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Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment

  • Yoon, Jiyoung (Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Cho, Byeong-Hoon (Department of Conservative Dentistry, Seoul National University School of Dentistry and Dental Research Institute) ;
  • Bae, Jihyun (Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Choi, Yonghoon (Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital)
  • 투고 : 2017.11.29
  • 심사 : 2018.01.26
  • 발행 : 2018.05.31

초록

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

키워드

참고문헌

  1. Abbott PV. The periapical space--a dynamic interface. Aust Endod J 2002;28:96-107. https://doi.org/10.1111/j.1747-4477.2002.tb00399.x
  2. Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Topics 2005;10:77-102. https://doi.org/10.1111/j.1601-1546.2005.00135.x
  3. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 1990;16:498-504. https://doi.org/10.1016/S0099-2399(07)80180-4
  4. Chugal NM, Clive JM, Spangberg LS. A prognostic model for assessment of the outcome of endodontic treatment: effect of biologic and diagnostic variables. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:342-352. https://doi.org/10.1067/moe.2001.113106
  5. Chugal NM, Clive JM, Spangberg LS. Endodontic infection: some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:81-90. https://doi.org/10.1016/S1079-2104(02)91703-8
  6. Wang N, Knight K, Dao T, Friedman S. Treatment outcome in endodontics-The Toronto Study. Phases I and II: apical surgery. J Endod 2004;30:751-761. https://doi.org/10.1097/01.don.0000137633.30679.74
  7. Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:86-93. https://doi.org/10.1016/S1079-2104(98)90404-8
  8. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 1981;89:321-328.
  9. Yang G, Yuan G, Yun X, Zhou X, Liu B, Wu H. Effects of two nickel-titanium instrument systems, Mtwo versus ProTaper universal, on root canal geometry assessed by micro-computed tomography. J Endod 2011;37:1412-1416. https://doi.org/10.1016/j.joen.2011.06.024
  10. Hubscher W, Barbakow F, Peters OA. Root-canal preparation with FlexMaster: canal shapes analysed by micro-computed tomography. Int Endod J 2003;36:740-747. https://doi.org/10.1046/j.1365-2591.2003.00723.x
  11. Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: assessment of torque and force in relation to canal anatomy. Int Endod J 2003;36:93-99. https://doi.org/10.1046/j.1365-2591.2003.00628.x
  12. Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT. Int Endod J 2003;36:86-92. https://doi.org/10.1046/j.1365-2591.2003.00626.x
  13. Weiger R, ElAyouti A, Lost C. Efficiency of hand and rotary instruments in shaping oval root canals. J Endod 2002;28:580-583. https://doi.org/10.1097/00004770-200208000-00004
  14. Peters OA, Roehlike JO, Baumann MA. Effect of immersion in sodium hypochlorite on torque and fatigue resistance of nickel-titanium instruments. J Endod 2007;33:589-593. https://doi.org/10.1016/j.joen.2007.01.007
  15. Choi YH, Bae JH, Kim YK, Kim HY, Kim SK, Cho BH. Clinical outcome of intentional replantation with preoperative orthodontic extrusion: a retrospective study. Int Endod J 2014;47:1168-1176. https://doi.org/10.1111/iej.12268
  16. Tam A, Yu DC. Location of canal isthmus and accessory canals in the mesiobuccal root of maxillary first permanent molars. J Can Dent Assoc 2002;68:28-33.
  17. Poorni S, Kumar R, Indira R. Canal complexity of a mandibular first molar. J Conserv Dent 2009;12:37-40. https://doi.org/10.4103/0972-0707.53341
  18. al-Nazhan S. Incidence of four canals in root-canal-treated mandibular first molars in a Saudi Arabian sub-population. Int Endod J 1999;32:49-52. https://doi.org/10.1046/j.1365-2591.1999.00188.x
  19. de Pablo OV, Estevez R, Peix Sanchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 2010;36:1919-1931. https://doi.org/10.1016/j.joen.2010.08.055
  20. Sperber GH, Moreau JL. Study of the number of roots and canals in Senegalese first permanent mandibular molars. Int Endod J 1998;31:117-122. https://doi.org/10.1046/j.1365-2591.1998.00126.x
  21. Cambruzzi JV, Marshall FJ. Molar endodontic surgery. J Can Dent Assoc 1983;49:61-65.
  22. Hsu YY, Kim S. The resected root surface. The issue of canal isthmuses. Dent Clin North Am 1997;41:529-540.
  23. Skidmore AE, Bjorndal AM. Root canal morphology of the human mandibular first molar. Oral Surg Oral Med Oral Pathol 1971;32:778-84. https://doi.org/10.1016/0030-4220(71)90304-5
  24. Barker BC, Parsons KC, Mills PR, Williams GL. Anatomy of root canals. III. Permanent mandibular molars. Aust Dent J 1974;19:408-413. https://doi.org/10.1111/j.1834-7819.1974.tb02372.x
  25. McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975;1:238-242. https://doi.org/10.1016/S0099-2399(75)80226-3
  26. Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005;31:669-671. https://doi.org/10.1097/01.don.0000153846.62144.d2
  27. Blum JY, Michailesco P, Abadie MJ. An evaluation of the bactericidal effect of the Nd:YAP laser. J Endod 1997;23:583-585. https://doi.org/10.1016/S0099-2399(06)81127-1
  28. Clark-Holke D, Drake D, Walton R, Rivera E, Guthmiller JM. Bacterial penetration through canals of endodontically treated teeth in the presence or absence of the smear layer. J Dent 2003;31:275-281. https://doi.org/10.1016/S0300-5712(03)00032-0
  29. Olgart L, Brannstrom M, Johnson G. Invasion of bacteria into dentinal tubules. Experiments in vivo and in vitro. Acta Odontol Scand 1974;32:61-70. https://doi.org/10.3109/00016357409002533
  30. Mjor IA. Dentin permeability: the basis for understanding pulp reactions and adhesive technology. Braz Dent J 2009;20:3-16. https://doi.org/10.1590/S0103-64402009000100001
  31. Pashley DH, Nelson R, Kepler EE. The effects of plasma and salivary constituents on dentin permeability. J Dent Res 1982;61:978-981. https://doi.org/10.1177/00220345820610081201

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