Canal Morphology Research Articles

Nonsurgical endodontic retreatment of C-shaped maxillary molars: case reports and review of literature

The root canal systems of maxillary first molar (MFM) and maxillary second molar (MSM) variations represent a clinical challenge for endodontists, especially the prevalence of fused C-shaped roots. Having a thorough knowledge of root canal configuration is an extremely important point for a successful root canal treatment to avoid missing extra canals. The aim of this article was to present 2 cases of maxillary molar with an unusual C-shaped configuration diagnosed during root canal retreatment/treatment and conduct a literature review of the MFM and MSM anatomy. Case 1 reports that three separate palatal root canals fused into a C-shaped configuration in the MFM, which with an enamel pearl in the furcation, was classified as Type D and first reported in MFM. Case 2 reflects the fusion of all three buccal canals of the MSM into a C-shaped configuration that finally formed an apical foramen with a supernumerary tooth, and the configuration was Type B. Evaluation at an 18-month and a 9-month recall revealed that two patients were symptom-free after the conduct of a non-surgical retreatment/treatment, and the X-ray revealed normal periapical tissue. In addition, the thickness of the Schneiderian membrane due to odontogenic maxillary sinusitis returns to normal after an effective retreatment in case 1. These reports serve to remind endodontists of the importance and complexity of anatomical variations, which should always be considered when formulating an effective root canal treatment plan. The combined use of cone-beam computerized tomography (CBCT) and a dental operating microscope (DOM) will be profitable to locate and identify extra canals when a periapical radiograph shows signs of an unusual canal morphology.

Parallelisms in the morphology and evolutionary transformations of two bones of the visceral skeleton in fossil and recent freshwater sculpins of the genus Triglopsis (Pisces: Cottidae)

The article considers the morphogenesis of two visceral skeleton bones, which are most important for identification, in five freshwater forms of the genus Triglopsis Girard, 1851. These forms evolved as a result of colonization of fresh waters by marine fishes in different geological periods and continents. On American continent, two fossil species, Triglopsis idahoensis (Smith, 1975) and T. antiquus (Smith, 1975), from the Pliocene Lake Idaho and one recent species T. thompsonii Girard, 1851 from Lake Michigan were studied. On European continent, two freshwater populations of one species T. quadricornis (Linnaeus, 1758) from Lakes Ladoga and Onega were investigated. Comparative analysis of the external features of the preopercular and dentary bones showed that all five studied forms have common characters inherent in the genus Triglopsis. The differences are in the size, shape and orientation of the spines; and hollows of the preopercular-mandibular sensory canal. The fossil species T. idahoensis and T. antiquus have wide, slightly curved preopercle with spines of similar length. Significant differences are found in the morphology of the sensory canal. The most primitive state of this canal is observed in T. antiquus. It is characterized by small size of hollows and wide bone bridges between them. Evolutionary transformations in morphology of the canal in fossil and recent species go in the direction of increasing passage of the canal in the bones. In recent forms, passage of the sensory canal occupies almost the entire width of the bone, which is significantly greater than in fossil species. Geographically remote and isolated fossil and recent forms of the genus Triglopsis, each with its own evolutionary fate, have a single trend of evolutionary transformations of the studied bones. Despite the fact that the lake forms were at different stages of differentiation, evolutionary transformations of the morphology of the studied bones proceed in parallel and in the same direction.

Assessment of Vidian canal morphology in axial section and its associated structures using cone beam computed tomography: A descriptive study

The Vidian Nerve (VN), a branch of the trigeminal nerve, passes by the Vidian Canal (VC), located at the base of the skull. The VC branches into the greater petrosal nerve and the VN in the pterygopalatine fossa, where the greater petrosal nerve carries parasympathetic fibers to the lacrimal glands and nasal mucosa, and the VN carries sensory fibers from the nasopharynx, nasal cavity, and palate. In this study, 60 subjects of both sexes who underwent cone beam computed tomography (CBCT) were selected by a convenient sampling technique. The data were subjected to statistical analysis following the examination of the various parameters in the axial sections. Among the various morphological characteristics appraised in the axial section, there was no significant sexual dimorphism, except for the angle between the VC and the medial wall of the maxillary sinus, which shows statistical significance. The present study aims to investigate morphometric analysis and its associated structures, offering insightful information about the complex structure of the Vidian canal (VC), which provides adequate knowledge for surgeons to plan with more caution complex skull base procedures, and eventually to lower the therapeutical risks associated with it.

