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Falcão NPDS, Marceliano-Alves MF, Tavares SJO, Amoroso-Silva P, Neves ADA, Bastos LF, Lopes RT, Dantas WCF, Galhardi MPW, Marceliano EFV, Gomes CC. Shaping Ability of TRUShape and XP-endo Shaper in C-Shaped Canals Using 3D-Printed Replicas: A Micro-CT Study. Eur J Dent 2024; 18:544-550. [PMID: 37729930 PMCID: PMC11132770 DOI: 10.1055/s-0043-1772568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE This study compared the shaping ability of TRUShape and XP-endo Shaper systems on C-shaped root canals replicas using microcomputed tomography (micro-CT). MATERIAL AND METHODS Thirty three-dimensional replicas based on a mandibular second molar classified as C1 type I C-shaped canal were randomly divided into two groups (n = 15): TRUShape (G.TRU) and XP-endo Shaper (G.XP) and instrumented with each system according to the manufacturer's instructions. Changes in volume and surface and the unprepared area of the root canal were measured by scanning on micro-CT before and after instrumentation. RESULTS The unprepared areas were 39% in the G.TRU and 43% in the G.XP group with no significant difference between them (p > 0.05), but both the tested systems left a high percentage of unprepared root canal walls of C-shaped root canals. CONCLUSION TRUShape and XP-endo Shaper showed a high rate of unprepared areas with similar results after C-shaped root canals replicas for root canal preparation.
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Affiliation(s)
- Natália Pereira da Silva Falcão
- Department of Dentistry, Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil
| | | | - Sandro Junio Oliveira Tavares
- Department of Dentistry, Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil
| | - Pablo Amoroso-Silva
- Department of Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | - Luan Ferreira Bastos
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Cinthya Cristina Gomes
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Firsova IV, Trigolos NN, Yaroshenko NN, Temkin ES, Kabytova MV. Effectiveness of various endodontic systems in treating teeth with C-shaped root canals. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction — C-shaped configuration is amongst the most complicated root canal varieties requiring additional effort for successful endodontic treatment. The goal of this study was the laboratory comparison of the endodontic treatment efficiencies via XP-endo vs. Gentlefile systems for the teeth with C-shaped root canals.
Material and Methods — In laboratory settings, 36 teeth with established C-shaped configuration, extracted for medical reasons (24 mandibular premolars and 12 mandibular second molars), underwent the root canal treatment by XP-endo (XP) and Gentlefile (GF) systems. Treatment quality was evaluated on the basis of dye penetration tests and examination of root dentinal surface with a scanning electron microscope. The significance of differences between the groups was assessed via Mann-Whitney U test.
Results — For GF instruments, the average size of stained area in the apical third of teeth was 3.33±2.73%, while in the coronal third it amounted to 13.49±13.58%. The results of using the XP instruments demonstrated the average size of stained area in the apical third equal to 15.45±12.48%, while in the coronal third it was 37.30±14.06%. The scanning electron microscopy revealed a rougher surface of dentin and the remnants of stained layer in root canals treated with GF system.
Conclusion — Thus, XP instruments exhibited a better treatment quality compared with GF system. The obtained data may justify the choice of instruments for endodontic teeth treatment in case of an intricate root canal system.
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Baghbani A, Bagherpour A, Ahmadis Z, Dehban A, Shahmohammadi R, Jafarzadeh H. The efficacy of five different techniques in identifying C-shaped canals in mandibular molars. AUST ENDOD J 2020; 47:170-177. [PMID: 33030295 DOI: 10.1111/aej.12445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 12/24/2022]
Abstract
Information regarding the canal anatomy especially in complex cases such as C-shaped canals is essential for a successful treatment. In this study, five different methods for identification of C-shaped canal configuration were compared. 108 extracted mandibular molars with fused roots were studied. Radiographic evaluation was carried out using periapical radiography and CBCT. After access cavity preparation, all specimens were evaluated by direct visual examination and then under dental operating microscope. Finally, the actual anatomy of each sample was determined by preparing horizontal cross sections of the roots (1 mm thick) and examining them under stereomicroscope as the gold standard. Among the techniques used, high-resolution CBCT manifested the highest accuracy, whereas periapical radiography had the lowest. All approaches can be useful in reaching a correct diagnosis. CBCT, especially the low-resolution modality, is an effective technique in the diagnosis of C-shaped anatomy.
