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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 -
Brazilian Dental Journal 2023This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation....
This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation.
Topics: Dental Pulp Cavity; Root Canal Preparation; Root Canal Therapy; X-Ray Microtomography; Gold
PubMed: 37194855
DOI: 10.1590/0103-6440202305231 -
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 -
Journal of Endodontics Oct 2023This laboratory study aimed to evaluate the accumulated hard tissue debris (AHTD) and shaping performance following root canal instrumentation with a novel stainless...
INTRODUCTION
This laboratory study aimed to evaluate the accumulated hard tissue debris (AHTD) and shaping performance following root canal instrumentation with a novel stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with two single-file nickel-titanium instruments of different kinematics through micro-computed tomography (micro-CT) analysis.
METHODS
Thirty isthmus-containing mesial roots of human mandibular molars with a curvature of 15°-35° were scanned with micro-CT at an isotropic resolution of 12 μm and randomly assigned to three groups (n = 10) according to the instruments used for canal preparation: Gentlefile (GF; #23/.04), One Curve (OC; #25/.06; Micro-Mega, Besancon, France), and Reciproc Blue R25 (RB; #25/.08; VDW, Munich, Germany). The AHTD, unprepared canal surface area, volume changes, surface area changes, and transportation were evaluated by comparing preoperative and postoperative micro-CT images. In addition, the time required for canal preparation was recorded. Data were statistically analyzed using the one-way analysis of variance (ANOVA) test or the Kruskal-Wallis test at a significance level of 5%.
RESULTS
No significant differences were observed in the percentage of AHTD or in the unprepared canal surface area between the three groups (P > .05). The RB group demonstrated a significantly greater percentage increase in volume and surface area than the GF group (P < .05). The GF and OC groups showed significantly less transportation at 3 mm from the apex than the RB group (P < .001). The OC group required significantly less time for instrumentation than the RB and GF groups (P < .05).
CONCLUSIONS
Instrumentation with GF (#23/.04), OC, and RB yielded similar levels of AHTD and unprepared surface area in isthmus-containing curved canals. GF achieved this with less dentin removal and apical transportation, at the expense of a longer preparation time.
Topics: Humans; Dental Pulp Cavity; X-Ray Microtomography; Root Canal Preparation; Tooth Root; Molar; Equipment Design
PubMed: 37516238
DOI: 10.1016/j.joen.2023.07.019 -
BMC Oral Health Jul 2022The mandibular second molars demonstrate variations on root and canal morphology. The aim of this study was to investigate all the root canal morphology of mandibular...
BACKGROUND
The mandibular second molars demonstrate variations on root and canal morphology. The aim of this study was to investigate all the root canal morphology of mandibular second molars and analyze the morphological variations in patients by gender and age in a Chinese population use CBCT imaging.
METHODS
Cone-beam computed tomographic images of 1200 bilateral mandibular second molars were obtained from 600 patients (300 females and 300 males) who required a preoperative assessment for implant surgery, surgical removal of impacted teeth, orthodontic treatment, surgery of maxillofacial tumour and cysts or LeFort I osteotomy. CBCT images were divided into 5 groups according to age: "15-24 years", "25-34 years", "35-44 years", "45-54 years" and "≥ 55 years"; and 2 groups by gender: "females" and "males". The following information were recorded: the number of roots and canals and their morphology, the frequency and configuration of C-shaped canals by gender, age and position (left and right). The chi-square test was used to analyse differences between groups. P value of < 0.05 was considered statistically significant.
RESULTS
Of the 1200 teeth, 61% had two separate roots located mesiodistally, 35.6% had one C-shaped root. The 45.3% teeth had three canals in two-rooted mandibular second molars. The mesial root showed a Vertucci type II configuration in 28.9% cases followed by type IV(24.4%). While the distal root showed a significant higher prevalence of type I configuration in 95.6%. In the examined 1200 teeth, 430 teeth (35.8%) had C-shaped root canals. The prevalence of C-shaped root canal systems was significantly higher in females (42.5%) than in males (29.1%) (P = 0.000), and did not differ with age (P = 0.126). The 80.4% C-shaped canals were bilateral (P = 0.000) and did not differ with side (left and right) (P = 0.758).
CONCLUSIONS
The most commonly observed root morphology for the mandibular second molars was 2 separate roots with three canals.The prevalence of C-shaped root canal is 35.8% and is more higher in females than in males.
