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Pan Y, Wei L, Zheng Z, Bi W. An evaluation of bone depth at different three-dimensional paths in infrazygomatic crest region for miniscrew insertion: A cone beam computed tomography study. Heliyon 2024; 10:e25827. [PMID: 38352741 PMCID: PMC10863323 DOI: 10.1016/j.heliyon.2024.e25827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Objective To investigate the difference and distribution of bone depth at different three-dimensional simulated paths to help optimize the insertion path for miniscrew placement in the infrazygomatic crest. Methods Cone beam computed tomography scans of 80 adults (38 males and 42 females; mean age, 27.0 years) were assessed. For each subject, bone depth of 81 simulated insertion paths at different insertion points and three-dimensional angulations was measured in 160 infrazygomatic crests; the differences were evaluated using the adjusted Friedman test. The bone deficiency ratio for each path was calculated. Distributions of measurements were analyzed and reported as specially designed colormaps. Results Bone depth increased, and bone deficiency ratio reduced mesially to distally (P < 0.001), apically to coronally (P < 0.01), and at a greater gingival and distal inclination (P < 0.05). The maximum bone depth (10.72 mm) was observed 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar. The minimum bone depth (3.4 mm) was observed 17 mm above the maxillary occlusal plane in the distobuccal root of the maxillary first molar. No bone deficiency was detected at the paths of 13 mm above the maxillary occlusal plane at a gingival inclination of 70° and distal inclination of 30° in the mesiobuccal root of the maxillary second molar. The highest bone deficiency ratio is present 17 mm above the maxillary occlusal plane at a gingival inclination of 60° and a distal inclination of 0° in the distobuccal root of the maxillary first molar (89/160). Conclusion Insertion paths located at 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar were optimal. A gingival inclination of 70° and a distal inclination of 30° could be beneficial. The distobuccal root of the maxillary first molar region or above the 17 mm insertion plane may not be recommended.
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Affiliation(s)
- Yingdan Pan
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Lijun Wei
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Zhanglong Zheng
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Wei Bi
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
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Martinho FC, Rollor C, Westbrook K, Aldahmash SA, Fay GG, Rivera E, Parsa A, Price JB, Tordik PA. A Cadaver-based comparison of Sleeve-Guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections. J Endod 2023:S0099-2399(23)00288-1. [PMID: 37263496 DOI: 10.1016/j.joen.2023.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER). METHODS Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). CBCT scans were taken pre- and postoperatively. The osteotomy and RER were planned virtually in the preoperative CBCT scan and guided using 3D-printed surgical guides in the FG sCAEMS and 3D-dynamic navigation system in the dCAEMS. The 2D and 3D deviations and angular deflection (AD) were calculated. The osteotomy volume, resected root length, and resection angle were measured. The osteotomy and RER time and the number of procedural mishaps were recorded. RESULTS FG sCAEMS was as accurate as dCAEMS, with no difference in the 2D and 3D deviation values or AD (p >.05). The osteotomy and RER time were shortened using FG sCAEMS (p <.05). The FG sCAEMS showed a greater number of incomplete RERs than dCAEMS. Osteotomy volume, RER angle, and root length resected were similar in both groups (p >.05). FG sCAEMS and dCAEMS were feasible for osteotomy and RER. CONCLUSIONS Within the limitations of this cadaver-based study, FG sCAEMS was as accurate as dCAEMS. Both FG sCAEMS and dCAEMS were time-efficient for osteotomy and RER, but FG sCAEMS required less surgical time.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland.
