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Liu J, Zhao X, Liu Y, Dong N, Zhang X. Prevalence and anatomic associations of middle mesial canals and isthmi in mandibular first molars: A CBCT-based study in a Northern Chinese population. AUST ENDOD J 2024; 50:69-77. [PMID: 37902140 DOI: 10.1111/aej.12807] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 10/31/2023]
Abstract
This study investigated the prevalence of the middle mesial canal (MMC) and isthmus in a northern Chinese subpopulation using cone-beam computed tomography (CBCT). CBCT images of 1060 mandibular first molars (MFMs) were analysed. Data analysis was performed using the chi-square test, t-test, and multiple logistic regression analysis (p < 0.05). The prevalence of MMC and isthmus was 15.2% and 40.6%, respectively. The average dentinal thickness in the danger zone was 1.61 ± 0.14 mm. Patients younger than 40 years were two times more likely to have MMC (odds ratio [OR] = 2.204). Additionally, for every 1 mm reduction in the MB-ML orifice distance, the likelihood of detection of MMC in MFM nearly doubled (OR = 1.738). Furthermore, MFMs with MB-ML isthmus were five times more likely to exhibit MMC than those without it (OR = 4.756). The findings revealed that the prevalence of MMC and isthmus in MFMs is high and suggested that anatomical and demographic variables can serve as valuable indicators for clinicians in anticipating their presence.
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Affiliation(s)
- Jiaojiao Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiangyu Zhao
- Department of Oral Emergency, Shenyang Stomatological Hospital, Shenyang, China
| | - Ying Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Nannan Dong
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiaodong Zhang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Arnold M, Ahmed HMA. Detection, characterisation and management of complex root canal configurations in the mesiobuccal roots of maxillary first molars: A case series. AUST ENDOD J 2024. [PMID: 38509790 DOI: 10.1111/aej.12842] [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: 01/07/2024] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/22/2024]
Abstract
This report presents the detection, characterisation, instrumentation and filling of complex canal configurations in the mesiobuccal (MB) root of maxillary first molars. Three patients were referred for root canal treatment in first maxillary molars. Medical history, age, sex and clinical findings were recorded. Intraoral periapical radiographs and cone beam computed tomography (CBCT) were used for diagnosis and pre-operative assessment. Using Ahmed et al. (2017) classification system, codes 3MaxM MB3-5-4-2 DB1-2-1 P1 (case 1), 3MaxM MB2-5-3-2 DB1 P1 (case 2) and 3MaxM MB1-4-2-1-2 DB1 P1 (case 3) were identified. Using the dental operating microscope, CBCT (if indicated) and troughing up to 3 mm allowed identification of more than three canals in the MB root of maxillary first molars. The coding system proposed by Ahmed et al. (2017) allows the classification of MB roots with highly complex canal configurations.
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Affiliation(s)
- Michael Arnold
- Praxis für Endodontie Und Zahnerhaltung, Dresden, Germany
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Altitinchi A, Schweizer A, Dean K, Lawson N, Sulaiman T, Fouad AF. An Ex-Vivo Model for Investigating Bacterial Extrusion from Infected Root Canals during Masticatory Function. J Endod 2023:S0099-2399(23)00502-2. [PMID: 37611655 DOI: 10.1016/j.joen.2023.08.008] [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: 01/25/2021] [Revised: 07/24/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The extrusion of bacteria from infected root canals may lead to increase in symptoms, expansion of periapical lesions, and contribution to systemic diseases. The aim of this study is to investigate a potential proof-of-concept model to study the extent to which bacteria can escape from infected root canals under dynamic loading (simulated chewing). METHODS The study was completed in 2 experiments performed at 2 institutions. Biofilms of Streptococcus intermedius in the first experiment and S. intermedius and Actinomyces naeslundii were allowed to grow in root canals of single-rooted extracted teeth for 3 weeks. The roots of the teeth were suspended in a small chamber containing dental transport medium and were mounted on a lower sample holder of a chewing simulator. In the experimental group, simulated chewing cycles equivalent to 1 year of function were conducted, and then bacterial migration was quantified and compared with stationary teeth. RESULTS All experimental samples of the loading group revealed bacterial penetration in both experiments. Several of the unloaded samples revealed no bacterial penetration. In the first experiment, a significantly higher number of bacteria were able to escape into the periapex of the loaded group compared with the unloaded group (P = .017). In the second experiment, there was no significant difference between the 2 bacterial species used in the amount of extruded bacteria; however, there was a highly significant effect for occlusal loading (P = .0001). CONCLUSIONS The potential for occlusal forces to enhance bacterial extrusion from infected root canals should be further explored.
