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Duman ŞB, Çelik Özen D, Bayrakdar IŞ, Baydar O, Alhaija ESA, Helvacioğlu Yiğit D, Çelik Ö, Jagtap R, Pileggi R, Orhan K. Second mesiobuccal canal segmentation with YOLOv5 architecture using cone beam computed tomography images. Odontology 2024; 112:552-561. [PMID: 37907818 DOI: 10.1007/s10266-023-00864-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023]
Abstract
The objective of this study is to use a deep-learning model based on CNN architecture to detect the second mesiobuccal (MB2) canals, which are seen as a variation in maxillary molars root canals. In the current study, 922 axial sections from 153 patients' cone beam computed tomography (CBCT) images were used. The segmentation method was employed to identify the MB2 canals in maxillary molars that had not previously had endodontic treatment. Labeled images were divided into training (80%), validation (10%) and testing (10%) groups. The artificial intelligence (AI) model was trained using the You Only Look Once v5 (YOLOv5x) architecture with 500 epochs and a learning rate of 0.01. Confusion matrix and receiver-operating characteristic (ROC) analysis were used in the statistical evaluation of the results. The sensitivity of the MB2 canal segmentation model was 0.92, the precision was 0.83, and the F1 score value was 0.87. The area under the curve (AUC) in the ROC graph of the model was 0.84. The mAP value at 0.5 inter-over union (IoU) was found as 0.88. The deep-learning algorithm used showed a high success in the detection of the MB2 canal. The success of the endodontic treatment can be increased and clinicians' time can be preserved using the newly created artificial intelligence-based models to identify variations in root canal anatomy before the treatment.
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Affiliation(s)
- Şuayip Burak Duman
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University Malatya, Malatya, Turkey.
| | - Duygu Çelik Özen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University Malatya, Malatya, Turkey
| | - Ibrahim Şevki Bayrakdar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Oğuzhan Baydar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University İzmir, İzmir, Turkey
| | | | | | - Özer Çelik
- Department of Mathematics-Computer, Faculty of Science, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Rohan Jagtap
- Division of Oral and Maxillofacial Radiology, Department of Care Planning and Restorative Sciences, Medical Center School of Dentistry, University of Mississippi, Jackson, MS, USA
| | - Roberta Pileggi
- Department of Endodontics, College of Dentistry, University of Florida, Florida, USA
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Srivastava S, Aldakhail NS, Javed MQ. Morphometric relationships in mesio-buccal roots of maxillary first molars in Saudi subpopulation: A CBCT study. AUST ENDOD J 2023; 49:614-622. [PMID: 37665125 DOI: 10.1111/aej.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
This CBCT-based study analysed morphometric relationships in Mesio-Buccal (MB) roots of maxillary first molars (MFM). 133 MFM with two MB canals were assessed and classified using Vertucci's classification. MB roots' length and MB1-MB2 canals inter-orifice distances (IOD) were noted. The data were analysed using SPSS software. The most frequently present canal was type IV (59.4%) followed by type II (40.6%). Mean MB roots' length for canals exhibiting type IV was 9.26 ± 0.21 mm and of those exhibiting type II was 12.8 ± 0.42 mm. Statistically significant relationship was found between MB root length and canal type. Mean IOD for type II and type IV canals was 2.4 ± 0.47 and 3.8 ± 0.21 mm, respectively. Statistically significant relationship was found between IOD and canal type. Length of MB root and IOD had a significant association with canal type present in MFM. This knowledge can enhance clinicians' understanding of canal morphology which can increase predictability and success rate of endodontic treatment.
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Affiliation(s)
- Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
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Nagahara T, Takeda K, Wada K, Naruse T, Shiba H. Rare root canal morphology of maxillary second molars: A report of three cases. Clin Case Rep 2023; 11:e7547. [PMID: 37415578 PMCID: PMC10320364 DOI: 10.1002/ccr3.7547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Key Clinical Message Endodontists should be aware that some maxillary second molars can have more than three roots. If any unusual anatomical features are detected during dental radiography or endodontic procedures, it is necessary to conduct cone-beam computed tomography (CBCT) scanning to prevent procedural mishaps. Abstract CBCT can provide three-dimensional reconstructed images of the root canal system. With the help of CBCT, variations in tooth root number and root canal morphology, such as extra canals, apical ramifications, apical deltas, and lateral canals, can be identified. Knowledge of the variations is very important for the success of endodontic treatment. This report suggests that endodontists must not assume that a MSM has only three tooth roots, which is the most prevalent number.
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Affiliation(s)
- Takayoshi Nagahara
- Nippon Kokan Fukuyama HospitalHiroshimaJapan
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Katsuhiro Takeda
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Tomoya Naruse
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Mufadhal AA, Madfa AA. The morphology of permanent maxillary first molars evaluated by cone-beam computed tomography among a Yemeni population. BMC Oral Health 2023; 23:46. [PMID: 36703140 PMCID: PMC9881305 DOI: 10.1186/s12903-023-02752-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The study's objective was to use CBCT to ascertain the root and root canal anatomy of the permanent maxillary first molars in a Yemeni population. It was considered how gender affected the prevalence of root canal morphology. METHODS A sample of 373 CBCT records of maxillary permanent first molars belonging to 373 Yemeni individuals (162 males and 211 females) aged between 12 and 65 years were included in this study. Using CBCT on the teeth, the root form and canal morphology for each root based on Vertucci's classification were evaluated. The distribution of MB2 occurrence was documented. The prevalence and resemblance of the men and females were investigated. The Chi-square test was performed to evaluate the findings. RESULTS Of the 373 maxillary first molars studied, the three separated root form was found in 94.9% of the studied MFMs while the two fused and one separate root form was found in 4.5%. The majority of the three-rooted MFMs (82.6%) had more than three root canals (four canals in 77.2% and five canals in 5.4%). The prevalence of MB2 was as high as 82.3% of the three-rooted MFMs. Vertucci type II configuration was the most frequent canal type (25%) followed by Vertucci type III (23.1%) and Vertucci type I (17.7%) in the mesiobuccal root. Vertucci type I was the most prevalent canal configuration in the distobuccal root and palatal root of the three-rooted MFMs (96% and 99.5%, respectively). CONCLUSIONS The maxillary first molars' root canal morphology indicated notable variations among a Yemeni population. The maxillary first molars of most of the Yemeni participants in this study had three roots and four canals. In light of the high occurrence of MB2 (82.3%) in permanent maxillary first molars, our findings emphasize the need of searching for and using cutting-edge techniques to locate the MB2 canals. Males outnumbered females in proportion.