| | - Corey Rollor
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Kyle Westbrook
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Sara A Aldahmash
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Guadalupe G Fay
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Elias Rivera
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Azin Parsa
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
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Bi C, Zhou M, Zhang Y, Zheng P. Endodontic Microsurgery of Mandibular Second Molars Using the Bony Lid Approach: A Case Series. J Endod 2022; 48:1533-1538. [DOI: 10.1016/j.joen.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
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Lee HS, Kim D, Kim SK. Proximity of maxillary molar apexes to the cortical bone surface and the maxillary sinus. Restor Dent Endod 2022; 47:e33. [PMID: 36090514 PMCID: PMC9436651 DOI: 10.5395/rde.2022.47.e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives Materials and Methods Results Conclusions
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Affiliation(s)
- Han Shin Lee
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Dokyung Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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Shetty N, Gupta I, Ahmed J, Mala K, Natarajan S, Shetty N. Proximity of the mandibular anterior root apices to the buccal bone surface: A cone-beam computed tomographic study. Endodontology 2022. [DOI: 10.4103/endo.endo_183_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
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Dianat O, Nosrat A, Mostoufi B, Price JB, Gupta S, Martinho FC. Accuracy and efficiency of guided root-end resection using a dynamic navigation system: a human cadaver study. Int Endod J 2021; 54:793-801. [PMID: 33368371 DOI: 10.1111/iej.13466] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
AIM To determine and compare the accuracy and efficiency of a dynamic navigation system (DNS) with a freehand (FH) technique when conducting root-end resection in a human cadaver model. METHODOLOGY Forty roots in cadaver heads were included and divided into two groups: DNS (n = 20) and FH (n = 20). Cone beam computed tomography (CBCT) scans of all teeth were taken. The drilling path and depth were planned virtually to using the X-guide software (X-Nav Technologies, Lansdale, PA, USA). Osteotomy and root-end resection were done under navigation in the DNS group, and freehand under the dental operating microscope in the FH group. Post-operative CBCTs were taken. Linear deviations, angular deflection, time of operation and number of mishaps were compared with determine the accuracy and efficiency. Shapiro-Wilk, one-way ANOVA and Fisher exact tests were used (P < 0.05). RESULTS Linear deviations, angular deflection and operation time were significantly less in the DNS group (P < 0.05). The number of mishaps was not different between the two groups (P > 0.05). Subgroup analyses revealed that the distance of >5 mm from buccal cortical plate was significantly associated with lower accuracy, increased operation time and greater incidence of mishaps in the FH group (P < 0.05), but not in the DNS group. CONCLUSIONS The dynamic navigation system was more accurate and more efficient in root-end resection in a cadaver model than the freehand technique. The distance of the roots from the buccal cortical plate had a significant negative impact on the accuracy and efficacy of the root-end resection procedure when using the freehand technique. The dynamic navigation system has the potential to be a safe and reliable technological addition to endodontic microsurgery.
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Affiliation(s)
- O Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - A Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - B Mostoufi
- Department of Oral & Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - J B Price
- Department of Oncology & Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - S Gupta
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - F C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
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Ferrari CH, Abu Hasna A, Martinho FC. Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates. Braz Oral Res 2021; 35:e022. [PMID: 33605353 DOI: 10.1590/1807-3107bor-2021.vol35.0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022] Open
Abstract
This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.
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Affiliation(s)
- Carlos Henrique Ferrari
- Universidade Estadual Paulista - Unesp, Institute of Science and Technology , Department of Restorative Dentistry , São José dos Campos , SP , Brazil
| | - Amjad Abu Hasna
- Universidade Estadual Paulista - Unesp, Institute of Science and Technology , Department of Restorative Dentistry , São José dos Campos , SP , Brazil
| | - Frederico Canato Martinho
- University of Maryland , School of Dentistry , Department of Advanced Oral Sciences and Therapeutics , Baltimore , MD , USA
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Lee JH, Ahn HN, Park JT. Three-dimensional visualization of the alveolar bone and posterior superior alveolar foramen in gender. Surg Radiol Anat 2020; 43:261-266. [PMID: 32960307 DOI: 10.1007/s00276-020-02576-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/12/2020] [Indexed: 11/24/2022]
Abstract
The present study applied a three-dimensional (3D) program to measure the distances from the maxillary sinus floor (MSF) to the lingual and buccal alveolar bone and also to the posterior superior alveolar foramen (PSAF), with the aim of determining differences according to gender. The study also attempted to verify the accuracy of measurements obtained from 3D images by performing comparisons with the results obtained in a preliminary study. The results showed that the alveolar bone length and the MAF-PSAF were generally larger in males than in females. It is also predicted that the accuracy of data obtained from a 3D program will be higher than that of data derived from conventional two-dimensional (2D) images. The accurate measurements obtained in this study are anticipated to prove useful in assessments related to dental implantation and anatomical structures. The fundamental data obtained in this study may also assist in setting the goals of future studies utilizing 3D programs.
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Affiliation(s)
- Jeong-Hyun Lee
- Department of Oral Anatomy, Dental College, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Hyun-Na Ahn
- Department of Oral Anatomy, Dental College, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Jong-Tae Park
- Department of Oral Anatomy, Dental College Dankook Institute For Future Science and Emerging Convergence, Dan-Kook University, Cheonan, 330-714, South Korea.