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Affiliation(s)
- Ali Altitinchi
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew Schweizer
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kimberly Dean
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nathaniel Lawson
- Division of Biomaterials, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Taiseer Sulaiman
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ashraf F Fouad
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama.
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Meyappan N, Mahadevan M, Manimaran ND, Paulaian B, Gopal R, Kumar N. Scanning Electron Microscopy Analysis of Smear Layer Removal Ability of Conventional Endodontic Irrigation Regimen, MTAD, and QMix™ Versus a Mixture of Azadirachta indica and Citrus limon: An In Vitro Study. Cureus 2023; 15:e42877. [PMID: 37664257 PMCID: PMC10474333 DOI: 10.7759/cureus.42877] [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] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Smear layer removal from root canals aid in the penetration of both irrigants and endodontic sealer into the dentinal tubules, thereby improving the efficacy of endodontic treatment. The aim of this in vitro study was to compare the smear layer removal ability of a conventional endodontic irrigation regimen, MTAD (mixture of tetracycline, acid, and detergent), and QMix™ (Dentsply Sirona, Charlotte, North Carolina, United States) with that of a mixture of herbal irrigants, namely, aqueous extracts of Azadirachta indica (neem) and Citrus limon (lemon), evaluated using scanning electron microscopy (SEM). MATERIALS AND METHODS We selected 40 extracted human premolar teeth for the study, which we randomly divided into five groups (eight samples each) according to irrigation solution: (i) Group A (normal saline); (ii) Group B (conventional endodontic regimen, 3% sodium hypochlorite (NaOCl) + 17% ethylenediamine tetraacetic acid (EDTA) + 2% chlorhexidine (CHX)); (iii) Group C (MTAD); (iv) Group D (QMix 2-in-1); and (v) Group E (aqueous extracts of Azadirachta indica and Citrus limon). After we prepared the canals with ProTaper Universal nickel-titanium (Ni-Ti) rotary files (Dentsply Sirona) and the respective irrigants, we split the teeth longitudinally to evaluate the amount of remnant smear layer in the coronal, middle, and apical thirds using SEM photomicrographs. We performed statistical analyses of the data using the Kruskal-Wallis and Mann-Whitney U tests, where the level of significance was set at 0.05. RESULTS The SEM analysis of the coronal third showed mean values of 3.83 in Group A, 3.67 in Group B, 2.79 in Group C, 3.63 in Group D, and 4.00 in Group E. The SEM analysis of the middle third showed mean values of 4.00 in Group A, 3.88 in Group B, 3.75 in Group C, 3.50 in Group D, and 3.50 in Group E. The SEM analysis of the apical third showed mean values of 3.92 in Group A, 3.63 in Group B, 3.71 in Group C, 3.88 in Group D, and 3.17 in Group E. Therefore, we found that there were significant statistical differences between the groups when an overall comparison was done for the coronal, middle, and apical third, with a p-value of 0.001. On multiple comparisons across the different tooth-section thirds. Groups A and B showed statistically significant differences in the apical third (p-value=0.017). Groups A and C showed statistically significant differences in the coronal third and middle third (p-values=0.001 and 0.010, respectively). Groups A and D showed statistically significant differences in the middle third (p-value=0.001). Groups A and E showed statistically significant differences in all thirds (p-values=0.039, 0.001, and 0.001, respectively) Conclusion: The conventional needle irrigation with MTAD showed the highest level of smear layer removal ability on the root canal surface, followed by QMix 2-in-1, the Azadirachta indica leaf and Citrus limon extract mixture, and the conventional endodontic regimen. Normal saline showed the lowest smear layer removal effect.