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Affiliation(s)
- Abdulbaset A. Mufadhal
- grid.412413.10000 0001 2299 4112Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Sana’a University, Sana’a, Yemen
| | - Ahmed A. Madfa
- grid.443320.20000 0004 0608 0056Department of Restorative Dental Science, Collage of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia ,grid.444928.70000 0000 9908 6529Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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Panithini DB, Sajjan GS, Kinariwala N, Medicharla UD, Varma KM, Kallepalli M. Real-time guided endodontics: A case report of maxillary central incisor with calcific metamorphosis. J Conserv Dent 2023; 26:113-117. [PMID: 36908734 PMCID: PMC10003280 DOI: 10.4103/jcd.jcd_506_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 12/12/2022] Open
Abstract
Dental trauma results in various complications and poses an enigma to the practitioner. Calcific metamorphosis is one of the sequelae of trauma. A female patient of 35 years visited the specialty clinic of endodontics for the management of a discolored tooth. Clinically, discolored 21 was observed with no pain on palpation and percussion. The pulp sensibility test revealed a negative response. Radiographic examination revealed pulp canal obliteration with an apical radiolucency of Peri Apical Index (PAI 4). The tooth was diagnosed as necrotic pulp with asymptomatic apical periodontitis. Attempt to negotiate the canal under a Dental Operating Microscope (LABOMED, Los Angeles, CA, USA) and ultrasonics (Satelec, Acteon, France) was futile. Cone-beam computed tomography image revealed a patent canal in the apical third. Using real-time guided endodontics with a dynamic navigation system (Navident, ClaroNav, Toronto, ON, Canada), the protocol of plan, trace, and place was followed, and successful canal negotiation was achieved. After radiographic confirmation, root canal treatment was completed.
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Affiliation(s)
- Durga Bhavani Panithini
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Girija S. Sajjan
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Niraj Kinariwala
- Department of Conservative Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Uma Devi Medicharla
- Department of Conservative Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - K. Madhu Varma
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Meghana Kallepalli
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
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Vhorkate K, Banga K, Pawar AM, Mir S, Arora S, Wahjuningrum DA, Bhardwaj A, Luke AM. Location angle of second mesio-buccal canal in maxillary molars of an Indian population: an in vivo retrospective CBCT evaluation and proposal of a new classification. PeerJ 2022; 10:e14234. [PMID: 36248703 PMCID: PMC9559056 DOI: 10.7717/peerj.14234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population. Methods Three-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using 3D Slicer. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MB-MB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (-0.1° to -1.9°), II (-2° to -4°), III (>-4°). On the data tabulated a new Banga Vhorkate and Pawar's (BVP's) angular classification for maxillary molars was proposed. Results The existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1-MB2 in maxillary 1st molar is seen to be 3.12-3.31 mm and this distance in maxillary 2nd molar is 2.8-3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06-5.22 mm in maxillary first molars and 4.9-5.8 mm in maxillary second molars. Conclusion Accurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal.
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Affiliation(s)
- Kishor Vhorkate
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Kulvinder Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India
| | - Shugufta Mir
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Universitas Airlingga, Faculty of Dental Medicine, Surabaya City, East Java, Indonesia
| | - Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Sciences & Hospital, Rau, Indore, India
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman, United Arab Emirates,Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman, United Arab Emirates
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Alnowailaty Y, Alghamdi F. The Prevalence and Location of the Second Mesiobuccal Canals in Maxillary First and Second Molars Assessed by Cone-Beam Computed Tomography. Cureus 2022; 14:e24900. [PMID: 35698689 PMCID: PMC9185178 DOI: 10.7759/cureus.24900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/05/2022] Open
Abstract
Objective This retrospective study aimed to investigate the prevalence and location of the second mesiobuccal (MB2) canal in the mesiobuccal root of the maxillary first molar (MFM) and the maxillary second molar (MSM) through cone-beam computed tomography (CBCT) imaging. Methods One thousand two hundred CBCT images of the MFM and MSM were divided equally and analyzed. To standardize the methodology of MB2 detection, the observation and measurements were located at the pulpal floor by 1 mm apically. The distances between canals were calculated from the center point of the MB2 canal (PMB2) to the center point of both the first mesiobuccal canal (PMB1) and the palatal canal (PP). The data were provided in the form of frequencies and percentages. The chi-square test was used to analyze the differences among maxillary molars, while the significance level was set at 0.05. Results The prevalence of the MB2 canal in the MFM and MSM was 46.7% (p=0.020) and 17.7% (p=0.457), respectively. Additionally, the prevalence of the MB2 canal was more frequent in females. The average distance between PMB1 and PMB2 for MFM and MSM was 1.87±0.42 mm and 1.24±0.76 mm, respectively. Furthermore, the average distances of PMB2 and PP were 0.74±0.21 mm and 0.43±0.18 mm for MFM and MSM, respectively. Conclusion The MB2 canal was found in 386 (32.2%) of the maxillary molars. The Saudi people have a high possibility of discovering the MB2 canal. The CBCT is a useful and high-precision diagnostic tool not only for detecting but also for locating in vivo MB2 canal in the mesiobuccal root of maxillary molars.