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Musu D, Cadeddu Dessalvi C, Shemesh H, Frenda MG, Mercuro G, Cotti E. Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo study. Int Endod J 2020; 53:1289-1298. [PMID: 32531801 DOI: 10.1111/iej.13346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves. METHODOLOGY Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra-bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2 mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2 mm) and large (5 mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2 mm) and large (5 mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver-operating characteristics (ROC) were analysed. The significance of the findings (P < 0.05) was appraised using the chi-square statistics with the Yates correction, whilst the intra- and inter-examiner agreements were evaluated through Kappa statistics. RESULTS USE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k-values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter-observer agreement. The intra-observer agreement was also high (k-value = 0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P < 0.0001). CONCLUSIONS USE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate.
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Affiliation(s)
- D Musu
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - C Cadeddu Dessalvi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - H Shemesh
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - M G Frenda
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - G Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - E Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
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Wang X, Zhang Y, Li X, Huang Z, Cui M, Huang Z, Zhang X, Hu X. Biometric analysis of apical surgery-related anatomy of mandibular first molars: a cone-beam computed tomography study in a Mongoloid population. J Int Med Res 2019; 48:300060519892396. [PMID: 31856630 PMCID: PMC7783284 DOI: 10.1177/0300060519892396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the apical surgery-related anatomy of two-rooted and three-rooted mandibular first molars (MFMs) in a Mongoloid population. Methods A total of 502 cone-beam computed tomographic images were used to evaluate the root configuration, the distance from the buccal bone to each root, root dimensions, and the complete root resection distance at the resection level for roots of MFMs. Results The prevalence of two-rooted and three-rooted MFMs was 85.1% and 14.9%, respectively. At the resection level, the distance from the buccal bone to the mesial and distal roots of two-rooted MFMs was 2.24 and 3.15 mm, respectively, while the distance was 2.44, 2.01, and 8.55 mm for the mesial, distobuccal, and distolingual roots of three-rooted MFMs, respectively. The distance from the buccal bone to each root was longer in men than in women. The largest distance for complete root resection was detected for the distal root in two-rooted MFMs and for the distolingual root in three-rooted MFMs. Conclusions The prevalence of three-rooted MFMs is common in the Mongoloid population. The distance from the buccal bone to root apex differs according to root configurations and sex. Surgical access to the distolingual root is difficult because of the long access distance.
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Affiliation(s)
- Xue Wang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuejiao Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolan Li
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zijing Huang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Minyi Cui
- Department of Radiology, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhuwei Huang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolei Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoli Hu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Xiaoli Hu, Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou, Guangdong, 510055, China.
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Corbella S, Baruffaldi M, Perondi I, Taschieri S. Surgically-oriented anatomical study of mandibular premolars: A CBCT study. J Clin Exp Dent 2019; 11:e877-e882. [PMID: 31636856 PMCID: PMC6797462 DOI: 10.4317/jced.55848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
Background The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to investigate the anatomical features of mandibular premolars, evaluating their relationship with mental nerve. Material and Methods CBCT scans were evaluated recording the number of roots, root canal configuration and the relationship with mental nerve of 100 mandibular premolars. After simulating a resection of 3 mm of the root, the shape and the number of canals, and the distance to the buccal and lingual bone plate and to the mental foramen was evaluated. Results The one root - one canal configuration was the most common configuration. The mental foramen was located at the level of MSPs in 40% cases, and it was between MSP and MFP in 46% of cases. The distance between the apex and the vestibular plate was lower than the distance to the lingual one. Conclusions We found a significant heterogeneity in the anatomy of mandibular premolars. CBCT could be considered important when planning surgical endodontics in this region. Key words:Cone-Beam Computed Tomography, bicuspid, root canal, root canal therapy, apicoectomy, mandibular nerve.
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Affiliation(s)
- Stefano Corbella
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
| | - Martino Baruffaldi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Isabella Perondi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Silvio Taschieri
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
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Abstract
Objectives To investigate the periapical bone thicknesses of maxillary posterior teeth at the preferred level for root resection (3 mm apical to the root end) and to determine vertical distances from apex to maxillary sinus floor (MSF) using cone beam computed tomography (CBCT) scans. Methods CBCT scans were collected from 341 subjects (2389 teeth). Associations of bone thicknesses and vertical distances with age and sex were determined by one-way analysis of variance. Results At the level of root-end resection, buccal bone was the thickest over the mesiobuccal roots of second molars (mean, 2.99 mm) and thinnest over the double-root first premolars (mean, 0.29 mm). In maxillary posterior teeth, thicker buccal bone was found in men than in women. The mesiobuccal roots of second molars were nearest to the MSF (mean, 1.33 mm), and were also most frequently extended into the sinus cavity (15.81%). Subjects more than 40 years of age had larger vertical distances from root apices to MSF in the molar region, compared with younger subjects. Conclusions Generally, periapical bone was thicker in men, and root apices were located nearer to the MSF in younger subjects. Age and sex should be considered before endodontic microsurgery.
