Materials and methods: Sixty extracted premolars were assigned to three groups according to the root canal system (Weine's classification; type I, II and III) of 20 teeth each using radiographic examination. The root tip was cut horizontally 1 mm from the anatomical apex and the apical cross-section was visualized using microscope at x50 magnification and photographed. Minimum and maximum apical root canal diameter of each tooth was measured and classified into three types by canal morphology (round, oval and flattened shape). Statistical analysis was performed to compare the apical root canal diameter and morphology according to the root canal system. Results: In apical root canal morphology at cross-sectional view, the most common shape was round in type I, flat in type II, and oval in type III. In apical root canal diameters at cross-sectional view, there was a significant difference between the minimum and maximum diameter in all types (p<0.05). The maximum diameter was 0.331 mm in type I, 0.519 mm in type II, and 0.310 mm in type III. There was a significant difference among type I, III and type II (p<0.05). Conclusion: The morphology and diameter of apical root canal was different according to the root canal system. Therefore, clinicians should consider the apical file size in view of the apical root canal shape according to the root canal system.
The aim of this study was to compare the root canal systems of maxillary and mandibular premolars that had a single root using radiographs and clearing samples. 142 single rooted premolars were selected and mesio-distal and bucco-lingual views were radiographed using intra-oral dental standard films. Four equally trained examiners classify the root canal types from the developed radiographs. After opening the tooth for access, it was stored in $5\%$ NaOCl to dissolve the pulp tissue. Indian ink was then injected into the pulp cavity to stain the pulp tissue. It was cleared in methyl salicylate after being decalcified with $5\%$ nitric acid for 48 hours, and the root canal type was evaluated at a magnification of $\times$ 20 using a stereomicroscope. The results are as follows ; There were statistically significant differences between the radiographs and clearing samples of the root canal types among examiners (p < 0.05). There might be differences in the root canal types among examiners when the same radiograph is used. Therefore, considering the difficulty in estimating the root canal types, clinicians need to be careful when interpreting radiographs before root canal therapy.
Kim, Jin-Woo;Ji, Hyo-Jin;Cho, Kyung-Mo;Kim, Sung-Min;Park, Se-Hee
Journal of Dental Rehabilitation and Applied Science
/
v.31
no.2
/
pp.104-111
/
2015
Purpose: The aim of this retrospective study was to investigate the prevalence rate and types of C-shaped roots and C-shaped canal in maxillary molars by analyzing cone-beam computed tomography (CBCT) in a Korean population. Materials and Methods: Total of 357 CBCT images of maxillary molars (186 first molar, 171 second molar) were evaluated by two Endodontic specialists. Results: Eight types of C-shaped roots and 5 types of C-shaped canals were founded, the prevalence rate of C-shaped roots and canals were 21.0% and 5.3% respectively. Conclusion: These anatomical variations were more frequent in second molars than the first molars. Clinicians should have anatomical knowledge about various types of C-shaped root and root canal for successful root canal therapy.
Purpose: The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. Materials and Methods: Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. Results: The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant(P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. Conclusion: Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.
The purposes of this study were to evaluate the changes in root canal configuration with canal instrumentation using different file types and techniques and to investigate most appropriate instrumentation technique in maintaining the original canal configuration with different file types. Fifty curved mesiobuccal or distobuccal canals of extracted human maxillary molar teeth were instrumented using a step-back technique with stainless steel K-files or nickel-titanium K-files, a crown-down pressureless technique with stainless steel K-files or nickel-titanium K-files and nickel-titanium engine-driven files. Radiographs were taken before and after instrumentation using a specially designed device that allowed for the pre-and postinstrumentation canals to be taken with the same X-ray angulation. Magnified X-ray images on a magnifier screen were traced and post instrumentation canal images were compared with the preinstrumentation ones. Changes in canal curvature and the incidence of procedural accidents were analyzed. The results were as follows : Crown-down pressureless technique with nickel-titanium K-files and nickel-titanium engine-driven filing produced no significant changes in canal curvature (p>0.05), while the step-back technique with stainless steel K-files or nickel-titanium K-files (p<0.01) and the crown-down pressureless technique with stainless steel K-files (p<0.05) produced significant changes. With nickel-titanium K-file, crown-down pressureless technique produced significantly less changes in canal curvature than step-back technique (p<0.05), while there was no significant difference between techniques with stainless steel K-files (p>0.05). File types exerted no significant influences in the changes of canal curvature both in the step-back technique and crown-down pressureless technique (0>0.05). Regardless of the file types used, step-back technique produced more procedural accidents such as ledge or elbow formation, apical zipping and apical transportation than the crowndown pressureless technique and nickel-titanium engine-driven filing. Both with stainless steel K-files and with nickel-titanium K-files, the incidence of apical extrusion of canal debris was higher in step-back technique than in crown-down pressureless technique.
Objectives: The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population. Materials and Methods: Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. Results: Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001). Conclusions: In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.
Purpose:The aim of the present study was to evaluate the incidence of the second mesiobuccal (MB2) canal, root fusion, and C-shaped root canal configuration in the Korean maxillary first (MM1) and second (MM2) molars by analyzing cone-beam computed tomographic (CBCT) images. Materials and methods: Patients undergoing presurgical CBCT examination were included in the current study. The CBCT images of 1498 MM1 and 1742 MM2 from 1658 Korean patients were assessed to determine the incidence of a MB2 canal, the types of canal configurations, root fusion, and C-shaped root canal configurations. Further, the correlations between the incidence of MB2 canal and age, gender, and tooth position were analyzed. Results: The study population was relatively old (mean age: 66.1 years). The percentage of MB2 canals in MB roots was 60.1% and 28.0% in MM1 and MM2, respectively, with the most common configurations being Weine type III in MM1 and Weine type II in MM2. Additionally, the frequency of a MB2 canal decreased with age in both molars and was higher in men than in women in the MM1 only. Furthermore, root fusion was present in 2.3% and 26.2% of the MM1 and MM2, respectively, whereas C-shaped root canals were observed in 0.4% and 2.7% of the MM1 and MM2, respectively. Conclusion: The MB2 canal was found more frequently in the MM1, whereas root fusion and C-shaped root canals were both seen more frequently in the MM2.
Purpose : To assess the diagnostic accuracy and value in an imaging technique field through the comparison of cone beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Materials and Methods : Participants consisted of 100 patients offered the images through cone beam computed tomography and panoramic radiography. PSR-$9000^{TM}$ Dental CT system (Asahi Roentgen Ind. Co., Ltd, Japan) was used as the unit of cone beam computed tomography. CE-II (Asahi Roentgen Ind. Co., Ltd, Japan) and Pro Max (Planmeca Oy, Finland) were used as the unit of panoramic radiography. The images obtained through panoramic radiography were classified into 3 types according to the distance between mandibular canal and root of mandibular third molar. And they were classified into 4 types according to the proximity of radiographic feature. The images obtained through cone beam computed tomography based on the classification above were classified into 4 types according to the location between the mandibular canal and the root and were analyzed. And they were classified into buccal, inferior, lingual, and between roots, according to the location between mandibular canal and root. The data were statistically analyzed and estimated by $X^2$-test. Results : 1. There was no statistical significance according to 3 types (type I, type II, type III) through CBCT. 2. The results of 4 types (type A, type B, type C, type D) through CBCT were as high prevalence of CBCT 1 in type A, CBCT 2 in type B, CBCT 3 in type C, and CBCT1 in type D and those of which showed statistical significance (P value=0.03). 3. The results according to location between mandibular canal and root through CBCT recorded each 49, 25, 17, 9 as buccal, inferior, lingual, between roots. Conclusion : When estimating the mandibular canal and the roots through the panoramic radiography, it could be difficult to drive the views of which this estimation was considerable. Thus it is required to have an accurate diagnostic approaching through CBCT that could estimate the location between mandibular canal and roots.
Objectives: To evaluate the accuracy of the Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigants, such as saline, 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine liquid, 2% chlorhexidine gel, and RC-Prep, and also to determine the electrical conductivities of these endodontic irrigants. Materials and Methods: A root perforation was simulated on twenty freshly extracted teeth by means of a small perforation made on the proximal surface of the root at 4 mm from the anatomic apex. Root ZX was used to locate root perforation and measure the electronic working lengths. The results obtained were compared with the actual working length (AWL) and the actual location of perforations (AP), allowing tolerances of 0.5 or 1.0 mm. Measurements within these limits were considered as acceptable. Chi-square test or the Fisher's exact test was used to evaluate significance. Electrical conductivities of each irrigant were also measured with an electrical conductivity tester. Results: The accuracies of the Root ZX in perforated teeth were significantly different between liquid types (saline, NaOCl) and gel types (chlorhexidine gel, RC-Prep). The accuracies of electronic working lengths in perforated teeth were higher in gel types than in liquid types. The accuracy in locating root perforation was higher in liquid types than gel types. 5.25% NaOCl had the highest electrical conductivity, whereas 2% chlorhexidine gel and RC-Prep gel had the lowest electrical conductivities among the five irrigants. Conclusions: Different canal irrigants with different electrical conductivities may affect the accuracy of the Root ZX in perforated teeth.
When conventional root canal treatment is failed or contraindicated, retrograde root canal filling following apicoectomy is a valuable procedure, aimed at hermetically sealing the root canal against leakage of irritants from the canal into the periapical tissue. In this in vitro investigation, to analyze apical microleakage electrochemically in teeth with different retrograde filling materials and preparation types, single - rooted tooth was cut 2mm from the apex and each Class I and Slot preparation was prepared. Experimental groups : Group 1. Amalgam filling with cavity varnish in Class I preparation Group 2. Scotchbond 2+Silux filling in Class I preparation Group 3. Gutta percha filling with ZOE cement in Class I preparation Group 4. Amalgam filling with cavity varnish in Slot preparation Group 5. Scotchbond 2+Silux filling in Slot preparation Each specimens was immersed in 1% solution of KCl, and applied a potential of 9V external power supply. Measurements of the current flow were obtained at 1, 2, 3, 7, 9, 12, 14, 18, 21, 25 and 28 day after immerson. Marginal microleakage were compared and evaluated. The results were as follows ; 1. The group filled with composite resin with dentin bonding agent shows lower apical microleakage value than the group filled with amalgam following varnish application (P<0.01). 2. In the group filled with gutta percha, apical microleakage value was the hightest 3. There was no significant difference between Class I cavity and Slot type cavity regardless of the used materials.
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