Morphological evaluation of maxillary second molars with fused roots: a micro‐<scp>CT</scp> study

Ordinola‐Zapata, Ronald; Martins, Jorge N.R.; Bramante, Clóvis Monteiro; Villas-Bôas, M. H.; Duarte, Marco Antônio Húngaro; Versiani, Marco Aurélio

doi:10.1111/iej.12752

Cited by 51 publications

(46 citation statements)

References 30 publications

(89 reference statements)

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“…, Ordinola‐Zapata et al . ) and maxillary lateral incisors (Gu ). The major anatomical feature of C‐shaped canals is the presence of a fin or web connecting individual root canals; the orifice may appear as a single ribbon‐shaped opening with a 180° arc linking the two main canals (Gulabivala et al .…”

Section: Introductionmentioning

confidence: 99%

“…These canal systems have a global prevalence of 13.9% and up to 44.0% in the Chinese population (von Zuben et al 2017). Analogous anatomy may be identified in mandibular premolars , Ring & Ring 2017, mandibular first molars (Silva et al 2013), maxillary second molars (Martins et al 2016, Ordinola-Zapata et al 2017 and maxillary lateral incisors (Gu 2011). The major anatomical feature of C-shaped canals is the presence of a fin or web connecting individual root canals; the orifice may appear as a single ribbon-shaped opening with a 180°arc linking the two main canals (Gulabivala et al 2002, Fan et al 2004.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C‐shaped canals

Zhao

Fan

et al. 2019

Int Endodontic J

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Aim To evaluate the effect of instrumentation using Reciproc Blue (RB; VDW, Munich, Germany) and XP‐endo Shaper (XP‐S; FKG Dentaire, La Chaux‐deFonds, Switzerland) systems on the area of untouched canal wall (AUCW), accumulated hard‐tissue debris (AHTD) and the efficacy of three irrigation protocols on percentage reductions (red%) of AHTD within C‐shaped canals of mandibular molars. Methodology Seventy mandibular molars with C‐shaped canals were scanned, matched and assigned to two shaping groups (n = 35): RB and XP‐S. Following instrumentation, specimens were triple‐matched with respect to the amount of remaining debris and assigned to three irrigation subgroups (n = 10): syringe‐and‐needle irrigation (SNI), XP‐endo Finisher (XP‐F; FKG Dentaire) and passive ultrasonic irrigation (PUI). The AUCW% and AHTD% after instrumentation and the red% of AHTD after irrigation were calculated from micro‐computed tomography. Data were analysed using comparisons for two groups (RB vs. XP‐S) or multiple subgroups followed by pairwise comparison procedures (SNI vs. XP‐F vs. PUI) at α = 0.05. Results For RB and XP‐S, 33.04% and 30.45%, respectively, of the canal wall remained untouched (P > 0.05). For both groups, the apical third had larger AUCW% than the coronal third (P < 0.05). Instrumentation with RB left more debris (2.8%) than XP‐S (1.1%) (P < 0.05). The PUI and XP‐F subgroups had higher mean red% of AHTD than the SNI subgroup; the difference was significant for RB (P < 0.05) but not for XP‐S. Conclusions Both RB and XP‐S systems were associated with similar AUCW after instrumenting C‐shaped canals. RB left significantly greater levels of AHTD compared with XP‐S. PUI and XP‐F irrigation removed more debris than SNI when using the RB system.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C‐shaped canals

Zhao

Fan

et al. 2019

Int Endodontic J

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“…However, it took several decades of technological advancements in endodontics until this information could be applied for the effective clinical management of C-shaped anatomy (Cooke & Cox 1979). Since then, several studies have addressed its morphological features reporting differences in the prevalence of this anatomical anomaly amongst various groups of teeth and populations (Fan et al 2012, Ladeira et al 2014, Martins et al 2016b, Ordinola-Zapata et al 2017, Shemesh et al 2017. Interestingly, despite authors justifying these differences based on ethnicity (Kato et al 2014, Martins et al 2018a), geographic location (von Zuben et al 2017) and gender (Kim et al 2016a,b, Martins et al 2016b, von Zuben et al 2017, no anthropological approach has been employed to support these findings.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of C‐shaped canal morphology using cone beam computed tomography – a systematic review with meta‐analysis