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Garg AK, Agrawal N, Wadhwani KK, Tikku AP. Comparison of Detection Rate of Root Canal Orifices of Maxillary First Molar Using Various Techniques: An in-vivo Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Zhang ZH, Yao HL, Zhang Y, Wang X. Endodontic management of the maxillary first molar with special root canals: A case report and review of the literature. World J Clin Cases 2020; 8:2590-2596. [PMID: 32607336 PMCID: PMC7322432 DOI: 10.12998/wjcc.v8.i12.2590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/02/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy, knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis. This article presents an endodontically managed left maxillary first molar with an unusual palatal root morphology. The available literature on the anatomic variation of maxillary first molars is also reviewed.
CASE SUMMARY A 36-year-old man with no medical history presented to the Stomatology Department of Peking University Third Hospital complaining of a toothache during mastication in the maxillary left posterior region for approximately 3 mo. He had a spontaneous and intermittent toothache that had worsened, particularly at night. The diagnosis based on clinical examination, X-ray imaging, and cone beam computed tomography (CBCT) was symptomatic irreversible pulpitis. Nonsurgical endodontic therapy was performed for the left maxillary first molar. Five root canals revealed by CBCT included a special palatal root canal (1-2-1-shaped), two mesiobuccal root canals, and one distobuccal root canal. Evaluation of the CBCT images confirmed the root canal morphology and the clinician performed more effective cleaning, obturation, and therapy. Finally, the tooth was restored using composite resin, and the patient was satisfied with the result.
CONCLUSION CBCT and a complete review of the literature may be beneficial for investigating the root canal system to achieve a biological and functional therapeutic effect.
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Affiliation(s)
- Zhi-Hui Zhang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Hai-Lin Yao
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Yan Zhang
- Department of Stomatology, Peking University Third Hospital Yanqing Hospital, Beijing 102100, China
| | - Xiao Wang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
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Tzeng LT, Chang MC, Chang SH, Huang CC, Chen YJ, Jeng JH. Analysis of root canal system of maxillary first and second molars and their correlations by cone beam computed tomography. J Formos Med Assoc 2020; 119:968-973. [PMID: 31594668 DOI: 10.1016/j.jfma.2019.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/15/2019] [Accepted: 09/20/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/PURPOSE Understanding the root canal systems of molars and the association of root canal system in adjacent or contralateral molars is important for dental practice. This study aimed to use cone-beam computed tomography (CBCT) to analyze the morphology similarity of root canal systems in the maxillary first and second molars. METHODS CBCT images of 1741 maxillary molars in a total of 519 patients were blindly examined to analyze the correlation of root canal systems between maxillary first and second molars as well as the bilateral first and second molars. RESULTS The most common type in maxillary first molars is 3R4C (3 roots/4 canals), whereas in maxillary second molars is 3R3C.The symmetry in type of root canals in bilateral maxillary first and second molars were 87.36% and 79.85%, respectively. The similarities of root canal system in adjacent maxillary first and second molars were 53.07% (right side) and 52.58% (left side). The concurrence of MB2 canal in bilateral maxillary first molars is 77.8%, and 35.97% in maxillary second molars. In the 110 patients with MB2 canal in bilateral maxillary second molars, the chance of bilateral MB2 canals in their maxillary first molar is almost 100%. CONCLUSION Maxillary first molars have higher prevalence of 3R4C than second molars. The symmetry in bilateral maxillary molars is higher than the similarity in adjacent maxillary first and second molars. Application of CBCT analysis of root canal system can improve endodontic treatment outcomes. The correlation of root canal system between teeth is useful for genetic linkage.
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Affiliation(s)
- Li-Ting Tzeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Chi Chang
- Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan, Taiwan; Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Shu-Hui Chang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Yi-Jane Chen
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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Ge YJ, Liu XQ. [Effects of loupes and microscope on laminate veneer preparation]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:100-104. [PMID: 30773552 DOI: 10.19723/j.issn.1671-167x.2019.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess and compare the effects of loupes and microscope on laminate veneer preparation of the first practitioner from the aspects of efficiency, quality and accuracy of preparation, and preference. METHODS Twenty young prosthodontists from the Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was prospective, single blind, self-control trials. The participants had no experience of using dental magnification devices. They prepared laminate veneers in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The time for tooth preparation was recorded. Thereafter, subjective assessments of efficiency, quality of preparation and preference were performed by themselves using visual analogue score (VAS). Expert assessments of quality and accuracy of preparation were performed by two professors using stereomicroscope and digital technique respectively. RESULTS In terms of efficiency, the subjective scores for the control group, loupes group and microscopic group were 7.15±1.73, 8.10±0.91 and 5.40±2.04, respectively. There was significant difference between the loupes group and microscopic group (P<0.05). The time of tooth preparation for the control group, loupes group and microscopic group was (430.10±163.04) s, (393.90±157.27) s and (441.95±164.18) s, respectively. There was significant difference between the loupes group and microscopic group (P<0.05). The loupes group was more efficient than the microscopic group. In terms of the quality of preparations, the subjective scores for the control group, loupes group and microscopic group were 6.55±2.09, 7.85±0.99 and 6.25±1.77, respectively. There was significant difference between the loupes group and microscopic group (P<0.05). The expert evaluations for the control group, loupes group and microscopic group were 12.20±1.67, 12.50±1.70 and 11.35±2.60, respectively. There was significant difference between the loupes group and microscopic group (P<0.05). The loupes group had higher quality than the microscopic group. In terms of the accuracy of preparations, the control group, loupes group and microscopic group of incisal 1/3 were (0.107±0.097) mm, (0.142±0.118) mm and (0.123±0.087) mm, respectively, of middle 1/3 were (0.128±0.073) mm, (0.113±0.105) mm and (0.125±0.077) mm, respectively, and of cervical 1/3 were (0.075±0.054) mm, (0.068±0.044) mm and (0.058±0.047) mm, respectively. There was no significant difference among the three groups (P>0.05). In terms of the preference, the subjective scores for the control group, loupes group and microscopic group were 6.55±2.31, 8.60±1.10 and 5.80±2.07, respectively. There was significant difference between the loupes group and microscopic group (P<0.05). The participants had the highest preference for loupes. CONCLUSION For the first practitioners, loupes is better than microscope for laminate veneer preparation.
