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Clinical Oral Investigations May 2017Narrowed radicular pulp spaces are frequently observed in teeth wearing extended restorations. The present study investigates whether the narrowing of particularly the... (Comparative Study)
Comparative Study
OBJECTIVES
Narrowed radicular pulp spaces are frequently observed in teeth wearing extended restorations. The present study investigates whether the narrowing of particularly the radicular pulp space can be attributed to coronal restorations.
MATERIALS AND METHODS
The study is based on an anonymized copy of the cone-beam computed tomography (CBCT) database from the Center of Dental Medicine of the University of Zurich. One hundred CBCT scans were selected out of 7317 data sets to match either a crowned (group A; n = 50) or a filled tooth (group B; n = 50) with a contralateral healthy, unrestored, and caries-free control tooth at the same position, respectively. Cross-sectional images were adjusted in the coronal, middle, and apical root third of each subjected tooth. Screenshots were taken in that position and analyzed. The area occupied by the pulp space was determined as percentage area of the whole root diameter on each cross section. The resulting values were compared between restored and control teeth.
RESULTS
In both groups (crowned and filled teeth) and in all the three root thirds, the radicular pulp space was significantly narrower in the restored teeth compared to the control teeth. The strongest narrowing effect was observed in the coronal root third and it decreased towards the apical root third (both groups).
CONCLUSIONS
Teeth with coronal restorations show within the limitations of the present study a significant narrowing of their radicular pulp space.
CLINICAL RELEVANCE
The asserted narrowing could have a complicating effect if root canal treatment becomes necessary in those teeth.
Topics: Cone-Beam Computed Tomography; Crowns; Dental Pulp Cavity; Dental Restoration, Permanent; Humans; Radiographic Image Interpretation, Computer-Assisted; Software; Tooth Root
PubMed: 27394425
DOI: 10.1007/s00784-016-1899-8 -
PeerJ 2022Mandibular molars are multi-rooted teeth with a complex and strenuous root canal anatomy. Because there is relatively negligible literature describing the pulp chamber...
The morphology of the pulp chamber floor of permanent mandibular first and second molars in an Indian subpopulation-a descriptive cross-sectional study employing Pawar and Singh classification.
BACKGROUND
Mandibular molars are multi-rooted teeth with a complex and strenuous root canal anatomy. Because there is relatively negligible literature describing the pulp chamber floor anatomy, predicting the exact anatomical layout and its variations is daunting. A thorough comprehension and knowledge of the same is required for efficacious endodontic treatment consequence. The purpose of this study was to characterise and ascertain the pulp chamber floor anatomy of permanent mandibular first (ManFMs) and second (ManSMs) molars in an Indian population.
METHODS
On 2,134 extracted human mandibular first (ManFMs = 1,067) and second molars (ManSMs = 1,067), a descriptive cross-sectional investigation was executed. Cleaning and removal of hard and soft tissue debris were performed, followed by flattening the anatomical crown until the pupal architecture was uncovered. A stereomicroscope with a magnification of 4.5 magnification was used to investigate the pulpal anatomy. Statistical analysis was carried out using chi square test, with 95% confidence intervals and a value of 0.05 considered statistically significant.
RESULTS
The majority of the ManFMs showed presence of three canal orifices in 57.73%, followed by four orifices 31.31%, five orifices 8.81%, and six orifices 2.15%. For ManSMs, majorly three orifices were found in 39.83% specimens, followed by two orifices in 37.39%, four orifices in 16.31%, and single root canal orifice was observed in 6.47%. The mesio-buccal, mesio-lingual, disto-buccal, disto-lingual canal orifices exhibited round and oval shapes in both ManFMs and ManSMs. The shape was predominantly oval with a single distal canal orifice (84.25% ManFMs and 74.16% ManSMs). In ManSMs, among the single root canal orifice, 66.66% were round in shape and 33.34% were C-shaped. In ManSMs with two root canal orifices, mesially 79.44% exhibited oval and 20.56% round shape. Distally, 74.16% were oval and 25.84% were round. The shapes of the access cavities for ManFMs were rectangular in 46.67% and triangular in 53.33%. For the ManSMs, the access cavities were triangular in 39.83%, rectangular in 16.31% and non-classified (others) in 43.86% of specimen. In both ManFMs and ManSMs, the pulp chamber floor morphology was predominately Y shaped (57.73% and 39.83%) according to the Pawar and Singh classification© of pulp chamber floor anatomy.
CONCLUSION
Our study indicated that the orifices on the pulp chamber floor are arranged in a typical manner, supporting the proposed categorization. Furthermore, description of the anatomical patterns of the pulp chamber guides the clinicians in chair-side treatment decisions.
