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Root Morphology and Canal Configuration of First and Second Maxillary Molars in a Selected Iranian Population: A Cone-Beam Computed Tomography Evaluation.

ABSTRACT: The aim of this investigation was to evaluate root canal morphology of maxillary first and second molars and also to assess the prevalence and morphology of the second mesiobuccal canal (MB2) in these teeth, using cone-beam computed tomography (CBCT).In this cross-sectional study, the total of 470 CBCT images from the archive of Radiology Department of Isfahan University of Medical Sciences (IUMS), Iran, was evaluated and 295 images were selected. The number of roots, and canal configuration were determined based on Vertucci's classification system. The data was analyzed using SPSS 20, and P-values less than 0.05 were considered significant.A total of 295 images from 295 patients (165 females and 130 males), including 389 maxillary first (197 right and 192 left) and 460 maxillary second (235 right and 225 left) molars were evaluated. The prevalence of MB2 canals were 70.2% and 43.4% in the maxillary first and second molars, respectively. The most common type of Vertucci's classification was type II (53.1%), followed by type I.The second mesiobuccal canal was present in almost two thirds of first and less than half of second molars. The morphology and canal configuration of a maxillary molar can almost predict the morphology of contralateral molar. However, it does not relate to the ipsilateral molar.

SUBMITTER: Khademi A

PROVIDER: S-EPMC5527201 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Incidence and Anatomical Properties of Retromolar Canal in an Iranian Population: A Cone-Beam Computed Tomography Study.

Project description:Objectives:Retromolar canal (RC) is an anatomic structure, and due to increasing demand for surgical procedure in the retromolar area of the mandible, the identification of the retromolar canal has become an issue of clinical concern. It can innervate the third molar and some of the muscles around the posterior segment of the mandible, complicating surgical procedures in the retromolar area and root canal treatment of third molars. The aim of this study was to evaluate the incidence and anatomical properties of RC in a western Iranian population using cone-beam computed tomography (CBCT) images. Materials and Methods. Two hundred bilateral CBCT images were collected and screened in the three spatial planes for the presence of an RC. Anatomical properties and location of the RCs were assessed according to their course and distance from the surrounding structures. The relationship between the presence of RC and age, sex, side, and presence of second and third molars was also evaluated. Independent samples t-test, ANOVA, Tukey's post hoc test, paired t-test, ANOVA, Tukey's post hoc test, paired. Results:At least one RC was observed in 22% of the mandibles. Its bilateral incidence was 5.5%. Two major types of canals were detected, namely, type I, following a straight or curved course from the mandibular canal (MC) to the retromolar area (47.3%), and type II, coursing from the retromolar area to the radicular part of the third molar (52.7%). Regarding linear measurements, the mean RC diameter and the mean distance to the MC, second, and third molars were 0.68?±?0.31, 13.7?±?2.8, 15.3?±?3.0, and 7.3?±?2.3?mm, respectively. Conclusion:Based on the results of this study, RC was found in 22% of the cases; thus, it should be considered as a normal anatomical variation in the Iranian population rather than a rare finding.

| S-EPMC7085402 | biostudies-literature

Anterior Maxillary Labial Bone Thickness on Cone Beam Computed Tomography.

Project description:AimThe objective of this research was to measure the labial bone thickness (LBT) in relation to the 6 anterior maxillary teeth at different levels along the long axis and the distance between cementoenamel junction and bone crest (CEJ-BC) based on cone beam computed tomography (CBCT) scans retrieved from patients of Arab ethnicity and identify any association with patients' characteristics.Materials and methodsA total of 100 CBCT scans were evaluated by one calibrated examiner. The thickness of the labial bone was measured perpendicular to the long axis of the tooth at 1, 3, and 5 mm from the alveolar crest (LBT-1, LBT-3, and LBT-5, respectively) and CEJ-BC using a medical imaging viewer.ResultsCBCT scans of 58 female patients and 42 male patients with a mean age of 39.7 ± 9.5 years were included. A high variation of CEJ-BC was observed (range, 0.55-3.90 mm). Statistically significant higher CEJ-BC values were associated with men and increased age (>50 years). The overall means of LBT-1 were 0.76 ± 0.26, 0.79 ± 0.26, and 0.83 ± 0.37 mm; LBT-3: 0.92 ± 0.36, 1.05 ± 0.46, and 1.03 ± 0.48 mm; LBT-5: 1.17 ± 0.52, 0.80 ± 0.45, and 0.81 ± 0.40 mm for central incisors, lateral incisors, and canines, respectively. The LBT was <1 mm in 74.2% of all maxillary anterior teeth, with central incisors showing the highest predilection (85% with LBT <1 mm). No significant association between LBT and patient characteristics was observed.ConclusionsThe CEJ-BC distance is greater in men and increases with age, particularly in those aged 50 years and older. The LBT in the 6 maxillary anterior teeth is predominantly thin (<1 mm) and has no correlation to age or sex. An increased LBT was observed at a 3-mm level when compared with LBT-1 and LBT-5. Such variability should be taken into consideration when planning for implant placement.

