Three-Dimensional Analysis of Root Anatomy and Root Canal Curvature in Mandibular Incisors Using Micro-Computed Tomography with Novel Software
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Root Canal Treatment of Permanent Mandibular First Molar with Six Root Canals: a Rare Case
CASE REPORT Turk Endod J 2016;1(1):52–54 doi: 10.14744/TEJ.2016.65375 Root canal treatment of permanent mandibular first molar with six root canals: a rare case Ersan Çiçek,1 Neslihan Yılmaz,1 Murat İçen2 1Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey 2Department of Oral Radiology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey This case report aims to present the management of a mandibular first molar with six root canals, four in mesial and two in distal root. A 16-year-old male patient who has suffered from localized dull pain in his lower left posterior region for a long time was referred to the endodontic clinic. On clinical examina- tion, neither caries lesion nor restoration was observed on the mandibular molar teeth; but the occlu- sal surface of the teeth had pathologic attrition. The mandibular and maxillary molars were tender to percussion due to bruxism, but there was no tenderness towards palpation. All of the molars revealed normal responses to the vitality tests. It was suggested that he should use the night-guard against brux- ism. After three months, his pain almost completely relieved, but the percussion of the left mandibular molar was still going on. After access cavity preparation, careful examination of the pulp chamber floor with dental loupe and endodontic explorer (DG 16 probe) showed six canal orifices, four of mesially and two of distally. CBCT scan was performed in order to confirm the presence of six canals. Following one year, it was observed that he had no pain. -
Endodontic Therapy in a 3-Rooted Mandibular First Molar: Importance of a Thorough Radiographic Examination
C LINICAL P RACTICE Endodontic Therapy in a 3-Rooted Mandibular First Molar: Importance of a Thorough Radiographic Examination • Juan J. Segura-Egea, DDS, MD, PhD • • Alicia Jiménez-Pinzón, DDS • • José V. Ríos-Santos, DDS, MD, PhD • Abstract This case report describes endodontic therapy on a mandibular first molar with unusual root morphology. In the initial treatment the working length had been determined with only an apex locator; no periapical radiographs had been obtained because the patient was pregnant. The root canal into an additional distolingual root had not been found and was therefore left untreated, which led to treatment failure after 11 months. The radiographic examina- tion performed in a subsequent endodontic treatment allowed detection of the anomalous root and completion of the root canal treatment. The distolingual root canal would have been identified during the initial endodontic therapy if a thorough radiographic examination had been carried out. This report highlights the importance of radiographic examination and points out the need to look for additional canals and unusual canal morphology associated with a mandibular first molar. Radiographic examination during pregnancy is also discussed. MeSH Key Words: dental care; molar/anatomy and histology; tooth root/anatomy and histology; pregnancy © J Can Dent Assoc 2002; 68(9):541-4 This article has been peer reviewed. oot canals may be left untreated during endodontic Thai origin had a third distolingual root. The additional therapy if the dentist fails to identify their presence, root is generally located on the lingual aspect and has a particularly in teeth with anatomical variations or Vertucci type I canal configuration.2 Such a variant has not R 1 extra root canals. -
Dental Arch Space Changes Following Premature Loss of Primary First Molars
