Canal Morphology Research Articles

Endocranial anatomy of the early prozostrodonts (Eucynodontia: Probainognathia) and the neurosensory evolution in mammal forerunners.

Prozostrodon brasiliensis and Therioherpeton cargnini are non-mammaliaform cynodonts that lived ~233 million years ago (late Carnian, Late Triassic) in western Gondwana. They represent some of the earliest divergent members of the clade Prozostrodontia, which includes "tritheledontids", tritylodontids, "brasilodontids", and mammaliaforms (including Mammalia as crown group). Here, we studied the endocranial anatomy (cranial endocast, nerves, vessels, ducts, ear region, and nasal cavity) of these two species. Our findings suggest that during the Carnian, early prozostrodonts had a brain with well-developed olfactory bulbs, expanded cerebral hemispheres divided by the interhemispheric sulcus, and absence of an unossified zone and pineal body. The morphology of the maxillary canal represents the necessary condition for the presence of facial vibrissae. A slight decrease in encephalization is observed at the origin of the clade Prozostrodontia. This new anatomical information provides evidence for the evolution of endocranial traits of the first prozotrodonts, a Late Triassic lineage that culminated in the origin of mammals.

Maxillary Canine with Rare Root Canal Morphology

Understanding root canal morphology is the main prerequisite for the clinician to carry out root canal therapy. The intricate structure of the root canals always creates challenges for the clinician during the cleaning and shaping procedure. Diversities in the canal morphology has to be thoroughly evaluated and studied using radiographs and also by the utilization of additional diagnostic aids before initiating the treatment procedure. This paper describes the management of maxillary canine with Vertucci type II canal configuration, a rare morphological occurrence.

Demystifying C shaped canals

Introduction: Knowledge of root canal anatomy is essential in order to achieve a successful root canal treatment. C shaped canal anatomy is most commonly seen in mandibular second molars and to some extent mandibular premolars. Such canals are difficult to negotiate, debride/disinfect and obturate due to its high incidence of fins, webs, lateral canals and anastomoses. Inability to identify and debride such canal anatomy may lead to endodontic failure.Case Report: These case series highlights on two different c shaped canals with two different obturation techniques.Conclusion: Complexity of C shaped canal morphology can be managed successfully with proper irrigation and obturation techniques.

Evaluation of root canal morphology of mandibular central and lateral incisor in Mosul city by using CBCT

Background: Lower incisor endodontic treatment failures are primarily due to missing canals, notably the lingual canal. Aim: The incisors' root architecture and the number of canals of the mandibular would be evaluated using computed tomography using a cone beam (CBCT). Methods: 220 patients with age (18-75) years who visited Al Noor Dental Center in Mosul over the course of two years had their 780 central and lateral incisors of the jaw evaluated using 3D CBCT images. The classification of the Vertucci system was applied to determine how the root canal was shaped. Results: A comparison between the incisors of lateral and central canal shape using the Vertucci method, the number of central incisors with only one root was higher than the lateral incisors with the roots of the same number. Where it was found that the central incisors of the first type are 377 teeth, while the number of incisors Lateral 358, the number of incisors in the second type was 5 teeth, and the lateral 3 teeth. Conclusions: The root morphology of the sexes differs significantly. Various morphological alterations should be anticipated by the dental professional when undertaking endodontic treatment. To ascertain the morphological traits of the conductor's anterior tooth roots, additional research is required.

Morphometric and morphological evaluation of mastoid emissary canal using cone-beam computed tomography.