| S-EPMC10023538 | biostudies-literature

Investigating the anatomical relationship between the maxillary molars and the sinus floor in a Chinese population using cone-beam computed tomography.

Project description:BackgroundThe anatomical relationship between the root apices of maxillary molars and the maxillary sinus floor (MSF) is important for the treatment of dental implantations and endodontic procedures. In this study, the detailed anatomical relationships between the root apices of maxillary molars and the MSF were studied in a Chinese population using CBCT.MethodsWe collected the CBCT data files of patients who visited the stomatology outpatient clinic in Shanghai Fifth People's Hospital, Fudan University from January 1, 2017 to January 1, 2019 and measured the following items: the distance between the molar root apices and the MSF, the thickness of the mucosa and cortical bone of the MSF closest to the root apices, and the angle between the buccal and palatal roots.ResultsThe shortest distances between the root apices and the MSF were 1.57 ± 3.33 mm (the mesiobuccal root of the left second molar) and 1.61 ± 3.37 mm (the mesiobuccal root of the right second molar). Apical protrusion over the inferior wall of the sinus most often occurred in the mesiobuccal root of left second molar (frequency, 20.5%). The mucosa of the MSF was thinnest at the distobuccal root of the right second molar (1.52 ± 0.85 mm), the cortical bone of the MSF was thinnest at the mesiobuccal root of the right second molar (0.46 ± 0.28 mm), and the angle between the buccal and palatal roots ranged from 12.01° to 124.2° (42.36 ± 24.33 °).ConclusionsAmong the root apices of the maxillary molars, the mesiobuccal root apex of the left second molar was closest to the MSF, and it had the highest incidence of protrusion into the sinus. The unique anatomical relationship between the maxillary molars and the MSF in this Chinese population is critical for treatment planning for dental implantation or endodontic procedures.

| S-EPMC6915992 | biostudies-literature

Cone beam computed tomography assessment of the maxillary incisive canal and foramen: considerations of anatomical variations when placing immediate implants.

Project description:IntroductionThe maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one's ability to place immediate implants in ideal position.ObjectiveTo avoid causing complication, variations in their dimensions were studied.Material and methodsImages of ninety Mongoloids patients examined with i-CAT Cone Beam Computed Tomography were included. The sizes of the nasopalatine foramen, the incisive canal and foramen, and anterior maxillary bone thickness were measured. The direction and course of the canals were assessed.ResultsThe mean labiopalatal and mesiodistal measurements of the incisive foramen were 2.80 mm and 3.49 mm respectively, while the labiopalatal width of the nasal foramen was 6.06 mm. The incisive canal was 16.33 mm long and 3.85 mm wide. The anterior maxillary bone has an average thickness of 7.63 mm. The dimensions of the incisive foramen and incisive canal, and anterior maxillary bone thickness demonstrated gender differences with males showing greater values. The anterior maxillary bone thickness was affected by age but this difference was not observed in canal dimensions. The majority of subjects have a funnel shape-like incisive canal with the broader opening located at its superior. They seem to have a longer slanted-curve canal with one channel at its middle portion and a narrower incisive foramen opening than those reported elsewhere.ConclusionsThis study found that gender is an important factor that affected the characteristics of the IC and the amount of bone anterior to it. Male generally had bigger IC and thicker anterior bone. In addition, the anterior maxillary bone thickness was affected by aging, where it becomes thinner with increased age even though the subjects were fully dentate.

| S-EPMC4332502 | biostudies-literature

Assessment of the Relationship between Maxillary Posterior Teeth and Maxillary Sinus Using Cone-Beam Computed Tomography.

