scholarly journals Cracked Tooth: A Report of Two Cases and Role of Cone Beam Computed Tomography in Diagnosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Pishipati Vinayak Kalyan Chakravarthy ◽  
Lahari Ajay Telang ◽  
Jayashri Nerali ◽  
Ajay Telang

Cracked tooth is a distinct type of longitudinal tooth fracture which occurs very commonly and its diagnosis can be challenging. This type of fracture tends to grow and change over time. Clinical diagnosis is difficult because the signs and symptoms are variable or nonspecific and may even resemble post-treatment disease following root canal treatment or periodontal disease. This variety and unpredictability make the cracked tooth a challenging diagnostic entity. The use of cone beam computed tomography (CBCT) in diagnosis of complex endodontic cases has been well documented in the literature. In this paper we present two cases of cracked tooth and emphasise on the timely use of cone beam computed tomography as an aid in diagnosis and as a prognostic determinant.

2014 ◽  
Vol 4 (1) ◽  
pp. 53-58
Author(s):  
AHM Zakir Hossain Shikdera ◽  
SM Abdul Quader ◽  
Shirin Sultana Chowdhury ◽  
Ferdousi Begum ◽  
Md Nazmul Hasan

Cracked tooth is a distinct type of longitudinal tooth fracture which occurs very commonly and its diagnosis can be challenging. This type of fracture tends to grow and change over time. Clinical diagnosis is difficult because the signs and symptoms are variable or nonspecific and may even resemble post-treatment disease following root canal treatment or periodontal disease. This variety and unpredictability make the cracked tooth a challenging diagnostic entity. In this paper we present a case of cracked tooth and emphasise on the timely proper diagnosis and management. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21176 Update Dent. Coll. j: 2014; 4 (1): 53-58


2019 ◽  
Author(s):  
David Aristizabal-Elejalde ◽  
Luis Ernesto Arriola-Guillén ◽  
Aron Aliaga-Del Castillo ◽  
Gustavo Armando Ruíz-Mora ◽  
Yalil Augusto Rodríguez-Cárdenas

Abstract Background: Root fractures are a diagnostic challenge for dentists because their signs and symptoms are not present in all cases, and they are difficult to differentiate from endodontic treatment failures, the purpose of the present study was to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT). Methods: Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 μm voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student's t-test, and multiple linear regression (α ˂0.05) were used. Results: No association was found between the type of fracture and type of retention or between the type of fracture and its extent (P ˃0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results. Conclusions: The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency. Keywords: Cone Beam Computed Tomography, Tooth Fracture, Root Canal Post, High Resolution


2012 ◽  
Vol 23 (5) ◽  
pp. 602-607 ◽  
Author(s):  
Karla de Faria Vasconcelos ◽  
Yuri Nejaim ◽  
Francisco Haiter Neto ◽  
Frab Norberto Bóscolo

A radiographic interpretation is essential to the diagnosis of invasive cervical resorption (ICR) and the difficulty in distinguishing this lesion from internal root resorption has been highlighted in the literature. This paper reports the use of cone beam computed tomography (CBCT) in the diagnosis of ICR. The cases reports describe how CBCT can be used to make a differential diagnosis and also show that the use of this technology can provide relevant information on the location and nature of root resorption, which conventional radiographs cannot. As a result, the root canal treatment was not initially considered. The patients will be monitored and will undergo a scan after a short period of time to detect any small changes. It was observed that both cases benefited from CBCT in the diagnosis of ICR, because this imaging modality determined the real extent of resorption and possible points of communication with the periodontal space.


2017 ◽  
pp. 14-19
Author(s):  
M. A. Batova

Research objective. The study aimed to evaluate cone-beam computed tomography (CBCT) capabilities in diagnostics of cystic masses of the jaw.Methods. Over a period of 2015–2016 32 patients age 6 to 67 underwent both panoramic tomography and CBCT (using panoramic tomographic scanner STRATO 2000 and cone-beam computed tomographic scanner i-Cat respectively). 47% (n = 15) of the participants were women, 53% (n = 17) – men. Radiation exposure for a single procedure amounts to 0,05 mSv for panoramic tomography, 0,07 mSv for CBCT (FOV =13 cm), 0,06 mSv for CBCT (FOV =8 cm).Results. Comparative analysis of obtained results demonstrates that CBCT showed 54% (n = 27) more cystic masses of the jaws than panoramic radiography could. CBCT additionally showed the following pathologies: granulomas smaller than4 mm diameter – 85% (n = 23), 83% (n = 23) of said granulomas were found on maxilla, radicular cysts of maxilla – 11% (n = 3), incisive canal cyst – 4% (n = 1). Additionally panoramic tomography analysis misdiagnosed 5 granulomas (80% (n = 4) on mandibular premolar and molar areas) that were not found during CBCT analysis.Conclusion. The low effective dose and high informativity of CBCT enables the method to be used instead of intraoral radiography, panoramic tomography and MSCT as a screening procedure in diagnostics of dento-facial system pathologies, including cystic masses of the jaw. 