This study aimed to determine mastoid emissary canal's (MEC) and mastoid foramen (MF) prevalence and morphometric characteristics on cone-beam computed tomography (CBCT) images to underline its clinical significance and discuss its surgical consequences. In the retrospective analysis, two oral and maxillofacial radiologists analyzed the CBCT images of 135 patients (270 sides). The biggest MF and MEC were measured in the images evaluated in MultiPlanar Reconstruction (MPR) views. The MF and MEC mean diameters were calculated. The mastoid foramina number was recorded. The prevalence of MF was studied according to gender and side of the patient. The overall prevalence of MEC and MF was 119 (88.1%). The prevalence of MEC and MF is 55.5% in females and 44.5% in males. MEC and MF were identified as bilateral in 80 patients (67.20%) and unilateral in 39 patients (32.80%). The mean diameter of MF was 2.4 ± 0.9 mm. The mean height of MF was 2.3 ± 0.9. The mean diameter of the MEC was 2.1 ± 0.8, and the mean height of the MEC was 2.1 ± 0.8. There is a statistical difference between the genders (p = 0.043) in foramen diameter. Males had a significantly larger mean diameter of MF in comparison to females. MEC and MF must be evaluated thoroughly if the surgery is contemplated. Radiologists and surgeons should be aware of mastoid emissary canal morphology, variations, clinical relevance, and surgical consequences while operating in the suboccipital and mastoid areas to avoid unexpected and catastrophic complications. CBCT may be a reliable imaging diagnostic technique.

Endodontic management of three rooted premolars with atypical root canal morphology: Case report

Anatomical variations in the root canal morphology is a commonly occurring phenomenon. Arriving at a precise diagnosis clinically and radio-graphically would lead us to appropriate treatment planning which is mandatory for successful outcome of the endodontic treatment. Maxillary and mandibular second premolars have intricate root canal anatomy. The incidence of three rooted premolars is very rare in Indian population, presence of additional roots would make the clinician’s job difficult and challenging. The following case report describes the endodontic and restorative management of maxillary and mandibular second premolar with atypical root canal anatomy being successfully treated with the help of magnification.

Calcium Silicate-Based Sealer Dentinal Tubule Penetration-A Systematic Review of In Vitro Studies.

The aim of this systematic review was to perform a qualitative synthesis of in vitro studies which evaluate and compare the penetration of calcium silicate-based sealers into dentinal tubules. A systematic advanced search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases on the 1 December 2022. In vitro studies that compared the tubular penetration of at least two calcium silicate-based sealers in extracted human teeth were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias included studies. The search identified a total of 680 preliminary records, among which 12 studies were eligible for review. The most used methodology to evaluate sealer penetration was the use of a fluorochrome together with the tested sealers and the analysis of their penetration under confocal laser microscopy. Regarding the results of the included studies, calcium silicate-based sealers exhibit a favorable dentinal tubule penetration. Tubular penetration, however, can be affected by factors such as the irrigation protocol, sealer activation, the filling method used, and root canal morphology. EndoSequence BC Sealer showed the highest sealer penetration among the tested sealers. The influence of different fluorochromes on the results of dentinal tubule penetration studies should also be further explored. The in vitro nature of the included studies limits the applicability of the results into the clinical setting. Prospero registration: CRD42022383896.

Morphologic Variations and Gender Dimorphism in Mandibular First Premolar Root Canal Pattern: A CBCT Study in South Indian Population

Objective: The study aimed to evaluate the variations in the RCM of mandibular first premolars (MFP) in south Indians and also evaluated the gender dimorphism and contralateral symmetry of the pattern. Methods: 200 Cone Beam Computed Tomography (CBCT) images of MFP of patients above 18 years were analyzed for the root canal morphology after excluding the distorted images, endodontically treated tooth or fractured root. The teeth were carefully evaluated in cross-sectional, axial and coronal sections and the information regarding the number of roots and the type of root canal as per Vertucci’s classification. Interobserver and intraobserver reliability were also checked. Results: Single rooted teeth with Type I (73.01%) variation was the most prevalent pattern observed in the study population, which was followed by Type III (14.11%) and Type V (5.52%), respectively. Type IV and Type VIII variations were not found in our study. Conclusions: In both males and females, type I configuration was the most common pattern with symmetry in contralateral mandibular single-rooted first premolars.

