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Australian Endodontic Journal : the... Aug 2023This study aimed to determine the prevalence of pulp canal obliteration (PCO) and its association with periapical pathology (Hypodense areas) in cone-beam computed...
This study aimed to determine the prevalence of pulp canal obliteration (PCO) and its association with periapical pathology (Hypodense areas) in cone-beam computed tomography (CBCT) scans of anterior teeth. A total of 2161 CBCT scans from patients 18 years or older taken between 2000 and 2020 were selected. Patient-, tooth- and scan-related data were registered. Two calibrated evaluators recorded the number of teeth with PCO ≥4 mm in the cervical third of the roots and the presence or absence of periapical hypodensities (PH). The length of the root canal that was calcified was also determined. Logistic regression analysis was used to determine whether any of the recorded factors influenced the presence of PCO and the presence of periapical pathology in teeth presenting with PCO. The only factor significantly related to the presence of PCO was patient age. The prevalence of PH in teeth exhibiting PCO was 10%.
Topics: Humans; Dental Pulp Cavity; Prevalence; Spiral Cone-Beam Computed Tomography; Root Canal Therapy; Dental Pulp Diseases; Cone-Beam Computed Tomography
PubMed: 35877115
DOI: 10.1111/aej.12669 -
Journal of Dentistry Sep 2023For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods...
OBJECTIVES
For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods rely on subjective observations of root canal exudates. This study aimed to confirm whether real-time optical detection using bacterial autofluorescence can evaluate endodontic infection status by assessing the red fluorescence (RF) detected from root canal exudates.
METHODS
During RCT, endodontic paper points were used to collect root canal exudates scored using conventional organoleptic tests to assess the severity of root canal infections. RF on the paper points was assessed using quantitative light-induced fluorescence (QLF) technology. RF intensity and area from the paper points were quantified, and their correlations with infection severity were assessed using their organoleptic scores. The oral microbiome composition of RF samples was compared with non-red fluorescent (non-RF) samples.
RESULTS
The RF detection rate was nil and >98% in the non-infectious and severe groups. The RF intensity and area significantly increased with infection severity (p<0.001) and showed strong correlations with organoleptic scores (r=0.72, 0.82, respectively). The diagnostic accuracy for detecting root canal infection using RF intensity was good to excellent (AUC = 0.81-0.95) and increased with infection severity. The microbial diversity of the RF samples was significantly lower than that of the non-RF samples. Gram-negative anaerobic bacteria such as Prevotella and Porphyromonas were more predominant in RF samples.
CONCLUSIONS
Optical detection using bacterial autofluorescence can objectively evaluate endodontic infection status in real-time by assessing the RF of endodontic root canal exudates.
CLINICAL SIGNIFICANCE
This real-time optical technology can be utilised to detect endodontic bacterial infection without conventional incubation, allowing clinicians to determine the endpoint of chemomechanical debridement and increase the positive outcomes of RCTs.
Topics: Bacteria; Root Canal Therapy; Dental Pulp Cavity
PubMed: 37392816
DOI: 10.1016/j.jdent.2023.104600 -
Clinical Oral Investigations Nov 2020To assess the internal and external morphologies of the mesiobuccal (MB) root of maxillary molars presenting a third root canal (MB3), using micro-computed tomography...
OBJECTIVES
To assess the internal and external morphologies of the mesiobuccal (MB) root of maxillary molars presenting a third root canal (MB3), using micro-computed tomography (micro-CT).
MATERIAL AND METHODS
Two-hundred and sixty-five extracted maxillary first and second molars with different root configurations were imaged in a micro-CT scanner at 19.6-μm pixel size. Sixteen teeth presenting MB3 canal were selected and evaluated regarding root configuration, minimal dentine thickness 2 mm under the furcation area, canal configuration of the MB root, MB3 canal morphology (location, independent or confluent orifice, and anatomy types), and the apical anatomy (aspect ratio, number of accessory canals and foramina, presence of isthmus, and independent MB3 foramen).
RESULTS
Overall, a high variability in canal configuration was detected in the MB root. MB3 canal was observed in 10 maxillary first molars and 6 maxillary second molars (n = 16). Minimal dentine thickness related to the MB3 canal at the coronal third was smaller than that of the MB1 canal. A complex internal anatomy comprising 13 different root canal configurations was observed. A high number of independent MB3 orifices at the pulp chamber floor was observed in the first molars (7 out of 10 teeth), while most of the specimens (n = 14) showed a confluent anatomy of the MB3 canal. A varied number of accessory canals and foramina were observed. At the apical third, isthmus could be observed in 6 specimens, while an independent MB3 foramen was present in 37.5% of the MB roots.
CONCLUSIONS
MB3 canal is a rare anatomical variation present in maxillary first and second molars. Its presence can be associated to a complex internal anatomy of the MB root which includes the presence of isthmuses and multiple accessory canals and foramina at the apical third, but also a thin dentine thickness at the coronal third and a confluent anatomy of the MB3 with the other main canals.