PEDIATRIC DENTISTRY V 30 / NO 4 JUL / AUG 08 Scientific Article Dental Arch Space Changes Following Premature Loss Of Primary First Molars: A Systematic Review William Tunison, BSc1 • Carlos Flores-Mir, DDS, DSc2 • Hossam ElBadrawy, DDS, MSc3 • Usama Nassar, DDS, MSc4 • Tarek El-Bialy, DDS, MSc OSci, PhD5 Abstract: Purpose: The purpose of this study was to consider the available evidence regarding premature loss of primary molars and the implications for treatment planning. Methods: Electronic database searches were conducted—including published information available until July 2007—for available evidence. A methodological quality assessment was also applied. Results: Although a significant number of published articles had dealt with premature primary molar loss, only 3 studies (including a total combined sample of 80 children) had the minimal methodological quality to be considered for this systematic review. Conclusion: A reported immediate space loss of 1.5 mm per arch side in the mandible and 1 mm in the maxilla—when normal growth changes were considered—was found. The magnitude, however, is not likely to be of clinical significance in most cases. Nevertheless, in cases with incisor and/or lip protrusion or a severe predisposition to arch length deficiency prior to any tooth loss, this amount of loss could have treatment implications. (Pediatr Dent 2008;30:297-302) Received June 5, 2007 | Last Revision August 30, 2007 | Revision Accepted August 31, 2007 KEYWORDS: PREMATURE TOOTH LOSS, MIXED DENTITION, SPACE LOSS, TOOTH MIGRATION, SPACE -
Furcation Root Surface Anatomy
the Furcation to the cementoenamal junction were excluded from Morphology sample. in Relative to Periodontal The sample is the same as was used by the author a previously reported study9 and the mesio-distal length Treatment and furcation entrance diameter reported there are used for correlation in the present investigation. a"lS Furcation Root Surface All teeth were sectioned at right angles to the long Anatomy as at a level 2 mm apical to the most apical root division illustrated in I. A fine carborundum disc was Figure 15 used to make the section except in 22 maxillary and by mandibular teeth where a coarser wheel was used. The m.d.sc. Robert C. Bower, latter teeth were not used in the second part of the study- (W. Australia)* The level of section was established using the micrometer screw chuck of a specially constructed tooth sectioning lathe. Recent longitudinal studies of teeth with periodontal The cut tooth surfaces were examined using a dissect- breakdown furcation mm involving the present encouraging ing microscopef with a lOx eyepiece and 10/ioo results for the of such teeth.1"'' Both prognosis pocket micrometer disc to give a stated magnification of 6.3*· elimination!·'' (sometimes necessitating root resection) Measurement the micrometer disc was ' by calibrated and soft tissue to offer a better readaptation" appear using a 1 cm certified plate. One reticle unit was found than was In either of these prognosis formerly imagined. equal to 1.065 mm. to 2 approaches the problem, the anatomy of the furcal The dimensions measured are illustrated in Figures 4 aspects of the roots is likely to influence the result. -
Study of Root Canal Anatomy in Human Permanent Teeth
Brazilian Dental Journal (2015) 26(5): 530-536 ISSN 0103-6440 http://dx.doi.org/10.1590/0103-6440201302448 1Department of Stomatologic Study of Root Canal Anatomy in Human Sciences, UFG - Federal University of Goiás, Goiânia, GO, Brazil Permanent Teeth in A Subpopulation 2Department of Radiology, School of Dentistry, UNIC - University of Brazil’s Center Region Using Cone- of Cuiabá, Cuiabá, MT, Brazil 3Department of Restorative Dentistry, School of Dentistry of Ribeirão Beam Computed Tomography - Part 1 Preto, USP - University of São Paulo, Ribeirão Preto, SP, Brazil Carlos Estrela1, Mike R. Bueno2, Gabriela S. Couto1, Luiz Eduardo G Rabelo1, Correspondence: Prof. Dr. Carlos 1 3 3 Estrela, Praça Universitária s/n, Setor Ana Helena G. Alencar , Ricardo Gariba Silva ,Jesus Djalma Pécora ,Manoel Universitário, 74605-220 Goiânia, 3 Damião Sousa-Neto GO, Brasil. Tel.: +55-62-3209-6254. e-mail: [email protected] The aim of this study was to evaluate the frequency of roots, root canals and apical foramina in human permanent teeth using cone beam computed tomography (CBCT). CBCT images of 1,400 teeth from database previously evaluated were used to determine the frequency of number of roots, root canals and apical foramina. All teeth were evaluated by preview of the planes sagittal, axial, and coronal. Navigation in axial slices of 0.1 mm/0.1 mm followed the coronal to apical direction, as well as the apical to coronal direction. Two examiners assessed all CBCT images. Statistical data were analyzed including frequency distribution and cross-tabulation. The highest frequency of four root canals and four apical foramina was found in maxillary first molars (76%, 33%, respectively), followed by maxillary second molars (41%, 25%, respectively). -