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Affiliation(s)
- Atefeh Baghbani
- Department of Prosthodontics, Faculty of Dentistry, Bojnurd University of Medical Sciences, Bojnurd, Iran
| | - Ali Bagherpour
- Department of Oral and Maxillofacial Radiology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Ahmadis
- Department of Prosthodontics, Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
| | - Arezou Dehban
- Department of Prosthodontics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Shahmohammadi
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Jafarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Roy A, Astekar M, Bansal R, Gurtu A, Kumar M, Agarwal LK. Racial predilection of C-shaped canal configuration in the mandibular second molar. J Conserv Dent 2019; 22:133-138. [PMID: 31142981 PMCID: PMC6519192 DOI: 10.4103/jcd.jcd_369_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The purpose of this article is to determine the racial predilection of C-shaped canal configuration in a mandibular second molar. Background: Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of root canal treatment outcome. C-shaped canal configuration is such an aberrant morphology of molar teeth that vary in different population and is commonly seen in a mandibular second molar. Thus, knowledge of racial predilection of C-shaped canal configuration in different population for early diagnosis is obligatory. Materials and Methods: An exhaustive search was undertaken to identify published research articles related to C-shaped canal configuration in mandibular second molars. Forty-three research articles were analyzed which included 12,481 mandibular second molars. Chi-square test using value of P < 0.05 was performed to assess the statistical significance of this anomalous anatomic variation among the different population. Results: Statistical test revealed a significant variation between the Asian and nonAsian population. The highest incidence of racial predilection was observed in China (Asia) with 93.1%, and the minimum was observed in America with 2.7%. Conclusion: This research reported that racial predilection of C-shaped canal configuration in mandibular second molar varies significantly.
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Affiliation(s)
- Aishwarya Roy
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rashmi Bansal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Anuraag Gurtu
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Mrityunjay Kumar
- Department of Anaesthesiology, Critical Care and Pain Management, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Lalit Kumar Agarwal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Tomaszewska IM, Skinningsrud B, Jarzębska A, Pękala JR, Tarasiuk J, Iwanaga J. Internal and external morphology of mandibular molars: An original micro-CT study and meta-analysis with review of implications for endodontic therapy. Clin Anat 2018; 31:797-811. [DOI: 10.1002/ca.23080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/08/2018] [Accepted: 03/20/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Iwona M. Tomaszewska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Bendik Skinningsrud
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Anna Jarzębska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
| | - Jakub R. Pękala
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Jacek Tarasiuk
- Micro- and Nanotomography Laboratory, Faculty of Physics; AGH University of Science and Technology; Krakow Poland
| | - Joe Iwanaga
- Seattle Science Foundation; Seattle Washington
- Department of Anatomy, Kurume University School of Medicine; Division of Gross and Clinical Anatomy; Kurume Fukuoka Japan
- Dental and Oral Medical Center, Kurume University School of Medicine; Kurume Fukuoka Japan
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Sekiya M, Maeda M, Katsuumi I, Igarashi M. Evaluation of four instruments with different working motion using artificial plastic model with C-shaped single canal. Odontology 2018; 106:422-428. [PMID: 29429057 PMCID: PMC6153976 DOI: 10.1007/s10266-018-0348-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/01/2018] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to evaluate four instruments with different working motion for preparation of a C-shaped single canal wall using the same artificial plastic models reproduced from a human tooth. One tooth with root canal morphology C1 (the shape is an uninterrupted “C” with no separation or division) was selected among three-dimensional micro-computed tomography (micro-CT) imaging data of extracted human teeth. Imaging data were then converted into STL form data, and twenty-four C-shaped root canal model blocks were manufactured using this STL form data. These blocks were randomly divided into four groups of six blocks each and instrumented as follows: stainless steel K-files (SSK), Self-Adjusting File (SAF), ProTaper NEXT (PTN) and RECIPROC (REC). Micro-CT images taken before and after canal preparation were superimposed, and instrumented canal area, percentage of instrumented canal area, part of instrumented canal area, volume of instrumented canal and time taken for instrumentation were evaluated for each group. The greatest instrumented canal area, percentage of instrumented canal area and volume of instrumented canal were as follows (in decreasing order): SSK > SAF > PTN > REC (P < 0.05). The longest time taken for instrumentation was as follows (in decreasing order): SAF > SSK > PTN > REC (P < 0.05). The conscious shaping of SSK and the lattice structure of SAF were instrumented all root canal walls equally. PTN and REC required less time taken for instrumentation, but showed unequal instrumentation.
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Affiliation(s)
- Miki Sekiya
- Department of Endodontics, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.
| | - Munehiro Maeda
- Department of Endodontics, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Ichiroh Katsuumi
- Department of Endodontics, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Masaru Igarashi
- Department of Endodontics, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
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Wadhwani S, Singh MP, Agarwal M, Somasundaram P, Rawtiya M, Wadhwani PK. Prevalence of C-shaped canals in mandibular second and third molars in a central India population: A cone beam computed tomography analysis. J Conserv Dent 2017; 20:351-354. [PMID: 29386785 PMCID: PMC5767832 DOI: 10.4103/jcd.jcd_273_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction To evaluate the prevalence of C-shaped root canals in mandibular molars using cone beam computed tomography (CBCT) in a subpopulation of Central India. Materials and Methods CBCT scans of patients from diagnostic imaging center were selected in accordance with the criteria given by Fan et al. (2004) for C-shaped canals. A total of 238 CBCT scans fulfilled the inclusion criteria and thereby divided into two groups: Group 1: Images showing C-shaped canal configuration in mandibular second molars. Group 2: Images showing C-shaped canal configuration in mandibular third molars. The frequency and distribution of canals and their configuration along with the position of lingual/buccal grooves in the images were evaluated, and the data was analyzed. Results CBCT evaluation showed that 9.7% of second molars and 8% of third molars had C-shaped canals. A prominent buccal groove was seen in these teeth. The data showed a significant difference (P = 0.038) for the presence of such anatomy on the right side for mandibular third molars. Conclusion The study showed a significant prevalence of C-shaped canal configuration in the subpopulation studied.
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Affiliation(s)
- Shefali Wadhwani
- Department of Conservative Dentistry and Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Mahesh Pratap Singh
- Department of Conservative Dentistry and Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Manish Agarwal
- Department of Conservative Dentistry and Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Pavithra Somasundaram
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, KSA
| | - Manjusha Rawtiya
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India
| | - P K Wadhwani
- Dental Health Centre, Bhopal, Madhya Pradesh, India
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8
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Karunakaran JV, Samuel LS, Rishal Y, Joseph MD, Suresh KR, Varghese ST. Root Canal Configuration of Human Permanent Mandibular First Molars of an Indo-Dravidian Population Based in Southern India: An In vitro Study. J Pharm Bioallied Sci 2017; 9:S68-S72. [PMID: 29284938 PMCID: PMC5731046 DOI: 10.4103/jpbs.jpbs_163_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This study aims to analyze root canal configuration of human permanent mandibular first molars of an indo-Dravidian population based in southern India. Materials and Methods: A total of 1147 mandibular first permanent molars were collected, cleansed, and stored. The number of roots was recorded, access preparations made, pattern of orifices recorded after pulpal floor debridement, dye injected into the canals using apical negative pressure and subjected to a clearing technique. They were then analyzed using a stereo microscope and the canal configurations recorded (Vertucci). The number of roots, the pattern of orifices and canal configuration were recorded. Results: The pattern of orifices was triangular (87.9%), rectangular (8.5%), C-shaped (3.0%), and two orifice pattern (0.6%). About 95.6% of teeth had two roots, and 4.4% had three roots. The most common canal system configuration in mesial root was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The distolingual root had a type I configuration. Conclusion: Awareness of canal configuration, adequate clinical skills, use of specialized techniques of diagnosis, debridement and obturation will pave the way for successful treatment outcomes.