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Affiliation(s)
- Y J Ge
- Department of Prosthodontics, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X Q Liu
- Department of Prosthodontics, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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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: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [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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Eichenberger M, Biner N, Amato M, Lussi A, Perrin P. Effect of Magnification on the Precision of Tooth Preparation in Dentistry. Oper Dent 2018. [PMID: 29513642 DOI: 10.2341/17-169-c] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the impact of magnification aids on the precision of tooth preparation under simulated clinical conditions. METHODS AND MATERIALS Two plastic blocks marked with a geometric shape were fixed in a dental phantom head: a circle as the distal surface of tooth 16 (UNS 3) and a y-shaped figure as the occlusal surface of tooth 36 (UNS 19). Sixteen dentists (mean age: 39 years; range: 26-67 years) prepared the geometric shapes from the inside to the boundary line with a cylindrical bur and water-cooling. The boundary line had to be touched but not erased. Chair-side assistance was provided to simulate the clinical situation. Tooth 16 was prepared under indirect vision via a dental mirror. Tooth 36 was prepared under direct vision A) without magnification aids, B) with Galilean loupes, 2.5× and light-emitting diode light, and C) with a microscope, 6.4× and coaxial light. The preparation procedure was performed three times in different sequences of the magnification devices and with a break of at least 1 week between each procedure. The correctly prepared contour and the incorrectly prepared areas were evaluated in relation to the whole circumference of the geometric shapes. RESULTS For both values the precision was significantly higher when a microscope was used, followed by preparation using loupes; precision was lowest without magnification aids ( p<0.0001). This was true for both indirect and direct vision ( p<0.05). CONCLUSIONS Magnification devices improved the precision of tooth preparation under simulated clinical conditions.
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Vasundhara V, Lashkari KP. An in vitro study to find the incidence of mesiobuccal 2 canal in permanent maxillary first molars using three different methods. J Conserv Dent 2017; 20:190-193. [PMID: 29279624 PMCID: PMC5706321 DOI: 10.4103/0972-0707.218308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: In-vitro study was done to evaluate the incidence of MB2 canals using three different methods (CBCT, CLINICAL ANALYSIS AND DENTAL LOUPES) and to compare the efficacy of the three methods in identifying the incidence of MB2 canals in maxillary permanent first molars. Materials and Methods: The study sample consisted of 120 extracted intact permanent maxillary molars. These extracted teeth were subjected to CBCT. Later the teeth were access opened with naked eye to find the incidence of MB2 canal, and then the teeth were visualised under dental loupe to locate MB2 canal if they were missed under naked eye. Results was statistically analysed by Mc Nemar's tests with Bonferroni correction, Chi square test and Cochran's Q test. Result: CBCT showed high incidence (68.3%) of MB2 canal in maxillary first molars and it showed to be a reliable method in detecting MB2 canal. When compared to dental loupe (52.5%) and naked eye (25%), the dental loupe improved the detection of MB2 canal. Conclusion: Within the parameter of this study in detecting the incidence of MB2 canal, using CBCT dental loupes and naked eye, detection of MB2 canal was significantly higher with CBCT followed by dental loupe and least with naked eye.
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Affiliation(s)
- V Vasundhara
- Department of Conservative Dentistry and Endodontics, KVG Dental College (affiliated by Dental Council of India and Rajiv Gandhi University of Health Sciences), Sullia, Karnataka, India
| | - Krishna Prasada Lashkari
- Department of Conservative Dentistry and Endodontics, KVG Dental College (affiliated by Dental Council of India and Rajiv Gandhi University of Health Sciences), Sullia, Karnataka, India
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Intraoperative Use of CBCT for Identification and Localization of Calcified Canals: A Clinical Technique. Case Rep Dent 2017; 2017:1265701. [PMID: 29279778 PMCID: PMC5723965 DOI: 10.1155/2017/1265701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/31/2017] [Indexed: 11/30/2022] Open
Abstract
Localization of calcified canals has always been a challenge in the field of endodontics. The following report of three cases describes a technique for the identification and negotiation of obliterated canals by use of cone beam computed tomography (CBCT) intraoperatively. Canal orifices could not be found clinically in all three cases. Gutta-percha points were placed and compacted at the position where the canal orifices were estimated to be. Intraoperative CBCT was taken, and the distance between the gutta-percha points and the canal orifices was calculated at all planes of space in the first two cases. In the third case, only one canal orifice could be identified due to obliteration of the other canals.