Project description:IntroductionBecause of the close contact between maxillary sinus and maxillary posterior teeth, procedural errors such as perforation of the sinus may occur during surgical intervention resulting in oroantral communication, which if not corrected, would develop into a fistula. The aim of this study was to evaluate the relationship between maxillary posterior teeth and maxillary sinus floor in a population of the western area of Saudi Arabia, and if age, gender, and size may affect such distance.Materials and methodsThis retrospective study evaluated 539 cone-beam computed tomography (CBCT) radiographs of patients over 20 years of age. Patients were divided into four groups according to age: group I (20-30 years), group II (31-40 years), group III (41-50 years), and group IV (more than 50 years). From coronal and sagittal images of CBCT, the vertical distance between the posterior maxillary root and the maxillary sinus was measured and classified according to its proximity to the maxillary sinus.ResultsGender and size did not significantly affect the distance between maxillary posterior root and maxillary sinus. However, there was a significant increase in this distance with increased age. Mesiobuccal root of the second molar was the nearest root to the maxillary sinus (0.8 ± 1.62, p < 0.001), while the buccal root of the first premolar was the farthest root (5.39 ± 3.26, p < 0.001).ConclusionRegarding the population of this study, the buccal roots of the second molars are the closest to the sinus floor. Complications associated with maxillary molar extraction and implantation are greater at a younger age. Because the distance between posterior maxillary teeth and maxillary sinus was mostly type 1 (0-2 mm), clinicians are advised to perform CBCT to get a better understanding of the relationship between maxillary posterior roots and maxillary sinus before surgical intervention.

| S-EPMC9277193 | biostudies-literature

Assessment of the prevalence and configuration of middle distal canals in the mandibular molars in a Saudi subpopulation using Cone-Beam computed tomography.

Project description:PurposeThe prevalence of the middle distal (MD) canal in the mandibular molar is significantly low among countries including the USA, Spain, Turkey, and Jordan; however, analysis of its prevalence and configuration has not been performed in Saudi Arabia. Therefore, we aimed to assess the prevalence and configuration of the MD canal in Saudi Arabia.MethodsA retrospective analysis of 132 cone-beam computed tomography (CBCT) images was performed to evaluate the presence of the MD canal in patients visiting the Radiology Department of The College of Dentistry in King Saud University between July 2018 and July 2019. The canal was examined if it was confluent with the distobuccal (DB) or distolingual (DL) canals, fin, or independent. Moreover, the distances from the MD canal to the DL and DB canals and cementoenamel junction (CEJ) were recorded.ResultsOne MD canal (0.7%) was observed in 145 teeth. It was confluent with the DL canal. No statistical significance was observed among sex and age. The distances from the MD canal to the DL canal, DB canal, and CEJ were 1.4 mm, 1.9 mm, and 3.1 mm, respectively.ConclusionsThe prevalence of the MD canal was significantly low in a Saudi subpopulation (0.7%). Careful evaluation of CBCT images and the pulpal floor is significantly important to detect the MD canal to ensure a good prognosis.

| S-EPMC8864375 | biostudies-literature

Cone Beam Computed Tomography Study of Root Canal Morphology of Permanent Mandibular Incisors in Indian Subpopulation.

Project description:The aim of the study was to determine the root canal morphology of permanent mandibular incisor teeth in the Indian subpopulation with the use of cone beam computed tomography (CBCT).CBCT images of 200 patients with 800 permanent mandibular incisors, fulfilling necessary inclusion criteria and aged 18 to 60 years were evaluated. The number of roots, number of root canals and canal configuration were investigated and then classified according to Vertucci's classification of root canals. The effect of gender on the incidence of root canal morphology was also investigated.All the permanent mandibular incisors had a single root. The majority of mandibular incisors (66.5%) had a single root with a single canal. The prevalence of second canals was as follows: right central incisor - 33.5%, left central incisor - 30%, right lateral incisors - 33.5% and left lateral incisor - 36.5%. According to gender, 15.2% of men and 20.4% of women had a second root canal. Type 1 Vertucci configuration was most prevalent, followed by type 3, type 2, type 5 and type 4 in that order.Type 1 Vertucci's classification (64.5%) was the most prevalent canal configuration in the mandibular anterior teeth in the Indian population. Type 5 Vertucci's classification was the most frequently observed canal configuration of the two-canalled teeth. CBCT is an excellent imaging modality for detection of different canal configurations of mandibular incisors.

| S-EPMC5513681 | biostudies-other

A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography.