Topics: Humans; Asian People; Cross-Sectional Studies; Dental Pulp Cavity; Molar; Tooth Root; India
PubMed: 36518276
DOI: 10.7717/peerj.14392 -
Scanning 2018The purpose of this study was to analyze various characteristics and classification of C-shaped root canals and evaluate the causes of endodontic failure of C-shaped...
The purpose of this study was to analyze various characteristics and classification of C-shaped root canals and evaluate the causes of endodontic failure of C-shaped root canals by examining the resected root surface with an endodontic microscope and a scanning electron microscope (SEM). Forty-two teeth with C-shaped root canals were included in this study and had undergone intentional replantation surgery. Before surgery, periapical radiography and cone-beam computed tomography were taken. The root canal configuration was analyzed and classified according to Melton's classification at coronal and apical level. After injection of 1 : 100,000 epinephrine with 2% lidocaine, the tooth was carefully extracted. After the root-end resection, the resected root surface was examined using an operating microscope and SEM. Mandibular second molars were most frequently involved teeth (90.4%). The most frequently observed root canal configurations were C1 at the coronal level (45.2%) and C3 at the apical 3 mm level (45.2%). The most common cause of failure for a C-shaped root canal treatment was a leaky canal (45.2%), followed by an isthmus (23.8%), missing canal, overfilling, and iatrogenic problems. In conclusion, C-shaped root canals were most frequently found in mandibular second molars. The most common cause of failure was a leaky canal and isthmus.
Topics: Adult; Cone-Beam Computed Tomography; Dental Pulp Cavity; Epinephrine; Female; Humans; Lidocaine; Male; Mandible; Middle Aged; Molar; Root Cause Analysis; Tooth Replantation; Tooth Root; Treatment Failure
PubMed: 30595786
DOI: 10.1155/2018/2516832 -
Indian Journal of Dental Research :... 2021To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning.
OBJECTIVE
To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning.
MATERIALS AND METHODS
Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment.
RESULTS
The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal-Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05.
CONCLUSION
Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS.
Topics: Calcium Compounds; Dental Pulp Cavity; Epoxy Resins; Root Canal Filling Materials; Silicates; X-Ray Microtomography
PubMed: 34269242
DOI: 10.4103/ijdr.IJDR_328_20 -
BMC Oral Health Jun 2024The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs).
METHODOLOGY
A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR).
RESULTS
Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs.
CONCLUSIONS
The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
Topics: Humans; Cone-Beam Computed Tomography; Bicuspid; Tooth Root; Dental Pulp Cavity
PubMed: 38835024
DOI: 10.1186/s12903-024-04419-y -
Acta Odontologica Latinoamericana : AOL Jun 2018The aim of the present study was to investigate the shaping abilities of XP Shaper and compare it with other single file rotary NiTi systems utilizing full rotation and... (Comparative Study)
Comparative Study
The aim of the present study was to investigate the shaping abilities of XP Shaper and compare it with other single file rotary NiTi systems utilizing full rotation and reciprocation motion, by cone beam computed tomography. Mesiobuccal canals of forty-five mandibular first molars, were allocated into three equal groups (n=15) according to the rotary system applied; WaveOne, OneShape and XP shaper. Pre-and post-instrumentation images were obtained at 3mm, 5mm and 7mm from the apex using cone beam computed tomography and assessed to determine canal transportation and centering ability. Data were analyzed using Kruskal-Wallis test to compare the three systems and Friedman's test to compare the root levels. Results showed that WaveOne and OneShape rotary systems produced greatest mean transportation with no statistically significant difference between them, while XP Shaper produced the lowest statistically significant mean transportation. Canal centering ability differed significantly among the three systems used. It was concluded that XP shaper preserved the original canal anatomy better than WaveOne and OneShape rotary systems.
Topics: Cone-Beam Computed Tomography; Dental Pulp Cavity; Equipment Design; Humans; In Vitro Techniques; Nickel; Root Canal Preparation; Titanium
PubMed: 30056469
DOI: No ID Found -
Journal of Oral Science Dec 2014Effective decontamination of root canal systems is a constant concern in clinical practice. In this article, we compare the performance of photodynamic therapy (PDT) and... (Comparative Study)
Comparative Study Review
Effective decontamination of root canal systems is a constant concern in clinical practice. In this article, we compare the performance of photodynamic therapy (PDT) and sodium hypochlorite (NaOCl) in reducing the amount of Enterococcus faecalis in root canals. Relevant studies were identified by searching electronic databases, including Web of Science, PubMed, BVS (Medline, Scielo, Lilacs and BBO), Scopus, and Cochrane, and by manually searching the references of identified studies. The terms used in the literature search were "photodynamic therapy" and "Enterococcus faecalis". We selected 13 experimental studies that exclusively assessed the performance of PDT in reducing E. faecalis in root canals of human teeth. In an evaluation of methodological quality, 12 articles were classified as moderate-quality reports and 1 as a high-quality report. No article needed to be excluded because of low-quality methodology. The results showed that PDT had a better antimicrobial effect when used as an adjuvant endodontic treatment to NaOCl. However, this finding should be carefully interpreted, as there are few relevant studies and the methods of the selected studies varied.