Permanent Maxillary First Molar with Two Rooted Anatomy: a Rare Occurrence Dentistry Section
DOI: 10.7860/JCDR/2018/35290.11823 Case Report Permanent Maxillary First Molar with Two Rooted Anatomy: A Rare Occurrence Dentistry Section RENITA SOARES1, IDA DE NORONHA DE ATAIDE2, KARLA MARIA CARVALHO3, NEIL DE SOUZA4, SERGIO MARTIRES5 ABSTRACT The basis of successful endodontic therapy resides on sound and thorough knowledge of the root canal anatomy, its variations and the clinical skills. The importance of the knowledge of the anatomy of root canals cannot be overemphasized. Unusual root and root canal morphologies associated with maxillary molars have been reported in several studies, in the literature. The morphology of the maxillary first molar has been studied and reviewed extensively. However the presence of two roots in a maxillary first molar is a rare occurrence and such cases have seldom been reported in literature. This clinical report presents a permanent maxillary first molar with an unusual morphology of two roots with two canals. Keywords: Aberration, Incidence, Root canal systems, Two canals CASE REPORT that permitted magnification. One orifice was located toward the A 42-year-old female patient with a non-contributory medical buccal aspect and was larger in diameter when compared to the history presented to the department of conservative dentistry and typically found buccal orifice in a maxillary first molar. The second endodontics with a chief complaint of pain in the region of the orifice was located towards the palatal aspect [Table/Fig-3]. Further maxillary right first molar. She gave a history of intermittent pain for close inspection and exploration of the pulpal floor was done for the last two months which had increased in intensity since three search of additional orifices with the aid of DG-16 explorer under days. -
Endodontic Management of Mandibular First Molars with Three
Case Report Adv Dent & Oral Health Volume 9 Issue 4- August 2018 Copyright © All rights are reserved by Yousef Hamad Al-Dahman DOI: 10.19080/ADOH.2018.09.555768 Endodontic Management of Mandibular First Molars with Three Distal Root Canals-A Report of Two Cases Al-Hawwas Abdullah Yousef1, Al-Dahman Yousef Hamad2, Aldosary Khalid M3, Al-Dakheel Majed D3, Al-Zuhair Hind4 and Al-Jebaly Asma Suliman4 1Endodontist, Head of Endodontic Division, Dental Department, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia 2Endodontist, Ministry of Health, Kingdom of Saudi Arabia 3Consultant in Restorative Dentistry, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia 4General Practitioner, Riyadh, Kingdom of Saudi Arabia Submission:June 28, 2018 Published: August 28, 2018 *Corresponding author: Yousef Hamad Al-Dahman, Endodontist, Ministry of Health, P. O. Box: 84891, Riyadh 11681, Kingdom of Saudi Arabia, Email: Abstract The proper knowledge of root canal anatomy of teeth and its variation is necessary for successful endodontic treatment. Permanent case reports in the literature. However, the presence of three distal canals in distal root is rare. This paper describes two case reports of root canal therapymandibular of permanent first molars mandibular are usually molars having with two mesialthree distal canals root and canals. one or two distal canals. Moreover, middle mesial canal was present in different Keywords: Root canal anatomy; Mandibular molar; Root canal treatment Introduction macroscopic or scanning electron microscopy (SEM) evaluation The knowledge of the anatomy of root canal system and its [20,21], computed tomography (CT) [20], spiral computed endodontic treatment [1]. -
Sensitive Teeth Sensitive Teeth Can Be Treated
