Root Canal Access Research Articles

A comparative evaluation of the effect of matrix metalloproteinase inhibitor on the fracture resistance of endodontically treated teeth restored with Everstick-reinforced composite resin: An in vitro study

Aim: To evaluate the effect of applying a matrix metalloproteinase (MMP) inhibitor on the fracture resistance of root-filled teeth restored with Everstick fiber-reinforced composite resin. Subjects and Methods: After the selection of 60 freshly extracted human mandibular first molar, root canal access and standard uniformly sized mesio-occluso-distal (MOD) cavities were made and the teeth were randomly assigned into three groups (n = 20 each): Group I, the MOD cavity was first lined with flowable composite resin and then restored with composite resin. In Group II, Everstick fiber was placed into the bed of flowable composite in buccal–pulpal–lingual direction before the composite restoration was placed. In Group III, after etching of the cavity, a 2% chlorhexidine MMP inhibitor was applied. Then, the MOD cavity was restored same as group II. A universal testing machine was employed to compressively load the teeth at a cross-head speed of 0.5 mm/min till fracture. The maximum fracture loads were recorded in Newtons (N) and data were analyzed with one-way ANOVA and post-hoc Tukey tests. Results: Group III exhibited significantly higher fracture resistance compared to all other groups (P < 0.001), whereas Group I demonstrated the lowest fracture resistance. Conclusion: The utilization of Everstick glass fiber, combined with MMP inhibitor treatment, yielded the greatest fracture resistance. Hence, this method may be prioritized over conventional restoration techniques for strengthening root canal-treated teeth with structurally compromised crowns.

Comparative evaluation of efficacy of guided endodontic technique with and without sleeve for access cavity preparation: An In Vitro study

BackgroundCalcific metamorphosis in root canals is common and presents challenges in gaining access. Guided endodontics offers a solution to overcome these difficulties. The PriciGuide® system is a patented guided endodontic technique claiming superior precision compared to sleeve-based guides. This study aims to compare deviation between the PriciGuide® system and the guide with sleeve. MethodsA patient with calcified canal underwent CBCT scanning to obtain a DICOM file. Using the DICOM file, 3D models were printed. The patient's cast was scanned to obtain an STL file. Using DICOM and STL files, the guide with sleeve was designed using BlueSkyBio software and 3D printed. The PriciGuide® system was obtained from Roots to Cusps® Private Limited. Access opening was performed using conventional method, guide with sleeve and guide without sleeve (PriciGuide® system).Samples underwent radiograph scans to measure coronal, apical, and angular deviations, as well as procedural time. ResultsOne-Way ANOVA and Post Hoc Bonferroni's test revealed that coronal, apical, and angular deviations were lowest in the guide without sleeve group. However, access opening times were similar in both guided technique groups. ConclusionsThe PriciGuide® system offers precise access cavity preparation for calcified canals, showing minimal deviation compared to the sleeve-based guides. It facilitates accurate root canal access regardless of the dentist's experience level. This study utilized 3D-printed teeth that do not fully replicate the complexities of natural teeth, further research is needed to validate the PriciGuide® system's performance on natural teeth and assess deviation using CBCT for a more comprehensive evaluation.

The effect of computer aided navigation techniques on the precision of endodontic access cavities: A systematic review and meta-analysis

AIM. To assess the impact of computer-assisted navigation techniques on the precision of endodontic access cavity preparation.MATERIALS AND METHODS. A systematic review was conducted following the PRISMA 2020 guidelines. Articles were searched for online using electronic databases, including Scopus, PubMed, Cochrane, and Web of Sciences. The success rate of root canal location using computer-aided navigation techniques in root canal access cavity preparation, along with the time required for cavity preparation and the extent of tooth substance removal were assessed in this review. After eliminating duplicate articles and applying inclusion criteria, 10 studies were chosen for analysis.RESULTS. Accuracy in location of root canal is significantly higher in the static and dynamic navigation group compared to the conventional group. Also, computer-aided static and dynamic navigation techniques removed significantly less tooth substance compared to conventional groups. Moreover, static navigation technique took significantly less time for access cavity preparation than conventional while there was no significant difference in the time taken for access cavity preparation between dynamic navigation technique and conventional technique.CONCLUSION. The root canal access cavities prepared using static and dynamic computer-aided navigation techniques are highly precise in detecting the root canal system, require less tooth substance removal, and take less time to complete.