Topics: Dental Pulp Cavity; Maxilla; Molar; Tooth Root; X-Ray Microtomography
PubMed: 32382930
DOI: 10.1007/s00784-020-03284-7 -
Journal of Endodontics Sep 2023This study aimed to compare the effectiveness of a dynamic navigation system and a three-dimensional microscope in retrieving broken rotary Nickel-Titanium files when...
INTRODUCTION
This study aimed to compare the effectiveness of a dynamic navigation system and a three-dimensional microscope in retrieving broken rotary Nickel-Titanium files when using trepan burs and the extractor system.
MATERIALS AND METHODS
Thirty maxillary first bicuspids with 60 separate roots were split into 2 comparable groups based on a comprehensive cone beam computed tomography analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated Nickel-Titanium rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time, and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05.
RESULTS
The microscope-guided group had a higher success rate than the dynamic navigation system guidance, but the difference was insignificant (P > .05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, shorter time to retrieve the fragments and less change in the root canal volume (P < .05).
CONCLUSION
Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.
Topics: Titanium; Nickel; Dental Pulp Cavity; Root Canal Preparation
PubMed: 37393950
DOI: 10.1016/j.joen.2023.06.014 -
BMC Oral Health Jul 2022Relatively high incidence of single canals with oval or round shape were observed in human mandibular incisors. In order to investigate the influence of the root canal...
BACKGROUND
Relatively high incidence of single canals with oval or round shape were observed in human mandibular incisors. In order to investigate the influence of the root canal morphology on root canal preparation, the shaping outcome of ProTaper NEXT in oval and round canals of mandibular incisors were evaluated by using micro-computed tomography (micro-CT) analysis.
METHODS
This experiment was approved by the School Medical Ethics Committee. The sample size calculation was conducted using G*Power software. Intact mandibular incisors with a single canal were selected. Oval canals (2 < aspect ratio (AR) ≤ 4) and round canals (AR ≤ 2) were pair-matched according to canal length, and assigned to two experimental groups (13 per group). ProTaper NEXT was used for root canal preparation for both groups. Untouched canal wall (UCW), root canal morphological parameters and three-dimensional (3D) dentin thickness were evaluated in the entire root canal and each canal third after micro-CT scanning.
STATISTICAL ANALYSIS
Data were collected and analyzed with Mann-Whitney test and Friedman test using SPSS statistics software 25 (P < 0.05). Additionally, correlations of UCW area with canal morphological parameters were also investigated.
RESULTS
After root canal preparation, no significant difference was observed in all analyzed parameters in the apical third between oval and round canal groups (P > 0.05). In the coronal two thirds of the canal, the post-operative structure model index (SMI), form factor and roundness were significantly increased, while the AR was significantly decreased in both groups (P < 0.05). In addition, in the coronal two thirds, significantly more UCW and higher UCWΔ% was observed in oval canal group (P < 0.05). Furthermore, UCW correlated very strongly to canal major diameter (0.924) and initial volume (0.938), and strongly to canal form factor (- 0.724), minor diameter (0.799) and canal area (0.882). Proximal dentin wall was associated with significantly thinner pre-operative dentin thickness and higher amount of dentin removal after root canal preparation in both oval and round canal groups.
CONCLUSIONS
(1) Both types of canals were more conical after root canal preparation, but oval root canals tend to leave more UCW area than round canals in the coronal two thirds of mandibular incisors, which contributes to the challenge for endodontic infection control. (2) Root canal preparation usually results in excessive dentin removal in the proximal dentin wall comparing with buccal and lingual walls in both types of canals of mandibular incisors.
Topics: Dental Pulp Cavity; Humans; Incisor; Molar; Root Canal Preparation; X-Ray Microtomography
PubMed: 35869473
DOI: 10.1186/s12903-022-02335-7 -
TheScientificWorldJournal 2021Successful endodontic treatment depends on cleaning and disinfecting the root canals, in order to provide conditions for three-dimensional filling, which should prevent... (Review)
Review
Successful endodontic treatment depends on cleaning and disinfecting the root canals, in order to provide conditions for three-dimensional filling, which should prevent root canal reinfection. However, anatomical complexities pose a challenge during endodontic treatment. The present study was a literature review carried out in the following databases: PubMed, SciELO, and MEDLINE, which were searched for articles published from 2017 to 2021. Micro-CT studies published in English, which analysed the capacity for preparation of oval and long-oval root canals, were included. The following keywords were used: "oval-shaped canals," "long-oval-shaped canals," "endodontics," and "micro-CT." The aim of this study was to carry out a literature review of micro-CT studies on the scope of the capacity for preparation performed in oval and long-oval root canals with rotary and reciprocating instruments.