Root and root canal morphology of permanent mandibular first and second molars in a Kuwaiti population: A retrospective cone-beam computed tomography study

AimEndodontic diseases typically affect the mandibular molars. Understanding the complex morphology of the root canal system and its variations is necessary for successful endodontic treatment. The aim of this study was to evaluate the morphology of roots and root canals of mandibular first and second permanent molar teeth in a Kuwaiti population using cone-beam computed tomography (CBCT). Materials and methodsCBCT images of 651 mandibular first and second molar teeth were obtained from specialist government dental centers. The age, sex, root canal configuration, and number and type of roots were recorded. The data were statistically analyzed. ResultsThe most common canal configuration in the mandibular first and second molars was type II (65.6% and 54.4%, respectively), with no significant difference seen between the sexes (p = 0.234). The canal configuration was significantly different between the mandibular first and second molars (p < 0.001). Most teeth had two roots (94.5%); split roots were common (92.6%) and the number thereof varied significantly. Radicular grooves were most common on the lingual side (4.9%). C-shaped canals were present in 43 (6.60%) teeth. Additionally, one tooth had a confluent middle mesial canal and nine (1.4%) had radix entomolaris. ConclusionMandibular molars in our Kuwaiti population typically had two split roots with type II and IV canal configurations. The prevalence rates of C-shaped canals, middle mesial canals, and radix entomolaris were remarkably low.

Morphological Study of the Alimentary Canal and Malpighian Tubules in the Adult of the Pollen Beetle Meligethes (Odonthogethes) chinensis (Coleoptera: Nitidulidae: Meligethinae)

Meligethes (Odonthogethes) chinensis is a highly specialized species of Nitidulidae in China that takes pollen as its main food source, and its main host plant is Rubus idaeus L. (Rosaceae). In this study, the structural morphology of the alimentary canal and Malpighian tubules of adult M. (O.) chinensis was observed under light, fluorescence, and scanning electron microscopy. The alimentary canal of adult M. (O.) chinensis is divided into foregut, midgut, and hindgut. The foregut is the shortest and consists of the pharynx, esophagus, proventriculus, and cardiac valve. The midgut is a straight, distended, cylindrical, thin-walled tube. Numerous blunt-fingered gastric ceca are distributed irregularly throughout the midgut. The hindgut is subdivided into the ileum, colon, and rectum. The ileum is coiled. The colon gradually enlarges posteriorly. The rectum is thickly muscled and followed by a membranous structure. The openings of proximal Malpighian tubules are evenly inserted into the junction of the midgut and hindgut, and distal Malpighian tubules are evenly attached to the colon to form a cryptonephridial system. In this study, we also compare the structure and infer the function of the alimentary canal and Malpighian tubules among beetles, as well as discuss the evolutionary and taxonomical implications.

Roots and Root Canals Characterization of Permanent Mandibular Premolars Analyzed Using the Cone Beam and Micro Computed Tomography—A Systematic Review and Metanalysis

This current paper aims to review the literature on the root canal configuration (RCC) and root structure of permanent mandibular premolars. To find the published scientific literature on the RCC of mandibular premolars up to July 2022, a systematic search of four electronic databases was performed. The studies were selected, rendering to a predetermined point of reference: "mandibular 2nd premolar", "root and canal system", "morphology of root and canal", "root and canal configuration", and "morphology", along with "anatomy" and "mandibular premolars". Cross-referencing along with screening through the bibliographies of the chosen articles resulted in the identification of further studies. In the current study, we examined 30 different articles, and we chose them based on the quality of research investigations. From 3471 retrieved studies, a total of 15981 mandibular 2nd premolars were observed in 30 studies. The mean JBI score for studies assessing the structure of the root, as well as the root canal of the mandibular 2nd premolar, was 7.78 ± 0.81. We have found a pooled prevalence of 91.82% for Vertucci class I root canal morphology and 78.63% pooled prevalence of single-rooted mandibular second premolar. A total of 8677 mandibular 1st premolars were observed in 22 studies. The mean JBI score for studies assessing the structure and anatomy of the root, as well as root canal of mandibular 1st premolar, was 7. 95 ± 0.85. We have found a pooled prevalence of 74.34% for Vertucci class I root canal morphology and 85.20% pooled prevalence of single-rooted mandibular 1st premolar. Mandibular first and second premolars were mostly single-rooted teeth (89.5-100%). The most frequently seen RCC is a 1-1-2-/2 (type V-Vertucci's), followed by 1-1-2-/1 (type IV- Vertucci's; type III-Weine's), and finally RCC 2-2-2-1 (type IV-Vertucci's; type III-Weine's). Presently, the imaging of CBCT is the most used research approach for studying Mn2Ps' structural characteristics.