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Evaluation of the root and canal systems of maxillary molars in Taiwanese patients: A cone beam computed tomography study. Biomed J 2017; 40:232-238. [PMID: 28918912 PMCID: PMC6136279 DOI: 10.1016/j.bj.2017.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/06/2017] [Accepted: 05/23/2017] [Indexed: 12/13/2022] Open
Abstract
Background This study evaluated variations in root canal configuration in the maxillary permanent molars of Taiwanese patients by analyzing patients' cone beam computed tomography (CBCT) images. Comparisons were made among these configurations and those previously reported. This information may serve as a basis for improving the success rate of endodontic treatment. Methods The root canal systems of 114 Taiwanese patients with bilateral maxillary first or second molars were examined using CBCT images. The number of roots, canals per root, and additional mesiobuccal (MB) canals, as well as the canal configuration were enumerated and recorded. Results Of the 196 maxillary first molars examined, three (1.5%) had a single root, two (1.0%) had two roots, and 191 (97.5%) had three separate roots. Out of all first molar roots examined, 44% of mesiobuccal (MB) roots had a single canal and the remainder had a second MB (MB2) canal. Of the 212 maxillary second molars examined, 16 (7.1%) had a single root, 51 (24.2%) had two roots, 143 (67.8%) had three roots, and two (0.9%) had four separate roots. For the MB roots, 92.3% of three-rooted maxillary second molars had a single canal and the remainder had an MB2 canal. In all three-rooted maxillary first and second molars, each of the distal and palatal roots had one canal. Conclusions The root canal configurations of the MB roots of maxillary molars were more varied than those of the distobuccal and palatal roots, and the root canal configurations of maxillary second molars were more varied than those of the first molars. These findings demonstrate CBCT as a useful clinical tool for endodontic diagnosis and treatment planning.
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Pérez-Heredia M, Ferrer-Luque CM, Bravo M, Castelo-Baz P, Ruíz-Piñón M, Baca P. Cone-beam Computed Tomographic Study of Root Anatomy and Canal Configuration of Molars in a Spanish Population. J Endod 2017; 43:1511-1516. [PMID: 28735786 DOI: 10.1016/j.joen.2017.03.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/29/2016] [Accepted: 03/16/2017] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The aim of this study was to identify morphologic peculiarities of roots and analyze the root canal configuration in maxillary and mandibular first and second molars by means using cone-beam computed tomographic (CBCT) imaging in a Spanish population. METHODS A total of 284 maxillary molars and 242 mandibular molars from 112 patients were examined in vivo by CBCT imaging; only untreated molars with healthy and fully matured apices were included in this study. Details regarding the number of roots, number of canals, and root canal configuration were recorded. RESULTS Maxillary first and second molars had 3 roots in 97.2% and 79%, respectively. In mandibular molars, the frequency of 2 roots was 94% in first molars and 83% in second molars. The canal configuration of the palatal root was 100% Vertucci type I (1-1) in first and second molars. The distobuccal root showed a Vertucci type I configuration in 97% of first and 100% of maxillary second molars. The mesiobuccal root for first molars showed a Vertucci type II configuration (2-1) in 56.5% cases and Vertucci type IV (2-2) in 23.2%. For maxillary second molars, the Vertucci type I configuration reached 52.7%. In mandibular molars, the mesial root showed higher variability. Most frequent was the presence of 2 canals, Vertucci type II for first and second molars. In the distal root, the most common configuration was Vertucci type I in both molars. CONCLUSIONS The greater percentage of fused roots was observed in maxillary molars. Vertucci type II configuration was more frequent than type IV in the mesial root of mandibular molars and the mesiobuccal root of maxillary molars. A third canal in the mesial root of first mandibular molars (6.7%) was higher than expected.
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Affiliation(s)
- Mercedes Pérez-Heredia
- Department Stomatology, School of Dentistry, University of Granada and Servicio Andaluz de Salud-Distrito Poniente, Granada, Spain.
| | - Carmen María Ferrer-Luque
- Department Stomatology, School of Dentistry, University of Granada and Servicio Andaluz de Salud-Distrito Poniente, Granada, Spain
| | - Manuel Bravo
- Department Stomatology, School of Dentistry, University of Granada and Servicio Andaluz de Salud-Distrito Poniente, Granada, Spain
| | - Pablo Castelo-Baz
- Department of Operative Dentistry and Endodontics, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Ruíz-Piñón
- Department of Operative Dentistry and Endodontics, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Baca
- Department Stomatology, School of Dentistry, University of Granada and Servicio Andaluz de Salud-Distrito Poniente, Granada, Spain
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Aktan AM, Yildirim C, Culha E, Demir E, Ertugrul Ciftci M. Detection of Second Mesiobuccal Canals in Maxillary First Molars Using a New Angle of Cone Beam Computed Tomography. IRANIAN JOURNAL OF RADIOLOGY 2016; 13:e31155. [PMID: 27895867 PMCID: PMC5116578 DOI: 10.5812/iranjradiol.31155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/07/2015] [Accepted: 09/14/2015] [Indexed: 11/23/2022]
Abstract
Background The localization of the additional canal orifice is one of the primary factors influencing the success of endodontic treatment. To deal with this problem, several techniques that each have their own advantages and disadvantages have been discussed in the literature. Objectives The aim of the present in vitro study was to review a new approach to localizing second mesiobuccal (MB2) canals in maxillary first molars using cone beam computed tomography (CBCT). Patients and Methods The CBCT scans of 296 patients who were referred to the department of dentomaxillofacial radiology were included in the study. The presence of MB2 canals, the angle formed by the mesiobuccal, distobuccal, and palatal root canal orifices (∠MDP), and the angle formed by the mesiobuccal, distobuccal, and MB2 canal orifices (∠MDMB2) were evaluated on the axial section. Pearson correlation and multiple linear regression methods were used for all predictions. All of the analyses were performed using SPSS for windows version 22.0. A two-sided P value < 0.05 was defined as statistically significant. Results Of the 468 first molars, MB2 canals were observed in 296 subjects (141 females and 155 males). There were no statistically significant differences between females and males (P = 0.300). The ∠MDP and ∠MDMB2 were detected and evaluated. A moderate positive correlation was found between the ∠MDP and the ∠MDMB2. To predict the ∠MDMB2 values, it was shown that the ∠MDMB2 increased by 0.420 degrees when the ∠MDP increased by 1 degree. If the ∠MDP was greater than 90.95 degrees, there was a 78% probability that MB2 canals could be found. Conclusion The determination of the presence of MB2 in the maxillary first molars may be carried out using CBCT scans. If the ∠MDP was 91 degrees or greater, there was considered to be a higher probability that MB2 canals would be found in the endodontic cavity. Due to the positive correlation between the ∠MDP and the ∠MDMB2, the localization of MB2 canals may be easily performed in relation to the main MB canal.
