclusion. Twenty studies scored high quality, while thirteen scored moderate quality. The global prevalence of MMC in the first molar was 4.4% (95% CI = 0.035-0.053, P<0.001), significantly higher than that of the second molar which was 1.3% (95%, CI = 0.008-0.018, P<0.001). Gender, molar side, and age were not influencing factors of MMC prevalence. CONCLUSION The prevalence of MMC is not uncommon, being higher in the mandibular first molar compared to the mandibular second molar. The prevalence of MMC is not influenced by age, molar's side, and gender.
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Affiliation(s)
- Arwa A Al-Maswary
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen; Faculty of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sana'a, Yemen.
| | | | | | | | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
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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.
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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
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Innovations in Diagnostic Imaging in Oral and Maxillofacial Diseases. Diagnostics (Basel) 2022; 12:diagnostics12020536. [PMID: 35204626 PMCID: PMC8871424 DOI: 10.3390/diagnostics12020536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
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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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Drouri S, Dhaimy S, Benkiran I, Jabri M, Al Jalil Z, Hamza M. Root and canal morphology of mandibular first molars in a Moroccan subpopulation by cone-beam computed tomography and its international comparison: A cross-sectional study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_104_21] [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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Nino-Barrera J, Alzate-Mendoza D, Olaya-Abril C, Gamboa-Martinez LF, Guamán-Laverde M, Lagos-Rosero N, Romero-Diaz AC, Duran N, Vanegas-Hoyose L. Atypical Radicular Anatomy in Permanent Human Teeth: A Systematic Review. Crit Rev Biomed Eng 2022; 50:19-34. [PMID: 35997108 DOI: 10.1615/critrevbiomedeng.2022043742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of the present study is to classify and quantify the anatomical variations of teeth in terms of form and number of root canals reported in human teeth employing the classification systems proposed previously. An electronic (PubMed) and manual search were performed to identify case reports noting any of the anatomical variations. Each alteration was studied independently. The electronic search was performed using the following keywords: anatomical aberration, root canal, permanent Dentition, case report, c-shaped canal, dens invaginatus, palato-radicular groove, palato-radicular groove, palato-gingival groove, radix entomolaris, dental fusion, dental gemination, taurodontism, dilaceration. The initial search revealed 1497 papers, of which 938 were excluded after analyzing the titles and abstracts. Therefore, 559 potential papers were considered. Of those, 140 articles did not meet the inclusion criteria. For the final revision, 419 papers were considered. We found that the mandibular first premolar had the highest prevalence of C-shaped canals. Dens invaginatus was more frequently found in the mandibular lateral incisor. Taurodontism was more prevalent in the maxillary first molar and in the mandibular first molar. Dilaceration was not clearly associated with a particular tooth. The classifications systems used in this review allowed for the better understanding and analysis of the many anatomical variations present in teeth. The variations in shape most found were dens invaginatus and radix entomolaris. The most frequently reported anatomical variation was in the number of canals.
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Affiliation(s)
- Javier Nino-Barrera
- Faculty of Dentistry, School of Endodontics, Universidad Nacional de Colombia, Bogota, Colombia; Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia; Research Group on Biomechanics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Diana Alzate-Mendoza
- Program Director, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | - Carolina Olaya-Abril
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | | | - Mishell Guamán-Laverde
- Professor, Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
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Ultrasound Imaging in Dentistry: A Literature Overview. J Imaging 2021; 7:jimaging7110238. [PMID: 34821869 PMCID: PMC8624259 DOI: 10.3390/jimaging7110238] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: the frequency with which diagnostic tests are prescribed with exposure to ionizing radiation, a cause of biological damage, has been studied, and with much more attention, patients are subjected to these diagnostic tests for diagnosis and follow-up. This review aimed, given the recent developments of this technology, to evaluate the possible use of ultrasound in different branches of dentistry. The possibility of applying ionizing-radiation-free diagnostic exams in dentistry, overcoming the limits of this application, has led scientific research in this area to obtain interesting results that bode well for the future. (2) Methods: a search for articles on the application of ultrasounds in dentistry was performed using the PubMed electronic database. (3) Results: only 32 studies were included, and these clearly stated that this examination is widely usable and in great progress. (4) Conclusions: regarding the modern application techniques of this diagnostic test, it is essential to consider technological evolution as an objective to reduce the damage and side effects of necessary diagnostic tests. The use of ultrasound in dentistry can represent a valid radiation-free alternative, in certain contexts, to the other most used exams.
