scholarly journals Accuracy of CBCT as modality to identify the presence of secondary mesiobuccal root canal in the maxillary first molar

2017 ◽  
Vol 29 (3) ◽  
Author(s):  
Haikal Halil ◽  
Mazlifa Mahidin ◽  
Nik Nur Farahiyah ◽  
Khairul Bariah Chi Adam

Introduction: Successful endodontic treatment requires the clinician to be able to locate, disinfect, and obturate all canals presence in the root canal system to remove the infection and prevent re-infection. However, some canals, such as secondary mesiobuccal (MB) root canal often missed upon examination and the treatment. The success of locating these canals is determined by the methods used, a periapical radiograph and Cone Beam Computed Tomography (CBCT). The purpose of this study was to examine the sensitivity and accuracy of the periapical radiograph (PA) and CBCT on determining the presence of the secondary MB root canal. Methods: As much as 40 intact crown and intact radicular of the maxillary first molars, without root caries, root restoration, and endodontic treated, were taken as the samples. The presence of a secondary MB root canal was evaluated by a PA radiograph, CBCT, and clinical sectioning. Samples were undergone each test and sectioned after being completed the radiographic evaluation steps. Results: CBCT radiograph was successfully identifying 62.5% secondary MB root canal presence, whilst the PA radiograph has detected only 20% of the samples. The sensitivity of CBCT and PA radiograph was compared with the gold standard method, resulting 86.2 and 27.6% respectively. The statistical analysis showed that there was no significant difference between CBCT test and the gold standard (p=0.00). Conclusion: CBCT was proven to be a reliable method to detect the presence of secondary MB root canals due to its accuracy as high as the clinical sectioning compared to the PA radiograph.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francisco Gomez ◽  
Gisbeli Brea ◽  
Jose Francisco Gomez-Sosa

Abstract Background The purpose of this study was to determine the anatomical variations of the root canal system of mandibular second molars using cone-beam computed tomography (CBCT). Methods 190 mandibular second molars cone-beam computed tomography images were reviewed. The evaluation was performed by a radiologist with endodontic experience and two endodontists trained with CBCT technology. Tooth position, number of root and root canals, C-shaped root canal system configuration, presence of extra root (radix), and radicular grooves were assessed. Data was statistically analyzed using The Chi-square test (α = 0,05) to determine any significant difference between gender and the total number of root and root canals, and any significant difference between gender and root canal anatomical variation. Results Overall, 85.5% showed two separated roots, 12.1% a single root, 2.6% three roots or radix. 87.7% showed three root canals, 12.1% two root canals, 2.6% four root canals, and 1.6% a single root canal. 10% showed a single foramen, 75.3% two foramina, 13.6% three foramina and 1% showed four foramina.19.5% showed C-shaped anatomical variation, 51.4% in male patients, 48.6% in female patients. According to Fan classification: C1 13.6% in cervical third, C2 10% in the middle third, C3 17.3% in middle third, 15.5% in apical third, and C4 12.7% in the apical third. Root canals number in these samples were 5.4% a single canal, 21.6% two canals, 70.3% three canals, and 2.7% four canals. The root showed 46% with one foramen, 46% two foramina, and 8% three foramina. Radicular grooves 83.3% were found in the lingual area and 16.2% towards the buccal area. Conclusions The most prevalent anatomic presentation of the evaluated sample was a mandibular second molars with two roots, three root canals, and two apical foramina. Their variation was C-shaped root canals and Radix Paramolaris.


2005 ◽  
Vol 13 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Janir Alves Soares ◽  
Mario Roberto Leonardo ◽  
Léa Assed Bezerra da Silva ◽  
Mário Tanomaru Filho ◽  
Izabel Yoko Ito

In the endodontic treatment of root canals with necrotic pulps associated with periapical radiolucent areas, one of the main objectives of treatment consists in eliminating the microorganisms spread throughout the ramifications of the root canal system. The scope of this study was to evaluate the antiseptic efficacy of biomechanical preparation and two calcium hydroxide-based pastes, in dogs' teeth with experimentally induced chronic periapical lesions. After initial microbiological sampling, instrumentation of the root canals was undertaken using the conventional technique, using K type files used in conjunction with a solution of 5.25% sodium hypochlorite. After ninety-six hours, further microbiological sampling was undertaken and Calen/CPMC or Calasept pastes were applied for 15 and 30 days. Ninety six hours after the removal of the medication, the third microbiological sampling was undertaken and finally histomicrobiological analysis followed using Brown & Brenn staining. The results were analyzed using the Kruskall-Wallis test, with a level of significance established at 5% (p<0.05). It was shown that the biomechanical preparation significantly reduced the number of colony forming units of microorganisms in root canals. In contrast, there was no significant difference between the antiseptic action of long-term dressings over two periods of action, although 30 days produced a greater reduction in the quantity of microorganisms and of positive microbiological cultures. In histological sections of the four experimental groups, similar microbiological patterns were shown (p>0.05), characterized by an elevated incidence of cocci, bacilli and filaments, predominantly gram-positive, in root canals, secondary canals and accessories, apical cementoplasts and dentinal tubules, but with a low incidence of microorganisms in areas of cementum resorption and the periapical lesion. The biomechanical preparation and intracanal dressing based on calcium hydroxide were important in the antisepsis of the root canal; however, both procedures did not produce significant changes in the microbiological aspects of the root canal system.


2015 ◽  
Vol 26 (4) ◽  
pp. 342-346 ◽  
Author(s):  
Juliane Maria Guerreiro-Tanomaru ◽  
Gisselle Moraima Chávez-Andrade ◽  
Norberto Batista de Faria-Júnior ◽  
Evandro Watanabe ◽  
Mário Tanomaru-Filho

<p>Endodontic irrigation aims to clean and disinfect the root canal system. Passive ultrasonic irrigation (PUI) is based on the use of an ultrasound-activated instrument into the root canal filled with irrigant. The aim of this study was to evaluate, ex vivo, the effectiveness of PUI in eliminating <italic>Enterococcus faecalis</italic> from root canals. Seventy-five extracted human single-root teeth were used. After root canal preparation, specimens were inoculated with <italic>E. faecalis</italic> and incubated at 37 °C for 21 days. Specimens were distributed into five groups (n=15), according to the irrigation method: PUI + saline solution (PUI/SS); PUI + 1% NaOCl (PUI/NaOCl); conventional needle irrigation (CNI) + saline solution (CNI/SS); CNI + 1% NaOCl (CNI/NaOCl); No irrigation (control). Microbiological samples were collected at three time points: initial (21 days after inoculation), post-irrigation (immediately after irrigation), and final (7 days after irrigation). Data were obtained in CFU mL<sup>-1</sup> and subjected to analysis by ANOVA and Tukey's tests at 5% significance level. The post-irrigation samples did not demonstrate statistical difference between PUI/SS and CNI/SS nor between PUI/NaOCl and CNI/NaOCl (p>0.05), but PUI/NaOCl and CNI/NaOCl had lower CFU mL<sup>-1</sup> number than the other groups (p>0.05). Statistically significant difference was observed between the initial and post-irrigation samples and between the post-irrigation and final samples (p<0.05) in all groups, except in the control. The final samples of all groups presented bacterial counts similar to the initial samples. PUI or CNI with 1% NaOCl contribute to disinfection, but are unable to eradicate <italic>E. faecalis</italic> from the root canal system.</p>


2019 ◽  
Vol 10 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Vidhi Walia ◽  
Mousumi Goswami ◽  
Shivesh Mishra ◽  
Nidhi Walia ◽  
Divya Sahay

Introduction: One of the primary goals of pulpectomy is to decrease the sum total of microorganisms and disinfect the tooth root canal system. To achieve this, mechanical preparation, irrigation, disinfection and obturation of the root canal is necessary. The present study was set out to evaluate the difference in the antibacterial efficacy of primary teeth root canals either irrigated with chlorhexidine, saline, and sodium hypochlorite or irradiated with a soft tissue diode laser (980 nm, Photon Plus, Zolar Tech & Mfg Co. Inc, Ontario, Canada). Methods: Sixty primary teeth of children requiring pulpectomy were divided into 4 groups of 15 each, group 1 (2% chlorhexidine), group 2 (1% sodium hypochlorite), group 3 (laser irradiation) and group 4 (saline). Pulp tissue was extirpated from the canals and the samples were collected using sterile absorbent paper points. After cleaning and shaping, the root canals of the teeth in each group were irrigated using sodium hypochlorite, chlorhexidine, and saline or were irradiated with the laser. The samples were obtained again and sent for microbiological examination. Results: The colony-forming unit (CFU) counts from pre-disinfection sample served as a baseline for comparisons throughout the study. The mean bacterial colony counts of all the isolated bacteria reduced after irrigation or irradiation. Intergroup comparisons showed no significant difference when groups 1, 2, and 3 were compared to each other (P>0.05). However, a significant difference was seen when groups 1, 2, 3 were compared to group 4 (P<0.05). Conclusion: Two percent chlorhexidine, 1% sodium hypochlorite and laser irradiation succeeded in reducing the root canal infection. Hence, diode laser irradiation may be a possible supplement to existing protocols for disinfecting the root canal system.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alfredo Sierra-Cristancho ◽  
Luis González-Osuna ◽  
Daniela Poblete ◽  
Emilio A. Cafferata ◽  
Paola Carvajal ◽  
...  

AbstractThis study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.