Evaluating the Impact of Ultrasonic Irrigation on Bacterial Levels and Activity Following Chemomechanical Procedures

IntroductionThis single-arm interventional trial aimed to investigate the efficacy of ultrasonic irrigation as a supplementary disinfection approach after chemomechanical procedures (CMP) using molecular techniques based on ribosomal RNA (rRNA) and rRNA genes (referred to as DNA). MethodsSamples were collected from 35 single-rooted teeth with radiographic evidence of apical periodontitis. Samples were taken after gaining root canal access (S1), (S2), and ultrasonic irrigation (S3). DNA-targeted quantitative polymerase chain reaction using universal primers was used to estimate total bacterial levels, while rRNA-targeted quantitative polymerase chain reaction was used to assess bacterial activity. Ratios between rRNA and DNA levels were calculated to search for active bacteria in the samples (rRNA/DNA ≥ 1). Wilcoxon matched-pairs signed-rank test was used to compare the differences in DNA levels between samples and DNA and rRNA levels within samples (P < .05). ResultsDNA-based methods revealed a significant decrease in bacterial levels from S1 to S2 and S2 to S3 (both P < .05). Notably, 11 out of 35 (31.4%) root canals did not harbor bacterial DNA after CMP, whereas ultrasonic activation increased DNA-negative samples to 17 (48.6%). However, all DNA-positive samples were also positive for rRNA, with significantly higher rRNA than DNA levels (P < .05), indicating bacterial activity at the sampling time. ConclusionsUltrasonic irrigation improved the disinfection of root canals after CMP by reducing bacterial levels. However, persisting bacteria remained active in the root canals after CMP and ultrasonic irrigation.

Root canal morphology of permanent mandibular anterior teeth in a Pakistani population: A cone beam computed tomography assessment.

To investigate the incidence of accessory canals and the variation in root canal morphology of permanent mandibular incisors and canines in Pakistani population using Cone Beam Computed Tomography (CBCT). A cross-sectional study was conducted in University College of Dentistry, The University of Lahore, Pakistan after getting institutional ethical permission from January 2020 to September 2022. The data included records of 111 patients consisting of 444 permanent mandibular incisors and 222 permanent mandibular canines. Accessory root, root canals and Vertucci canal configuration for each tooth was recorded. Data analysis was done using SPSS v20. Descriptive statistics were calculated for each anatomical parameter. Chi-square test was applied to determine association of gender with the presence of accessory roots and root canals. Among the 111 records evaluated, 48.6% were males and 51.4% were females. No accessory root was found in the central and lateral incisors. However, an accessory root was found in 4.9% of the canines. The incidence of accessory canals in the central incisors, lateral incisors and canines was 18.9%, 25.2% and 10.4% respectively. The most common canal configuration in teeth with accessory canals was Type-III, followed by Type-II and Type-V. None of the central or lateral incisor showed accessory root while it was detected in 4.9% canines. The frequency of accessory root canal was found to be 18.9%, 25.2% and 10.4% in central incisors, lateral incisors and canines respectively. The most common canal configuration was Type-I, followed by Type-III and Type-II. Type-V, VI and VII were less common.