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Van Pham K. Endodontic length measurements using 3D Endo, cone-beam computed tomography, and electronic apex locator. BMC Oral Health 2021; 21:271. [PMID: 34006262 PMCID: PMC8130300 DOI: 10.1186/s12903-021-01625-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/10/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The objective of this study is to investigate the accuracy of the 3D Endo software, cone-beam computed tomography (CBCT) software, and the electronic apex locator (EAL) in endodontic length determination. METHODS 302 root canals in 111 human extracted molars were chosen. Access cavity was performed, and root canal lengths were measured with a digital caliper for actual length (AL) and EAL for electronic length. Teeth were then scanned using CBCT device at voxel size of 0.10 mm. It measured root canal lengths using the CBCT (Romexis Viewer), 3D Endo for proposed length (3D-PL) and correct length (3D-CL). Mean differences between the four methods with the AL were calculated and compared. Fisher's exact test, paired t-test, Bland-Altman plot were used to test the differences among the experimental modalities in working length determination at the significance of 0.05. RESULTS The accuracy in the range of ± 0.5 mm of the EAL ProPex II was highest among the experimental modalities, however this method disagreed with the actual length. CONCLUSIONS The correct working length after adjustment from the semi-automatically length by the 3D Endo software and Romexis Viewer measurements agreed with the AL.
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Affiliation(s)
- Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, 652 Nguyen Trai Street, Ward 11, District 5, Ho Chi Minh City, Vietnam.
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Van Pham K. Endodontic length measurements using cone beam computed tomography with dedicated or conventional software at different voxel sizes. Sci Rep 2021; 11:9432. [PMID: 33941828 PMCID: PMC8093273 DOI: 10.1038/s41598-021-88980-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/20/2021] [Indexed: 11/09/2022] Open
Abstract
The aim of this study is to investigate the accuracies and the agreements of the 3D Endo software, conventional CBCT software Romexis Viewer at three voxel sizes, and the EAL ProPex Pixi in endodontic length measurements. Three hundred and twenty-nine root canals in 120 intact human extracted molars were accessed. The actual lengths (AL) and electronic lengths (EL) were measured using the ruler and electronic apex locator (EAL), respectively. Teeth were scanned using the CBCT at different voxel sizes (0.075, 0.10, and 0.15 mm). Root canal lengths were measured using 3D Endo with proposed length (3D-PL) by software, corrected length (3D-CL), Romexis Viewer. The Fisher's exact test, paired t-test and Bland-Altman plots were calculated to detect the agreements of the four methods with AL measurements. The ProPex Pixi measurements obtained the highest accuracy in the range of ± 0.5 mm. There was agreement between the 3D-PL and the 3D-CL with AL measurements at voxel size of 0.15 mm and at voxel size of 0.10 mm, respectively. The CBCT Romexis Viewer measurements agreed with AL at three voxel sizes. The conventional CBCT measurements using Romexis Viewer and dedicated software did not reach to the 100% accuracy in the range of ± 0.5 mm.
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Affiliation(s)
- Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam.
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Estimation Accuracy of Root Canal Curvatures from Different Dental Diagnostic Imaging Techniques: An In Vitro Experimental Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6699635. [PMID: 33511210 PMCID: PMC7822666 DOI: 10.1155/2021/6699635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 01/05/2023]
Abstract
In clinical endodontics, preoperative estimation of root canal curvature is crucial regarding the prevention of iatrogenic errors. Reproduction of the two-dimensional radiographic images causes certain proximal view curvatures not seen. Therefore, the present study is aimed at investigating the degree of root canal curvature identified in different radiographic views. A total of 60 human permanent single-rooted teeth with varying degrees of curvature were selected. The root canal curvature for each tooth was measured on cone-beam computed tomography (CBCT) images (clinical view), standard digital periapical view (0° angle), digital periapical horizontal parallax view (30° angle), and digital periapical proximal view (0° angle), by using the Schneider method. No statistically significant difference was found in the degree of curvatures estimated on CBCT images and standard digital periapical view (0° angle) in the same tooth. The results revealed a significant difference between the proximal view and the other three groups (p < 0.05). There was no significant difference in this respect between the horizontal parallax view (30° angle), clinical view (CBCT images), and standard digital periapical view (p > 0.05). Proximal view curvatures cannot be predicted or estimated only from examining a clinical view radiograph. A horizontal parallax view (30° angle) is highly recommended as specific guidelines on how to estimate root canal curvature in case difficulty assessment protocols.