FOR THE DENTAL PATIENT ... TREATMENT Sensitive teeth Sensitive teeth can be treated. Depending on the cause, your dentist may suggest that you try Causes and treatment desensitizing toothpaste, which contains com- pounds that help block sensation traveling from the tooth surface to the nerve. Desensitizing f a taste of ice cream or a sip of coffee is toothpaste usually requires several applications sometimes painful or if brushing or flossing before the sensitivity is reduced. When choosing makes you wince occasionally, you may toothpaste or any other dental care products, look have a common problem called “sensitive for those that display the American Dental Asso- teeth.” Some of the causes include tooth ciation’s Seal of Acceptance—your assurance that Idecay, a cracked tooth, worn tooth enamel, worn products have met ADA criteria for safety and fillings and tooth roots that are exposed as a effectiveness. result of aggressive tooth brushing, gum recession If the desensitizing toothpaste does not ease and periodontal (gum) disease. your discomfort, your dentist may suggest in- office treatments. A fluoride gel or special desen- SYMPTOMS OF SENSITIVE TEETH sitizing agents may be applied to the sensitive A layer of enamel, the strongest substance in the areas of the affected teeth. When these measures body, protects the crowns of healthy teeth. A layer do not correct the problem, your dentist may rec- called cementum protects the tooth root under the ommend other treatments, such as a filling, a gum line. Underneath the enamel and the crown, an inlay or bonding to correct a flaw or cementum is dentin, a part of the tooth that is decay that results in sensitivity. -
Original Article Concurrent Measurements of Danger Zone Anatomy in Mandibular First Molars Using Micro-Computed Tomography: a Pilot Study
Int J Clin Exp Med 2018;11(8):7692-7700 www.ijcem.com /ISSN:1940-5901/IJCEM0067321 Original Article Concurrent measurements of danger zone anatomy in mandibular first molars using micro-computed tomography: a pilot study Jiawei Lu1, Lizong Liang1, Jie Ran1, Gao Wu1, Chenghao Li2, Jianping Ge2, Jianxiang Tao1 Departments of 1Prosthodontics, 2Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 20072, China Received October 16, 2017; Accepted May 9, 2018; Epub August 15, 2018; Published August 30, 2018 Abstract: The aim of this study is to describe the anatomical characteristics of the ‘danger zone’ in human mandibu- lar first molars by measuring the thickness of the bending point (point α) and the thinnest point (point β) of each root in human mandibular first molars. Eighteen mandibular first molars were scanned by micro-computed tomography and reconstructed three-dimensionally by Mimics Research 17.0. To identify characteristics of the ‘danger zone’, the actual root curvature, the minimal dentin thickness of the bending slice and the thinnest slice were selected as parameters. Furthermore, to describe the relationship of point α and point β, the distance between them was also measured. The results showed that the actual canal curvatures in the mandibular first molars were 5-10 degrees larger than those measured in 2-D images including X-ray or CBCT. The thinnest thickness of roots in all canals was less than 1 mm except the two distal roots of three-rooted mandibular first molars. Moreover, as for some two-rooted mandibular first molars, their point α and point β were located in the same furcation surface of root, the result might be coincident in the mesiolingual side; whereas for three-rooted mandibular first molars, the distal two canals were found significantly thicker than the mesial two (p<0.05). -
Anatomical Analysis of the Resected Roots of Mandibular First Molars After Failed Non-Surgical Retreatment
Restor Dent Endod. 2018 May;43(2):e16 https://doi.org/10.5395/rde.2018.43.e16 pISSN 2234-7658·eISSN 2234-7666 Research Article Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment Jiyoung Yoon ,1 Byeong-Hoon Cho ,2 Jihyun Bae ,1 Yonghoon Choi 1* 1Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea 2Department of Conservative Dentistry, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea Received: Nov 29, 2017 ABSTRACT Accepted: Jan 26, 2018 Objectives: Yoon J, Cho BH, Bae J, Choi Y Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very *Correspondence to important. This study examined the cross-sectional root canal structure of mandibular first Yong-Hoon Choi, DDS, MSD, PhD molars confirmed to have failed non-surgical root canal treatment using digital images Associate Professor, Department of Conservative Dentistry, Section of Dentistry, obtained during intentional replantation surgery, as well as the causative factors of the failed Seoul National University Bundang Hospital, conventional endodontic treatments. 82 Gumi-ro 173-beon-gil, Bundang-gu, Materials and Methods: This study evaluated 115 mandibular first molars. Digital Seongnam 13620, Korea. photographic images of the resected surface were taken at the apical 3 mm level and E-mail: [email protected] examined. The discolored dentin area around the root canal was investigated by measuring Copyright © 2018. The Korean Academy of the total surface area, the treated areas as determined by the endodontic filling material, and Conservative Dentistry the discolored dentin area. -