Unusual Canal Morphology in Mandibular Premolars With Two Distal and One Mesial Canal: A Case Series

Unusual Canal Morphology in Mandibular Premolars With Two Distal and One Mesial Canal: A Case Series

Endodontic management of distinctive anatomic aberration with maxillary 1 molar -a case report of three mesiobuccal canal on one side and taurodontism on contralateral arch

The present case describes root canal treatment in a maxillary first molar with unusual anatomy of MB3 canal in one arch and Taurodontism on the contralateral arch. Understanding the differences in root canal morphology is crucial to the success of endodontic treatment. Taurodontism in the contralateral maxillary molar is an uncommon condition. A male patient was referred for the treatment of maxillary right and left first molar tooth. Clinical examination of the pulpal floor revealed 3 orifices in the mesio-buccal root in #16 while Taurodontism in #26. The tooth was treated successfully. Anatomic variations must be taken into consideration in clinical and radiographic evaluation during endodontic treatment.

Endodontic Management of Failed Root Canal Treatment in Teeth With Previously Missed Canals: A Report of Two Cases With Rare Root Canal Morphology

Endodontic Management of Failed Root Canal Treatment in Teeth With Previously Missed Canals: A Report of Two Cases With Rare Root Canal Morphology

Radicular Dentin Thickness and Root Canal Morphology of Mandibular Incisors in Indian Subpopulation Using Cone Beam Computed Tomography

Radicular Dentin Thickness and Root Canal Morphology of Mandibular Incisors in Indian Subpopulation Using Cone Beam Computed Tomography

C-Shaped Canal Prevalence and Morphology in Maxillary Molar Teeth: A Cone Beam Computed Tomography Evaluation

C-Shaped Canal Prevalence and Morphology in Maxillary Molar Teeth: A Cone Beam Computed Tomography Evaluation

Root and Canal Morphology of Permanent Maxillary and Mandibular Canines in a Sample of Yemeni Population Using Cone Beam Computed Tomography

Aims and Objective: This study aimed to investigate the external and internal morphological characteristics, including crown shape, root curvature, canal diameter, and root canal configuration, of maxillary and mandibular canine teeth in a Yemeni population using cone-beam computedtomography (CBCT). Materials and Methods: A total of 400 CBCT images (200 maxillary, 200 mandibular) were analyzed from 400 Yemeni subjects (averageage 34). Results: All maxillary canineshad a single root, while 4% of mandibular canineshad two roots (slightly higherin females, but not significantly). Maxillary canines were markedly larger in males (p = 0.001). Most maxillary canines(98.5%) had a single root canal, while 16.5% of mandibular canines had two (significantly higher in males). Using the Vertucci classification, root canal configuration analysis showed that maxillary canineswere predominantly Type I, while mandibular canines displayed more variation. Conclusion: This study provides insights into the morphological characteristics of Yemeni canine teeth. Gender is a significant factor in canine dimensions, with males having larger teeth.

Root and Canal Morphology of Maxillary Incisors Teeth in a Sample of Yemeni Population Using Two Classification Systems: A CBCT Study