Investigation of Morphological Variations of Canal and Root of First Mandibular Molar in Tomographic Images Computer with Cone Beam in Patients of Arak City

Introduction: Being the first teeth to erupt, first molars have the most complex root system and canal morphology and are among the most susceptible teeth to decay and destruction. The aim of this study is to determine the frequency of morphological variations of the canal and root of the mandibular first molar in cbct images so that appropriate treatment can be performed with a better understanding of the anatomy of the root and canal of the molar tooth.Materials &amp; Methods: In this descriptive cross-sectional study, the morphological variation of the mandibular first molar canal and root was investigated in 170 cbct radiology image samples. In this study, the age and gender of the individual, the number of roots and canals of the mandibular first molar, the morphology of the canal in each root, the presence of the midmesial canal and the presence of the distolingual root were also investigated. In the end, frequency and percentage indicators were used to analyze data and chi-square test was used to compare frequencies.Results: The average age of the subjects studied was 39.2 years. The subjects included 86 women and 84 men. The most seen sample was a molar tooth with two roots and three canals. In terms of canal morphology in the mesial root, the most common canal morphology was type 4 and then type 2. In terms of canal morphology in the distal root, the most common canal morphology was type 1. In the studied samples, midmesial canal was not found in 99.4% of cases and distolingual root was not found in 94.7% of cases.Conclusion: Two-rooted and three-channel molar without midmesial canal and without distolingual root was the most common case found in this study. The most common canal morphology in the mesial root was type 4 and the most common canal morphology in the distal root was type 1.

Artificial intelligence in endodontics: relevant trends and practical perspectives

Background. Overall pool of studies regarding artificial intelligence (AI) implementation in dentistry is increasing every year, while possibilities for using AI methods within everyday endodontic practice is still quite confined and not always enough affirmed. &#x0D; Objective. To systematize and depict principal data regarding use of virtual artificial intelligence for various endodontic-related clinical purposes.&#x0D; Materials and Methods. Targeted literature search was provided within National Center for Biotechnology Information databases using pre-specified Mesh-terms algorithm. The following information was extracted from each publication during content analysis: diagnostic and treatment planning aspects of endodontic practice for which AI methods could be applied; accuracy levels registered for AI models used for different endodontic-related purposes; limitations of using AI within endodontic practice.&#x0D; Results. AI features could be used in endodontic practice for the following reasons: analysis of root canal morphology, identification of root fractures, verification of periapical lesions, estimation of root canal working length, root canal treatment planning, prediction of pain development during post-treatment period, predication of endodontic interventions success. The most prevalently used artificial intelligence methods for different endodontic diagnostic and treatment planning objectives were the following: convolutional neural network, artificial neurons network, case-based reasoning, deep learning, machine learning, neuro-fuzzy inference system, probabilistic neural network.&#x0D; Conclusion. Main advantage of using AI models in endodontic practice associated with improvement of diagnostic accuracy within reduced amount of time needed for X-ray images and clinical data analysis. AI application for apical foramen detection and working length determination demonstrates the highest level of accuracy compared to AI performance for other clinically related objectives in endodontics.

A MORPHOLOGICAL ODDITY IN MANDIBULAR LEFT SECOND PREMOLAR WITH TWO ROOTS: A CASE REPORT

Thorough knowledge of different root canal morphology with appropriate assessment of the pulp chamber floor and proper interpretation of radiographs are prerequisite for successful root canal therapy. The possibility of additional or extra root or canal should be considered even in teeth with a low frequency of abnormal root canal anatomy. This article reports on a case of mandibular second premolar with two roots which was successfully treated using endodontic therapy with adequate restoration.

Accuracy verification of dental cone-beam computed tomography of mandibular incisor root canals and assessment of its morphology and aging-related changes.