Topics: Adolescent; Adult; China; Cone-Beam Computed Tomography; Dental Pulp Cavity; Female; Humans; Male; Mandible; Molar; Young Adult
PubMed: 35790917
DOI: 10.1186/s12903-022-02299-8 -
European Endodontic Journal Jun 2022The 'glide path' in non-surgical root canal treatment refers to a smooth radicular tunnel from the root canal orifice to its terminus. Its establishment is aimed at... (Review)
Review
The 'glide path' in non-surgical root canal treatment refers to a smooth radicular tunnel from the root canal orifice to its terminus. Its establishment is aimed at creating sufficient space to facilitate the subsequent and safer use of engine-driven nickel titanium (NiTi) shaping files. Glide paths were originally prepared using stainless steel hand files to, at least, a loose International Organisation for Standardisation (ISO) size 10 or larger. However, the advent of engine-driven NiTi instrumentation has led to the availability of many engine-driven NiTi glide path files. The aims of this review were to assess the effects of engine-driven and manual glide path preparation (GPP) on root canal shaping procedures and outcomes. An online search of the PubMed, Embase, Scopus and ScienceDirect databases was conducted and 32 studies were identified. The published literature suggests the use of engine-driven glide path files to be beneficial in maintaining the original root canal anatomy, reducing preparation time, decreasing apical extrusion of debris and causing less postoperative pain. However, there was no difference between engine-driven and manual GPP with regards to the physical strain exerted on the shaping files. Future research focused on clinical outcomes is needed to help ascertain the clinical benefits for patients.
Topics: Dental Pulp Cavity; Humans; Molar; Root Canal Preparation; Root Canal Therapy; Stainless Steel
PubMed: 35786583
DOI: 10.14744/eej.2022.97659 -
Brazilian Dental Journal 2020This study evaluated by micro-computed tomography (μCT) the filling ability in curved root canals, besides the flow of AH Plus (AHP) and Neo MTA Plus (NMTAP) sealers...
This study evaluated by micro-computed tomography (μCT) the filling ability in curved root canals, besides the flow of AH Plus (AHP) and Neo MTA Plus (NMTAP) sealers using different methodologies. Mandibular molars mesial roots with two root canals and degree of curvature between 20° and 40° were selected. The specimens were prepared with the ProDesign R system up to size 35.05 and were filled with the sealers by a continuous wave of condensation technique, Thermo Pack II (n=12). The teeth were scanned using μCT after root canal preparation and obturation. The volumetric percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 (n=10). Flow and filling were also evaluated in μCT using a glass plate with a central cavity and four grooves from the central cavity (n=6). Flow was linearly calculated into the grooves. The central cavity filling (CCF) and lateral cavity filling (LCF) were calculated in mm³. Data were submitted to non-paired t test with a significance threshold at 5%. The percentage of filling and voids between the root canals filled with AHP or NMTAP was similar (p>0.05). NMTAP presented the lowest flow in conventional test (p<0.05). Using μCT, sealers had similar CCF, LCF and linear flow (p>0.05). In conclusion, NMTAP and AHP had similar filling ability in curved mesial root canals of mandibular molars without presence of isthmus. Although AHP presented better flow than NMTAP using ISO methodology, there was no difference between these materials regarding volumetric filling when evaluated by μCT.
Topics: Dental Pulp Cavity; Gutta-Percha; Root Canal Filling Materials; Root Canal Obturation; Root Canal Preparation; X-Ray Microtomography
PubMed: 33146333
DOI: 10.1590/0103-6440202003328 -
Indian Journal of Dental Research :... 2022To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone-beam computed tomography (CBCT).
OBJECTIVES
To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone-beam computed tomography (CBCT).
METHODS
A retrospective cross-sectional study was performed, where CBCT scans of children less than 10 years of age taken for valid diagnostic purposes previously were considered and images were analyzed. The number of roots, root canals, and variations in morphology were recorded. Left-right symmetry was also noted.
RESULTS
A total of 433 deciduous maxillary and mandibular primary molars were studied. It was observed that two separate roots with three separate canals were common in primary mandibular first molars, whereas two separate roots with two canals in each root were common in mandibular second primary molars. In primary maxillary molars, three separate roots with one canal each were the most common. Maxillary first molars (17.21%) and 17.35% second molars had fused distobuccal and palatal roots. It was observed that primary maxillary molars showed more left-right symmetry (86.7% in first molars and 82.7% in second molars) compared to primary mandibular molars (54.05% in first molars and 68% in second molars).
CONCLUSIONS
It was concluded that in both primary maxillary first and second molars, three separate roots, a mesiobuccal root, a distobuccal root, and a palatal root with one canal in each root, were the most common. Two separate roots with three separate canals were the most common in primary mandibular first molars, whereas two separate roots with two canals each in both roots were more common in mandibular second primary molars.
Topics: Child; Cone-Beam Computed Tomography; Cross-Sectional Studies; Dental Pulp Cavity; Humans; Molar; Retrospective Studies; Spiral Cone-Beam Computed Tomography; Tooth Root
PubMed: 35946238
DOI: 10.4103/ijdr.IJDR_748_20 -
Scientific Reports Dec 2021Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change...
Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.
Topics: Adolescent; Adult; Aged; Anatomic Variation; Cone-Beam Computed Tomography; Dental Pulp Cavity; Female; Humans; Male; Mandible; Middle Aged; Molar; United Arab Emirates
PubMed: 34903785
DOI: 10.1038/s41598-021-03329-1