Accuracy evaluation of dental CBCT and scanned model registration method based on pulp horn mapping surface: an in vitro proof-of-concept

Background and aim3D fusion model of cone-beam computed tomography (CBCT) and oral scanned data can be used for the accurate design of root canal access and guide plates in root canal therapy (RCT). However, the pose accuracy of the dental pulp and crown in data registration has not been investigated, which affects the precise implementation of clinical planning goals. We aimed to establish a novel registration method based on pulp horn mapping surface (PHMSR), to evaluate the accuracy of PHMSR versus traditional methods for crown-pulp registration of CBCT and oral scan data.Materials and methodsThis vitro study collected 8 groups of oral scanned and CBCT data in which the left mandibular teeth were not missing, No. 35 and No. 36 teeth were selected as the target teeth. The CBCT and scanned model were processed to generate equivalent point clouds. For the PHMSR method, the similarity between the feature directions of the pulp horn and the surface normal vectors of the crown were used to determine the mapping points in the CBCT point cloud that have a great influence on the pulp pose. The small surface with adjustable parameters is reconstructed near the mapping point of the crown, and the new matching point pairs between the point and the mapping surface are searched. The sparse iterative closest point (ICP) algorithm is used to solve the new matching point pairs. Then, in the C + + programming environment with a point cloud library (PCL), the PHMSR, the traditional sparse ICP, ICP, and coherent point drift (CPD) algorithms are used to register the point clouds under two different initial deviations. The root square mean error (RSME) of the crown, crown-pulp orientation deviation (CPOD), and position deviation (CPPD) were calculated to evaluate the registration accuracy. The significance between the groups was tested by a two-tailed paired t-test (p < 0.05).ResultsThe crown RSME values of the sparse ICP method (0.257), the ICP method (0.217), and the CPD method (0.209) were not significantly different from the PHMSR method (0.250). The CPOD and CPPD values of the sparse ICP method (4.089 and 0.133), the ICP method (1.787 and 0.700), and the CPD method (1.665 and 0.718) than for the PHMSR method, which suggests that the accuracy of crown-pulp registration is higher with the PHMSR method.ConclusionCompared with the traditional method, the PHMSR method has a smaller crown-pulp registration accuracy and a clinically acceptable deviation range, these results support the use of PHMSR method instead of the traditional method for clinical planning of root canal therapy.

In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis.

This study aimed to assess the efficacy of root canal debris removal in primary teeth through irrigation using the Endo-Irrigator Plus (CWAIS). A total of 25 primary mandibular first molars were divided into five groups, with five teeth in each group. After determining the working length and performing biomechanical preparation, groups I and II were subjected to hand and rotary instrumentation (ProTaper, Dentsply, United States of America) with conventional syringe irrigation with positive pressure, while groups III and IV were instrumented using hand and rotary instrumentation with positive and negative pressure irrigation employing the Endo-Irrigator Plus (CWAIS) system. Sodium hypochlorite (5.25%) and ethylenediaminetetraacetic acid (EDTA) (17%) were used as irrigants. Group V served as the control group, undergoing only root canal access opening. The removal of the smear layer was analyzed at the cervical, middle, and apical thirds of the canal using environmental scanning electron microscopy (SEM). Statistical significance was set at p < 0.05. Statistically significant differences were observed among all groups at the cervical, middle, and apical levels (p < 0.05). Groups III and IV exhibited significantly lower smear scores at all levels, particularly in the apical third, as observed through SEM examination. The use of the Endo-Irrigator Plus (CWAIS) system demonstrated superior debridement of intracanal debris in primary teeth compared to the positive pressure irrigation method. Badnaware SD, Kakade A, Takate V, et al. In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis. Int J Clin Pediatr Dent 2024;17(6):653-657.

Students' Perception of Remote Extended Reality Simulation Systems Using Patient-specific Three-Dimensional-printed Models in Endodontic Education: A Pilot Study.