The root canal morphology undergoes aging-related changes, and relevant quantitative analyses have not yet been reported. We compared the cone beam computed tomography (CBCT) and micro-computed tomography (micro-CT) scans of extracted mandibular incisors to check the accuracy of morphological measurements. Thereafter, the root canal morphology and aging-related changes in the mandibular incisors of Japanese individuals were assessed using CBCT. Six extracted teeth were fixed in a phantom head and imaged using CBCT and micro-CT. The correlation between the findings of the two imaging modalities was examined. Further, CBCT reconstructed images of the mandibular incisors of 81 individuals were observed. Age-related changes of the root canals were compared between participants aged <30 years and those aged ≥30 years. The CBCT and micro-CT findings regarding the root canals of the extracted teeth coincided in 94.4% of the cases. Mandibular incisors exhibiting two root canals in either cross-section accounted for 9.9% of central incisors and 12.4% of lateral incisors. Mandibular central incisors with two root canals were observed in two (6.3%) individuals aged <30 years and six (12.2%) aged ≥30 years. Mandibular lateral incisors with two root canals were observed in one (3.1%) individual aged <30 years and nine (18.4%) aged ≥30 years. CBCT allows accurate evaluation of complex root canal morphologies and is useful for endodontic preoperative assessment. Mandibular incisors have more frequent occurrence of two root canals with aging.

Microcomputed tomographic analysis of the efficiency of two retreatment techniques in removing root canal filling materials from mandibular incisors

This study aimed to evaluate the removal effect of the ProTaper Next system (PTN) combined with manual nickel-titanium Hedström (MNiTiH) files or chloroform on filling materials of mandibular incisors by microcomputed tomography (micro-CT). Sixty-four extracted human mandibular incisors were finally selected and assigned to two groups (n = 32) based on root canal morphology after instrumentation. Two subgroups (n = 16) were formed based on two retreatment methods. The volume of residual filling materials (RFMs) and the surface area covered by RFMs were analyzed by micro-CT, the apical extrusion and the time taken for removing the filling materials were recorded. A smaller percentage of the volume of RFMs and less surface area covered by RFMs occurred in PTN combined with MNiTiH groups and round-shaped canal incisors (P < 0.05). The time taken for removing the filling materials was not significantly different in all groups (P > 0.05). The apical extrusion was significantly less in PTN combined with MNiTiH groups than in PTN combined with chloroform groups (P < 0.05). Neither of the two methods rendered root canals completely free from filling materials. PTN combined with MNiTiH could reduce the apical extrusion and remove filling materials more efficiently than PTN combined with chloroform.

Evaluation of the morphology of accessory canals of the canalis sinuosus via cone-beam computed tomography

Purpose: This study aims to assess the presence of accessory canal (AC) associated with canalis sinuous (CS), describing their frequency, lateralization, location, direction, and measurements in cone beam computed tomography (CBCT).Methods: Axial, coronal, sagittal, and cross-sectional reconstructions were analyzed in 248 CBCT images and the presence of CS, the presence of AC associated with CS, the lateralization, localization, and direction course of AC associated with CS was evaluated. CS diameter, AC diameter, the distance between the nasal cavity floor and CS (M1), CS and the buccal cortical bone (M2), and CS and the alveolar ridge (M3) were measured.Results: CS was detected in all CBCT scans as bilaterally. The prevalence of AC associated with CS was 35.5%. There was a significant difference between dental status anthe d presence of AC associated with CS. There was a significant difference between gender, dental status, and lateralization of AC associated with CS. While M1 was greater in male patients than females, M3 was greater in female patients. M2 and M3 were greater in younger patients.Conclusion: Clinicians performing surgical procedures should keep in mind that anatomical variations of the vascular nerve bundle may be seen. M1, M2, and M3 measurements can be affected by gender, age, and dental status.

Prevalence and morphological analysis of isthmuses in mandibular molars of the Indian population: A micro-computed tomographic study.