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PradeepKumar A, Kumar B, Krishnamoorthy S, Shanmugam S. The time taken for retrieval of separated instrument and the change in root canal volume after two different techniques using CBCT: An in-vitro study. Indian J Dent Res 2021; 32:489-494. [DOI: 10.4103/ijdr.ijdr_403_21] [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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Estrela C, Costa MVC, Bueno MR, Rabelo LEG, Decurcio DA, Silva JA, Estrela CRA. Potential of a New Cone-Beam CT Software for Blooming Artifact Reduction. Braz Dent J 2020; 31:582-588. [DOI: 10.1590/0103-6440202005899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.
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Affiliation(s)
| | | | - Mike R Bueno
- Faculdade São Leopoldo Mandic, Brazil; CROIF Oral Radiology Center, Brazil
| | | | | | | | - Cyntia R A Estrela
- Universidade de Cuiabá, Brazil; Centro Universitário de Anápolis, Brazil
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Nguyen PN, Pham KV. Endodontic Length Measurements Using Different Modalities: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:752-758. [PMID: 33437709 PMCID: PMC7791584 DOI: 10.4103/jispcd.jispcd_357_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/29/2020] [Accepted: 09/18/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The aim of this study was to investigate and compare the accuracy of the 3D Endo software, conventional CBCT software Romexis Viewer, and the EAL E-Pex Pro in WL determination. MATERIALS AND METHODS Three hundred and two root canals in 110 intact human extracted molars were accessed. The actual lengths (ALs) were measured. Root canal lengths were measured using 3D Endo with proposed length (3D-PL) by software, correct length (3D-CL), Romexis Viewer, and the E-Pex Pro. The percentages of the measurements in the range of ±0.5 mm to the AL were compared using the Fisher's exact test. The paired t test and Bland-Altman plots were calculated to detect the agreement of the four methods with the AL measurements. The statistical significance was set at P<0.05. RESULTS The accuracies in the range of ±0.5 mm to the AL were 83.8%, 86.7%, 48.3%, and 99.7% for 3D-PL, 3D-CL, Romexis Viewer, and E-PexPro, respectively. There were agreements between 3D-PL and Romexis Viewer with the AL measurements. CONCLUSION The CBCT measurements using 3D Endo with the proposed length by the software and Romexis Viewer with the voxel size of 0.15 mm agreed with the AL measurements of the root canals.
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Affiliation(s)
- Phuc Ngoc Nguyen
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Gambarini G, Galli M, Morese A, Stefanelli LV, Abduljabbar F, Giovarruscio M, Di Nardo D, Seracchiani M, Testarelli L. Precision of Dynamic Navigation to Perform Endodontic Ultraconservative Access Cavities: A Preliminary In Vitro Analysis. J Endod 2020; 46:1286-1290. [DOI: 10.1016/j.joen.2020.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/09/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
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Borges CC, Estrela C, Decurcio DDA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G. Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 2020; 34:e056. [PMID: 32578799 DOI: 10.1590/1807-3107bor-2020.vol34.0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022] Open
Abstract
This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.
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Affiliation(s)
- Caroline Cristina Borges
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Jesus Djalma PÉcora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Valenti-Obino F, Di Nardo D, Quero L, Miccoli G, Gambarini G, Testarelli L, Galli M. Symmetry of root and root canal morphology of mandibular incisors: A cone-beam computed tomography study in vivo. J Clin Exp Dent 2019; 11:e527-e533. [PMID: 31346372 PMCID: PMC6645266 DOI: 10.4317/jced.55629] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/13/2019] [Indexed: 12/27/2022] Open
Abstract
Background Aim of this study was to analyze the root canal configuration in mandibular central and lateral incisors in vivo using cone-beam computed tomography (CBCT) imaging. Material and Methods A total of 487 mandibular central incisors and 491 mandibular lateral incisors from 250 patients were examined using CBCT imaging, previously taken for diagnosis and treatment. The number of roots, root canal system configuration, presence of apical confluences, distance between confluences and radiographic root end, symmetry between left and right elements were recorded and statistically analyzed. Results All the examined teeth presented only one root. No significant differences were found between the prevalence of two root canals in mandibular central incisors (219 teeth, 45%) compared to lateral incisors (211 teeth, 43%). Conclusions The percentage of Vertucci type II configuration was higher than expected, being more frequent than type III. Type I was the prevalent, while other configurations were present but rare. Key words:Cone-beam computed tomography, mandibular incisors, root canal anatomy, confluences.