Extended reality (XR) technology using head-mounted devices enables the operator to visu-alise anatomical structures. We aimed to investigate student perceptions regarding applying XR simu-lation for transferring endodontic educational information between a lecturer in Japan and students in Saudi Arabia. In this study, the students engaged with an XR simulation system and viewed teeth in virtual reality (VR). Pictures of dental anatomy were shown in the VR space, allowing participants to manipulate them. Then, the participants viewed a patient-specific three-dimensional printed model and three-dimensional root canal access guide in a second VR area. Before the sessions, the students completed a questionnaire on demograph-ic data and information concerning their VR experience. After the sessions, they completed a questionnaire evaluating the XR simulation system. The questionnaire included questions on dental anatomy, root canal access, usability, emotional impression, and data transfer. Eleven 5th-year dental students, comprising six male and five female students, were enrolled; three of them had previous VR experience, whereas eight did not. The highest levels of satisfaction were noted in the tooth anatomy (4.6+-0.4) and emotional impression (4.5+-0.5) domains, whereas the lowest level was noted in the data transmission domain (3.5+-0.9). Female participants and those without previous VR experience reported higher satisfaction levels across questionnaire domains compared to male participants and those with previous VR experience. XR can be successfully used in dental education and integrated into online lectures. Restrictions on education caused by health crises can be averted by using XR. Further, fifth-generation networks can offer better data transmission than wireless fidelity.

A Rare Case of Radicular Cyst in the Maxillary Sinus Masquerading as Mucous Retention Cyst

Abstract Cysts are pathological cavities lined by the epithelium that contains fluid or semifluid material. The term “odontogenic cyst” refers to the cyst related to the teeth. One of the most common odontogenic cysts, the periapical cyst, also known as the radicular cyst, is linked to a dead or nonvital tooth. Most often, the apices of the affected nonvital teeth serve as the epicenter of these cysts, although they can also be discovered on the lateral aspects of the roots in connection with lateral accessory root canals. There is something provocative about them. Most radicular cysts are small, but on rare occasions, they may enlarge to the point where they press against the maxillary sinus. In this instance, you can distinguish between pathology coming from the maxillary sinus itself and pathology with an odontogenic origin that is causing the sinus to be displaced by performing a comprehensive examination in conjunction with computed tomography (CT) imaging. This article highlights the use of advanced 3D diagnostic technologies like CT that details the care of a rare case of a huge radicular cyst involving the maxillary sinus in a 50-year-old female requiring surgical intervention.

A micro-computed tomographic evaluation of maxillary first molar accessory root canal morphology in a Black South African subpopulation.

The aim of this study was to investigate the accessory root canal morphology of maxillary first molars in a Black South African subpopulation. Micro-computed tomography was used to investigate 101 maxillary first molars (from 50 male and 51 female teeth, right 53 teeth, left 48 teeth). The prevalence of chamber canals, and the number, type and location (root third) of accessory canals were recorded. The relationships between arch side, sex and age were examined using chi-squared tests of association. Intra- and inter-observer reliability were assessed using Cohen's kappa test. Intra- and inter-rater agreement was 96.9% and 98.1%, respectively. Variations in accessory root canal anatomy according to side, sex and age were evident. Chamber canals were identified in 10.9% of teeth. Accessory canals were found mainly in the apical third of most teeth in the sample, and distributed predominantly in the mesio-buccal root. Apical deltas were most prevalent in the mesio-buccal root, and their frequency decreased in the palatal and then finally the disto-buccal root. Accessory root canals were common in this population, and showed a diverse range of anatomy. The present findings will be of assistance to clinicians during endodontic treatment and will also be valuable for educational purposes.

Internal Morphology of Mandibular Second Premolars Using Micro-Computed Tomography.