Topics: Anti-Bacterial Agents; Bacterial Load; Dental Pulp Cavity; Enterococcus faecalis; Humans; Photochemotherapy; Root Canal Irrigants; Sodium Hypochlorite
PubMed: 25500925
DOI: 10.2334/josnusd.56.277 -
BMC Oral Health Nov 2021Various systems of nickel-titanium (NiTi) instrument have long been commercially available. However, the preparation of narrow and curved root canals has always been...
BACKGROUND
Various systems of nickel-titanium (NiTi) instrument have long been commercially available. However, the preparation of narrow and curved root canals has always been challenging. The purpose of this study was to compare the shaping ability of two NiTi systems (2Shape and NeoNiTi) in severely curved root canals with different morphological patterns using micro-computed tomography (Micro-CT).
METHODS
A total of 22 human extracted permanent teeth of mandibular first molars, with the exact mesial angle of curvature of 25 and 35 degrees, according to Schneider's technique, were distributed randomly into two groups (group I: 2Shape, group II: NeoNiTi) based on the rotary system used (n = 22). The groups were subdivided into two subgroups corresponding to the angle of canal curvature (25° and 35°) (n = 11). Canals were scanned using Micro-CT pre- and post-preparation to assess the volume of dentin removed; canal transportation; and canal centering ratio at 3, 6, and 9 mm from the apex. The Mann-Whitney U test was utilized to determine any significant differences between the two systems. The level of statistical significance was set at p < 0.05.
RESULTS
There was no significant difference between the two groups in volume of dentin removed; canal transportation; and centering ability for 25° and 35° canal curvatures at 3, 6, and 9 mm from the apex (coronal, middle, and apical) thirds (p > 0.05). At the middle third, the NeoNiTi group demonstrated a statistically significant increase in volume of dentin removed for 35° canal curvatures compared to the 2Shape group.
CONCLUSION
Within the limitation of our in vitro study, 2Shape and NeoNiTi systems with severely curved canals were confirmed to be relatively safe in preparation and to respect original canal anatomy. Nevertheless, NeoNiTi instruments produced more centered preparation and minimal canal deviation compared to the 2Shape system.
Topics: Dental Alloys; Dental Pulp Cavity; Dentin; Equipment Design; Humans; Root Canal Preparation; Titanium; X-Ray Microtomography
PubMed: 34798874
DOI: 10.1186/s12903-021-01961-x -
Journal of Oral Science Jul 2022This study investigated the root and canal morphology of the permanent anterior dentition in a Black South African population.
PURPOSE
This study investigated the root and canal morphology of the permanent anterior dentition in a Black South African population.
METHODS
In total 2,343 permanent anterior teeth were evaluated using cone-beam computed tomography images and described according to the Vertucci and Ahmed et al. classifications. Demographic information, root number and internal canal morphology were recorded. Age and sex associations were made using Fisher's exact test (P < 0.05).
RESULTS
All anterior teeth were single-rooted (100%). The most frequent configuration in maxillary anteriors was a single canal (Vertucci Type I/MXA). In mandibular anteriors, single canal configurations (Type I/MDA) predominated, however 36.6% of mandibular central and 33.9% of lateral incisors displayed two canals. Older subjects (>40 years) demonstrated single canals more than younger subjects (P = 0.0004). Females displayed variations more compared to males (P = 0.002). The two classifications were found to be comparable for evaluation of permanent anterior teeth. Complex configurations were better described using the newer system.
CONCLUSION
The permanent anterior teeth of this population exhibited exclusively single roots and diverse internal characteristics. Clinicians should be aware of anatomical variations, particularly in mandibular incisors, as these may result in adverse endodontic outcomes if not taken into consideration by the treating practitioner.
Topics: Cone-Beam Computed Tomography; Dental Pulp Cavity; Dentition; Female; Humans; Male; South Africa; Tooth Root
PubMed: 35644562
DOI: 10.2334/josnusd.22-0027 -
BMC Oral Health Apr 2022Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation...
Vertucci's root canal configuration of 11,376 mandibular anteriors and its relationship with distolingual roots in mandibular first molars in a Cantonese population: a cone-beam computed tomography study.
BACKGROUND
Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).
METHODS
A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student's t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.
RESULTS
In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.
CONCLUSION
In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.
Topics: Cone-Beam Computed Tomography; Dental Pulp Cavity; Female; Humans; Male; Mandible; Molar; Tooth Root
PubMed: 35429982
DOI: 10.1186/s12903-022-02078-5