Project description:BackgroundAccessory maxillary ostium (AMO) has a major role to play in the aetiology of maxillary sinusitis. Mucosal thickening is one of the key radiographic features of chronic maxillary sinusitis. The aim of this study was to identify the location of the AMOs and investigate the association between Mucosal Thickening [MT] and AMO using Cone Beam Computed Tomography [CBCT].MethodsCBCT scans of 400 maxillary sinuses from the records of 200 patients who seeked various dental treatments at the Thumbay Dental Hospital, Gulf Medical University, Ajman, United Arab Emirates were evaluated. The incidence, anatomical position and maximal length of accessory maxillary ostia (AMO) in the maxillary antrum were reviewed using CBCT by two examiners. The association between MTs and AMOs were also analysed.ResultsAmong the 200 CBCT scans, 131 belonged to male patients and 69 scans belonged to female subjects within the age group of 18-65 years (mean age 41.32 years). AMOs were found in 142 maxillary antra (35.5 %). The inter-observer reliability for using CBCT to detect AMO was (k = 0.83). There was no significant difference in the frequency of AMOs when the age (P = 0.19) and gender (P = 0.54) distribution were considered. Sinuses with AMOs, showed significantly greater frequency of MTs (p = 0.001). AMOs with maximal length of less than 1mm were most commonly observed (51.40 %). AMOs with larger greater maximal length were associated with higher degrees of MT. The location of the AMOs, were not affected by the degree of MT.ConclusionsThe study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. However, the location of the AMO is independent of the degree of the MT. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.

| S-EPMC8278720 | biostudies-literature

Rapid Maxillary Expansion and Upper Airway Morphology: A Systematic Review on the Role of Cone Beam Computed Tomography.

Project description:This study aimed to investigate the quality of cone beam computed tomography (CBCT) studies evaluating the effects of rapid maxillary expansion on upper airway morphology.A database search was conducted using PubMed, Ovid, and Cochrane Library up to December 2016. Studies in which CBCT was adopted to visualize the upper airway before and after rapid maxillary expansion were included. The population target was growing patients. Methodological quality assessment was performed.The screening process resulted in the exclusion of 1079 references, resulting in only 9 remaining papers that fulfilled the inclusion criteria. No randomized clinical trials were found. The quality scores ranged from 36% to 68% of the maximum achievable, and the mean quality score of the studies was 50%. No good quality studies were detected in our sample.Inconsistencies in the CBCT protocols utilized were detected between studies. Head posture, tongue position, and segmentation protocols were not consistent. These discrepancies were reflected in the different results obtained in the studies. A valid and consistent protocol with regard to head and tongue positioning, as well as nasal cavity volume segmentation, is required.

| S-EPMC5534278 | biostudies-other

Deep Learning Method for Mandibular Canal Segmentation in Dental Cone Beam Computed Tomography Volumes.

Project description:Accurate localisation of mandibular canals in lower jaws is important in dental implantology, in which the implant position and dimensions are currently determined manually from 3D CT images by medical experts to avoid damaging the mandibular nerve inside the canal. Here we present a deep learning system for automatic localisation of the mandibular canals by applying a fully convolutional neural network segmentation on clinically diverse dataset of 637 cone beam CT volumes, with mandibular canals being coarsely annotated by radiologists, and using a dataset of 15 volumes with accurate voxel-level mandibular canal annotations for model evaluation. We show that our deep learning model, trained on the coarsely annotated volumes, localises mandibular canals of the voxel-level annotated set, highly accurately with the mean curve distance and average symmetric surface distance being 0.56 mm and 0.45 mm, respectively. These unparalleled accurate results highlight that deep learning integrated into dental implantology workflow could significantly reduce manual labour in mandibular canal annotations.

| S-EPMC7125134 | biostudies-literature

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