To examine root canal morphology of mandibular second premolars (Mn2P) of a mixed Swiss-German population by means of micro-computed tomography (micro-CT). Root canal configuration (RCC) of 102 Mn2P were investigated using micro-CT unit (µCT 40; SCANCO Medical AG, Brüttisellen, Switzerland) with 3D software imaging (VGStudio Max 2.2; Volume Graphics GmbH, Heidelberg, Germany), described with a four-digit system code indicating the main root canal from coronal to apical thirds and the number of main foramina. A total of 12 different RCCs were detected. 1-1-1/1 (54.9%) was most frequently observed RCC, followed by 1-1-1/2 (14.7%), 1-1-2/2 (10.8%), 1-2-2/2 (4.9%), 1-1-3/3 (3.9%), 1-1-1/3 (2.9%), 2-1-1/1 (2.9%) and less frequently 1-1-2/3, 1-2-1/2, 2-1-2/2, 1-1-2/5, 1-1-1/4 with each 1.0%. No accessory foramina were present in 35.3%, one in 35.3%, two in 21.6%, three and four in 2.9%, and five in 2.0%. In 55.9% Mn2Ps, accessory root canals were present in apical third and 8.8% in middle third of a root. Connecting canals were observed less frequently (6.9%) in apical and 2.9% in the middle third, no accessory/connecting canals in coronal third. Every tenth tooth showed at least or more than three main foramina. Almost two thirds of the sample showed accessory root canals, predominantly in apical third. The mainly single-rooted sample of Mn2Ps showed less frequent morphological diversifications than Mn1Ps.

The effect of 3D stereopsis and hand-tool alignment on learning effectiveness and skill transfer of a VR-based simulator for dental training.

Recent years have seen the proliferation of VR-based dental simulators using a wide variety of different VR configurations with varying degrees of realism. Important aspects distinguishing VR hardware configurations are 3D stereoscopic rendering and visual alignment of the user's hands with the virtual tools. New dental simulators are often evaluated without analysing the impact of these simulation aspects. In this paper, we seek to determine the impact of 3D stereoscopic rendering and of hand-tool alignment on the teaching effectiveness and skill assessment accuracy of a VR dental simulator. We developed a bimanual simulator using an HMD and two haptic devices that provides an immersive environment with both 3D stereoscopic rendering and hand-tool alignment. We then independently controlled for each of the two aspects of the simulation. We trained four groups of students in root canal access opening using the simulator and measured the virtual and real learning gains. We quantified the real learning gains by pre- and post-testing using realistic plastic teeth and the virtual learning gains by scoring the training outcomes inside the simulator. We developed a scoring metric to automatically score the training outcomes that strongly correlates with experts' scoring of those outcomes. We found that hand-tool alignment has a positive impact on virtual and real learning gains, and improves the accuracy of skill assessment. We found that stereoscopic 3D had a negative impact on virtual and real learning gains, however it improves the accuracy of skill assessment. This finding is counter-intuitive, and we found eye-tooth distance to be a confounding variable of stereoscopic 3D, as it was significantly lower for the monoscopic 3D condition and negatively correlates with real learning gain. The results of our study provide valuable information for the future design of dental simulators, as well as simulators for other high-precision psycho-motor tasks.

Guided Endodontic Surgery: A Narrative Review.

Background and objectives: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the healing of lesions of endodontic origin. The main objective of this review paper is to define and characterize guided surgical endodontics as well as its benefits and drawbacks by reviewing the most recent relevant scientific literature. Methods: A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were 'guided endodontics', 'surgical endodontics', and 'endodontic microsurgery'. Results: In total, 1152 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 388 articles were excluded. A total of 45 studies were finally included in the review. Conclusions: Surgical-guided endodontics is a relatively new area of study that is still maturing. It has many applications such as root canal access and localization, microsurgical endodontics, endodontic retreatment, and glass fiber post removal. Additionally, it does not matter how experienced the operator is; the procedure can be completed for the patient in less time and provides greater accuracy and safety than conventional endodontics.

A Study on Sequale of Development and Clinical Features of Radicular Cyst

Radicular cysts are the most common cystic lesions affecting the jaws. They are most commonly found at the apices of the involved teeth, however they may also be found on the lateral aspects of the roots in relation to lateral accessory root canals. Quite often a radicular cyst remains behind in the jaws after removal of the offending tooth and this is referred to as a residual cyst. Radicular cysts are the most common of all jaw cysts and comprise about 52% to 68% of all the cysts affecting the human jaws.

Method to Identify Accessory Root Canals using a New CBCT Software.