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Affiliation(s)
- Ali Murat Aktan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Uşak, Uşak, Turkey
- Corresponding author: Ali Murat Aktan, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Uşak, Uşak, Turkey. Tel: +90-5327074499, E-mail:
| | - Cihan Yildirim
- Department of Endodontics, Faculty of Dentistry, University of Gaziantep, Gaziantep, Turkey
| | - Emre Culha
- Department of Endodontics, Faculty of Dentistry, University of Zirve, Gaziantep, Turkey
| | - Erhan Demir
- Department of Endodontics, Faculty of Dentistry, University of Marmara, Istanbul, Turkey
| | - Mehmet Ertugrul Ciftci
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Akdeniz, Antalya, Turkey
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Coelho MS, Parker JM, Tawil PZ. Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.6.tb06135.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marcelo Santos Coelho
- Department of Endodontics; School of Dentistry; University of North Carolina; Chapel Hill
| | - Jeffrey M. Parker
- Department of Endodontics; School of Dentistry; University of North Carolina; Chapel Hill
| | - Peter Z. Tawil
- Department of Endodontics; School of Dentistry; University of North Carolina; Chapel Hill
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Habib AA, Kalaji MN, Al saysd TJ, Al jawfi KA. Root canal configurations of the first and second mandibular premolars in the population of north Syria. J Taibah Univ Med Sci 2015. [DOI: 10.1016/j.jtumed.2015.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lyra CM, Delai D, Pereira KCR, Pereira GM, Pasternak Júnior B, Oliveira CAP. Morphology of Mesiobuccal Root Canals of Maxillary First Molars: a comparison of CBCT scanning and Cross-sectioning. Braz Dent J 2015; 26:525-9. [DOI: 10.1590/0103-644020130096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 07/01/2015] [Indexed: 11/21/2022] Open
Abstract
Abstract: The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.
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Affiliation(s)
| | - Débora Delai
- UFRGS - Universidade Federal do Rio Grande do Sul, Brazil
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Detection of a Second Mesiobuccal Canal in Maxillary Molars by Swept-source Optical Coherence Tomography. J Endod 2014; 40:1865-8. [DOI: 10.1016/j.joen.2014.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/27/2014] [Accepted: 07/10/2014] [Indexed: 11/24/2022]
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Habib AA. Anatomical study of the mesiobuccal root in maxillary first molars. J Taibah Univ Med Sci 2014. [DOI: 10.1016/j.jtumed.2013.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Park E, Chehroudi B, Coil JM. Identification of Possible Factors Impacting Dental Students’ Ability to Locate MB2 Canals in Maxillary Molars. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.5.tb05731.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Babak Chehroudi
- Department of Oral Health Sciences; Faculty of Dentistry; University of British Columbia
| | - Jeffrey M. Coil
- Division of Endodontics; Department of Oral Biological and Medical Sciences; Faculty of Dentistry; University of British Columbia
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Tocci L, Plotino G, Grande NM, Testarelli L, Messineo D, Ciotti M, D’ambrosio F, Gambarini G. Analisi alla Cone Beam Computed Tomography della simmetria anatomica in molari superiori ed inferiori. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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26
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Plotino G, Tocci L, Grande NM, Testarelli L, Messineo D, Ciotti M, Glassman G, D'ambrosio F, Gambarini G. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo. J Endod 2013; 39:1545-8. [PMID: 24238444 DOI: 10.1016/j.joen.2013.09.012] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 08/28/2013] [Accepted: 09/09/2013] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The aim of the present study was to use cone-beam computed tomography (CBCT) to analyze root canal anatomy and symmetry of maxillary and mandibular first and second molar teeth of a white population. METHODS A total of 201 patients who required CBCT examinations as part of their dental diagnosis and treatment were enrolled in the present study. Overall, 596 healthy, untreated, well-developed maxillary and mandibular molar teeth (161 maxillary first molars, 157 maxillary second molars, 117 mandibular first molars, and 161 mandibular second molars) were examined by CBCT to establish the symmetry in root and canal anatomy between right and left sides in the same patient by evaluating the number of roots and root canals and the root canal configuration. RESULTS Three separate roots with 3 separate canals was the normal anatomy of maxillary first and second molars. Most mandibular first and second molars had 2 separate roots, and the majority had 3 canals. In the present study, first molars, both maxillary and mandibular, exhibited greater asymmetry than the second molars. Maxillary first molars were found to be symmetrical in 71.1% of patients, whereas maxillary second molars were symmetrical in 79.6%. The remaining 28.9% and 20.4% of patients, respectively, showed asymmetry. Around 30% of the mandibular first molars and 20% of the mandibular second molars showed asymmetry. CONCLUSIONS The results of the present study reported a percentage of symmetry that varied from 70%-81%. These variations in symmetry should be taken in high consideration when treating 2 opposite molars in the same patient, because their anatomy may be different in up to 30% of the cases.