Objective: To determine the root and canal morphology of permanent maxillary central and lateral incisors in a sample of Yemeni population using cone-beam computed tomography (CBCT). Materials and Methods: A retrospective CBCT analysis of 400 maxillary anterior teeth from a Yemeni adults (18-50 years) was conducted. Image evaluation in sagittal, axial, and coronal planes using Ez3D-i software assessed root number, canal orifice number, canal number, and canal configuration based on Vertucci's and Ahmed's classifications. Descriptive statistics and Chi-square test were employed (p < 0.05). Results: All incisors exhibited a single root and canal with a single orifice. The predominant canal configuration was Type 1 according to both Vertucci's (93.5%) and Ahmed's (93.8%) classifications. Type 5 (bifurcation at the apex) was observed in 6.25% (Vertucci) and 6.0% (Ahmed) of cases, while Type 3 (canal division and reunion) was rare (0.25% Vertucci, 0.2% Ahmed). Conclusion: Permanent maxillary central and lateral incisors in the Yemeni population primarily demonstrate a single root and canal. Although variations in canal configuration exist, they are infrequent.

Analysis on the related factors of misplacement of freehand pedicle screws via posterior approach in degenerative scoliosis

BackgroundTo study the risk factors associated with misplacement of freehand pedicle screws through a posterior approach for degenerative scoliosis.MethodsA total of 204 patients who underwent posterior pedicle screw-rod system surgery for degenerative scoliosis in our hospital from December 2020 to December 2023 were retrospectively analyzed. Patient demographics, radiographic accuracy, and surgery-related information were recorded.ResultsA total of 204 patients were included. A total of 2496 screws were placed. 2373 (95.07%) were in good position. Misplacement screws were 123 (4.93%). None of the patients had postoperative spinal nerve symptoms due to screw malposition. The misplacement rate of thoracic (T10-T12) pedicle screws was 11.11% (60/540). Misplacement of pedicle screws in the lumbar spine (L1-L5) was 3.22% (63/1956). Age, gender, surgeon, and operation time had no significant effect on misplacement of pedicle screws (P>0.05). Body mass index, Hu value, number of screw segments, Cobb angle, vertebral rotation, and spinal canal morphology had some correlation with pedicle screw misplacement. Among them, BMI, Hu value, number of screw segments, Cobb angle, and vertebral rotation grade were independent risk factors for PS misplacement (P<0.05). The height of the posterior superior iliac spine had a significant effect on pedicle screw misplacement in the lower lumbar spine (L4/5) (P<0.05).ConclusionBMI, Hu value, number of screw levels, Cobb angle, and vertebral rotation grade were independent risk factors for pedicle screw misplacement in patients with degenerative scoliosis. Posterior superior iliac spine height has a large impact on PS placement in the lower lumbar spine. Patients with degenerative scoliosis should be preoperatively planned for the size and direction of the placed screws by X-ray and CT three-dimensional, to reduce the misplacement rate of pedicle screws.

Three-dimensional assessment of root canal morphology of primary dentition using cone beam computed tomography.

Root canal therapy in primary teeth is exceedingly complex due to the unique internal geometry of the pulp cavity. The purpose of this study was to evaluate variations in primary teeth root canal morphology and applicability of the Ahmed etal. (Int Endod J, 50, 2017, 761) alphanumeric system for classifying them. A retrospective analysis of 2024 primary teeth from an existing CBCT database was performed for assessing variations in root canal morphology. Descriptive statistics and the chi-squared test were used for data analysis. The maxillary canines exhibited splitting levels of 5.9% (right) and 6.6% (left), and merging levels of 1% (both sides); maxillary lateral incisors showed splitting levels of 2.6% (right) and 0.8% (left), with no merging observed; mandibular second molars had splitting levels of 1.5% (right) and 0.8% (left), with no merging observed; and mandibular lateral incisors exhibited a merging level of 0.9% (right), with no splitting observed. This study provides new insights into the variations in root canal morphology of primary teeth, particularly highlighting the variations found in primary canines. The Ahmed etal. (Int Endod J, 50, 2017, 761) classification system was found to be a useful tool for categorizing these variations.

Root Canal Morphology of Premolars in Population of Hyderabad, Pakistan: A Cone Beam Computerised Tomographic Analysis.