2019 ◽  
Vol 22 (1) ◽  
pp. Process
Author(s):  
Rajamohan Rajakeerthi ◽  
Malli Suresh Babu Nivedhitha

Objective: The complex root canal anatomy is inherently colonised by microbial flora. Endodontic treatment success is always related to adequate disinfection of the root canal space, which ultimately affects the treatment outcome. A thorough understanding of the external and internal root canal anatomy by using adequately imaging modalities is essential before planning any treatment. The aim of this study was to investigate the number and morphology of the root canals of maxillary and mandibular premolars in Chennai population. Material and Methods: Full-size cone-beam computed tomographic images were randomly collected from 100 patients, resulting in a total of 200 first and 200 second maxillary premolars as well as 200 first and 200 second mandibular premolars. All the eight premolars were analysed in single patients, who underwent cone-beam computed tomography scanning during pre-operative assessment (before implant surgery, orthodontic treatment, diagnosis of dental-alveolar trauma or difficult root canal treatment). Total number of roots and root canals, frequency and correlations between men and women were recorded and statistically analysed by using chi-square tests. The root canal configurations were rated according to the Vertucci’s classification. Results: In the maxillary first premolar group (n = 200), 36.3% had 1 root, 56.7% had 2 roots and 7.0% had 3 roots, with most exhibiting a type IV canal configuration. In the maxillary second premolar group (n = 200), 60% had 1 root, 29.8% had 2 roots and 10.2% had 3 roots, with the majority of single-rooted second premolars exhibiting a type I canal configuration. In the mandibular first premolar group (n = 200), 80.5% had 1 root, 9.8% had 2 roots and 5% had 3 roots. In the mandibular second premolar group (n=200), 90.1% had 1 root, 6.4% had 2 roots and 3.5 % had 3 roots, with most exhibiting a type I canal configuration. No statistical correlation was found between number of roots, gender and tooth position. Conclusion: This cone-beam computed tomographic study confirmed previous anatomical and morphological investigations. Therefore, the possibility of additional root canals should be considered when treating premolars. Keywords: Cone-beam computed tomography; Mandibular; Maxillary; Premolar; Root canal; Morphology.


2021 ◽  
Vol 6 (2) ◽  
pp. 101-105
Author(s):  
Kadam Krutika Kiran ◽  
Vagarali Hemant ◽  
Pujar Madhu A ◽  
Tamase Aishwarya S ◽  
Sahana Umesh

This study aimed to compare the canal transportation and canal centering ability in the preparation of curved root canals after instrumentation with TruNatomy (TN) (TN; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) and ProTaper Gold (PG) (PG; Dentsply, Tulsa Dental Specialties, Tulsa, OK, USA) files using cone‑beam computed tomography (CBCT). 30 Single rooted extracted human teeth with root curvature ranging from 20-30° according to Schneider’s method were selected. Teeth with any visible cracks or fractures, calcifications, previous root canal treatments were excluded. The teeth were randomly assigned into two groups i.e. Group 1-TN and Group 2-PG (n = 15 each). The teeth were instrumented according to manufacturer’s guidelines for both the groups. Canals were scanned using a CBCT scanner before and after preparation to evaluate the transportation and centering ratio at 3 mm, 5 mm, and 7 mm from the apex. The data analysis was done using SPSS software and the test used was independent sample t test for comparison between the 2 groups.Data obtained suggested that TN group presented lesser canal transportation at the middle third of the root. The PG group showed better centering abitily at apical third of the root canal when both the groups were compared. TN resulted in less transportation than PG at the middle third, and PG showed better centering ability at the apical third. Overall, both systems safely prepared root canals, causing minimal errors.


2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Claudemir de Souza Júnior ◽  
Ricardo Machado ◽  
Renee Ashley Batts ◽  
Lucas da Fonseca Roberti Garcia

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling.   Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.


2019 ◽  
Author(s):  
Young-Eun Jang ◽  
Yemi Kim ◽  
Bom Sahn Kim ◽  
Sin-Young Kim ◽  
Hyung-Jong Kim

Abstract Background A knowledge regarding anatomical variants is important to achieve success in endodontic treatment. Root canal treatment of mandibular first premolars (PM1s) is challenging due to the existence of numerous variations in canal configurations, including a C-shaped variant. We aim to determine the prevalence and morphologic characteristics of non-single canals of mandibular first (PM1s) and second (PM2s) premolars in a Korean population using cone beam computed tomography (CBCT) and to evaluate correlations between non-single canals of PM1s and other anatomical variants, such as distolingual roots (DLRs) in mandibular first molars (M1s) and C-shaped canals in mandibular second molars (M2s). Methods A total of 971 PM1s and 997 PM2s from 500 patients were examined in vivo by CBCT. Root canal configurations and C-shaped canals were determined in accordance with the Vertucci classification and Fan classification, respectively. The correlation between non-single canals in PM1s and DLRs in M1s was evaluated using logistic regression analysis. Results PM2s typically had one root (99.89%) with one canal (98.4%). Among PM1s with non-single canals (21.2%), Vertucci type V (10.9%) and C-shaped (3.7%) canals were prevalent. Among C-shaped PM1 canals, the majority were Vertucci type V (77.8%); a C-shaped configuration (C2) was predominant mostly at the middle and/or apical third of the root. After adjusting for other variables (i.e., sex, age, and side), C-shaped canals in PM1s was significantly correlated with the presence of DLRs in M1s (odds ratio = 2.616; 95% confidence interval, 1.257–5.443; p = 0.010). Conclusions The presence of C-shaped PM1 canals was positively related to the presence of DLRs in M1s. Although C-shaped canals in PM1s are difficult to distinguish, this finding could aid clinicians in predicting C-shaped canal configurations in PM1s of patients who exhibit DLRs in M1s.


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