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Affiliation(s)
- Nagammai Meyappan
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
| | - Mageshwari Mahadevan
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
| | - Niranjana Devi Manimaran
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
| | - Benin Paulaian
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
| | - Rajesh Gopal
- Department of Conservative Dentistry and Endodontics, Private Practice, Thiruvananthapuram, IND
| | - Naveen Kumar
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Di Taranto V, Libonati A, Montemurro E, Gallusi G. Radiographic and electronic working length comparison. An in vivo study of three Electronic Apex Locator devices. J BIOL REG HOMEOS AG 2021; 35:77-85. [PMID: 34289667 DOI: 10.23812/21-3supp1-10] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study is to compare the working length measured with Root ZX (EAL1), Propex II (EAL2) and Endo Analyzer Model 8005 (EAL3) with radiographic measurements during endodontic treatment. Fifty single canal teeth scheduled for endodontic treatment were selected for the study. After endodontic access preparation, pulp chamber was irrigated with 5mL of 5% sodium hypochlorite (NaOCl). The canal was scouted with a size 10 K-file introduced slightly over the apex to verify the canal patency. The working length (WL) was measured using all three EAL devices and radiographically. All measured working lengths were recorded and compared using ANOVA for repeated measures considering the multiple comparison of paired data Least Significant Difference (LSD). The WL mean values for EAL1 were 19.1 ± 1.7 mm; for EAL2 were 19.4 ± 1.7; for EAL3 were 19.4 ± 1.6 and for RG were 19.2 ± 1.7. The Pearson correlation coefficients indicated that the following correlation between electronic devices and radiographic WL: EAL1- 0.986, EAL2- 0.953 and EAL3- 0.931. Considering the mean values compared to radiographic measures, Root ZX gave better results than the other tested EAL devices. Endo Analyzer Model 8005 showed the worst performance.
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Affiliation(s)
- V Di Taranto
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - A Libonati
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - E Montemurro
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - G Gallusi
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Natanasabapathy V, Rajesh PS, Ashritha MCV, Mishra A, Namasivayam A, Kandaswamy D, Srinivasan MR. Root canal isthmi and interorifice distance in human permanent teeth of an Indian subpopulation using cone-beam computed tomography: A retrospective cross-sectional study. J Conserv Dent 2021; 23:563-570. [PMID: 34083910 PMCID: PMC8095684 DOI: 10.4103/jcd.jcd_576_20] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/04/2022] Open
Abstract
Objective: The aim of the study was to evaluate the prevalence of root canal isthmus (RCI) and measure the interorifice distance (IOD) between the root canals. Additionally to correlate IOD with the RCI in human permanent teeth using conebeam computed tomography (CBCT) in an Indian sub-population (Chennai). Materials and Methods: A total of 5881 teeth from 280 CBCT full mouth scans were analyzed. The presence or absence of complete and incomplete RCI of each tooth was identified using the map-reading strategy. IOD was calculated by measuring the distance between the center of each root canal orifice to that of the center of the adjacent orifice at the level of the cementoenamel junction using the axial and sagittal sections. Chi-square analysis and correlation statistics using Spearman's rank-order test was done (P < 0.05). Results: High prevalence of RCI was found in maxillary first premolars, mesial root of mandibular molars, and mesiobuccal root of maxillary first molars, while its prevalence was low in maxillary canines and mandibular premolars and absent in maxillary incisors. RCI was predominantly seen in the cervical and middle third of the root canal in all the teeth evaluated. A weak negative correlation was established between the IOD and RCI for maxillary premolars, whereas a weak positive correlation was seen in maxillary first molars and mandibular second molars. Conclusion: The prevalence of RCI was high in the posterior teeth in comparison to the anterior teeth in the present study. There was no strong correlation between IOD and RCI in all the teeth evaluated.