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Affiliation(s)
- J V Karunakaran
- Department of Conservative Dentistry, JKK Nataraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
| | - Leo Sujith Samuel
- Department of Conservative Dentistry, JKK Nataraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
| | - Yousef Rishal
- Department of Conservative Dentistry, Malabar Dental College and Research Institute, Malappuram, Kerala, India
| | - M Derick Joseph
- Department of Conservative Dentistry, Malabar Dental College and Research Institute, Malappuram, Kerala, India
| | - K Rahul Suresh
- Department of Conservative Dentistry, JKK Nataraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
| | - Sam T Varghese
- Department of Conservative Dentistry, JKK Nataraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
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Bertrand T, Kim SG. Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report. Restor Dent Endod 2016; 41:68-73. [PMID: 26877993 PMCID: PMC4751210 DOI: 10.5395/rde.2016.41.1.68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/04/2015] [Indexed: 11/11/2022] Open
Abstract
This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.
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Affiliation(s)
- Thikamphaa Bertrand
- Division of Endodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Sahng Gyoon Kim
- Division of Endodontics, Columbia University College of Dental Medicine, New York, NY, USA
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10
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Kato A, Ziegler A, Higuchi N, Nakata K, Nakamura H, Ohno N. Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics. Int Endod J 2014; 47:1012-33. [PMID: 24483229 PMCID: PMC4258081 DOI: 10.1111/iej.12256] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 01/27/2014] [Indexed: 01/15/2023]
Abstract
The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts.
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Affiliation(s)
- A Kato
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, Aichi, Japan
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Fernandes M, de Ataide I, Wagle R. C-shaped root canal configuration: A review of literature. J Conserv Dent 2014; 17:312-9. [PMID: 25125841 PMCID: PMC4127687 DOI: 10.4103/0972-0707.136437] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/08/2013] [Accepted: 02/23/2014] [Indexed: 12/11/2022] Open
Abstract
The aim is to review and discuss the etiology, incidence, anatomic features, classification, diagnosis and management of the C-shaped canal configuration. C-shaped canal configuration is a variation that has a racial predilection and is commonly seen in mandibular second molars. The intricacies present in this variation of canal morphology can pose a challenge to the clinician during negotiation, debridement and obturation. Manual and electronic searches of literature were performed from 1979 to 2012, in Pub Med by crossing the keywords: C-shaped canals, mandibular second molar, mandibular first premolar, root canal morphology. Knowledge of the C-shaped canal configuration is essential to achieve success in endodontic therapy. Radiographic and clinical diagnoses can aid in identification and negotiation of the fan-shaped areas and intricacies of the C-shaped anatomy. Effective management of this anomalous canal configuration can be achieved with rotary and hand instrumentation assisted with sonics and ultrasonics. Modifications in the obturation techniques will ensure a 3-dimensional fill of the canal system and chamber retained restorations like amalgam or composites, serve as satisfactory post endodontic restorations.
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Affiliation(s)
- Marina Fernandes
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, India
| | - Ida de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, India
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12
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Raisingani D, Gupta S, Mital P, Khullar P. Anatomic and diagnostic challenges of C-shaped root canal system. Int J Clin Pediatr Dent 2014; 7:35-9. [PMID: 25206235 PMCID: PMC4144060 DOI: 10.5005/jp-journals-10005-1230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 09/28/2013] [Indexed: 11/26/2022] Open
Abstract
Successful root canal treatment depends on the thorough management of the canal anatomy. The use of periapical radiographs is essential to identify and monitor the canal's morphological variations. The C-shaped single canaled man-dibular 2nd molar probably requires a different regimen of treatment from the two rooted, three canaled version, as it is rare. Because of the importance of its true diagnosis and treatment, a comprehensive review of published information and investigations about it in addition to approaches for its treatment is necessary. In this article, a detailed review and three case reports with different C-shaped canal configurations have been described which were successfully negotiated, prepared and obturated. How to cite this article: Raisingani D, Gupta S, Mital P, Khullar P. Anatomic and Diagnostic Challenges of C-Shaped Root Canal System. Int J Clin Pediatr Dent 2014;7(1):35-39.
