Analysis of Cause of Endodontic Failure of C-Shaped Root Canals

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.

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Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption

The Angle Orthodontist ◽

10.2319/050512-372.1 ◽

2012 ◽

Vol 83 (2) ◽

pp. 189-195 ◽

Cited By ~ 37

Author(s):

Hongyu Ren ◽

Jun Chen ◽

Feng Deng ◽

Leilei Zheng ◽

Xiong Liu ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Resorption ◽

Root Surface ◽

Cone Beam ◽

Radiographic Images ◽

Apical Root Resorption ◽

Periapical Radiography

ABSTRACT Objective: To compare the diagnostic accuracy between cone-beam computed tomography (CBCT) and periapical radiography for detecting simulated external apical root resorption (EARR) in vitro. Materials and Methods: The study sample consisted of 160 single-rooted premolar teeth for simulating EARR of varying degrees according to four setups: no (intact teeth), mild (cavity of 1.0 mm in diameter and depth on root surface), moderate (0.4 mm, 0.8 mm, 1.2 mm, and 1.6 mm root shortening), and severe (2.4 mm, 2.8 mm, 3.2 mm, and 3.6 mm root shortening). Two groups of radiographic images were obtained via CBCT and periapical radiography. The absence or presence and the severity for all resorption lesions were evaluated blindly by two calibrated observers. Results: With the CBCT method, the rates of correct classification of no, mild, moderate, and severe EARR were 96.3%, 98.8%, 41.3%, and 87.5%, respectively; with the periapical radiography method, the rates were 82.5%, 41.3%, 68.8%, and 92.5%, respectively. Highly significant differences were found between the two imaging methods for detection of mild (P < .001), moderate (P < .001), and all EARR (P < .001). For detection of all EARR, the sensitivity and specificity values were 75.8% and 96.3% for CBCT, compared with 67.5% and 82.5% for periapical radiography. Conclusion: CBCT is a reliable diagnostic tool to detect simulated EARR, whereas periapical radiography underestimates it. However, if a periapical radiograph is already available to the diagnosis of EARR, CBCT should be used with extreme caution to avoid additional radiation exposure.

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Morphology of Mesiobuccal Root Canals of Maxillary First Molars: a comparison of CBCT scanning and Cross-sectioning

Brazilian Dental Journal ◽

10.1590/0103-644020130096 ◽

2015 ◽

Vol 26 (5) ◽

pp. 525-529 ◽

Cited By ~ 6

Author(s):

Carina Maria Lyra ◽

Débora Delai ◽

Keila Cristina Rausch Pereira ◽

Guy Martins Pereira ◽

Bráulio Pasternak Júnior ◽

...

Keyword(s):

Root Canal ◽

Cone Beam ◽

Type I ◽

Type Ii ◽

Type Iii ◽

Root Canals ◽

Type Iv ◽

The Cross ◽

Cbct Analysis

Abstract: The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.

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Use of Cone Beam Computed Tomography to Identify the Morphology of Maxillary and Mandibular Premolars in Chennai Population

Brazilian Dental Science ◽

10.14295/bds.2019.v22i1.1673 ◽

2019 ◽

Vol 22 (1) ◽

pp. Process

Author(s):

Rajamohan Rajakeerthi ◽

Malli Suresh Babu Nivedhitha

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Treatment Success ◽

Cone Beam ◽

Type I ◽

Root Canals ◽

Computed Tomographic ◽

Root Canal Anatomy ◽

Computed Tomography Scanning

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.

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Comparative evaluation of shaping ability of trunatomy and protaper gold files in curved canals using cone?beam computed tomography: An invitro study

IP Indian Journal of Conservative and Endodontics ◽

10.18231/j.ijce.2021.023 ◽

2021 ◽

Vol 6 (2) ◽

pp. 101-105

Author(s):

Kadam Krutika Kiran ◽

Vagarali Hemant ◽

Pujar Madhu A ◽

Tamase Aishwarya S ◽

Sahana Umesh

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Cone Beam ◽

Human Teeth ◽

Root Canals ◽

Before And After ◽

Canal Transportation ◽

Group 2 ◽

Shaping Ability

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.