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Affiliation(s)
- Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Parashar Saumya Rajesh
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - M C V Ashritha
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Anisha Mishra
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Ambalavanan Namasivayam
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Deivanayagam Kandaswamy
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Manali Ramakrishanan Srinivasan
- Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
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Abstract
Introduction The purpose of this study was to evaluate the antibacterial effectiveness of probiotics lactobacilli group and Bifidobacterium against Enterococcus faecalis and Candida albicans in both planktonic stage and biofilm stage. Materials and Methods Phase 1 of the study was conducted by agar well diffusion method. About 0.5 ml of test pathogen culture was inoculated on 20 ml of molten agar and allowed to solidify. 4-5 circular wells of diameter 8-10 mm were punched in each poured plates and 150 μl of diluted test samples were added to the wells. Phase 2 was deferred antagonism test, wherein purified culture of pathogen strain was streaked at right angle to the original producer growth and incubated at 37°C for 24 h. Zone of inhibition was measured for both the phases. Phase 3 biofilm stage evaluation was conducted by mixing 9 ml of 30% poloxamer 407 and De Man, Rogosa and Sharpe (MRS) broth in a test tube with 500 μl of either pathogen, together with 500 μl of test probiotic strains and incubated (37°C, 48 h), followed by serially diluting the mixture by 1 ml into 9 ml sterile saline till 108 dilutions for evaluation of colony-forming unit/ml counts. Controls were endodontic pathogens in 30% poloxamer with MRS broth and no probiotics. Results Results were evaluated and statistically analysed using one-way analysis of variance and unpaired t-test. In the planktonic stage, probiotics showed inhibitory activity against endodontic pathogens with valid statistical significance (P < 0.05), while there was no activity by deferred antagonism method. In biofilm stage, all three probiotics showed growth reduction for E. faecalis, while lactobacilli group showed reduction in C. albicans colonies. Conclusion This preliminary study suggested that probiotics are effective for preventing the growth of endodontic pathogens in vitro. Poloxamer could be utilised as an ideal delivery vehicle for probiotics.
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Affiliation(s)
- Aarti Ashok Bohora
- Department of Conservative Dentistry and Endodontics, SMBT Institute of Dental Science and Research, Dhamnagaon, Nasik, Maharashtra, India
| | - Sharad R Kokate
- Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
| | - Smita Khedkar
- Department of Microbiology, Bac-Test Laboratory, Nasik, Maharashtra, India
| | - Ashok Vankudre
- Department of Community Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nasik, Maharashtra, India
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Maddalone M, Citterio C, Pellegatta A, Gagliani M, Karanxha L, Del Fabbro M. Cone-beam computed tomography accuracy in pulp chamber size evaluation: An ex vivo study. AUST ENDOD J 2019; 46:88-93. [PMID: 31617650 DOI: 10.1111/aej.12378] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2019] [Indexed: 12/29/2022]
Abstract
This study aimed to assess ex vivo the accuracy of cone-beam computed tomography (CBCT), as compared to operative microscope, for evaluating pulp chamber size. A total of forty teeth were extracted for periodontal reasons and a horizontal section was done at the most apical level of the cement-enamel junction. The pulp chamber was photographed using a digital camera connected to an optical microscope. Then, the tooth was scanned with CBCT and the horizontal slide matching the anatomical section of pulp chamber was digitally stored. The pulp chamber section area was measured through image analysis software. The two methods provided similar results, either for monoradicular (P = 0.14) or multiradicular teeth (P = 0.93). Correlation was statistically significant (P < 0.0001), being the coefficient r = 0.89 and 0.94 for monoradicular and multiradicular teeth, respectively. Conclusively, CBCT is suitable for pulp chamber morphology evaluation. However, it has limitations in detecting the anatomical variability of small branches in root canal system.