This study evaluated the prevalence, configurations, and correlation of isthmuses at coronal, middle, and apical root 3rd in mandibular molars of the Indian population using micro-computed tomography μCT). One hundred and five permanent mandibular molar teeth were scanned under μCT. The axial sections were analyzed at the coronal, middle, and apical thirds of the root for isthmus types and classified according to Hsu and Kim's classification. Descriptive statistics for each isthmus type were calculated. The correlations between the apical, middle, and coronal thirds of the root were determined using Pearson's correlation coefficient. Type IV isthmus was the most common in the coronal third of the mesial root of mandibular 1st molar (42.9%), while Type V was prevalent in the coronal third of the mesial root of 2nd molar (42.9%). Type I isthmus was found to be highly prevalent in the middle 3rd (71.4%) and apical 3rd (61.9%) of mesial roots of 1st molars, and in the middle 3rd (71.4%) and apical 3rd (42.9%) of mesial roots of 2nd molars. Type V isthmus was the most prevalent in all the thirds of the distal roots of both 1st and 2nd molars, ranging from 40% to 50%. Furthermore, a strong correlation of 0.965 (P < 0.01) was found between the isthmuses in the apical and middle thirds of roots. There are variations in the prevalence and type of isthmuses across different sections of the root, including the presence of atypical isthmuses. Micro-CT with high-resolution imaging and three-dimensional reconstruction is crucial for investigating root canal morphology. Clinicians could benefit from considering demographic characteristics to better predict the presence of isthmus variations. The isthmus configurations and frequency differ at each section of mandibular teeth.

A CBCT Study to Evaluate the Root and Canal Morphology of Permanent Maxillary First Molars in Children.

For the correct diagnosis and endodontic therapy, a complete understanding of root canal morphology is required. One of the causes of endodontic failure is the inability to identify every canal in the root canal system; the second mesiobuccal canal (MB2) in the permanent maxillary first molar is the most commonly missed canal. Studies examining the root canal differences in pediatric Indian populations' permanent maxillary first molars are somewhat uncommon. Cone-beam computed tomography (CBCT) will be used to assess the root and canal morphology of permanent maxillary first molars in the pediatric Indian population. In the age range of 7-13 years, 25 children's CBCT pictures (50 images) were gathered from the institutional database and private diagnostic facilities. SCANORA® software was used to reconstruct the CBCT pictures, and Statistical Package for the Social Sciences (SPSS) for Windows was used to evaluate and analyze the data. The roots of each permanent maxillary first molar were distinct. And all of the palatal and distobuccal roots were found to have a single root canal (100%), whereas the mesiobuccal roots were found to have a single root canal in 80% of cases and a double root canal in 20% of cases. The Vertucci type II structure, followed by types IV and V, was the most prevalent in roots with two channels. Within the constraints of this investigation, we came to the conclusion that the permanent maxillary first molar root canal configuration varied among the patients from the pediatric Indian population. Krishnamurthy NH, Athira P, Umapathy T, et al. A CBCT Study to Evaluate the Root and Canal Morphology of Permanent Maxillary First Molars in Children. Int J Clin Pediatr Dent 2022;15(5):509-513.

Prevalence of Second Root and Root Canal in Mandibular and Maxillary Premolars Based on Two Classification Systems in Sub-Population of Northern Region (Saudi Arabia) Assessed Using Cone Beam Computed Tomography (CBCT): A Retrospective Study.

The objective of this paper is to assess the prevalence of a second canal in maxillary and mandibular premolars based on two classification systems of root canal morphology using Cone beam computed tomography (CBCT) images. A total of 286 CBCT scans from the archive of the Radiology department of a hospital were assessed for the presence of a second canal in maxillary and mandibular premolars. The canal configuration and its assessment was undertaken using Vertucci and Ahmed's classification. A Chi-square test was used to test the significance of the difference between gender and age. A total of 286 premolars were examined (217 mandibular premolars and 69 maxillary premolars); of these, 173 teeth (60.5%) were from males and 113 were from females (39.5%). Some 62% of maxillary left first premolars had two roots, followed by maxillary right first premolars (47%), and then maxillary left second premolars (30%) and maxillary right ones (27%), respectively. Type IV Vertucci were seen in maxillary premolars, while type I were ordinarily seen in the included mandibular premolars. Surprisingly, Vertucci type III was only found in mandibular left first premolars at a frequency of 2%. One orifice with two separate canals and two orifices of two distinct canals with two portals of exit were predominantly noticed with maxillary first premolars (2 FP B1 P1) in 73% and 81%, respectively, followed by (1 FP 2) 19%. The prevalence of a second canal in maxillary and mandibular premolars was low in the investigated premolars in comparison to the premolars that had just one root and canal, as assessed based on Vertucci and Ahmed's root canal system classification.