To investigate the mean tooth length and root canal configuration of human maxillary and mandibular premolars in the population of Hyderabad, Pakistan, using Cone Beam Computed Tomography (CBCT). Observational study. Place and Duration of the Study: Department of Operative Dentistry and Endodontics, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan, from December 2022 to March 2023. Using retrospective analysis of CBCT scans, tooth length, the number of roots, and root canal configuration of 536 mandibular and maxillary premolars were assessed in the subpopulation of Pakistan. The data were analysed employing descriptive statistics, Chi-square tests, and One-Way ANOVA to determine the association between various factors and root canal morphology. Vertucci Type 1 (one canal) was the most common configuration in maxillary premolars, with frequencies ranging from 46.3 to 52.2%. The mean length of all 8 premolars ranged from 20.56 mm to 21.58 mm. C-shaped canal configurations were observed in a small percentage of maxillary and mandibular premolars, with C1 being the most common. No significant association was found between gender and canal configuration or tooth length, and in tooth lengths among different canal configurations. Vertucci Type 1 was the most common configuration in maxillary premolars, followed by Vertucci Type 4. Single-rooted premolars were more prevalent, while two-root configurations were less common. C-shaped canal configurations were observed in a small percentage of premolars, with higher frequency in mandibular premolars. Cone beam computed tomography, Dental anatomy, Endodontics, Premolars, Root canal morphology.

Evaluation of canalis sinuosus and accessory canal morphology by cone-beam computed tomography.

To evaluate canalis sinuosus (CS) and accessory canalis sinuosus (AC) morphology and their relationship with the impacted canine on cone-beam computed tomography (CBCT) images. The diameter and location of the CS, its distance from the nasal cavity (NC-CS), its distance from the buccal cortical plate (BC-CS), and its distance from the alveolar ridge crest (AR-CS) were evaluated on 1000 CBCT scans. The prevalence and termination of AC and the presence of impacted canines were also evaluated. CS was detected in 89 (8.9%) of 1000 CBCTs. The mean CS diameter was found as 1.34 ± 0.53mm. No statistically significant difference was found between gender, age, direction, and CS presence and diameter. CS was most frequently seen in regions 11 (23.6%) and 13 (23.6%). The average NC-CS, BC-CS, and AR-CS length was 6.14, 6.06 and 4.35mm, respectively. AC was detected in 22 patients (24.71%). There was no statistically significant difference between the presence of AC and gender, age, CS diameter, NC-CS, BC-CS, and AR-CS distance. BC-CS length and AR-CS length were statistically significantly higher in patients with impacted canines. It should be kept in mind that the CS diameter, NC-CS, BC-CS, and AR-CS distance may increase in the presence of an impacted canine and the integrity of the neurovascular structure should be preserved. The fact that the CS is often localized in the palatial region requires a detailed evaluation of the anterior maxillary region with three-dimensional imaging methods.

Morphology and root canal configuration of maxillary lateral incisors: a systematic review and meta-analysis.

The purpose of this study was to explore maxillary lateral incisors (MxLI) intern morphology by analyzing existing literature. We searched five electronical databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed) using keywords and predefined search terms. Additional studies were identified by cross-referencing and reviewing bibliographies of relevant articles. From 92 initial studies, 27 duplicates were removed, and 65 records screened. After full-text review and hand searching were 19 studies included. The most reported root canal configurations (RCC) of MxLI were Vertucci (Ve) I (1-1-1/1; 78.1-100%), Ve II (2-2-1/1; 0.2-5%), Ve III (1-2-1/1; 0.1-14.6%), Ve IV (2-2-2/2; 0.5%), and Ve V (1-1-2/2; 0.5-4.9%). A meta-analysis of six studies from Europe and Asia indicated sex-differentiated patterns in RCC prevalence: higher occurrences of Ve II (2-2-1/1; OR [95%CI] = 1.19 [0.51, 2.73]), Ve III (1-2-1/1; (OR [95%CI] = 1.72 [0.61, 4.85]), and Ve V (1-1-2/2; (OR [95%CI] = 2.95 [1.02, 8.55]) configurations were noted in males, whereas females predominantly exhibited Ve I (1-1-1/1; [95%CI] = 0.99 [0.97, 1.02]), and Ve IV (2-2-2/2; (OR [95%CI] = 0.11 [0.01, 2.02]). Examination methods varied, with cone beam computed tomography (CBCT) being most commonly (n = 11), followed by staining & clearing (n = 5), and radiographic analysis (n = 1). The predominant RCC in MxLI is type Vertucci I. CBCT is the most common method for assessing the morphology of root canals. However, up to 20% of cases may present with complex and sex-specific patterns, highlighting the need for clinicians to be aware of these differences to prevent complications during endodontic treatments.