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Affiliation(s)
| | - Dario Di Nardo
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
| | - Linda Quero
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
| | - Gabriele Miccoli
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
| | - Gianluca Gambarini
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
| | - Massimo Galli
- Department of Oral and Maxillo Facial Sciences "Sapienza" University of Rome, Italy
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Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J 2019; 52:1138-1152. [PMID: 30868610 DOI: 10.1111/iej.13115] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/11/2019] [Indexed: 12/14/2022]
Abstract
The use of cone beam computed tomography (CBCT) in the diagnosis and/or management of endodontic problems is increasing and is reflected in the exponential rise in publications on this topic in the last two decades. The aim of this paper is to: (i) Review current literature on the endodontic applications of CBCT; (ii) Based on current evidence make recommendations for the use of CBCT in Endodontics; (iii) Highlight the areas in which more research is required.
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Affiliation(s)
- S Patel
- Department of Conservative Dentistry, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - J Brown
- Department of Maxillofacial & Dental Radiology, King's College London Dental Institute, London, UK
| | - T Pimentel
- Department of Conservative Dentistry, King's College London Dental Institute, London, UK
| | - R D Kelly
- Department of Conservative Dentistry, King's College London Dental Institute, London, UK
| | - F Abella
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - C Durack
- Speciailist Practice, Limerick, Ireland
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The Impact of Different Diagnostic Imaging Modalities on the Evaluation of Root Canal Anatomy and Endodontic Residents' Stress Levels: A Clinical Study. J Endod 2019; 45:406-413. [DOI: 10.1016/j.joen.2018.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/27/2018] [Accepted: 12/01/2018] [Indexed: 12/12/2022]
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Gambarini G, Seracchiani M, Piasecki L, Valenti Obino F, Galli M, Di Nardo D, Testarelli L. Measurement of torque generated during intracanal instrumentation
in vivo. Int Endod J 2018; 52:737-745. [DOI: 10.1111/iej.13042] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/12/2018] [Indexed: 12/01/2022]
Affiliation(s)
- G. Gambarini
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
| | - M. Seracchiani
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
| | - L. Piasecki
- Division of Endodontics University at Buffalo Buffalo NY USA
| | - F. Valenti Obino
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
| | - M. Galli
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
| | - D. Di Nardo
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
| | - L. Testarelli
- Department of Oral and Maxillo‐Facial Sciences La Sapienza University Rome Italy
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Piasecki L, José dos Reis P, Jussiani EI, Andrello AC. A Micro–computed Tomographic Evaluation of the Accuracy of 3 Electronic Apex Locators in Curved Canals of Mandibular Molars. J Endod 2018; 44:1872-1877. [DOI: 10.1016/j.joen.2018.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022]
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Bueno MR, Estrela C, Azevedo BC, Diogenes A. Development of a New Cone-Beam Computed Tomography Software for Endodontic Diagnosis. Braz Dent J 2018; 29:517-529. [DOI: 10.1590/0103-6440201802455] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/11/2018] [Indexed: 01/10/2023] Open
Abstract
Abstract Cone-beam computed tomography (CBCT) has promoted changes in approaches in Endodontics, and enhanced decision-making in complex clinical cases. Despite the technological advancements in CBCT hardware, the interpretation of the acquired images is still compromised by viewing software packages that often have limited navigational tools and lack adequate filters to overcome some challenges of the CBCT technology such as artefacts. This study reviews the current limitations of CBCT and the potential of a new CBCT software package (e-Vol DX, CDT- Brazil) to overcome these aspects and support diagnosing, planning and managing of endodontic cases. This imaging method provide high resolution images due to submillimeter voxel sizes, dynamic multi-plane imaging navigation and ability to change the volume parameters such as slice thickness and slice intervals and data correction applying imaging filters and manipulating brightness and contrast. The main differences between e-Vol DX and other software packages are: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; Custom slice thickness adjustment, often limited and pre-defined in other applications; Custom Sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; preset imaging filters, dedicated endodontic volume rendering filters with the ability to zoom the image over 1000x (3D reconstructions) without loss of resolution and automatic imaging parameters customization for better standardization and opportunities for research; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications. This new CBCT software package may support decision-making for the treatment of complex endodontic cases and improve diagnosis and treatment results. Effective improvement of image quality favors the rational prescription and interpretation of CBCT scans.
