Evaluation of Distolingual Canal/Roots in Mandibular Molars and Mesiobuccal Canals in Maxillary Molars by CBCT.
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ABSTRACT:
SUBMITTER: Pekiner FN
PROVIDER: S-EPMC5543659 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:OBJECTIVES:Compare findings among observers in panoramic images (PAN) and cone beam CT (CBCT); and assess findings in PAN as indicators for marginal bone loss and resorption observed in CBCT. METHODS:120 impacted maxillary third molars with PAN and CBCT were included. Four observers assessed morphological features: (1) tooth angulation; (2) number of roots; (3) bony impaction (yes/no) and pathology; (4) marginal bone level at the second molar (normal/>3 mm = bone loss); (5) resorption in the second molar (no/superficial/< half way through the dentin/? half way through the dentin/involving the pulp); (6) size of follicular space (normal/> 4 mm(cyst)). Percentage accordance and ? statistics described observer variation in PAN and CBCT. Logistic regression analyses tested findings in PAN as indicators for marginal bone loss or resorption observed in CBCT. RESULTS:? values were fair and interobserver accordance was marginally higher in CBCT than PAN. Agreement between PAN and CBCT was 81-88% for marginal bone loss and 68-81% for resorption. Severe resorption was more often observed in CBCT. Mesio-angulated third molars and marginal bone loss interpreted in PAN significantly indicated marginal bone loss observed in CBCT (odds ration 17-34; p < 0.012; 8.8-52.8; p < 0.02). In contrast, findings in PAN were not significant indicators for resorption observed in CBCT (p > 0.05). CONCLUSION:In general, there was a fair agreement for marginal bone loss between PAN and CBCT, and PAN could significantly predict bone loss observed in CBCT. However, presence of resorption observed in CBCT could not be determined from PAN, and more severe resorption was observed in CBCT. CBCT is indicated if resorption in the second molar needs to be assessed.
| S-EPMC6592588 | biostudies-literature
Project description: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.
| S-EPMC8668958 | biostudies-literature
Project description:BACKGROUND:While there is ample research into the anatomy of mandibular molars, little is known regarding isthmuses and middle mesial (MM) canals in Chinese populations. The goal of this study was to determine the prevalence of MM canals and isthmuses in the mesial root of mandibular first molars using Cone-beam Computed Tomography. METHODS:Cone-beam Computed Tomography images of 357 mature mandibular first molars were retrospectively analyzed. Presence of isthmuses and MM canals, and the length of isthmuses in the mesial root were recorded. Meanwhile, we also recorded possible correlated factors such as demographics, side of mandible, presence of separated distal-lingual roots. RESULTS:Of these 357 teeth, 209 showed evidence of either complete or partial communication in the mesial root. Of these, 11(3.1%) exhibited true MM canals while 198(55.5%) exhibited isthmuses. Sex or side of mandible was not correlated with the prevalence of isthmuses (P?>?0.05). However, there was a significant association between the presence of a distal-lingual root and the prevalence of such communication (P?<?0.001). The average length of isthmuses was 4.3 ± 3.1?mm. CONCLUSIONS:We detected high rate of isthmuses and low rate of MM canals in mesial roots of mandibular first molars, which is important as such areas should be identified and cleaned during root canal treatment.
| S-EPMC7206827 | biostudies-literature
Project description: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.