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Affiliation(s)
- Marcello Maddalone
- Department of Translational Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Claudio Citterio
- Department of Translational Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alberto Pellegatta
- Department of Translational Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Massimo Gagliani
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Dental Clinic, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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Tomaszewska IM, Jarzębska A, Skinningsrud B, Pękala PA, Wroński S, Iwanaga J. An original micro-CT study and meta-analysis of the internal and external anatomy of maxillary molars-implications for endodontic treatment. Clin Anat 2018; 31:838-853. [PMID: 29732629 DOI: 10.1002/ca.23201] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/16/2018] [Accepted: 04/30/2018] [Indexed: 12/19/2022]
Abstract
The aim of this work was to conduct a radiological micro-CT study and meta-analysis to determine the morphological features of the root canal anatomy of the maxillary molars. The radiological study included micro-CT scans of 110 maxillary first molars and 98 maxillary second molars. To identify articles eligible for inclusion in our meta-analysis, PubMed, Embase, and Web of Science were search comprehensively. The following data were extracted: study type (cadaveric, intraoperative or imaging), Vertucci types of canal configuration, presence/number of canals, roots, apical foramina, apical deltas, and inter-canal communications. The mesiobuccal root was the most variable with respect to canal configuration, type I being the most common configuration followed by type II and type IV. Type I was the most common canal configuration in the distobuccal and palatal root. Regarding the number of canals in the maxillary first and second molars, one canal was most prevalent in all roots of the three molars, except for the mesiobuccal root of maxillary first molar, in which two canals were most prevalent. The most prevalent number of roots in all maxillary molars was three. Knowledge of endodontic anatomy determines the parameters of root canal treatment and significantly affects the probability of success. It is therefore especially important to know the morphology of the root canal system in order to perform endodontic treatment correctly. Clin. Anat. 31:838-853, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Iwona M Tomaszewska
- 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
| | - Bendik Skinningsrud
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Przemysław A Pękala
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Sebastian Wroński
- Micro- and Nanotomography Laboratory, Faculty of Physics, AGH University of Science and Technology, Krakow, Poland
| | - Joe Iwanaga
- Seattle Science Foundation, Seattle, Washington.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Kurume University School of Medicine, Dental and Oral Medical Center, Kurume, Fukuoka, Japan
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Razumova S, Brago A, Khaskhanova L, Barakat H, Howijieh A. Evaluation of Anatomy and Root Canal Morphology of the Maxillary First Molar Using the Cone-Beam Computed Tomography among Residents of the Moscow Region. Contemp Clin Dent 2018; 9:S133-S136. [PMID: 29962778 PMCID: PMC6006881 DOI: 10.4103/ccd.ccd_127_18] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The success of endodontic treatment depends on the knowledge of root canal system. The root canals have complex morphology and wide individual variations. The aim of this study was to evaluate the root canal morphology of the maxillary first molars among residents of the Moscow region using cone-beam computed tomography (CBCT) scanning. MATERIALS AND METHODS Three hundred CBCT images of patients aged 20-70 years old were analyzed to study the root canal system (the number of canals and the configuration according to Vertucci's classification) of the maxillary first molars. The prevalence of a second mesiobuccal (MB2) in the mesiobuccal root (MB) was recorded in each age group. RESULTS three separated roots of the maxillary first molar were observed in 100% of cases. MB2 canals were found in 59.8% of cases. A second distobuccal canal was observed in 0.5% of cases. The canal morphology in the MB root was 40.2% in Type I, 22.4% in Type II, and 37.3% in Type IV. CONCLUSION The prevalence of MB2 canals was 59.8%, and the most common canal morphology was Vertucci's Type I. Using CBCT scanning is a useful technique to evaluate and analyze the root canal system.