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GuttaFlow Bioseal as Monocone Obturation Technique in Curved Root Canals: A Scanning Electron Microscopy Study

Science Letters ◽

10.24191/sl.v15i2.13824 ◽

2021 ◽

Vol 15 (2) ◽

pp. 42-59

Author(s):

Musliana Mustaffa ◽

◽

Hajar Ar Rahmah Nasri ◽

Insyirah Kamarulzaman ◽

Mohamad Shafiq Mohd Ibrahim ◽

...

Keyword(s):

Surface Area ◽

Root Canal ◽

Current Approach ◽

Filling Material ◽

Sem Images ◽

Root Canals ◽

Gutta Percha ◽

Curved Root Canals ◽

Scanning Electron ◽

Group 1

The obturation quality of GuttaFlow Bioseal in curved root canals is not commonly investigated although there has been a current approach toward utilizing this material in extracted molars in recent years. This study assessed the obturated surface area, extrusion of root filling material beyond the apical foramen and duration of obturation procedure in curved root canals using monocone obturation technique. Access cavity was prepared in 20 human mandibular molars. Root canals with curvature of more than 10 as determined according to Schneider’s method were included. Samples were prepared using Hyflex CM rotary files and divided into two groups (n=10): Group 1 [gutta-percha cone and GuttaFlow Bioseal] and Group 2 [gutta-percha cone and RoekoSeal Automix root canal sealer]. The duration of obturation procedure was recorded and obturation radiographs were taken. Samples were bisected and the mesial roots were sectioned horizontally to obtain 3 root segments; apical, middle and coronal. All resected roots were mounted on brass stubs, sputter-coated with thin platinum coating and observed under scanning electron microscope (SEM) at 70x magnification. The SEM images were transferred to the SketchAndCalc Area Calculator software. No statistically significant differences in the obturated surface area and extrusion of root filling material were observed between Group 1 and 2, irrespective of the status of root canal curvature. Duration for obturation in severe root canal curvatures between Group 1 and 2 were statistically significant. Obturated surface area and extrusion of root filling material were not affected by the root canal curvature, however duration for obturation using GuttaFlow Bioseal in severe root canal curvatures was slightly longer.

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Evaluation of the Root and Canal Morphology of Maxillary Permanent Molars and the Incidence of the Second Mesiobuccal Root Canal in Greek Population Using Cone-beam Computed Tomography

The Open Dentistry Journal ◽

10.2174/1874210601509010267 ◽

2015 ◽

Vol 9 (1) ◽

pp. 267-272 ◽

Cited By ~ 12

Author(s):

Georgia E. Nikoloudaki ◽

Taxiarchis G. Kontogiannis ◽

Nikolaos P. Kerezoudis

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Greek Population ◽

Root Canal Treatment ◽

Cone Beam ◽

Second Molar ◽

Root Canals ◽

Permanent Molars ◽

Canal Morphology

Objectives: Cone-Beam Computed Tomography is an alternative imaging technique which has been recently introduced in the field of Oral & Maxillofacial Radiology. It has rapidly gained great popularity among clinicians due to its ability to detect lesions and defects of the orofacial region and provide three-dimensional information about them. In the field of Endodontics, CBCT can be a useful tool to reveal tooth morphology irregularities, additional root canals and vertical root fractures. The objective of this study is to evaluate the root and root canal morphology of the maxillary permanent molars in Greek population using Cone-Beam Computed Tomography.Materials and Methods:273 cone-beam computed tomography (CBCT) images were examined. The number of roots and root canals of the first and second maxillary molars were evaluated. Root canal configuration was classified according to Weine’s classification by two independent examiners and statistical analysis was performed.Results:A total of 812 molars (410 first and 402 second ones) were evaluated. The vast majority of both first and second molars had three roots (89.26% and 85.07%, respectively). Most first molars had four canals, while most second molars had three. In the mesiobuccal roots, one foramen was recorded in 80.91% of all teeth. Other rare morphologic variations were also found, such as fusion of a maxillary second molar with a supernumerary tooth.Conclusion:Within the limitations of this study, it can be concluded that more attention should be given to the detection of additional canals during root canal treatment in maxillary permanent molars. Towards this effort, CBCT can provide the clinician with supplemental information about the different root canal configurations for successful Root Canal Treatment.