| S-EPMC5527201 | biostudies-other
Project description:BackgroundMandibular premolars demonstrate high variability in root canal morphology, especially mandibular first premolars. The purposes of this study were to determine the prevalence of root canal configurations of mandibular premolars according to Vertucci classification in a Thai population.MethodsTotal of 1159 CBCT images of Thai patients who received radiographic imaging at the Department of Radiology, Faculty of Dentistry, Chulalongkorn University in 2017-2018 was evaluated. The data were reported using descriptive statistics and the relationship between the prevalence of the root canal complexities and sex was analyzed using the chi-squared test.ResultsThe most common root canal configuration was Vertucci type I, with a 63.1% and 98% prevalence in the mandibular first and second premolars, respectively. More than 98% of mandibular premolars had a single root. The prevalence of a bifurcation was 28.5% and 1.5% in the mandibular first and second premolars, respectively. The prevalence of a trifurcation was 3.2% in the mandibular first premolar. A C-shaped root canal was observed at 23.7% and 0.7% in the mandibular first and second premolars, respectively. The level of branching was mostly found at the middle 1/3 of the root. Bilateral appearance of the same root canal configuration was identified in 80.3% and 95.9% in the mandibular first and second premolars, respectively. There was no relationship between sex and the prevalence of a bifurcation, trifurcation, or C-shaped root canal.ConclusionMandibular first premolars have more root canal complexities than mandibular second premolars. Horizontal tube shift x-ray technique, CBCT, dental operating microscope, and knowledge of root canal configurations have an important role in root canal identification in mandibular premolar with suspected complex root canal morphology.
| S-EPMC8444426 | biostudies-literature
Project description:Pell and Gregory, and Winter's classifications are frequently implemented to classify the mandibular third molars and are crucial for safe tooth extraction. This study aimed to evaluate the classification accuracy of convolutional neural network (CNN) deep learning models using cropped panoramic radiographs based on these classifications. We compared the diagnostic accuracy of single-task and multi-task learning after labeling 1330 images of mandibular third molars from digital radiographs taken at the Department of Oral and Maxillofacial Surgery at a general hospital (2014-2021). The mandibular third molar classifications were analyzed using a VGG 16 model of a CNN. We statistically evaluated performance metrics [accuracy, precision, recall, F1 score, and area under the curve (AUC)] for each prediction. We found that single-task learning was superior to multi-task learning (all p < 0.05) for all metrics, with large effect sizes and low p-values. Recall and F1 scores for position classification showed medium effect sizes in single and multi-task learning. To our knowledge, this is the first deep learning study to examine single-task and multi-task learning for the classification of mandibular third molars. Our results demonstrated the efficacy of implementing Pell and Gregory, and Winter's classifications for specific respective tasks.
| S-EPMC8758752 | biostudies-literature
Project description:Objectives:To investigate the success rate of supplemental intraseptal and buccal infiltration anaesthesia in mandibular molars undergoing endodontic therapy/extraction when the inferior alveolar nerve block has failed. Material and Methods:A prospective clinical trial including 200 patients undergoing lower molar root canal treatment/teeth extraction was conducted. Only 80 patients of the participants who had profound lower lip anaesthesia after the administration of inferior alveolar nerve block (IANB) were in pain within treatment. Patients experiencing moderate to severe pain upon using elevators, forceps, bur, or endodontic file were randomly allocated to the 2% lidocaine intraseptal injection and 4% articaine buccal infiltration groups. Level of pain was assessed every 2 to 10 min on standard 100 mm visual analogue scales. Results:Overall, 55 (69%) of patients who were given either intraseptal injection of 2% lidocaine or buccal infiltration of 4% articaine had successful anaesthesia of lower molar teeth within 10 min. However, 25 (31%) of participating patients in the buccal infiltration and the intraseptal groups had failed anaesthesia within the study duration (10 min), and they received additional local anaesthetic. IANBs were more painful than buccal and intraseptal injections. However, buccal articaine injections were significantly more comfortable than intraseptal lidocaine injections (P > 0.001). Conclusions:Supplemental intraseptal injection of 2% lidocaine and buccal infiltration of 4% articaine achieved profound pulpal anaesthesia in 69% of patients when the inferior alveolar nerve block failed. Recommendations can be given to dental practitioners to use infiltration of 4% articaine in conjunction with intraseptal injection of 2% lidocaine to anaesthetize the lower molar teeth when inferior alveolar nerve block fails.