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Affiliation(s)
- Svetlana Razumova
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Anzhela Brago
- Department of Propaedeutics of Dental Diseases, Medical Institute, RUDN University, Moscow, Russia
| | - Lamara Khaskhanova
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Haydar Barakat
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Ammar Howijieh
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
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Ormiga F, Ferreira de Assis D, de Andrade Risso P. Ability of Three Endodontic Sealers to Fill the Root Canal System in Association with Gutta-Percha. Open Dent J 2016; 10:12-8. [PMID: 27006719 PMCID: PMC4780516 DOI: 10.2174/1874210601610010012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/15/2014] [Revised: 11/10/2015] [Accepted: 11/16/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction: The present study compared the ability of the
endodontic sealers AH Plus, Pulp Canal Sealer and EndoREZ to fill the root canal
system in association with gutta-percha. Methods: Ninety
mandibular premolars were accessed, prepared and divided into three groups of 30
teeth each, according to the sealer used to fill the canals: AH Plus, Pulp Canal
Sealer and EndoREZ. All the teeth were filled using the continuous wave of
condensation technique. The specimens were then decalcified, dehydrated,
rendered transparent, and analyzed by three independent evaluators with 8x
magnification. Chi-squared test (χ2, p < 0.05) was used to compare
the groups in relation to the totally filled, the partially filled and the non
filled ramifications. The same test was used to compare the directions of filled
ramifications and the number of ramifications among the three thirds of the
roots. Results: EndoREZ filled a significantly higher
number of ramifications than AH Plus and Pulp Canal Sealer (χ2, p <
0.05). All the groups showed higher number of totally filled ramifications than
partially filled and unfilled ramifications. The ramifications were more
frequently detected in the apical third, followed by medium and coronal thirds,
respectively (χ2, p < 0.05). The ramifications were more frequently
detected towards lingual direction (χ2, p < 0.05). Conclusion: EndoREZ presented higher ability to fill
the root canal system in association with gutta-percha when compared to AH Plus
and Pulp Canal Sealer. The ramifications were more frequently detected in the
apical third, running in a lingual direction.
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Affiliation(s)
- Fabiola Ormiga
- Department of Clinical Dentistry, Federal University of Rio de Janeiro, Brazil
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Ahmad IA, Al-Jadaa A. Three root canals in the mesiobuccal root of maxillary molars: case reports and literature review. J Endod 2014; 40:2087-94. [PMID: 25443283 DOI: 10.1016/j.joen.2014.07.034] [Citation(s) in RCA: 11] [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: 05/16/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The knowledge of root canal anatomy is essential to ensure a successful outcome of surgical and nonsurgical root canal treatment. The aims of this article were to present 2 cases of maxillary molars with 3 mesiobuccal root canals and to review the available literature on this anatomic variation. METHODS The first case described a nonsurgical root canal treatment of tooth #16 in a 29-year-old man with the aid of a dental operating microscope. In the second case, an extracted maxillary right first molar was scanned by a micro-computed tomographic system and reconstructed 3-dimensionally using modeling software. RESULTS In both cases, the mesiobuccal root had 3 canals (type 3-2 in case I and type 3-3 in case II), whereas the distobuccal and palatal roots had a single canal. The literature review showed that the overall incidence of 3-canaled mesiobuccal roots in maxillary molars ranged from 1.3%-2.4% and that the most common root canal configuration was type 3-2. CONCLUSIONS Clinicians should always anticipate the presence of extra canals in maxillary molars and use all the available tools to locate and treat these.
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Affiliation(s)
- Ibrahim Ali Ahmad
- Restorative Dentistry Department, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Kingdom of Saudi Arabia.
| | - Anas Al-Jadaa
- Clinic for Preventive Dentistry, Periodontology and Cariology, University Dental Center, University of Zurich, Zurich, Switzerland
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Huang YD, Wu J, Sheu RJ, Chen MH, Chien DL, Huang YT, Huang CC, Chen YJ. Evaluation of the root and root canal systems of mandibular first premolars in northern Taiwanese patients using cone-beam computed tomography. J Formos Med Assoc 2014; 114:1129-34. [PMID: 25174647 DOI: 10.1016/j.jfma.2014.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 04/29/2014] [Revised: 05/17/2014] [Accepted: 05/22/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/PURPOSE Cone-beam computed tomography (CBCT) can provide valuable data for root canal systems of human teeth in vivo. This study used CBCT to evaluate the number of roots and canals of 300 mandibular first premolars in 150 northern Taiwanese patients. METHODS The root canal systems of 300 mandibular first premolars in 150 northern Taiwanese patients with bilateral premolars were analyzed by CBCT. RESULTS Of the 300 mandibular first premolars, 197 (65.7%) had one root with one canal (1R1C), 49 (16.3%) had one root with two canals (1R2C), 51 (17.0%) had two roots with one canal in each root (2R2C), and three (1.0%) had three roots with one canal in each root (3R3C). Statistical analyses showed that women had a significantly higher incidence of 1R1C mandibular first premolars (71.4%) than men (58.8%, p = 0.031), and men had a significantly higher incidence of 2R2C mandibular first premolars (27.2%) than women (8.5%, p < 0.001). One hundred and twenty-two (81.3%) of the 150 patients had a symmetrical root and root canal system between the right and left mandibular first premolars. Men had a significantly higher symmetrical rate of 2R2C mandibular first premolars (26.5%) than women (8.2%, p = 0.013). CONCLUSION Approximately 82% of mandibular first premolars in northern Taiwanese patients have one root with either one or two canals. There are significant differences in the number of roots and canals and symmetry of the root canal system of bilateral mandibular first premolars between male and female northern Taiwanese patients.