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Prognosis of root canal treatment in teeth with preoperative apical periodontitis: a study with cone‐beam computed tomography and digital periapical radiography

International Endodontic Journal ◽

10.1111/iej.13168 ◽

2019 ◽

Vol 52 (11) ◽

pp. 1533-1546 ◽

Cited By ~ 7

Author(s):

F. A. Restrepo‐Restrepo ◽

S. J. Cañas‐Jiménez ◽

R. D. Romero‐Albarracín ◽

P. A. Villa‐Machado ◽

M. I. Pérez‐Cano ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Apical Periodontitis ◽

Root Canal Treatment ◽

Cone Beam ◽

Periapical Radiography

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CBCT-Aided Microscopic and Ultrasonic Treatment for Upper or Middle Thirds Calcified Root Canals

BioMed Research International ◽

10.1155/2016/4793146 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Ying-Ming Yang ◽

Bin Guo ◽

Li-Yang Guo ◽

Yan Yang ◽

Xiao Hong ◽

...

Keyword(s):

Computed Tomography ◽

Great Risk ◽

Ultrasonic Treatment ◽

Root Canal ◽

Three Dimensions ◽

Cone Beam ◽

Operating Microscope ◽

Limited Information ◽

Root Canals ◽

Upper Third

Root canal calcification is considered a great challenge during root canal treatment. Although the application of ultrasonic instruments and dental operating microscope (DOM) has advantages, dealing with calcified root canals still suffers a great risk of failure because of limited information about the location, length, and direction of obliteration on periapical radiographs. In this work, a cone-beam computed tomography- (CBCT-) aided method aimed at solving complicated calcified root canals in which conventional approaches could not work was proposed. Thirteen teeth with sixteen calcified canals (12 calcified in the upper third, 4 calcified in the middle third), which cannot be negotiated with conventional methods, were treated with the aid of CBCT. The location of calcification and depth of instrumentation and operating direction were calculated and assessed in three dimensions with ultrasonic instruments under DOM. In all thirteen teeth, canals with upper and middle thirds calcification were treated successfully. Finally, a guideline was proposed to help achieve consistent apical patency in calcified canals.

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A Rare Root Canal Configuration of Bilateral Maxillary First Molar with 7 Root Canals Diagnosed Using Cone-beam Computed Tomographic Scanning: A Case Report

Journal of Endodontics ◽

10.1016/j.joen.2013.09.004 ◽

2014 ◽

Vol 40 (2) ◽

pp. 296-301 ◽

Cited By ~ 16

Author(s):

Gautam P. Badole ◽

Manjusha M. Warhadpande ◽

Pratima R. Shenoi ◽

Chandrakant Lachure ◽

Shital G. Badole

Keyword(s):

Case Report ◽

Root Canal ◽

Cone Beam ◽

Root Canals ◽

Computed Tomographic

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A scanning electron microscopic evaluation of different root canal irrigation regimens

Brazilian Oral Research ◽

10.1590/s1806-83242006000300010 ◽

2006 ◽

Vol 20 (3) ◽

pp. 235-240 ◽

Cited By ~ 12

Author(s):

Chaves Medici Mônika ◽

Izabel Cristina Fröner

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Ricinus Communis ◽

Smear Layer ◽

Electron Microscopic ◽

Canal Irrigation ◽

Root Canals ◽

Root Canal Irrigation ◽

Microscopic Evaluation ◽

Scanning Electron

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl); 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

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