Martins

Marques

Silva³

et al. 2019

Int Endodontic J

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Background and aim To perform a systematic review of anatomical studies using cone beam computed tomography (CBCT) to assess the influence of demographic factors (age, gender and geographic region) on the prevalence of C‐shaped canal anatomy in maxillary molars, mandibular premolars and molars. Data sources A search was conducted between May and August 2018 in four electronic databases and five peer‐reviewed journals. The authors of included articles were also contacted for additional studies and the bibliographic references hand‐searched. Study eligibility criteria, participants and interventions The research protocol was previously registered in the International Prospective Register of Ongoing Systematic Reviews (CRD42018095201) and included defined inclusion/exclusion criteria. Prevalence studies on C‐shaped canal anatomy in maxillary molars, mandibular premolars and molars were searched. Study appraisal and synthesis methods The selected studies were submitted to full‐text analysis and critical appraisal by two evaluators using the Joanna Briggs Institute Critical Appraisal tool. The final group of papers (n = 25) were pooled and forest plots with proportions and odds ratio with a 95% confidence interval performed. Meta‐regression was undertaken to evaluate possible sources of heterogeneity and funnel plot visual analysis to assess publication bias. Results The included studies reported data on 25 445 teeth of 13 142 patients. A significant difference in the average prevalence proportion of C‐shaped configuration was observed between mandibular first (0.3%; 0.1–0.6%) and second (12%; 10.3–13.7%) molars (P < 0.05). No significant difference in the prevalence of C‐shaped configurations was observed comparing males (13.5%; 8.8–18.3%) and females (20.5%; 13.7–27.4%) in mandibular second molars (P > 0.05), although males were associated with significantly lower odds (0.573; 0.511–0.641) (P < 0.05). The pooled proportion of C‐shaped anatomy in mandibular second molars in East Asian countries (39.6%; 36.0–43.1%) was significantly higher compared with other regions. Limitations Because of the limited number of studies, no statistical analysis was performed for maxillary molars and mandibular premolars. Conclusion Meta‐analysis revealed that gender and geographic region may act as a confounding factor for the prevalence of C‐shaped anatomy in mandibular second molars, whilst age did not influence the prevalence of C‐shaped configurations in this tooth group. Knowing these preoperative factors would help to anticipate complex morphologies in clinics.

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“…, Ordinola‐Zapata et al . ,); however, this axiom has not been fully addressed in the literature. Thus, the aims of this study were: (i) to evaluate whether the cross‐sectional root morphology of mesiobuccal roots in maxillary first molars is associated with the presence of complex apical root canal systems; (ii) to evaluate the prevalence of accessory canals in the apical 4 mm regarding which types of canals are more common, location of the foramen and point of origin within the root; and (iii) to evaluate the dentine thickness of the MB1 and MB2 canals of maxillary first molars at the apical 3 mm level.…”

Section: Introductionmentioning

confidence: 99%

Apical root canal anatomy in the mesiobuccal root of maxillary first molars: influence of root apical shape and prevalence of apical foramina – a micro‐CT study

et al. 2019

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Aim To determine whether a relationship exists between the apical shape of roots and root canal system complexity by performing a micro‐computed tomography analysis. Methodology One hundred extracted permanent maxillary first molars were scanned using a micro‐computed tomography device at 19.6 μm voxel size. Two groups of mesiobuccal roots were formed according to the root aspect ratio value in the apical 3‐mm cross‐sectional level (‘<2 and ≥ 2.00’). Data were recorded regarding the number and presence of accessory canals and their location, isthmus, presence of the mesiobuccal canal and dentine thickness. Depending on the analysed variable, Mann–Whitney U test and Z‐test for proportions were used to compare groups. The significant level was set at 5%. Results Mesiobuccal roots with an aspect ratio ≥ 2.00 at the apical 3‐mm cross‐sectional level had higher percentages of accessory canals, apical foramina and MB2 root canals in the apical 3 mm. The vertical average distance from the accessory foramina and origin from the anatomic apex was 1.40 and 2.19 mm, respectively. Overall, 21.8% of the accessory canals had their origin coronal to a 3‐mm root resection line. There was no difference between the groups regarding dentine thickness. Conclusion The shape of the apical 3 mm of maxillary first molar mesiobuccal roots was a predictive factor for the presence of complex root canal systems. Roots with a lower aspect ratio had less complex apical anatomy.

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Morphological evaluation of maxillary second molars with fused roots: a micro‐CT study

Abstract: The root canal system of maxillary second molars with fused roots may have a high incidence of merging canals, isthmuses, apical deltas and C-shaped configurations.

Cited by 51 publications

References 30 publications

Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C‐shaped canals

Evaluation of several instrumentation techniques and irrigation methods on the percentage of untouched canal wall and accumulated dentine debris in C‐shaped canals

Prevalence of C‐shaped canal morphology using cone beam computed tomography – a systematic review with meta‐analysis

Apical root canal anatomy in the mesiobuccal root of maxillary first molars: influence of root apical shape and prevalence of apical foramina – a micro‐CT study

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