Morphologic Variations of Maxillary Molars Palatal Root and the Importance of Its Knowledge for Endodontic Practice: a Case Series
10.5005/jp-journals-10024-1024 RobertaCASE REPORT Kochenborger Scarparo et al Morphologic Variations of Maxillary Molars Palatal Root and the Importance of Its Knowledge for Endodontic Practice: A Case Series Roberta Kochenborger Scarparo, Letícia Pereira, Diana Moro, Grasiela Gründling Maximiliano Gomes, Fabiana Soares Grecca ABSTRACT treated of root canals greatly decreases the chances of 1-5 Aim: The present report describes and discusses root canal treatment success. The maxillary first molar usually variations in the internal morphology of maxillary molars. presents three roots and four canals (one canal in the palatal 4 Background: Dental internal anatomy is directly related to all root, two in the mesiobuccal root and one in the distal root). the technical stages of the endodontic treatment. Even though, On the contrary, the maxillary second molar often shows in some situations a typical anatomical characteristics can be three roots and three canals (one canal in the palatal root, faced, and the professional should be able to identify them. one in the mesiobuccal root and one canal in the distobuccal Case descriptions: This clinical report describes five cases 4 with different pulpar and periapical diagnostics where the root). However, due to the complexity of the root canal 1-6 endodontic treatment was performed, in which during the system, some variations have been reported. treatment the unusual occurrence of two or three canals in the Clinical studies confirm the presence of four root canals palatal root ‘or even two distinct palatal roots’ of first and second on maxillary first molars as the anatomical feature most maxillary molars, were described and important details for 7 achieving treatment success were discussed. -
Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar—A Case Report
dentistry journal Case Report Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar—A Case Report Konstantina Tsironi 1,* , Emmanouil Inglezos 1, Emmanouil Vardas 2 and Anastasia Mitsea 3 1 Posidonos 14, Imia square, Voula, 16673 Athens, Greece 2 Clinic of Hospital Dentistry, Dental School, National and Kapodistrian University of Athens, Thivon 2 Goudi, 11527 Athens, Greece 3 Department of Oral Diagnosis and Radiology, Dental School, National and Kapodistrian University of Athens, Thivon 2 Goudi, 11527 Athens, Greece * Correspondence: [email protected]; Tel.: +30-698-682-7064 Received: 3 April 2019; Accepted: 21 May 2019; Published: 27 June 2019 Abstract: The purpose of this paper is to present a case of an impacted mandibular first molar associated with a dentigerous cyst and a missing mandibular second molar in an 11-year-old girl that was treated with combined surgical and orthodontic procedures. After clinical and radiographic evaluation, marsupialization of the cyst was decided, and a molar attachment was bonded on the buccal side of the impacted molar as a part of a full orthodontic treatment with fixed appliances. After 18 months of orthodontic traction, the molar was moved to a more advantageous position, and new bone apposition was observed on the site of the cystic lesion. Histological examination confirmed a dentigerous cyst. The molar was left to erupt spontaneously for 14 more months. A functional occlusion was finally achieved. An interdisciplinary approach proved to be an effective modality in treating a large dentigerous cyst associated with a deeply impacted first mandibular molar, presenting many advantages, such as new bone apposition and patient comfort.