Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery

Taschieri, Silvio; Weinstein, Tommaso; Rosano, Gabriele; Fabbro, Massimo Del

doi:10.1016/j.ijom.2011.11.006

Cited by 12 publications

(11 citation statements)

References 32 publications

(50 reference statements)

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“…The anterior maxilla is often described as a relatively safe region for surgical interventions, especially with regard to apical surgery [1]. However, increasing numbers of surgical interventions and variations of local anatomical structures may increase the risk of complications [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The indication for apical surgery is based on clinical and radiological aspects, whereby either two-(2D) or threedimensional (3D) radiography is used [13]. In case of clinical symptoms such as swelling in the anterior maxilla, nasal obstruction or sensory disturbance, a presurgical 3D radiographic analysis is recommended [1]. For the posterior maxilla, several studies investigated the relationship between the roots of the posterior teeth and the maxillary sinus using cone beam computed tomography (CBCT) [14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…For the posterior maxilla, several studies investigated the relationship between the roots of the posterior teeth and the maxillary sinus using cone beam computed tomography (CBCT) [14][15][16][17][18][19][20][21]. In contrast, only one study has examined the relationship between the roots of the anterior maxillary teeth and the nasal floor using computed tomography (CT) [1]. Because of a generally lower radiation dose in contrast to medical CT, wide availability in private practice, scan time reduction and higher spatial resolution, CBCT is nowadays the method of choice for 3D imaging in dental medicine [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

“…Because of a generally lower radiation dose in contrast to medical CT, wide availability in private practice, scan time reduction and higher spatial resolution, CBCT is nowadays the method of choice for 3D imaging in dental medicine [22][23][24]. Specifically for indications in the field of endodontology, CBCT allows better identification of endodontic pathologies, shows the relationship of pathological changes to important neighbouring anatomical structures and is therefore superior to two-dimensional radiographs for treatment planning in conventional and surgical endodontics [1,25].…”

Section: Introductionmentioning

confidence: 99%

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Distances of root apices to adjacent anatomical structures in the anterior maxilla: an analysis using cone beam computed tomography

et al. 2018

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Objectives The aim was to assess the anatomical relationship of anterior maxillary teeth to the nasal floor in patients referred for apical surgery. Materials and methods Cone beam computed tomographic images (CBCT) of 83 patients were analysed retrospectively to quantify the distances between the root apices of maxillary anterior teeth (canine to canine) to the nasal floor or maxillary sinus (whichever was closer). Secondary outcome variables were the distances of the periapical lesion to the nasal floor, distances of the apices to the labial and palatal bone plates as well as to the neighbouring teeth. Results A total of 93 teeth (39 central, 35 lateral incisors and 19 canines) were analysed. The mean shortest distances of the apices to the nasal floor (or maxillary sinus) were 8.54 mm for central incisors, 9.49 mm for lateral incisors and 5.39 mm for the canines. The canines exhibited a significantly shorter distance to the nasal floor/maxillary sinus. In the presence of an osteolysis, the distance to the nasal floor was significantly shorter compared to the teeth without lesions. The lateral and central incisors showed significant proximity to each other at the level of the future surgical resection (3 mm from the apex). Conclusions A close proximity between apices and adjacent anatomical structures such as nasal floor, maxillary sinus or adjacent roots could be shown in some cases. Clinical relevance CBCT could be a valuable adjunctive imaging tool prior to apical surgery in the anterior maxilla to assess the risk for and decrease the incidence of damage to neighbouring anatomical structures such as the nasal floor, maxillary sinus or adjacent roots.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Distances of root apices to adjacent anatomical structures in the anterior maxilla: an analysis using cone beam computed tomography

et al. 2018

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“…The first step to prevent bleeding is a good assessment of bleeding risk. However, in apical surgery, a low profuse bleeding, typical of a healthy patient, may be enough to affect the sealing ability of filling materials (3-5). There are different haemostatic techniques or materials to reduce bleeding.…”

Section: Introductionmentioning

confidence: 99%

Haemostatic agents in apical surgery. A systematic review

Clé-Ovejero¹,

Valmaseda‐Castellón²

2016

Med Oral

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BackgroundBlood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing ability. ObjetiveTo describe which are the most effective and safest haemostatic agents to control bleeding in patients undergoing apical surgery.Material and MethodsTWe carried out a systematic review, using Medline and Cochrane Library databases, of human clinical studies published in the last 10 years.ResultsThe agents that proved more effective in bleeding control were calcium sulphate (100%) and collagen plus epinephrine (92.9%) followed by ferric sulphate (60%), gauze packing (30%) and collagen (16.7%). When using aluminium chloride (Expasyl®), over 90% of the apical lesions improved, but this agent seemed to increase swelling. Epinephrine with collagen did not significantly raise either blood pressure or heart rate.ConclusionsDespite the use of several haemostatic materials in apical surgery, there is little evidence on their effectiveness and safety. The most effective haemostatic agents were calcium sulphate and epinephrine plus collagen. Epinephrine plus collagen did not seem to significantly raise blood pressure or heart rate during surgery. Aluminium chloride did not increase postoperative pain but could slightly increase postoperative swelling. Randomized clinical trials are needed to assess the haemostatic effectiveness and adverse effects of haemostatic materials in apical surgery. Key words:Haemostasis, apical surgery.

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Endodontics Using Cone Beam Computed Tomography

Levin¹

2013

Cone Beam Computed Tomography

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Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery

Cited by 12 publications

References 32 publications

Distances of root apices to adjacent anatomical structures in the anterior maxilla: an analysis using cone beam computed tomography

Distances of root apices to adjacent anatomical structures in the anterior maxilla: an analysis using cone beam computed tomography

Haemostatic agents in apical surgery. A systematic review

Endodontics Using Cone Beam Computed Tomography

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