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Affiliation(s)
- Gianluca Plotino
- Department of Endodontics, "Sapienza" University of Rome, Rome, Italy.
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Tocci L, Plotino G, Grande NM, Testarelli L, Messineo D, Ciotti M, D’ambrosio F, Gambarini G. Analisi della morfologia radicolare e canalare di molari superiori ed inferiori in una popolazione Caucasica: studio in vivo alla CBCT. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Second Canal in Mesiobuccal Root of Maxillary Molars Is Correlated with Root Third and Patient Age: A Cone-beam Computed Tomographic Study. J Endod 2013; 39:588-92. [DOI: 10.1016/j.joen.2013.01.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/04/2013] [Accepted: 01/30/2013] [Indexed: 10/27/2022]
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Location and negotiability of second mesiobuccal canal in upper molar by tomographic and anatomical macroscopic analysis. Surg Radiol Anat 2013; 35:791-5. [DOI: 10.1007/s00276-013-1101-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/04/2013] [Indexed: 11/25/2022]
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30
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Peeters HH, Suardita K, Setijanto D. Prevalence of a second canal in the mesiobuccal root of permanent maxillary first molars from an Indonesian population. J Oral Sci 2012; 53:489-94. [PMID: 22167035 DOI: 10.2334/josnusd.53.489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
A sample of 308 extracted human permanent maxillary first molars from an Indonesian population was randomly selected. A rhomboid access cavity was made in all teeth in anticipation of identifying a second mesiobuccal canal (MB2). Ultrasonic tips were used to open the subpulpal groove to locate the second canal in the mesiobuccal root. Dentin was carefully removed from the trifurcation area at the expense of the mesial wall. If a second canal was located, a 0.8 C+ file was inserted into it until the file reached the apex. The prevalence of a second canal in the mesiobuccal root of the permanent maxillary first molar was 68.5% (95% CI: 63.1%-73.4%) in this population. Sections of the mesial root showed that the MB2 was a separate canal in 52.6% of the sample and a joined canal in 47.4%. The mean (SD) distance between MB1 and MB2 was 1.55 (0.66) mm. The data obtained from this study provide theoretical and experimental evidence to aid in the clinical management of the MB2 canal and may increase the success rate for root canal treatment of the maxillary first molar.
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32
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Brüllmann DD, Weichert CI, Daubländer M. Intraoral Cameras as a Computer-Aided Diagnosis Tool for Root Canal Orifices. J Dent Educ 2011. [DOI: 10.1002/j.0022-0337.2011.75.11.tb05202.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Catharina I.D. Weichert
- Department of Oral Surgery; University Medical Center of the Johannes-Gutenberg University; Mainz Germany
| | - Monika Daubländer
- Department of Oral Surgery; University Medical Center; Mainz Germany
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Ali Z, Keshani D. Indications for surgical endodontics and findings of an audit into referrals. DENTAL UPDATE 2011; 38:610-614. [PMID: 22238993 DOI: 10.12968/denu.2011.38.9.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Peri-radicular surgery is a valuable treatment modality allowing thorough treatment of chronic infection of the peri-radicular tissues. It is important that this treatment option is prescribed appropriately and steps are taken to help improve outcomes of surgery. We discuss the indications for peri-radicular surgery, considerations when planning treatment for teeth where orthograde endodontics has failed and present the findings of an audit into the appropriateness of referrals for peri-radicular surgery to the Department of Oral and Maxillofacial Surgery at a District General Hospital. CLINICAL RELEVANCE This article highlights the indications and contra-indications for peri-radicular surgery to general dental practitioners.
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Al-Fouzan KS, Ounis HF, Merdad K, Al-Hezaimi K. Incidence of canal systems in the mesio-buccal roots of maxillary first and second molars in Saudi Arabian population. AUST ENDOD J 2011; 39:98-101. [DOI: 10.1111/j.1747-4477.2010.00289.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PMH. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int Endod J 2010; 44:162-9. [PMID: 21091495 DOI: 10.1111/j.1365-2591.2010.01826.x] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIM To investigate variations in root canal configuration in the maxillary permanent molar teeth of a Chinese subpopulation using cone-beam computed tomography (CBCT). METHODOLOGY A total of 269 patients with healthy, untreated, well-developed maxillary molars were enrolled, including those suffering facial trauma, and those who required a pre-operative assessment for implants. Radiographic examination by CBCT was conducted as part of their routine examination, diagnosis and treatment planning. Overall, 299 maxillary first and 210 maxillary second molar teeth were examined in vivo by CBCT. The number of roots, the number of canals per root, the canal configuration and the presence of additional mesiobuccal canals were recorded. Vertucci's classification for root-canal configurations was utilized. RESULTS All maxillary first molars had three separate roots; however, 52% of mesiobuccal (MB) roots had two canals with the remainder having one. All distobuccal and palatal roots had Vertucci Type I canal configurations. When the MB2 canal was present, 14, 69 and 16% of MB roots had Type II, IV and V canal configurations, respectively. The root canal system of the maxillary first molar teeth could be categorized into two variants: one with three separate roots with one canal in each of the distobuccal and palatal roots and two canals in the MB root, and the other with three separate roots with one canal in each root. Of 210 maxillary second molars, 10% had one root, 8% two roots and 81% three roots. Of the MB roots, 22% had two canals with the remainder having one. When the MB2 canal was present, 18%, 58%, 10% and 3% of MB roots had type II, IV, V and VI canal configurations, respectively. The root canal system of the maxillary second molar could be categorized into eight variants. CONCLUSIONS Mesiobucccal roots of maxillary molar teeth had more variation in their canal system than the distobuccal or palatal roots. The root canal configuration of the maxillary second molars was more variable than that of the first molars. CBCT can enhance detection and mapping of the mesiobuccal root-canal system with the potential to improve the quality of root canal treatment.
