Full-mouth Periapical Radiographs Research Articles

The Prevalence of Three-rooted Mandibular Permanent First Molars in a German Population

The purpose of this retrospective study was to assess the prevalence of three-rooted mandibular first molars among a German dental school patient population. A total of 800 patients' full-mouth periapical radiographs were screened, and, out of these, 524 patients possessing at least one mandibular first molar were selected. The radiographs of these cases were evaluated under optimal conditions using double magnifying glasses. The incidence of three-rooted mandibular first molars and the correlation between left- and right-side occurrences and between males and females were recorded and analyzed using the chi-square test. A total of 1,024 mandibular first molars were evaluated. Left molars comprised 500 teeth and right molars 524 teeth. Seven patients were found to have a three-rooted mandibular first molar, three females and four males (p = 0.981). The overall incidence of patients with three-rooted mandibular first molars was 1.35%. All three-rooted molars occurred unilaterally. The prevalence of teeth showing an extra root from all teeth examined was 0.68%. The right first molar had an incidence of 0.57% and the left molar of 0.80%, respectively (p = 0.953). In conclusion, the occurrence of three-rooted mandibular first molars among this German population was rare.

Predicting and preventing root resorption: Part I. Diagnostic factors.

The purpose of this study was to determine whether it would be possible to identify pretreatment factors that will allow the clinician to predict the incidence, location, and severity of root resorption before the commencement of orthodontic treatment. The records of 868 patients who were treated with full, fixed edgewise appliances were obtained from 6 private offices; full-mouth periapical radiographs were used to accurately assess apical root resorption from first molar to first molar in both arches. The results showed that resorption occurs primarily in the maxillary anterior teeth, averaging over 1.4 mm. The worst resorption was seen in maxillary lateral incisors and in teeth with abnormal root shape (pipette, pointed, or dilacerated). Adult patients experienced more resorption than children did in the mandibular anterior segment only. Asian patients were found to experience significantly less root resorption than white or Hispanic patients. Increased overjet, but not overbite, was significantly associated with greater root resorption. There was no difference in either the incidence or severity of root resorption between male and female patients.

Survey of radiographic practices for periodontal disease in UK and Irish dental teaching hospitals.

To assess current radiographic practices in dental teaching hospitals for the management of patients with periodontal diseases. All 17 dental teaching hospitals in UK and Ireland were sent a questionnaire on radiographic equipment and radiograph selection currently used for assessment of patients with destructive periodontal diseases. Opinions were recorded for advantages and disadvantages of the most frequently used radiographic views. A 100% response rate was achieved. All hospitals used panoramic and specific periapical radiographs as one of their radiographic regimes for patients with periodontal disease. Fifty-three per cent of respondents most frequently took panoramic and selected periapical radiographs. Twenty-four per cent took full mouth periapical radiographs (FMPAs) most frequently and 18% took a panoramic radiograph alone. Twenty-four per cent of hospitals operated a protocol for selection of radiographs for periodontal patients. The most commonly used views taken to assess periodontal status are panoramic radiographs with selected periapicals. Few hospitals operate a protocol for prescribing radiographs.

Prevalence of periradicular periodontitis associated with crowned teeth in an adult Scottish subpopulation.

To examine the periradicular status of crowned teeth in an adult population in Scotland. Examination of full-mouth periapical radiographs from 319 consecutive adult patients (7596 teeth) attending Glasgow and Dundee Dental Hospitals for clinical examination. The periradicular status of teeth with a crown present was assessed to determine the presence of a radiolucency which may indicate pulpal disease. 63.3% (n = 202) of patients had at least one tooth that was crowned. The total number of crowns assessed was 802, of which 458 (57.1%) were vital preparations, and 87 (19.0%) of these had radiographic signs of periradicular disease. The majority of the teeth (62.0%) had distinct widening of the periodontal membrane space which is considered to be an early sign of periapical disease. 42.9% (n = 344) of the crowned teeth had previous root canal treatment of which 50.8% (175) had evidence of a periradicular radiolucency. Pulpal damage may occur during procedures to provide a crown which may require subsequent root canal treatment. Radiographic follow-up of crowned teeth should be undertaken routinely.

Technical standard of root canal treatment in an adult Scottish sub-population.

To examine the periapical status, technical standard and frequency of root canal treatment in an adult population in Scotland. Examination of full-mouth periapical radiographs from 340 consecutive adult patients (8420 teeth) attending Glasgow and Dundee Dental Hospitals for clinical examination. Position and quality of the root fillings were assessed together with signs of periradicular radiolucencies. The influence of the type of coronal restoration was also assessed. Pathologies associated with impacted third molars and outcomes following surgical removal of third molars. 54% of the patient sample had root filled teeth. 5.6% of the teeth examined radiographically had root fillings, and of these, 58.1% had radiographic signs of periapical disease. 41% of the patients had at least one non-root canal treated tooth with periapical disease. 77% of teeth with post-retained crowns had evidence of periapical pathology. Root fillings judged to be adequate radiographically had a reduced incidence of radiolucencies. Teeth obturated beyond the apex had more radiolucencies than those obturated flush with or within 2 mm of the radiographic apex. A high proportion of post-retained crowns were associated with periapical pathology. There is a substantial future need both for root canal treatment and for standardised treatment methods.

Perception of the need for removal of impacted third molars by general dentists and oral and maxillofacial surgeons

This prospective study investigated the influence of professional training and method of payment on how dental practitioners planned extraction of impacted third molars. The subjects were four groups of dental practitioners in metropolitan Chicago: 1) general dentists in traditional fee-for-service practice; 2) general dentists who were members of a preferred provider organization; 3) general dentists who were members of an Independent Practice Association model of a capitation system; and 4) oral and maxillofacial surgeons, all of whom were in fee-for-service practice. A carefully selected and trained professional actress, in good health, with four unerupted, impacted, and asymptomatic third molars, brought her recently taken full mouth periapical and panoramic radiographs to randomly selected dentists for a consultation. The number of planned extractions (no treatment was ever done) was compared. Data showed that oral and maxillofacial surgeons suggested significantly more extractions than capitation dentists and the average of all general dentists, combined.

Associations Between Crestal Lamina Dura and Periodontal Status

The purpose of the present study was to investigate associations between radiographic crestal lamina dura and the clinical periodontal status of the corresponding interdental area. The population consisted of 90 individuals (53 females and 37 males), ages 21 to 45 years (mean 31 years), who underwent a comprehensive periodontal examination. Buccal and lingual to the contact point at each interdental area four different clinical criteria were scored as being present or absent: (i) visual inflammation, (ii) bleeding after probing with 25 gm force, (iii) pocket depth greater than 3 mm after probing with 50 gm force, (iv) loss of connective tissue attachment. Bite-wing and full-mouth periapical radiographs were taken and processed using standardized techniques. Each interdental crestal area on the radiographs was examined and scored for presence or absence of an intact lamina dura. Statistical analyses were undertaken using correlated means to compare the presence or absence of lamina dura with the individual and simultaneous clinical criteria. No significant differences were obtained between any of the comparisons and, in addition, there was no correlation between lamina dura images on periapical and bite-wing radiographs. The results indicated that crestal lamina dura on radiographs did not appear to be related to the presence or absence of clinical inflammation, bleeding upon probing, periodontal pockets or loss of attachment.