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Affiliation(s)
- Xiaoli Hu
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lizhen Lei
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Minyi Cui
- Department of Radiology, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuwei Huang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaolei Zhang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
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Patil SA, Patil AC, Patil PA. Anesthetic efficacy of anterior middle superior alveolar injection in single-visit endodontic therapy: an in vivo study. Clin Oral Investig 2019; 24:1701-1707. [PMID: 31350627 DOI: 10.1007/s00784-019-03028-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 07/16/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate and compare the anesthetic efficacy of anterior middle superior alveolar (AMSA) injection in single-visit endodontic therapy, an in vivo study. MATERIALS AND METHODS Teeth in the maxillary anterior segment (N = 60) requiring single-visit endodontic (SVE) therapy were selected. A conventional syringe with 26-guage needle containing 1.5 ml lignocaine with 1:80,000 epinephrine was used for the AMSA injection. The SVE therapy was performed using standard protocol. Profoundness of anesthesia during therapy was evaluated at 15-, 30-, 60-, and 90-min intervals using pain rating score and marked on visual analogue scale. In patients who reported pain/ineffectiveness of anesthesia during the course of endodontic therapy, additional supplemental anesthesia (buccal/labial infiltration) was administered. Depending on effectiveness of anesthesia with the AMSA injection alone or the need for additional supplementary injections, patients were divided as: group I-only AMSA and group II-AMSA with one or two supplemental anesthesia. RESULTS The AMSA injection was effective in 91.67% of the patients undergoing the SVE therapy and the duration of anesthesia for the AMSA injection alone was adequate until the completion of the SVE therapy. Supplementary injections were required in 8.33% of cases at 15-min interval to achieve profound anesthesia. CONCLUSION The AMSA injection technique could be used as an alternative to the conventional infiltration technique for anesthetizing teeth in maxillary anterior segment during the SVE therapy. CLINICAL RELEVANCE The AMSA injection provides profound pulpal anesthesia of teeth in maxillary anterior segment during endodontic therapy.
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Affiliation(s)
- Sneha A Patil
- Department of Conservative Dentistry and Endodontics; KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India.
| | - Anand C Patil
- Department of Conservative Dentistry and Endodontics; KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Pratibha A Patil
- Department of Public Health Dentistry; KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India
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Uğur Aydın Z, Göller Bulut D. Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis. Clin Oral Investig 2019; 23:3637-3644. [PMID: 30712074 DOI: 10.1007/s00784-019-02834-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery. METHODS A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured. RESULTS The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm. CONCLUSIONS It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery. CLINICAL RELEVANCE The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.
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Affiliation(s)
- Zeliha Uğur Aydın
- Faculty of Dentistry, Department of Endodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Duygu Göller Bulut
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Aksoy U, Orhan K. Risk Factor in Endodontic Treatment: Topographic Evaluation of Mandibular Posterior Teeth and Lingual Cortical Plate Using Cone Beam Computed Tomography (CT). Med Sci Monit 2018; 24:7508-7516. [PMID: 30343309 PMCID: PMC6206815 DOI: 10.12659/msm.908970] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Topographic relationships of mandibular posterior teeth with mandibular cortical plate are extremely important both in terms of infection spread and endodontic and surgical procedures to be performed. The aim of this study was to determine the relationship between root apex of the mandibular posterior teeth and lingual plate of the mandible. Material/Methods CBCT data of 138 patients were retrospectively analyzed. The topographic relationship between root apex and lingual plate was classified as non-contact, contact, or perforation. Morphology of the mandibular lingual plate was classified into the 4 types (convex, parallel, undercut, slanted) and recorded for each tooth region. The prevalence of each group was calculated. Results In 6.2% of all mandibular posterior teeth, the lingual plate was perforated by at least 1 root of the corresponding tooth. The teeth with the highest perforation rate were the third molar tooth (31.6%) and the second molar tooth (14.7%). The most common mandibular lingual plate morphology type was “undercut type” (61.3%) in the molar teeth region, while “parallel type” (55.7%) was most common in the premolar teeth region. Conclusions In conclusion, a high percentage of mandibular second and third molars root apex have topographically close relationships to the lingual plate of the mandible. Hence, endodontic consultants must be aware by this anatomical relationship and be aware of possible complications during endodontic and surgical procedures using radiographical modalities.
