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BMC Oral Health May 2023A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars.
METHOD
An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types.
RESULTS
Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I = 86%) and Fan's isthmus (I = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively.
CONCLUSION
Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
Topics: Humans; X-Ray Microtomography; Tooth Root; Cone-Beam Computed Tomography; Molar; Dental Pulp Cavity; Mandible
PubMed: 37248469
DOI: 10.1186/s12903-023-03036-5 -
BMC Oral Health Oct 2023This study aimed to compare the shaping ability of different instruments, TruNatomy Glider (TRN-G), WaveOne Gold Glider (WOG-G), and ProGlider (Pro-G) using...
BACKGROUND
This study aimed to compare the shaping ability of different instruments, TruNatomy Glider (TRN-G), WaveOne Gold Glider (WOG-G), and ProGlider (Pro-G) using micro-computed tomography (micro-CT).
METHODS
The mesial canals of 27 mandibular molars with two separate mesial canals and moderate curvature were included in this study [n = 27 mesiobuccal (MB) and mesiolingual (ML) root canal]. According to the manufacturer's instructions, the glide path was created with TRN-G, WOG-G, and Pro-G glide path instruments (n = 9 MB and ML root canal in each group). Micro-CT scanning was performed before and after preparation. Mesiodistal (MD) and buccolingual (BL) transportation and the centering ratio were measured at three levels within the canal (3, 5 and 7 mm). A three-way robust ANOVA was used to compare the parameters.
RESULTS
TRN-G showed significantly greater transportation in the MD direction than the other instruments throughout the root canal (overall root canal) (p < 0.05). The best centering ability in the BL direction was shown by the WOG-G, regardless of level within the canal and canal distinction (MB vs. ML) (p < 0.05). There was no significant difference between groups according to the level within the canal and canal parameters (p > 0.05). Whether the root canal was MB or ML did not affect centering or transportation (p > 0.05).
CONCLUSIONS
Glide path instruments can be used to shape moderately curved canals with minimal apical transportation and better centering ability. All three tested glide path files can used safely before the shaping file.
Topics: Humans; X-Ray Microtomography; Root Canal Preparation; Tooth Root; Root Canal Therapy; Dental Pulp Cavity; Equipment Design
PubMed: 37875946
DOI: 10.1186/s12903-023-03529-3 -
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 -
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 -
Journal of Endodontics Jun 1993Apical surgery is known to be an effective and practical way of treating endodontic failures. However, in spite of seemingly proper root end management, surgical...
Apical surgery is known to be an effective and practical way of treating endodontic failures. However, in spite of seemingly proper root end management, surgical failures may occur as a result of lateral canal, dentinal tubule, end retrograde leakage. Since surgical retreatment of such failures would likely result in failure, the alternative of a nonsurgical retreatment should be carefully considered. An understanding of the relationship which exists between the quality of the orthograde treatment and the surgical prognosis is necessary to properly direct the course of treatment.
Topics: Adult; Apicoectomy; Dental Fistula; Dental Pulp Cavity; Female; Humans; Middle Aged; Patient Care Planning; Prognosis; Reoperation; Retrograde Obturation; Root Canal Therapy; Treatment Failure
PubMed: 8228752
DOI: 10.1016/s0099-2399(06)80462-0 -
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 -
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 -
Stomatologija 2008A traditional concept is that apical periodontitis is the result of pathogenic effects of the microorganisms colonizing the root canal system and the response of the... (Review)
Review
A traditional concept is that apical periodontitis is the result of pathogenic effects of the microorganisms colonizing the root canal system and the response of the host defence system. The composition of the microflora of root canals differs in primary endodontic treatment and retreatment cases. Persistent disease in the periapical region after root canal treatment presents a more complex situation as it was thought earlier. Scientific evidence indicates that unsatisfactory outcome of cases in which treatment has followed the highest technical standards mainly is associated with microbial factors, comprising extraradicular and/or intraradicular infections.
Topics: Bacteria; Dental Pulp Cavity; Humans; Periapical Periodontitis; Root Canal Therapy; Treatment Outcome
PubMed: 18493159
DOI: No ID Found -
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 -
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