2011 ◽  
Vol 12 (5) ◽  
pp. 368-371 ◽  
Author(s):  
Matheus Melo Pithon ◽  
Deyla Duarte Vilela ◽  
Manoel Matos Neto ◽  
Alexandre Mascarenhas Villela

ABSTRACT Aim To evaluate the interference of the intracanal medication Calen® (SSWhite, São Paulo, Brazil) on the filling of simulated lateral canals. Materials and methods Twenty human anterior teeth were used. Before the endodontic filling procedures the access of cavity was made, and after this root canals were made in all the teeth to simulate the presence of lateral canals. After preparation, the teeth were randomly divided into two groups (n=10). In group I, the root canal system was filled directly after chemicalmechanical preparation; in group II, endodontic treatment was performed in multiple sessions, and after preparation the calcium hydroxide-based intracanal medication Calen® was inserted. After the period of 7 days, the root canals were vigorously irrigated and then they were filled. Next, the teeth were radiographed to verify the quality of the filling. Results The results demonstrated that the teeth treated in a single session, without calcium hydroxide medication, presented 47 canals out of 60 with radiographic evidence of filling, whereas the teeth in which intracanal medication was used, only 07 presented a radiographic image compatible with filling (p < 0.05). Conclusion The use of the calcium hydroxide-based medication Calen made it difficult to obtain a hermetic filling of the root canal system. Clinical significance The clinical significance of this work basing on the fact that once the dentist knowing that property obliteration of calcium hydroxide can be taken care when they are used in the presence of lateral canals. How to cite this article Vilela DD, Neto MM, Villela AM, Pithon MM. Evaluation of Interference of Calcium Hydroxide-based Intracanal Medication in Filling Root Canal Systems . J Contemp Dent Pract 2011;12(5):368-371.


2020 ◽  
Vol 73 (6) ◽  
pp. 1145-1148
Author(s):  
Maryna A. Goray ◽  
Nataliia G. Gadzhula ◽  
Olena V. Muntian ◽  
Olena L. Cherepakha ◽  
Larysa F. Kurdysh

The aim: To compare the quality of root canal system preparation with the use of manual K-files, machine Protaper Universal and Silk files by in vitro studies. Materials and methods: Root canals preparation in 45 extracted premolars was performed in three groups with 15 teeth in each with K-files, Protaper Universal and Silk files. Transverse sections of the dental root were prepared. Histologically were assessed: amount of sawdust and predentin remaining, the purity degree of root canal walls. Results: When calculating the sawdust amount at the distance of 3 mm from an apex, a high degree of contamination was observed in the manual K-file group: 53.3% versus 33.3% in the Protaper Universal group and against 20.0% in the Silk file group. The amount of predentin after root canal treatment with manual files reached 25-30%. At the distance of 5 mm from the apex the root canals with high and medium purity degree were detected in 86.7% with Silk files and 80.0% with Protaper Universal files used. All predentin was removed when working with Protaper Universal and Silk files. Conclusions: In the histological sections of the root canals treated with K-files, the larger amount of dentine particles and predentin has been revealed than when using machine tools. The largest amount of predentin and dentine were removed with Protaper Universal files. Silk endodontic system is better for treatment of the root canals dentine surface in the apical area compared to Protaper Universal and K-files.


2017 ◽  
Vol 7 (3) ◽  
pp. 54 ◽  
Author(s):  
Celalettin Topbas ◽  
Ozkan Adiguzel

The goal of endodontic treatment is to remove all the vital and necrotic tissues, microorganisms and microbial byproducts from root canal system. This goal can be achieved through chemical and mechanical debridement of root canals. This article narrates the specifics and requirements of the irrigation solutions. Sodium hypochlorite is proposed as the primary irrigant by virtue of its organic tissue dissolution capacity and broad antimicrobial properties. On the other hand, chelation solutions are recommended as auxiliary solutions to remove the smear layer or to hinder its formation on dentin surface. Thus, it's hoped that sealers and root canal fillers can penetrate to dentin tubules and obturate the canals hermetically. There are new studies on traditional irrigants especially on some irrigants that can replace sodium hypoclorite. This article reviews the new irrigants which can be used in future endodontic practice, and their advantages and limitations. Moreover, actions and interactions of recently used irrigants are adverted.   How to cite this article: Topbas C, Adiguzel O. Endodontic Irrigation Solutions: A Review. Int Dent Res 2017;7:54-61.  Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.


Author(s):  
Girish Nanjannawar ◽  
Saquib Mulla ◽  
Divya Gupta ◽  
Sharad Kamat

It is a well-recognised fact that incomplete cleaning, shaping and obturation of root canals will lead to endodontic failure. Mandibular second premolars usually have a single root and a single root canal. The presence of four separate roots and four root canals is quite rare. Hence, a comprehensive knowledge about the normal canal configuration along with its variations becomes an indispensable pre-requisite to achieve the success of endodontic treatment. Authors hereby present a case of a 26-year-old male patient and describe its succesful treatment of the mandibular second premolar with four roots and four root canals. The clinical implications of this paper aim at establishing an accurate diagnosis of the root canal system using diagnostic aids such as angulated radiographs and making use of advanced endodontic instruments for successful retreatment of endodontic therapy (C+ files and NiTi rotary endodontic instruments).


2019 ◽  
Vol 10 (2) ◽  
pp. 179-182
Author(s):  
Mario Buonvivere ◽  
Matteo Buonvivere

The proper knowledge of the root canal system anatomy is crucial to perform successful endodontic treatments. Maxillary lateral incisors usually have a single root. However, aberrant canal configurations of this tooth have been reported in the literature. The clinician should be aware of the difficulties arising from this more complex root canal anatomy and should be able to manage them. A rare case of a maxillary lateral incisor with three root canals is presented in this article; the challenge of diagnosis and treatment in similar situations is also discussed.


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