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Affiliation(s)
- Deepak Raisingani
- Professor, Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur Rajasthan, India
| | - Shailendra Gupta
- Professor and Head, Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur Rajasthan, India
| | - Prachi Mital
- Postgraduate Student (1st Year), Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur Rajasthan, India
| | - Poorva Khullar
- Postgraduate Student (2nd Year), Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur Rajasthan, India
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Martins JNR, Quaresma S, Quaresma MC, Frisbie-Teel J. C-shaped maxillary permanent first molar: a case report and literature review. J Endod 2013; 39:1649-53. [PMID: 24238466 DOI: 10.1016/j.joen.2013.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 05/14/2013] [Accepted: 06/29/2013] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The C-shaped configuration is rare in the upper first molar.The purpose of this article is to present 2 cases diagnosed during endodontic therapy and perform a literature review of this anatomy in the upper first molar. METHODS Endodontic therapy was performed by using a dental operating microscope and a cone-beam computed tomography analysis for better understanding of this anatomy. A literature search was conducted to identify and compare all the published cases of C-shaped upper first molar. RESULTS Before the cases reported in this article, only 5 cases were available in the published literature. Three different types of C-shaped configurations in the upper first molar have been presented. CONCLUSIONS The C-shaped maxillary first molar is a rare anatomic configuration. The use of the dental operating microscope may help in the endodontic therapy of these cases. Three types of C-shaped configurations have been reported; the fusion of the distobuccal root with the palatal root appears to be the most usual one.
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Affiliation(s)
- Jorge N R Martins
- Department of Endodontics, Instituto de Implantologia, Lisbon, Portugal.
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14
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Ballullaya SV, Vemuri S, Kumar PR. Variable permanent mandibular first molar: Review of literature. J Conserv Dent 2013; 16:99-110. [PMID: 23716959 PMCID: PMC3659872 DOI: 10.4103/0972-0707.108176] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 08/15/2012] [Accepted: 08/23/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.
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Affiliation(s)
- Srinidhi V Ballullaya
- Department of Conservative dentistry and Endodontics, St Joseph Dental College, Duggirala, Eluru, West Godavari District, India
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Root Anatomy and Canal Configuration of the Permanent Mandibular First Molar: A Systematic Review. J Endod 2010; 36:1919-31. [DOI: 10.1016/j.joen.2010.08.055] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/26/2010] [Accepted: 08/28/2010] [Indexed: 12/20/2022]
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Jafarzadeh H, Wu YN. The C-shaped root canal configuration: a review. J Endod 2007; 33:517-23. [PMID: 17437864 DOI: 10.1016/j.joen.2007.01.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Revised: 12/25/2006] [Accepted: 01/02/2007] [Indexed: 11/30/2022]
Abstract
Recognition of unusual variations in the canal configuration is critical because it has been established that the root with a single tapering canal and apical foramen is the exception rather than the rule. The early recognition of these configurations facilitates cleaning, shaping, and obturation of the root canal system. "C" configuration, which is an important anatomic variation, presents a thin fin connecting the root canals. Because of the importance of its true diagnosis and treatment, a comprehensive review of published information and investigations about it in addition to approaches for its treatment is necessary.
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Affiliation(s)
- Hamid Jafarzadeh
- Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abstract
AIM The aim of this study was to determine the frequency of C-shaped canals in mandibular second molars in a population in Saudi Arabia and to establish a classification for the most common configurations. METHODOLOGY One hundred and fifty-one mandibular second molars scheduled for root-canal treatment were examined over a 1-year period. The C-shaped canals were detected by radiographic and clinical examination. Teeth with C-shaped canal systems were categorized by using a modification of the classification of Melton. RESULTS Of the 151 molars, 16 (10.6%) exhibited C-shaped canals. Five molars were classified as category I, and three were considered category II. The remaining eight cases were classified as category III, with two in subdivision I, two in subdivision II, and the remaining four in subdivision IIL. CONCLUSIONS The C-shaped canals in mandibular second molars vary considerably in their anatomical configuration with the result that debridement, obturation, and restoration may be difficult.
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Affiliation(s)
- K S Al-Fouzan
- Dental Department, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia
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Haddad GY, Nehme WB, Ounsi HF. Diagnosis, classification, and frequency of C-shaped canals in mandibular second molars in the Lebanese population. J Endod 1999; 25:268-71. [PMID: 10425954 DOI: 10.1016/s0099-2399(99)80157-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
C-shaped canals are mostly found in mandibular second molars. Studies have shown that frequency ranges from 2.7 to 31%. This study was undertaken to provide further knowledge of the distribution of such canal anatomy, by determining the frequency of C-shaped canals in a sample representing the Lebanese population. Ninety-four mandibular second molars with scheduled endodontic treatment were examined over a 1-yr period. Of the 94 treated molars, 18 exhibited C-shaped canals that would represent 19.1% of the sample. The geographical position of Lebanon could represent an explanation for this phenomenon.