Topics: Dental Instruments; Dental Pulp Cavity; Equipment Design; Humans; Root Canal Preparation; X-Ray Microtomography
PubMed: 34475808
DOI: 10.1155/2021/5330776 -
Quintessence International (Berlin,... Jan 2022The purpose of this study was to evaluate the root canal shaping abilities of different heat-treated NiTi engine--driven single files. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The purpose of this study was to evaluate the root canal shaping abilities of different heat-treated NiTi engine--driven single files.
METHOD AND MATERIALS
A total of 45 mandibular first molar teeth with a root canal curvature of between 25 and 35 degrees were selected for this in vitro study. The mesial roots were separated and scanned with micro-CT. The specimens were randomly divided into three groups. Root canal preparations were performed using HyFlex EDM OneFile in Group 1; OneCurve (25/06) in Group 2, and WaveOne Gold Primary in Group 3. Root canals were scanned again with micro-- CT after root canal preparation. Apical transportation value and centering ability ratio of files were evaluated using the preinstrumentation and postinstrumentation micro-CT images at 1, 2, 3, 4, and 7 mm. The data were statistically analyzed using the Kruskal-Wallis test. The Bonferroni-Dunn test was used for multiple comparisons. The level of statistical significance was set at P < .05.
RESULTS
There was no significant difference between the apical transportation values of experimental groups in mesiodistal direction (P > .05) and buccolingual direction (P > .05). The OneCurve file group showed better centering ability in the buccolingual direction than the WaveOne Gold file group at 4 mm (P = .048). The difference between the centering ability values of experimental groups was not significant at other levels (P > .05).
CONCLUSION
According to the results of this study, all tested single files caused apical transportation and showed similar centering ratio at most of the root sections.
Topics: Dental Pulp Cavity; Equipment Design; Hot Temperature; Humans; Molar; Root Canal Preparation; X-Ray Microtomography
PubMed: 34595903
DOI: 10.3290/j.qi.b2091311 -
Australian Endodontic Journal : the... Sep 2023To study the anatomical characteristics of the root and root canal system of the mandibular second molars in the population of Gansu province, and to provide theoretical...
To study the anatomical characteristics of the root and root canal system of the mandibular second molars in the population of Gansu province, and to provide theoretical and clinical references for improving the success rate of root canal therapy (RCT) of mandibular second molars. The number of roots and root canals, root canal type and pulp chamber height of mandibular second molars were determined by observing cone-beam computed tomography (CBCT) images of people living in Gansu. The most common type of mandibular second molars in the Gansu province population was a double root with three root canals (47.55%), followed by a C-shaped root (35.56%). There were more females than males with a C-shaped root (p < 0.05). The most common root canal subtype of the C-type root was C3 (13.91%). Most of the population (77.11%) had bilateral mandibular second molars with symmetrical root canal morphology. With an increase in age, the height of the pulp chamber decreased significantly. The incidence of root canal variation of the mandibular second molars is relatively high in the population of Gansu province. Preoperative examination with CBCT is essential for mandibular second molars that need RCT to avoid root canal treatment failure and decrease the occurrence of postoperative pain as much as possible.
Topics: Male; Female; Humans; Dental Pulp Cavity; Spiral Cone-Beam Computed Tomography; Tooth Root; Mandible; Molar; Root Canal Therapy; Cone-Beam Computed Tomography
PubMed: 36125937
DOI: 10.1111/aej.12692 -
Clinical Oral Investigations Dec 2019This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVES
This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation.
MATERIALS AND METHODS
Mesial root canals of mandibular molars with severe curvature (25-70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%).
RESULTS
The micro-CT method showed that XPS's shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023).
CONCLUSIONS
Micro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups.
CLINICAL RELEVANCE
Root canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.
Topics: Dental Pulp Cavity; Equipment Design; Humans; Molar; Radiography, Dental, Digital; Root Canal Preparation; Switzerland; Tooth Root; X-Ray Microtomography
PubMed: 30834991
DOI: 10.1007/s00784-019-02870-8 -
Critical Reviews in Microbiology Mar 2020Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as... (Review)
Review
Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as it is commonly known is founded on the ability to eradicate microbial biofilm infection and prevent re-infection of the highly complex root canal space. Despite many "advances" in clinical endodontics we have seen little improvement in outcomes. The aim of this critical review paper is to provide a contemporary view of endodontic microbiology and biofilm polymicrobiality, provide an understanding of the host response, and how together these impact upon clinical treatment. Ultimately, it is intended to provide insight into novel opportunities and strategies for the future diagnostics, treatment, and prevention of endodontic disease.
Topics: Animals; Bacteria; Bacterial Infections; Bacterial Physiological Phenomena; Biofilms; Dental Pulp Cavity; Dental Pulp Diseases; Endodontics; Humans
PubMed: 32233822
DOI: 10.1080/1040841X.2020.1739622