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Affiliation(s)
- Mike R. Bueno
- School of Dentistry São Leopoldo Mandic, Brazil; CROIF, Brazil
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Accuracy of Software-Based Three-Dimensional Root Canal Length Measurements Using Cone-Beam Computed Tomography. Eur Endod J 2018; 4:28-32. [PMID: 32161883 PMCID: PMC7006557 DOI: 10.14744/eej.2018.46320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/28/2018] [Accepted: 10/21/2018] [Indexed: 11/20/2022] Open
Abstract
Objective This study aims to evaluate the accuracy of three-dimensional root canal length measurements performed by dentists with different experience levels using a special software based on cone beam com-puted tomography (CBCT). Methods A CBCT scan of an artificial resin maxillary molar was used to train dentists (n=65) in using the software (3D Endo, DentsplySirona, Ballaigues, Switzerland) as part of a continuing education course. At the beginning, each participant completed a questionnaire on endodontic and CBCT experiences. After com-prehensive instructions, each participant performed an entire three-dimensional treatment plan by tracing the root canal anatomy between the apical foramen and the center of the canal orifice and simulating a straight-line access. The final root canal length was indicated after the virtual rubber stop of a simulated instrument was adapted to the adjoining cusp. To evaluate the individual accuracy in terms of trueness and precision, differences between the three-dimensional planning and the actual root canal length (ARCL) were calculated, and statistically analyzed. Results Mean absolute differences between the measurements with the 3D Endo™ software (n=260) and the ARCL were 0.30±0.22 mm. All measurements were within a limit of ±1 mm. The accuracy of root canal length measurements was significantly influenced by the type of root canal (p<0.0001). The smallest devia-tions were observed for the palatal root canal (0.18±0.13 mm), followed by the mesiobuccal (0.26±0.22 mm), the distobuccal (0.32±0.17 mm), and the second mesiobuccal root canal (0.46±0.24 mm). Conclusion Within the limitations of this study, the 3D Endo software enables reproducible and accurate root canal length measurements as part of a three-dimensional endodontic treatment plan. However, mea-surements should always be clinically verified, as root canal morphology has a statistically significant influence.
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Gambarini G, Piasecki L, Miccoli G, Gaimari G, Di Giorgio R, Di Nardo D, Azim AA, Testarelli L. Classification and cyclic fatigue evaluation of new kinematics for endodontic instruments. AUST ENDOD J 2018; 45:154-162. [DOI: 10.1111/aej.12294] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gianluca Gambarini
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Lucila Piasecki
- Division of Endodontics University at Buffalo Buffalo NY USA
| | - Gabriele Miccoli
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Gianfranco Gaimari
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Roberto Di Giorgio
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Dario Di Nardo
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Adham A Azim
- Division of Endodontics University at Buffalo Buffalo NY USA
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
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The Accuracy of a New Cone-beam Computed Tomographic Software in the Preoperative Working Length Determination Ex Vivo. J Endod 2018; 44:1024-1029. [PMID: 29703619 DOI: 10.1016/j.joen.2018.02.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study investigates the accuracy of 3D Endo software (Dentsply Sirona, Salzburg, Austria) to determine the working length when using preoperative cone-beam computed tomographic (CBCT) scans of extracted teeth, compared with conventional CBCT software and an electronic apex locator (EAL). METHODS CBCT scans of 30 premolars were obtained. Using OnDemand3D software (Cybermed, Seoul, Korea), the measurement obtained from the coronal reference to the apical foramen (AF) was recorded as the conventional CBCT length. Then, using 3D Endo software (Dentsply Sirona), the suggested length (3D-SL) and the operator-adjusted length (3D-OL) were obtained. Teeth were accessed, and the actual length was measured. Finally, the teeth were embedded in alginate to obtain the electronic length (EL) using the EAL Root ZX (J Morita, Tokyo, Japan). The means of the absolute values and the percentages of distribution of the tested measurement methods were compared to the actual length. RESULTS No difference was found regarding the mean measurements (analysis of variance, P > .05). All the CBCT measurements presented a high reliability (Dahlberg's formula). The measurements within a ±0.5-mm range from the AF were 86.6% for the 3D-SL, 80% for the 3D-OL and EL, and 73.3% for the CBCT length. The EL presented significantly fewer underestimated measurements (P < .05). The 3D-OL and 3D-SL presented significantly fewer measurements beyond the AF (P < .05). CONCLUSIONS The preoperative working length determination using 3D Endo was reliable and similar to conventional CBCT software. However, the combined use of CBCT with an EAL is required to increase the accuracy in the location of the AF.
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