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Affiliation(s)
- G Y Haddad
- Saint Joseph University, Beirut, Lebanon
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Ricucci D. Three independent canals in the mesial root of a mandibular first molar. ENDODONTICS & DENTAL TRAUMATOLOGY 1997; 13:47-9. [PMID: 9206390 DOI: 10.1111/j.1600-9657.1997.tb00010.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Endodontic therapy was performed in a mandibular first molar with three canals in the mesial root. The mesiobuccal and the mesiolingual canals were found in their normal locations. The third was located in the middle of the distance between the other two. Radiographically, it ended in its own distinct foramen. Many reports deal with three orifices in the mesial root, but very few describe three independent canals, indicating a rare anatomical configuration. To locate the third possible intermediate canal it was suggested to reduce the mesial dentinal wall of the pulp chamber after instrumenting the main two canals.
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Abstract
Three cases of mandibular second molars with C-shaped root canal morphology are described. Two of these molars did not radiographically show the usual anatomic configuration of two separated roots, but rather had a single conical root. Only two root canals orifices were observed in the pulp chamber floor: a mesial-lingual orifice in its normal position and a buccal C-shaped fissure that was continuous from the normal location of the mesiobuccal canal to that of the distal canal. The fissure became smaller in the apical third, ending in a distal direction. The third case, a second molar extracted because of severe periodontal involvement showed, after sectioning, a C-shaped root with connections between all three canals.
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Affiliation(s)
- D Ricucci
- Department of Restorative Dentistry and Endodontology, University of Connecticut, Farmington 06030, USA
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Abstract
The root canal anatomy of 149 mandibular second molars was studied using a technique in which the pulp was removed, the canal space filled with black ink and the roots demineralized and made transparent. Of the 149 teeth, 22 per cent had single roots, 76 per cent had two roots and 2 per cent had three roots. In the single-rooted teeth, three canals were most common, while in the mesial root of the two-rooted teeth, two canals that joined near the apex and one canal in the distal root were most frequent. Round canals were most common in two-rooted teeth and C-shaped canals in single-rooted teeth. Transverse anastomoses were found in 33 per cent of roots, most commonly in the middle third of the root. Lateral canals were found in 72 per cent of roots, most commonly in the apical third of the root. The apical foramen was positioned at the apex in only 33 per cent of roots, and apical deltas were found in 35 per cent. The patient's age and race affected canal shape, with more round canals present in patients over 35 years of age, and more C-shaped canals in Asians. The sex of the patient and the side of the mouth affected the presence of apical deltas, with more being found in males and on the left side. Single-rooted teeth had more complex root canal systems than two-rooted teeth, with more lateral canals, transverse anastomoses, apical deltas and C-shaped canals.
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Affiliation(s)
- S A Manning
- Department of Restorative Dentistry, University of Melbourne, Victoria, Australia
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Abstract
The root canal anatomy of 19 mandibular second molars with C-shaped canals was investigated by rendering the roots transparent and allowing the canal system to be observed by black ink infiltration. The presence of three root canals was most frequent, and lateral canals were found in all roots. Transverse anastomoses were found in 15 of the 19 roots. The apical foramen was most commonly situated away from the apex, and apical deltas were found in 16 of the 19 roots. The C-shaped canals were found more frequently in Asians than in other racial groups (P less than 0.02). The formation of C-shaped roots and their racial predilection is discussed. A case report of the root canal treatment of a C-shaped canal is included and suggestions are made concerning suitable procedures for use in root canal treatment of these complex canal systems.
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Affiliation(s)
- S A Manning
- Department of Restorative Dentistry, University of Melbourne, Victoria, Australia
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Yang ZP, Yang SF, Lin YC, Shay JC, Chi CY. C-shaped root canals in mandibular second molars in a Chinese population. ENDODONTICS & DENTAL TRAUMATOLOGY 1988; 4:160-3. [PMID: 3267526 DOI: 10.1111/j.1600-9657.1988.tb00315.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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