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Affiliation(s)
- Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Zahedi S, Mostafavi M, Lotfirikan N. Anatomic Study of Mandibular Posterior Teeth Using Cone-beam Computed Tomography for Endodontic Surgery. J Endod 2018; 44:738-743. [DOI: 10.1016/j.joen.2018.01.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 11/29/2022]
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Shapiro MR, McDonald NJ, Gardner RJ, Peters MC, Botero TM. Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial. J Endod 2018; 44:523-528. [PMID: 29397214 DOI: 10.1016/j.joen.2017.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/08/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Profound pulpal anesthesia is difficult to achieve in mandibular molars with irreversible pulpitis (IP). However, there are no published randomized controlled clinical trials comparing the success of supplemental buccal infiltration (BI) in mandibular first versus second molars with IP. The purpose of this prospective, randomized, double-blind study was to compare the efficacy of 4% articaine with 2% lidocaine for supplemental BIs in mandibular first versus second molars with IP after a failed inferior alveolar nerve block (IANB). This study's sample was combined with data from a previous trial. METHODS One hundred ninety-nine emergency subjects diagnosed with IP of a mandibular molar were selected and received an IANB with 4% articaine. Subjects who failed to achieve profound pulpal anesthesia, determined by a positive response to cold or pain upon access, randomly received 4% articaine or 2% lidocaine as a supplemental BI. Endodontic access was begun 5 minutes after infiltration. Success was defined as less than mild pain during endodontic access and instrumentation on the Heft-Parker visual analog scale. RESULTS There was a 25% IANB success rate with 4% articaine. The success rate for articaine supplemental BI in first molars was 61% versus 63% for second molars (P > .05). The success of lidocaine in first molars was 66%, but for second molars it was 32% (P = .004). CONCLUSIONS The success rate for IANB with 4% articaine was 25%. Articaine and lidocaine had similar success rates for supplemental infiltration in first molars, whereas articaine was significantly more successful for second molars. However, because BI often did not provide profound pulpal anesthesia, additional techniques including intraosseous anesthesia may still be required.
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Affiliation(s)
- Michael R Shapiro
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Private Practice Limited to Endodontics
| | - Neville J McDonald
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Richard J Gardner
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Private Practice Limited to Endodontics, Ann Arbor, MI
| | - Mathilde C Peters
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Tatiana M Botero
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan.
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Kim Y, Roh B, Shin Y, Kim BS, Choi Y, Ha A. Morphological Characteristics and Classification of Mandibular First Molars Having 2 Distal Roots or Canals: 3-Dimensional Biometric Analysis Using Cone-beam Computed Tomography in a Korean Population. J Endod 2018; 44:46-50. [DOI: 10.1016/j.joen.2017.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 03/02/2017] [Accepted: 08/02/2017] [Indexed: 11/18/2022]
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Adiguzel O, Belgin CA, Falakaloglu S, Cangul S, Akkus Z. Maxillary Cortical Bone Thickness in a South-Eastern Anatolian Population: A Cone-Beam Computed Tomography Study. Med Sci Monit 2017; 23:5812-5817. [PMID: 29216024 PMCID: PMC5729695 DOI: 10.12659/msm.906229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 07/26/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The aim of this study was to measure the distance between the maxillary premolar and molar teeth apices to the buccal cortical bone and evaluate differences in gender and age group, using cone beam computed tomography (CBCT). MATERIAL AND METHODS This retrospective study comprised of 451 premolar and molar teeth of one hundred and thirteen patients who were admitted to Dicle University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology for different reasons. Data were analyzed using Student's t-tests and Tukey HSD tests. RESULTS There was significant difference in buccal bone thickness by gender (p<0.05). The thinnest point of the maxillary buccal bone was measured in women as 2.11 mm and in men as 2.02 mm in the first premolar teeth. The thickest point of maxillary buccal bone was measured in women as 9.87 mm and in men 10.71 mm palatinal root of the first molar. A comparison of buccal bone thickness between age showed a statistically significant difference at the distobuccal and palatinal roots of the first molar, at the mesiobuccal root of the second molar (p<0.05). CONCLUSIONS The measurements of maxillar buccal bone thickness using CBCT for various dental procedures especially in endodontic surgery, orthodontic mini implant treatment, dental implant procedures, and healing after tooth extraction that are important knowledge.
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Affiliation(s)
- Ozkan Adiguzel
- Department of Endodontics, Dicle University, Faculty of Dentistry, Diyarbakir, Turkey
| | - Ceren Aktuna Belgin
- Department of Dentomaxillofacial Radiology, Dicle University, Faculty of Dentistry, Diyarbakir, Turkey
| | - Seda Falakaloglu
- Department of Endodontics, Dicle University, Faculty of Dentistry, Diyarbakir, Turkey
| | - Suzan Cangul
- Department of Restorative Dentistry, Dicle University, Faculty of Dentistry, Diyarbakir, Turkey
| | - Zeki Akkus
- Department of Biostatistics, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
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Zhang X, Xu N, Wang H, Yu Q. A Cone-beam Computed Tomographic Study of Apical Surgery-related Morphological Characteristics of the Distolingual Root in 3-rooted Mandibular First Molars in a Chinese Population. J Endod 2017; 43:2020-2024. [PMID: 29033081 DOI: 10.1016/j.joen.2017.07.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/17/2017] [Accepted: 07/30/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Apical surgery on the separate distolingual (DL) root of a 3-rooted mandibular first molar is thought to be difficult because DL roots are always severely curved, small, and shorter than distobuccal (DB) roots, and they are located far from the buccal cortical bone. The purpose of this study was to use cone-beam computed tomographic images to investigate the apical surgery-related morphological characteristics of DL roots in a Chinese population. METHODS The screening process identified 83 subjects with 128 mandibular first molars with separate DL roots. The degree of root canal curvature was measured in the mesiodistal (MD) and buccolingual (BL) planes using the Schneider method. Distances were measured from the DL root apex to the buccal cortical bone, to the buccal cortical bone opposite the DB root apex, and to the buccal cortical bone opposite the mesiobuccal (MB) root apex. The lengths of the remaining DB, MB, and DL roots were measured after resection of 3 mm of the DL apical root. Angulations of the DL root canal were determined before and after DL apical root resection. RESULTS The teeth were classified into 3 types: type I, straight in the MD and BL planes; type II, straight in the MD plane and curved in the BL plane; and type III, curved in the MD and BL planes. Only 5 molars (3.9%) were classified as type I, whereas 52 (40.6%) molars were type II and 71 (55.5%) molars were type III. The type I DL root has a significantly shorter length and longer distance from the DL root apex to the buccal cortical bone than type II and III roots (P < .05). The distance from the DL root apex to the buccal cortical bone opposite the MB root apex is significantly longer than the distance to the buccal cortical bone opposite the DB root apex in types I and II (P < .05), whereas the distance is nearly equal for type III. The angulations for root-end preparation of types II and III DL roots vary from 57.5° to 129.1° and from 55.8° to 128.1°, respectively. CONCLUSIONS A new classification was proposed for DL roots in 3-rooted mandibular first molars based on the root canal curvature. Type I is unsuitable for apical surgery. Access to the type II DL root apex should be through the DB root apex, whereas access to the type III DL root apex through the MB root apex is more feasible. Apical surgery on types II and III DL roots may be accomplished when the depth of the root-end preparation is reasonably reduced, and fine and personalized angulated ultrasonic retro tips are used.
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Affiliation(s)
- Xiao Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Ning Xu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Hanguo Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
| | - Qing Yu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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Jang Y, Lee SJ, Yoon TC, Roh BD, Kim E. Survival Rate of Teeth with a C-shaped Canal after Intentional Replantation: A Study of 41 Cases for up to 11 Years. J Endod 2016; 42:1320-5. [DOI: 10.1016/j.joen.2016.05.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 05/13/2016] [Accepted: 05/13/2016] [Indexed: 12/11/2022]
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Kim D, Ha JH, Jin MU, Kim YK, Kim SK. Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study. Restor Dent Endod 2016; 41:182-8. [PMID: 27508159 PMCID: PMC4977348 DOI: 10.5395/rde.2016.41.3.182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/17/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. Materials and Methods Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. Results The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). Conclusions For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.
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Affiliation(s)
- Dokyung Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Myoung-Uk Jin
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Young-Kyung Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Sung Kyo Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
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Lavasani SA, Tyler C, Roach SH, McClanahan SB, Ahmad M, Bowles WR. Cone-beam Computed Tomography: Anatomic Analysis of Maxillary Posterior Teeth-Impact on Endodontic Microsurgery. J Endod 2016; 42:890-5. [PMID: 27130335 DOI: 10.1016/j.joen.2016.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/03/2016] [Accepted: 03/06/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION It is imperative that the endodontic surgeon be knowledgeable of the anatomic dimensions of the surgical site. If cone-beam computed tomography is not available because of location/cost, it is prudent for the clinician to consult a knowledge base for the surgical site. An understanding of the root thickness of maxillary premolars and molars at the preferred level for root resection (3.0-3.6 mm), bone thickness over these roots, and the proximity of each root apex to the maxillary sinus will help the surgeon before and during the surgical procedure. METHODS Cone-beam computed tomography scans from 155 patients were used to evaluate measurements from 505 teeth and respective areas. RESULTS (1) Buccal bone was thinnest over the buccal root of the 2-rooted first premolar (0.66 mm) and the mesiobuccal (MB) root of the first molar (0.84 mm) and thickest over the MB root of the second molar (1.91 mm). (2) The palatal bone was thinnest over the palatal root of the maxillary first molar (1.24 mm) and thickest over the single-rooted second premolar (3.26 mm). (3) The longest distances to complete resection were found for the 2-rooted first and second premolars (8.81 mm and 9.14 mm, respectively) and the MB root of the second molar (7.40 mm). (4) The MB root of the second molar had the closest proximity to the sinus floor, with an average distance of 0.66 mm. CONCLUSIONS An understanding of the maxillary posterior tooth anatomy for apical resection is beneficial to the endodontist.
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Tikku AP, Bharti R, Sharma N, Chandra A, Kumar A, Kumar S. Role of ultrasound and color doppler in diagnosis of periapical lesions of endodontic origin at varying bone thickness. J Conserv Dent 2016; 19:147-51. [PMID: 27099421 PMCID: PMC4815543 DOI: 10.4103/0972-0707.178694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS To access the role of ultrasound and color doppler in diagnosing periapical lesions of maxilla and mandible. SETTINGS AND DESIGN This study was conducted in the Department of Conservative Dentistry and Endodontics (Faculty of Dental Sciences), Department of Radiotherapy, and Department of Pathology. MATERIALS AND METHODS The study group comprised 30 patients with periapical lesions of endodontic origin in maxilla and mandible requiring endodontic surgery. After thorough clinical and radiographic examination patients were subjected to ultrasound and color doppler examination, where the lesions were assessed for their contents as to cystic or solid. Following which periapical surgery was done and the pathological tissue obtained was subjected to histopathological examination. The results of the ultrasound examination were correlated with histopathological features. The diagnostic validity of ultrasound was assessed by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. STATISTICAL ANALYSIS USED The statistical analysis was done using statistical package for social sciences (SPSS) version 15.0 statistical analysis software. The values were represented in number (%). RESULTS Within the limitations of the current study it can be stated that although ultrasound may not establish the definitive diagnosis, it can facilitate the differential diagnosis between cystic and solid granulomatous lesions. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone. CONCLUSION Ultrasound can routinely be recommended as a complimentary method for the diagnosis of periapical lesions of endodontic origin. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone.
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Affiliation(s)
- Aseem P Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neha Sharma
- Department of Conservative Dentistry and Endodontics, Government Dental College, Shimla, Himachal Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashutosh Kumar
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunil Kumar
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
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Abstract
The infraorbital nerve (ION) is a cardinal cutaneous nerve that provides general sensation to the mid face. Its twigs are vulnerable to iatrogenic damage during medical and dental manipulations. The aims of this study were to elucidate the distribution pattern of the ION and thus help to prevent nerve damage during medical procedures and to enable accurate prognostic evaluation where complications do occur. This was achieved by treating 7 human hemifaces with the Sihler modified staining protocol, which enables clear visualization of the course and distribution of nerves without the accidental displacement of these structures that can occur during classic dissection. The twigs of the ION can be classified into the usual 5 groups: inferior palpebral, innervating the lower eyelid in a fan-shaped area; external and internal nasal, reaching the nosewing and philtrum including the septal area between the nostrils, respectively; as well as medial and lateral superior labial, supplying the superior labial area from the midline to the mouth corner. Of particular note, the superior labial twigs fully innervated the infraorbital triangle formed by the infraorbital foramen, the most lateral point of the nosewing, and the mouth corner. In the superior 3-quarter area, the ION twigs made anastomoses with the buccal branches of the facial nerve, forming an infraorbital nervous plexus. The infraorbital triangle may be considered a dangerous zone with respect to the risk for iatrogenic complications associated with the various medical interventions such as implant placement.