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Affiliation(s)
- R Zhang
- West China Hospital of Stomatology, Key Laboratory of Oral Biomedical Engineering of the Ministry of Health, Sichuan University, Chengdu, China
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Detection of Mesiobuccal Canal in Maxillary Molars and Distolingual Canal in Mandibular Molars by Dental CT: A Retrospective Study of 100 Cases. Int J Dent 2010; 2010:291276. [PMID: 20613946 PMCID: PMC2896839 DOI: 10.1155/2010/291276] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 04/05/2010] [Accepted: 04/12/2010] [Indexed: 11/17/2022] Open
Abstract
Objective. To detect presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars by Dental CT. Material and Methods. A retrospective study of 100 Dental CTs was done. Axial and paraxial images obtained were used to assess the presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars. Results. The youngest patient was of 11 years while the eldest patient was of 77 years. Males were 58 in number and females were 42 in number. MB2 canals were present in 57 patients and distolingual canal was present in 18 patients. Maximum MB2 canals were present in age group between 51 and 60 years, while distolingual canals were present in age group of 21–30 years. Conclusion. Dental CT allows adequate visualization of variation in root canal morphology and can be important diagnostic tool for successful endodontic therapy.
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Efficacy of Cone-Beam Computed Tomography as a Modality to Accurately Identify the Presence of Second Mesiobuccal Canals in Maxillary First and Second Molars: A Pilot Study. J Endod 2010; 36:867-70. [DOI: 10.1016/j.joen.2009.12.023] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 12/27/2009] [Accepted: 12/28/2009] [Indexed: 11/18/2022]
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Baratto Filho F, Zaitter S, Haragushiku GA, de Campos EA, Abuabara A, Correr GM. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod 2009; 35:337-42. [PMID: 19249591 DOI: 10.1016/j.joen.2008.11.022] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 11/27/2008] [Accepted: 11/28/2008] [Indexed: 12/29/2022]
Abstract
The success of endodontic treatment depends on the identification of all root canals so that they can be cleaned, shaped, and obturated. This study investigated internal morphology of maxillary first molars by 3 different methods: ex vivo, clinical, and cone beam computed tomography (CBCT) analysis. In all these different methods, the number of additional root canals and their locations, the number of foramina, and the frequency of canals that could or could not be negotiated were recorded. In the ex vivo study, 140 extracted maxillary first molars were evaluated. After canals were accessed and detected by using an operating microscope, the teeth with significant anatomic variances were cleared. In the clinical analysis, the records of 291 patients who had undergone endodontic treatment in a dental school during a 2-year period were used. In the CBCT analysis, 54 maxillary first molars were evaluated. The ex vivo assessment results showed a fourth canal frequency in 67.14% of the teeth, besides a tooth with 7 root canals (0.72%). Additional root canals were located in the mesiobuccal root in 92.85% of the teeth (17.35% could not be negotiated), and when they were present, 65.30% exhibited 1 foramen. Clinical assessment showed that 53.26%, 0.35%, and 0.35% of the teeth exhibited 4, 5, and 6 root canals, respectively. Additional root canals were located in this assessment in mesiobuccal root in 95.63% (27.50% could not be negotiated), and when they were present, 59.38% exhibited 1 foramen. CBCT results showed 2, 4, and 5 root canals in 1.85%, 37.05%, and 1.85% of the teeth, respectively. When present, additional canals showed 1 foramen in 90.90% of the teeth studied. This study demonstrated that operating microscope and CBCT have been important for locating and identifying root canals, and CBCT can be used as a good method for initial identification of maxillary first molar internal morphology.
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Hartwell G, Appelstein CM, Lyons WW, Guzek ME. The incidence of four canals in maxillary first molars. J Am Dent Assoc 2007; 138:1344-6. [PMID: 17908848 DOI: 10.14219/jada.archive.2007.0050] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted an in vivo study to report the incidence of fourth root canals located and treated in maxillary first molars during a seven-month period in a postgraduate endodontic program. METHODS In this retrospective study, the authors determined the number of canals treated by postgraduate students in an endodontic program. The attending postgraduate endodontic faculty member supervising the case verified the number of canals in the teeth. The authors then collected the data from each resident and compiled them. RESULTS The residents treated a total of 121 maxillary molars, 85 (70.2 percent) of which met the criterion of having four or more canals treated. Approximately 99 percent of the fourth canals were located in the mesiobuccal root. CONCLUSIONS Overall, 70 percent of the maxillary first molars contained at least four canals that required instrumentation. CLINICAL IMPLICATIONS The results of this study demonstrate that it is imperative for any dentist performing root canal therapy on maxillary first molars to examine carefully the pulpal floor to locate all canals, especially the second mesiobuccal canal. Performing thorough examinations may increase the chance of treatment success.
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Affiliation(s)
- Gary Hartwell
- Department of Endodontics, University of Medicine and Dentistry Of New Jersey, New Jersey Dental School, Newark, NJ 07101 USA
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CANTATORE GIUSEPPE, BERUTTI ELIO, CASTELLUCCI ARNALDO. Missed anatomy: frequency and clinical impact. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2009.00240.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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