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Affiliation(s)
- Yao-Der Huang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Jay Wu
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan; Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Rong-Jiun Sheu
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Der-Lan Chien
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ya-Ting Huang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Chia Huang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Yunn-Jy Chen
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Dentistry, National Taiwan University, Taipei, Taiwan.
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Yang L, Chen X, Tian C, Han T, Wang Y. Use of cone-beam computed tomography to evaluate root canal morphology and locate root canal orifices of maxillary second premolars in a Chinese subpopulation. J Endod 2014; 40:630-4. [PMID: 24767555 DOI: 10.1016/j.joen.2014.01.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 12/18/2013] [Accepted: 01/11/2014] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The aim of this study was to investigate root canal morphology and locate root canal orifices of maxillary second premolars in a Chinese subpopulation using cone-beam computed tomographic imaging. METHODS A total of 392 cone-beam computed tomographic images of maxillary second premolars were obtained from 238 patients who required a preoperative assessment for implant surgery or orthodontic treatment. The number of roots and root canals and root canal configuration were investigated and categorized using Vertucci's criteria. The distance between the root canal orifice and the anatomic apex and the distance between root canal orifices in those teeth with 2 root canals were measured and evaluated. The Fisher exact test was used to analyze the correlation between the number of roots and sex. RESULTS Among the 392 teeth, 86.5% (n = 339) had 1 root; 45.4% (n = 178) of the teeth had 1 root canal, and 54.3% (n = 213) had 2 root canals that ranged from type II-type V. The majority of teeth with 2 root canals showed a type IV canal configuration (n = 79, 20.2%) followed by type II (n = 64, 16.3%), type III (n = 45, 11.4%), and type V (n = 25, 6.4%). Only 1 tooth had 3 root canals. No significant difference was found between the number of roots and sex (P > .05). Among the 213 teeth with 2 root canals, the most frequent distribution of the distance between the root canal orifice and the anatomic apex was 5-10 mm (n = 157). The distance between the 2 orifices of 189 teeth was 1-4 mm. CONCLUSIONS The frequency of teeth with 2 root canals was high in maxillary second premolars. The internal morphology of teeth with 2 root canals was variable. This study provided useful information about the root canal morphology of maxillary second premolars in a Chinese subpopulation.
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Affiliation(s)
- Lin Yang
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China
| | - Xinyu Chen
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China
| | - Cheng Tian
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China
| | - Ting Han
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China
| | - Yan Wang
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China.