Evaluation of Root Canal Morphology of the Maxillary Permanent First Molar among Iraqi Population: A Cone Beam Computed Tomography Study (Retrospective Study)

Purpose: Endodontic success mainly depends on the complete root canal system debridement, both mechanically and chemically. The maxillary first molar possesses one of the most complex root canal anatomy. The purpose of this study was to map the maxillary first molar's root canal anatomy and its variations. Cone Beam Computed Tomography (CBCT) was used to determine the prevalence of the Second Mesiobuccal Canal (MB2) and its possible relation to the gender of the patient in the Iraqi population. Materials and Methods: Images from documented archives of CBCT scans for 415 patients who had maxillofacial diagnosis or root canal treatment were used in this study. Totally 656 maxillary first molars (336 females and 320 males) were included. The root canal configuration, frequency of MB2, and its two-sided symmetry were observed. The (chi-square test) was used to calculate the gender correlation. The P-value of less than 0.05 (p &lt; 0.05) was considered significant. Results: In 61.1% of the cases, the MB2 canal was discovered with high bilateral symmetry (73.6%). Genders did not show any statistically significant differences. Conclusion: The existence of MB2 canal in the maxillary first molars is high and approximately more than half of the cases. No relation was found between the existence of the MB2 canal and the gender of the patient. CBCT is a clinically efficient method for the diagnosis and improvement of root canal therapy.

Root canal morphology of mandibular anterior permanent teeth in Turkish sub-population using two classification systems: a cone-beam computed tomography study.

This study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I (1MA1) was the most frequent, followed by Type III (1MA1-2-1). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III (1MA1-2-1) was significantly more prevalent in males than females (p = 0.038) and Type I (1MA1) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.

Exploring the Root Canal Morphology of Third Molars in the Bosnia and Herzegovina Population.

The objective of this study was to evaluate the root canal morphology of third molars in the Bosnia-Herzegovina population. A total of 241 extracted third molars (105 maxillary and 136 mandibular) were subjected to a clearing procedure. The specimens were categorized into ten groups based on the Alavi classification for maxillary third molars (MaxTMs), and six groups were based on the Gulabivala classification for mandibular third molars (ManTMs). Root canal type according to the Vertucci classification, the presence and position of lateral canals, and intercanal communication were analyzed using a stereomicroscope x15. MaxTMs had three roots in 77.13% of the samples. Among MaxTMs, the most common morphology was three fused roots (33.33%) and Vertucci's type VIII (54. 28% of samples in Alavi's Group IV). 60.29% of ManTMs have two separate roots (Gulabivala's Groups II and III). The most prevalent types in mesial roots were type I (41.46% in Group II) and type IV (48.78% in Group III), although type I predominated in distal roots (91.24% and 100% in Groups II and III, respectively). Single-rooted third molars usually have a root canal morphology that is more favorable for endodontic treatment. In contrast, third molars with fused roots often have more complex root canal morphology.

Cone-Beam Computed Tomography Study of Root and Canal Morphology of Mandibular First and Second Premolars in Nepalese Population

Cone-Beam Computed Tomography Study of Root and Canal Morphology of Mandibular First and Second Premolars in Nepalese Population

Assessment of cone beam computed tomography use in pediatric and adolescent patients: a cross-sectional study

BackgroundThe use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA’s recommendations.MethodsFor each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading “other”.ResultsThe most common indication was the “other” category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was “orofacial cleft” (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed.ConclusionsAlthough the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed.