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European Endodontic Journal Aug 2021Adequate understanding and accurate characterization of normal and unusual root and canal morphology are essential requirements for successful root canal treatment. A... (Review)
Review
Adequate understanding and accurate characterization of normal and unusual root and canal morphology are essential requirements for successful root canal treatment. A new coding system for classifying root and canal morphology, accessory canals and anomalies has been introduced. In addition to technological advances related to experimental studies involving micro-computed tomography, the continuing clinical advances in magnification, illumination, imaging and intra-operative root canal treatment procedures have allowed clinicians to identify an increasingly wide range of anatomical variations in roots and canals in an attempt to achieve more predictable clinical outcomes. This review aims to provide a step-by-step explanation for the clinical application of the new coding system in dental practice, and to describe the anatomical variations in roots and canals for teeth scheduled for root canal treatment.
Topics: Dental Pulp Cavity; Root Canal Therapy; Tooth; Tooth Root; X-Ray Microtomography
PubMed: 34650010
DOI: 10.14744/eej.2021.38257 -
International Dental Journal Jun 2023During mechanical preparation of the primary root canal, the original anatomy of the tooth should be preserved and the instrument should be perfectly balanced centrally... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
During mechanical preparation of the primary root canal, the original anatomy of the tooth should be preserved and the instrument should be perfectly balanced centrally into the canal space for reducing the probability of canal transportation. The aim of this research was to compare canal transportation and canal centring ability in primary root canals using ProTaper Next (Dentsply Mailfair,), AF baby (Fanta), and Kidzo Elephant (Endostar, Poldent Sp.) files.
MATERIALS AND METHODS
Eighteen root canals were randomly divided into 3 experimental groups (n = 6 in each group). Instrumentation was performed using ProTaper Next, Fanta AF baby, and Kidzo Elephant files in groups 1, 2, and 3, respectively. During the instrumentation procedure, the irrigation of 2 mL of 1.5% sodium hypochlorite between each file was done, followed by 5 mL of 17% ethylenediaminetetraacetic acid as a final irrigating solution. Cone-beam computed tomography images were obtained before and after instrumentation. Each group was evaluated for transportation and centring ratios.
RESULTS
On comparing all the tested groups within each root canal level canal transportation, the results revealed a statistically nonsignificant difference in the buccolingual direction (P > 0.05). Meanwhile, in the mesiodistal direction, group 1 showed a statistically highly significant difference compared to groups 2 and 3 at the cervical level (P < .01). However, in both middle and apical root canal levels, there was a statistically nonsignificant difference amongst all groups (P > 0.05). Regarding the centring ability comparison of the 3 groups within each root canal level, there was a statistically nonsignificant difference amongst all groups (P > 0.05) in both buccolingual and mesiodistal directions.
CONCLUSIONS
The ProTaper Next regular rotary file and the paediatric rotary files showed no difference in canal transportation and centring ability in the buccolingual direction, while in the mesiodistal direction at the cervical root canal level, the ProTaper Next showed high transportation liability.
Topics: Animals; Child; Humans; Dental Pulp Cavity; Elephants; Equipment Design; Molar; Root Canal Preparation; Tooth, Deciduous; X-Ray Microtomography
PubMed: 36241464
DOI: 10.1016/j.identj.2022.09.003 -
The Journal of Contemporary Dental... Oct 2023To evaluate and compare canal-centering ability (CCA), canal transportation (CT), and dentinal crack formation by using Hyflex-electrical discharge machining (EDM),...
AIM
To evaluate and compare canal-centering ability (CCA), canal transportation (CT), and dentinal crack formation by using Hyflex-electrical discharge machining (EDM), OneShape, WaveOne Gold, and Reciproc single file system in the mesiobuccal root of maxillary first molar at coronal, middle, and apical third using cone-beam computed tomography (CBCT) and scanning electron microscopy (SEM).
MATERIALS AND METHODS
Mesiobuccal roots of 120 freshly extracted maxillary molar teeth were divided into four experimental groups; Hyflex-EDM, OneShape, WaveOne Gold, and Reciproc ( = 30/group). Preinstrumentation scanning was done using CBCT for all samples at coronal one-third (4 mm), middle one-third (8 mm), and apical one-third (12 mm). After cleaning and shaping with standard irrigation protocol, the specimens were again scanned. Canal-centering ability and CT were calculated using pre- and postinstrumentation CBCT values. A scanning electron microscope was used to identify dentinal crack formation.
RESULTS
No significant difference was found for CCA by any of the systems at coronal, middle, and apical third, respectively. However, OneShape was found to have better CCA at the coronal third and WaveOne Gold at the middle and apical third. There was a significant difference in canal transportation at the apical third ( = 0.004) with WaveOne Gold having the least CT followed by Reciproc at the apical third. OneShape resulted in more dentinal cracks in the coronal and middle thirds. Also, Hyflex-EDM was better in the apical third.
CONCLUSION
No difference in CCA was observed between the groups. The lowest values for CT were obtained for WaveOne Gold (similar to Reciproc) whereas both rotary files showed higher values for CT. Also, OneShape showed the most dentinal at all levels. Furthermore, Hyflex-EDM and WaveOne Gold produced the least dentinal cracks at all levels.
CLINICAL SIGNIFICANCE
Given that the Reciprocating file system had the least CT and least dentinal cracks, the clinical success rate of root canal treatment (RCT) with the Reciprocating file system can be a better choice to improve the longevity of root canal-treated teeth.
Topics: Dental Pulp Cavity; Molar; Root Canal Preparation; Root Canal Therapy
PubMed: 38152914
DOI: 10.5005/jp-journals-10024-3571 -
Anatomical Sciences Education May 2022Dental anatomy is an integrated, core fundamental dental course, which prepares students for all future clinical dental courses. This study aimed to build up an online...
Dental anatomy is an integrated, core fundamental dental course, which prepares students for all future clinical dental courses. This study aimed to build up an online dental learning platform of micro-computed tomography-based three-dimensional (3D) tooth models with pulp cavity, and to further evaluate its effectiveness for dental anatomy education using a cohort study. First, ninety-six extracted permanent teeth were scanned by micro-computed tomography and the enamel, dentine, and pulp cavity of each was distinguished by different grey-scale intensities using Mimics software. Three-dimensional images allowed further discrimination and insights into permanent three-rooted premolars, central tip, and dental diseases including deep caries and wedge-shaped defects. Furthermore, a second mesiobuccal canal (MB2) in maxillary permanent molar teeth and Vertucci type III root canal configuration in mandibular anterior teeth could be detected using the 3D analytical tool. A digitized 3D tooth model learning platform was implemented. Last, two groups of dental students were assessed to evaluate the effect of 3D models on dental anatomy education. Participants in the Digital group were allowed to use the online dental learning platform freely after class, while the participants in the Traditional group were not. Assessment quizzes showed that participants' scores improved in the Digital group with the use of the learning platform compared with scores in the Traditional group. A questionnaire survey indicated that the participants had a positive attitude toward the 3D models. Thus, adding digital 3D resources to a traditional curriculum may have a positive effect on academic achievements.
Topics: Anatomy; Cohort Studies; Dental Pulp Cavity; Humans; Tooth; Tooth Root; X-Ray Microtomography
PubMed: 33829672
DOI: 10.1002/ase.2085 -
Journal of Endodontics Aug 2021Separated endodontic instruments may adversely affect the outcome of endodontic treatment. The combination of ultrasonic techniques and dental operating microscopes...
INTRODUCTION
Separated endodontic instruments may adversely affect the outcome of endodontic treatment. The combination of ultrasonic techniques and dental operating microscopes appears to be effective in the removal of separated instruments compared with more randomized techniques. This study evaluated the roles of root canal curvature and separated instrument length on the time needed to loosen and retrieve the instrument fragments.
METHODS
The retrieval procedures of 128 separated instruments referred to a private endodontic practice for retreatment by general practitioners were evaluated in patients who were monitored for a minimum of 6 months. Preoperative cone-beam computed tomographic images were used to measure separated instrument lengths in relation to the degrees of canal curvatures. Ultrasonic instruments were used in the initial phase to remove the tooth structure and to loosen the fractured instrument. In the second phase, ultrasonic instruments, wire loops, or XP Shapers (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) were used for fragment removal. The time periods for all procedures were recorded. Statistical analysis was completed applying log-normal regression, structural equation modeling, and linear regression using Stata Version 14.2 software (StataCorp LLC, College Station, TX).
RESULTS
All separated instruments were successfully retrieved. Using the protocol in this study, 89.8% of the instruments were removed using ultrasonic instruments alone with a mean time of 221 seconds. The instrument removal time was dependent on both the instrument length and the root canal curvature. Additionally, preparation times were proportionately longer with increasing separated instrument lengths when the loop device was required.
CONCLUSIONS
The preparation phase appears to have an important role in the retrieval of separated instruments. Preparation times for both non-loop and loop groups demonstrate that length and curvature are independent predictors of the log-transformed time. Generally, procedure times were extended with increasing file lengths and higher degrees of canal curvature.
Topics: Cone-Beam Computed Tomography; Dental Instruments; Dental Pulp Cavity; Humans; Retreatment; Root Canal Preparation
PubMed: 34000326
DOI: 10.1016/j.joen.2021.05.003 -
Clinical Oral Investigations Mar 2022This study aimed to investigate the anatomy of mandibular premolars from two perspectives-the canal configuration and radicular grooves-using cone-beam computed...
OBJECTIVES
This study aimed to investigate the anatomy of mandibular premolars from two perspectives-the canal configuration and radicular grooves-using cone-beam computed tomography (CBCT) in a large Korean population.
