Root canal configuration and its relation with endodontic technical errors in premolar teeth: a CBCT analysis

Abstract

Aim To evaluate the association between endodontic technical errors and the root canal configuration (RCC) of human premolars, as well as their relationship with periapical lesions through cone‐beam computed tomography (CBCT) images. Methodology The sample consisted of CBCT scans belonging to 136 patients, totalling 152 root filled premolars (185 roots). CBCT images were evaluated by two oral radiologists. RCC was recorded according to Vertucci's classification, and the endodontic treatment quality was judged on the presence and type of technical endodontic errors (underfilling, overfilling, nonhomogeneous filling, nonfilled canal, fractured instruments, root deviation and absence of coronal restoration). In addition, the presence of periapical lesions associated with each RCC was recorded. Data were expressed by frequencies and percentages, and intraobserver agreement was calculated using the Kappa test. Results The most common RCC was type I (71%), followed by type IV (15%), type II (8%), type V (3%), type VI (1%) and type III (1%). Types VII and VIII were not observed in the sample. Underfilling was the most frequent endodontic technical error for most RCCs, except for types IV, V and ‘other’, whose most frequent error was a nonfilled canal. The presence of technical errors was greater with an increase in the proportion of the periapical lesions. The intraobserver agreement was excellent. Conclusions There was an increase in the prevalence of endodontic technical errors and in the presence of periapical lesions as the anatomical complexity of the root canals increased. Underfilled and nonfilled canal were the most frequent endodontic technical errors.

Root Anatomy and Canal Configuration of Maxillary Premolars: A Cone-beam Computed Tomography Study

“…Different studies have shown that the external and internal anatomy of these teeth is highly variable, considering that root number ranges from one to three and many different root canal configurations are possible (Pécora et al, 1993;Vertucci, 2005;Estrela et al, 2015;Bürklein et al, 2017;Saber et al, 2019). As anatomical complexity in premolars increases, so do procedural errors and associated apical periodontitis (Nascimento et al, 2019).…”

Uso de tomografias computadorizadas de feixe cônico no estudo da morfologia radicular de pré-molares maxilares

“…Os pré-molares são elementos dentários conhecidos pela sua alta variabilidade e complexidade radicular, e isso faz com que se torne imprescindível o estudo de sua anatomia interna. (Nascimento et al, 2019;Vertucci, 1984;Sousa et al, 2017).…”

“…Também foi possível observar que os erros técnicos em tratamentos endodônticos aumentam progressivamente à medida em que os sistemas de canais radiculares se tornam mais complexos, sendo as configurações de tipo I e IV consideradas as menos complexas e menos passíveis de erros, diferentemente das demais configurações, que apresentam ramificações e convergências ao longo do trajeto de seus canais, o que torna os elementos dentários pertecentes a esses grupos mais suscetíveis aos erros. (Nascimento et al, 2019;Alqedairi et al, 2018;Jang et al, 2019;Li et al, 2018).…”

“…Em seguida, Nascimento et al (2019) analisaram a associação da morfologia interna dos sistemas radiculares em uma população brasileira com erros técnicos em tratamentos endodônticos, classificando esses elementos dentários obturados através de imagens por TCFC. Quanto ao número de raízes, verificou-se que nos pré-molares superiores o maior número de elementos dentários são unirradiculares (54,7% nos primeiros pré-molares e 86,4% nos segundos).…”

Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

“…Knowledge of the internal morphology of different dental groups is essential for proper endodontic treatment. 1,2,3,4 Maxillary first molars have a complex internal anatomy, particularly in the mesiobuccal (MB) roots because of the presence of an additional canal (MB2). 1,2,33 MB2 usually has more atresia and its patency cannot be easily achieved compared with the main canal (MB1).…”