| S-EPMC7191379 | biostudies-literature
Project description:Impacted mandibular third molars (M3M) are associated with the occurrence of distal caries on the adjacent mandibular second molars (DCM2M). In this study, we aimed to develop and validate five machine learning (ML) models designed to predict the occurrence of DCM2Ms due to the proximity with M3Ms and determine the relative importance of predictive variables for DCM2Ms that are important for clinical decision making. A total of 2642 mandibular second molars adjacent to M3Ms were analyzed and DCM2Ms were identified in 322 cases (12.2%). The models were trained using logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting ML methods and were subsequently validated using testing datasets. The performance of the ML models was significantly superior to that of single predictors. The area under the receiver operating characteristic curve of the machine learning models ranged from 0.88 to 0.89. Six features (sex, age, contact point at the cementoenamel junction, angulation of M3Ms, Winter's classification, and Pell and Gregory classification) were identified as relevant predictors. These prediction models could be used to detect patients at a high risk of developing DCM2M and ultimately contribute to caries prevention and treatment decision-making for impacted M3Ms.
| S-EPMC8322059 | biostudies-literature
Project description:Sodium hypochlorite is an effective irrigant for chemical debridement of root canals. However, increasing the intracanal pressure during irrigant delivery may result in irrigant extrusion into the bone and soft tissues surrounding the tooth. Because clinicians often encounter teeth with intracanal communications, the objective of the present study was to examine the effects of canal anastomosis on the generation of periapical fluid pressure at different fluid flow rates and insertion depths. Two similar polycarbonate models were used to simulate a single root with double canals, one containing, and the other without communicating channels between the canals. For both models, periapical pressure increased with increasing irrigant flow rates and insertion depths of a 30-gauge side-venting needle. In the presence of communicating channels, the magnitude of pressure build-up decreased by almost 90% irrespective of the fluid flow rate or needle insertion depth. Pressure reduction in anastomoses-containing roots provides an explanation why pressure generation in single roots is considerably higher. Nevertheless, it is still possible in teeth with canal anastomoses for pressure exceeding the intraosseous pressure to be generated when the fluid flow rate is sufficiently high and when the needle tip is close to the apical terminus.
| S-EPMC5431501 | biostudies-literature
Project description:ObjectivesThe majority of human maxillary first molars is usually described as having three roots, but different morphologies were documented in several studies and case reports. One very rare and less investigated anatomical anomaly is the occurrence of four radicular structures in the upper first molars. This communication aimed to define the prevalence of four-rooted maxillary first molars on a meta-analytical basis. The external and internal morphology of these teeth was described by the collection of published case reports.Materials and methodsSix electronic databases were accessed to collect case reports dealing with four-rooted maxillary first molars, as well as population-based cone-beam computed tomography (CBCT) studies. Afterward, the publications were selected according to predefined inclusion/exclusion criteria and evaluated using the Joanna Briggs Institute Critical Appraisal tool. The teeth of the chosen case reports were then independently analyzed by two dental professionals according to different dental classifications. Furthermore, the population studies were meta-analyzed to calculate the global and regional prevalence of four-rooted maxillary molars.ResultsIncluded were forty-nine population-based CBCT studies containing 26663 maxillary first molars. Upon these data, the global incidence of four-rooted maxillary molars was meta-analytically determined as 0.047% (95%-CI:0.011-0.103%). In combination with the case reports, it was pointed out that this anomaly is distributed worldwide. Furthermore, forty-eight case reports were included containing fifty-three maxillary molars with four roots. The analyzed teeth exhibited Versiani´s pulpal chamber floor Types A and B. The majority of four-rooted maxillary first molars were classified as Type I regarding Christie's configuration. But, also 7.54% of the altered teeth could not be described by this classification. 62.34% exhibited four root canals, but also variations with five, six, or seven canals were identified. Furthermore, a significant difference was found in the occurrence rate between male and female patients.ConclusionDue to the worldwide occurrence, dental professionals should be aware of this rare anomaly to avoid treatment errors, especially during endodontic or surgical therapies.
| S-EPMC7843171 | biostudies-literature