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De-Deus G, Marins J, Neves ADA, Reis C, Fidel S, Versiani MA, Alves H, Lopes RT, Paciornik S. Assessing accumulated hard-tissue debris using micro-computed tomography and free software for image processing and analysis. J Endod 2013; 40:271-6. [PMID: 24461417 DOI: 10.1016/j.joen.2013.07.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 06/04/2013] [Revised: 07/23/2013] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The accumulation of debris occurs after root canal preparation procedures specifically in fins, isthmus, irregularities, and ramifications. The aim of this study was to present a step-by-step description of a new method used to longitudinally identify, measure, and 3-dimensionally map the accumulation of hard-tissue debris inside the root canal after biomechanical preparation using free software for image processing and analysis. METHODS Three mandibular molars presenting the mesial root with a large isthmus width and a type II Vertucci's canal configuration were selected and scanned. The specimens were assigned to 1 of 3 experimental approaches: (1) 5.25% sodium hypochlorite + 17% EDTA, (2) bidistilled water, and (3) no irrigation. After root canal preparation, high-resolution scans of the teeth were accomplished, and free software packages were used to register and quantify the amount of accumulated hard-tissue debris in either canal space or isthmus areas. RESULTS Canal preparation without irrigation resulted in 34.6% of its volume filled with hard-tissue debris, whereas the use of bidistilled water or NaOCl followed by EDTA showed a reduction in the percentage volume of debris to 16% and 11.3%, respectively. The closer the distance to the isthmus area was the larger the amount of accumulated debris regardless of the irrigating protocol used. CONCLUSIONS Through the present method, it was possible to calculate the volume of hard-tissue debris in the isthmuses and in the root canal space. Free-software packages used for image reconstruction, registering, and analysis have shown to be promising for end-user application.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Grande Rio University, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Juliana Marins
- Department of Dental Clinics, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Aline de Almeida Neves
- Department of Endodontics, Grande Rio University, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Claudia Reis
- Department of Dental Clinics, University of Espirito Santo, Espirito Santo, Brazil
| | - Sandra Fidel
- Department of Dental Clinics, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Marco A Versiani
- Department of Restorative Dentistry, Dental School of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
| | - Haimon Alves
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
CONTEXT For successful endodontic treatment, it's imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. AIM To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. MATERIALS AND METHODS A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a 'U' shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT) images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. STATISTICAL ANALYSIS When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal) along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. RESULTS Cone-Beam Volumetric Tomography (CBVT) evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3(rd), 29.16% in middle 3(rd) and 16.66% were in apical 3(rd). CONCLUSION Within the limitations of this study, it can be concluded that- (1) more than half of maxillary first molars have four canals and (2) most of the additional canals were located in the MBR and CBVT is a good diagnostic tool to help diagnose these additional canals. Further investigations using larger sample sizes would be helpful.
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Affiliation(s)
- R Pratima Shenoi
- Department of Conservative Dentistry and Endodontics, V.S.P.M's Dental College and Research Centre, Nagpur, India
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Shahi S, Yavari HR, Rahimi S, Torkamani R. Root canal morphology of human mandibular first permanent molars in an Iranian population. J Dent Res Dent Clin Dent Prospects 2008; 2:20-3. [PMID: 23285325 PMCID: PMC3533633 DOI: 10.5681/joddd.2008.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 01/20/2008] [Indexed: 11/17/2022] Open
Abstract
Background and aims
The knowledge of variations in root canal morphology is critical for a successful endodontic treatment. The purpose of this study was to investigate variations in the root canal system of human mandibular first permanent molars in an Iranian population.
Materials and methods
In this study, 209 mandibular first molar teeth were decalcified, dye-injected, and cleared in order to determine the number and configuration of the root canals.
Results
The results demonstrated that 65.56% of the mandibular first molars under study had three, 31.57% had four and 2.87% had two canals.
Conclusion According to the results of this study and considering variations in the root canal systems of the mandibular first molars, it seems that great care should be taken in the root canal treatment of these teeth.
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Affiliation(s)
- Shahriar Shahi
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences
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Shahi S, Yavari HR, Rahimi S, Ahmadi A. Root canal configuration of maxillary first permanent molars in an Iranian population. J Dent Res Dent Clin Dent Prospects 2007; 1:1-5. [PMID: 23277826 PMCID: PMC3522903 DOI: 10.5681/joddd.2007.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 01/27/2007] [Indexed: 12/26/2022] Open
Abstract
Background and aims
It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The purpose of this study was to investigate variations in the root canal system of maxillary first permanent molars in an Iranian population.
Materials and methods
In this study, 137 maxillary first molars were decalcified, dye-injected, cleared and studied.
Results
The results demonstrated that 37.96% of the maxillary first molars under study had three canals, 58.4% had four canals and 3.64% had five canals.
Conclusion According to the results of this study and considering variations in the root canal systems of maxillary first molars, it seems that great care should be taken in the root canal treatment of these teeth.
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Affiliation(s)
- Shahriar Shahi
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Iran
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