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Kang SH, Kim BS, Kim Y. Proximity of Posterior Teeth to the Maxillary Sinus and Buccal Bone Thickness: A Biometric Assessment Using Cone-beam Computed Tomography. J Endod 2015; 41:1839-46. [PMID: 26411520 DOI: 10.1016/j.joen.2015.08.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/16/2015] [Accepted: 08/16/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the vertical and horizontal relationships between the maxillary sinus floor (MSF) and the root apices of maxillary posterior teeth with various root configurations and the distance from the root apex to the MSF and the buccal cortical plate. METHODS Serial axial, coronal, sagittal, and paraxial cone-beam computed tomographic images of 132 Korean patients with fully erupted bilateral maxillary posterior teeth were analyzed. The vertical and horizontal relationships between the roots of maxillary posterior teeth and the MSF were determined. Distances from the apex to the MSF and the buccal bone plate were measured. The data were correlated with age, sex, side, and tooth type. RESULTS In total, 2159 apices in 1056 teeth were evaluated. For the vertical relationships, the frequency in group 1, in which a root apex protruded into the MSF, significantly increased toward the posterior (first premolars: 1.5%, second premolars: 14.8%, first molars: 40.5%, second molars: 44.7%, P < .001). The apices of the mesiobuccal roots of the second molars were found frequently in group 1 (35.8%) and had the shortest mean vertical distance to the MSF (0.18 mm) and the thickest mean horizontal distance to the buccal cortical plate (4.99 mm) among buccal roots of 3-rooted molars (P < .001). The frequency of group 1 differed significantly by age (P < .05). No statistically significant difference was found in sex or side analysis. For the horizontal relationship between the molar roots and the MSF, most teeth were in group BP, in which the lowest point of the MSF was located centrally, relative to the roots (94.3% for first molars, 81.0% for second molars). For the first molars, no significant difference according to sex or side was found. However, the right side (P = .003) and males (P = .005) showed higher incidences for second molars. CONCLUSIONS The data in this study highlight the close proximity between the root apex of maxillary posterior teeth and the MSF and provide estimated distances from the root apex to the buccal cortical plate. Special care must be taken in treatment planning in the maxillary posterior region.
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Affiliation(s)
- Sung Hyun Kang
- Department of Conservative Dentistry, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bom Sahn Kim
- Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yemi Kim
- Department of Conservative Dentistry, Ewha Womans University School of Medicine, Seoul, Korea.
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Lee HS, Choi HM, Choi DS, Jang I, Cha BK. Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study. Imaging Sci Dent 2013; 43:261-6. [PMID: 24380065 PMCID: PMC3873314 DOI: 10.5624/isd.2013.43.4.261] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 05/14/2013] [Accepted: 06/02/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. Materials and Methods CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. Results The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. Conclusion In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.
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Affiliation(s)
- Hyub-Soo Lee
- Department of Orthodontics, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
| | - Hang-Moon Choi
- Department of Oral and Maxillofacial Radiology, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
| | - Dong-Soon Choi
- Department of Orthodontics, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
| | - Insan Jang
- Department of Orthodontics, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
| | - Bong-Kuen Cha
- Department of Orthodontics, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
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Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura H. Effectiveness of dental computed tomography in diagnostic imaging of periradicular lesion of each root of a multirooted tooth: a case report. J Endod 2006; 32:583-7. [PMID: 16728257 DOI: 10.1016/j.joen.2005.09.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Revised: 09/22/2005] [Accepted: 09/22/2005] [Indexed: 01/29/2023]
Abstract
Radiography by use of the three-dimensional (3D) Accuitomo XYZ Slice View Tomograph (3DX), a device for compact computed tomography in dentistry, was performed as a new diagnostic imaging technique for a patient who needed endodontic therapy. The 3DX was used for examining and diagnosing the presence and expansion of periradicular lesions in each root of a multirooted tooth. High-resolution 3D images were observed and compared with those obtained by routine conventional radiography. It was difficult to diagnose the cause of clinical symptoms by general examinations including the usual intraoral radiography and panoramic radiography. The images obtained by the 3DX, however, clearly showed the apparent presence and expansion of a periradicular lesion in only one root of the multirooted tooth. The 3DX, a newly developed dental computed tomography, provides abundant new image information not attainable by either intraoral radiography or panoramic radiography, and its application for clinical use is very effective for examining and diagnosing regions of interest for endodontic therapy.
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Affiliation(s)
- Kazuhiko Nakata
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
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Abstract
Nonsurgical retreatment and surgical endodontics are not always viable solutions to endodontic disease. Access for retreatment may be limited by posts. Surgical endodontics may be limited by anatomical features including bone thickness and nerve and sinus proximity. Anatomical limitations and complex restorations may prevent implant placement. Intentional replantation is considered by many as a procedure of last resort when nonsurgical or surgical endodontics is contra-indicated. The treatment described demonstrates intentional replantation as a procedure to be considered when endodontic procedures or a dental implant are not possible.
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