MATERIALS AND METHODS
CBCT images of mandibles acquired from March 2018 to December 2019 for dental treatment were randomly selected. In each image, the root canal of premolars was classified into 8 types according to the canal merging or diverging pattern and the number of apical foramens. The presence and the location of radicular grooves were also assessed. Statistical analysis was performed.
RESULTS
A total of 1463 first and 1448 s premolars from 732 patients (390 males, 342 females, mean age of 36.1 years) were evaluated. A single canal with one foramen predominated in both first (85.7%) and second (99.5%) premolars, while complete or partial multi-canals accounted for 14.3% and 0.5% of first and second premolars, respectively. The prevalence of radicular grooves was significantly higher in first premolars (13.2%) than in second premolars (0.5%) and in males (4.3%, n = 119) than in females (2.5%, n = 73).
CONCLUSIONS
Although most premolars were complete single canals, the first premolars showed a relatively higher number of complex canals compared to the second premolar. In addition, radicular grooves in mandibular premolars were significantly more common in male patients.
CLINICAL RELEVANCE
When planning the endodontic treatment of mandibular premolars, clinicians should be aware of their morphologic complexity, especially in the first premolar of male patients.
Topics: Adult; Bicuspid; Cone-Beam Computed Tomography; Dental Pulp Cavity; Female; Humans; Male; Mandible; Republic of Korea; Tooth Root
PubMed: 34846559
DOI: 10.1007/s00784-021-04313-9 -
European Endodontic Journal Jan 2024With the ever-increasing understanding of tooth anatomy, there is a renewed focus on the pulp chamber as an important component of the root canal system. For example,... (Review)
Review
With the ever-increasing understanding of tooth anatomy, there is a renewed focus on the pulp chamber as an important component of the root canal system. For example, the pulp chamber is of critical relevance during diagnostic procedures such as pulp sensibility tests, deep caries removal, vital pulp treatments, access cavity preparation, tooth whitening, tooth restoration as well as methods for examining the floor of the pulp chamber to aid the detection of root canal orifices or the presence of perforations and cracks. The more recent concept of minimal invasive endodontics has also created a need to understand better the anatomy of the pulp chamber. The purpose of this article is to discuss the research methods used to study pulp chamber anatomy and the significance of the pulp chamber in endodontic research and clinical practice. In addition, directions for future research are emphasised.
Topics: Dental Pulp Cavity; Root Canal Preparation; Endodontics; Root Canal Therapy; Tooth
PubMed: 37990569
DOI: 10.14744/eej.2023.76598 -
International Endodontic Journal Mar 2022It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal... (Review)
Review
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
Topics: Dental Pulp Cavity; Equipment Design; Models, Theoretical; Research Design; Root Canal Preparation; Root Canal Therapy
PubMed: 34800299
DOI: 10.1111/iej.13665 -
Internal morphology of distal roots of mandibular first molars revealed by computed microtomography.Australian Endodontic Journal : the... Sep 2023To evaluate the internal morphology of 100 distal roots of mandibular first molars using micro-CT. Teeth were scanned to characterise: Vertucci type, root length, canal...
To evaluate the internal morphology of 100 distal roots of mandibular first molars using micro-CT. Teeth were scanned to characterise: Vertucci type, root length, canal shape, presence and location of accessory canals, and the number of foramina at 4 mm from the apex, presence of root isthmus and the length from the primary canal to the apical foramen. Vertucci type I was found in 57% of cases, followed by V (27%). The most common cross-section 1 mm from the apex was oval (49%) and circular (38%). The average root length was 16.06 mm (16.61-19.02 mm). The mean foramen size was 0.32 and 0.53 mm for the minor and major diameters, respectively. The volume, surface area and SMI were 7.84 mm , 68.87 mm and 1.52 mm, respectively. Root isthmi were found in 47% of the samples, and the length mean from the primary canal to the apical foramen was 2,03 mm. The internal morphology of the distal roots of mandibular first molars may be complex and shows variations.
Topics: Mandible; Tooth Root; Tooth Apex; Dental Pulp Cavity; Molar; X-Ray Microtomography
PubMed: 36057963
DOI: 10.1111/aej.12682 -
BMC Oral Health Dec 2022The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel-titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper...
BACKGROUND
The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel-titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals.
METHODS
A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal-Wallis test (CT, SEM-score), the level of significance was set at α = 0.05.
RESULTS
There were no significant differences between the five systems regarding the AD, VI, and UTA parameters (P > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex (P < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending (P < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups (P < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds (P < 0.01 and P < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds.
CONCLUSION
The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.
Topics: Humans; Dental Pulp Cavity; Equipment Design; Molar; Root Canal Preparation; Smear Layer; Tooth Root; X-Ray Microtomography; Dental Instruments
PubMed: 36577985
DOI: 10.1186/s12903-022-02668-3