This study describes a methodology to identify accessory root canals using the e-Vol DX software in CBCT scans. Accessory root canals are strategic shelters for microorganisms present in root canal infections. The identification of these small canals in periapical radiographic exams has limitations, besides being markedly limited accessibility to the action of endodontic instruments and to the antimicrobial agents. A significant number of accessory canals have sufficient diameters to be visible on cone-beam computed tomography (CBCT) images of high spatial resolution. Therefore, it may go unnoticed or even confused when there is no specific training for this type of diagnosis. The methodology consists in establishing thin slices (0.1mm or smaller) obtained from coronal, sagittal and axial slices. The method consists of the following steps: during navigation along the long axis of a root canal when finding a possible hypodense line of main root canal in a tomographic section (axial, sagittal or coronal), the navigation software lines of the multiplanar reconstruction (MPR) must be adjusted so that they are parallel and perpendicular to the hypodense line (parallax correction). Then, after judiciously adjusted, the accessory canal image will invariably appear as a line on one of the MPR tomographic slices, another line on another slice, and a dot on the third slice. The three sections of the MPR present images with the "line-line-dot" sequence. In this way, it is possible to identify an accessory root canal and also visualize it in volumetric reconstruction in a specific filter. The application of this method is easy to employed and may benefit the diagnosis when you want to visualize accessory root canals and distinguish it from root fracture line.

Dental Mitigation Strategies to Reduce Aerosolization of SARS-CoV-2

Limiting infection transmission is central to the safety of all in dentistry, particularly during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Aerosol-generating procedures (AGPs) are crucial to the practice of dentistry; it is imperative to understand the inherent risks of viral dispersion associated with AGPs and the efficacy of available mitigation strategies. In a dental surgery setting, crown preparation and root canal access procedures were performed with an air turbine or high-speed contra-angle handpiece (HSCAH), with mitigation via rubber dam or high-volume aspiration and a no-mitigation control. A phantom head was used with a 1.5-mL min−1 flow of artificial saliva infected with Φ6-bacteriophage (a surrogate virus for SARS-CoV-2) at ~108 plaque-forming units mL−1, reflecting the upper limits of reported salivary SARS-CoV-2 levels. Bioaerosol dispersal was measured using agar settle plates lawned with the Φ6-bacteriophage host, Pseudomonas syringae. Viral air concentrations were assessed using MicroBio MB2 air sampling and particle quantities using Kanomax 3889 GEOα counters. Compared to an air turbine, the HSCAH reduced settled bioaerosols by 99.72%, 100.00%, and 100.00% for no mitigation, aspiration, and rubber dam, respectively. Bacteriophage concentrations in the air were reduced by 99.98%, 100.00%, and 100.00% with the same mitigations. Use of the HSCAH with high-volume aspiration resulted in no detectable bacteriophage, both on nonsplatter settle plates and in air samples taken 6 to 10 min postprocedure. To our knowledge, this study is the first to report the aerosolization in a dental clinic of active virus as a marker for risk determination. While this model represents a worst-case scenario for possible SARS-CoV-2 dispersal, these data showed that the use of HSCAHs can vastly reduce the risk of viral aerosolization and therefore remove the need for clinic fallow time. Furthermore, our findings indicate that the use of particle analysis alone cannot provide sufficient insight to understand bioaerosol infection risk.

Preoperative Intraligamentary Injection of Dexamethasone Can Improve the Anesthetic Success Rate of 2% Lidocaine during the Endodontic Management of Mandibular Molars with Symptomatic Irreversible Pulpitis

IntroductionThe aim of this randomized, double-blind clinical trial was to evaluate the effect of preoperative administration of intraligamentary injections of diclofenac sodium and dexamethasone on the anesthetic efficacy of 2% lidocaine given as an inferior alveolar nerve block in the endodontic management of symptomatic irreversible pulpitis. MethodsOne hundred seventeen patients randomly received 1 of the 3 intraligamentary injections before the endodontic treatment: 0.9% normal saline, 25 mg/mL diclofenac sodium, or 4 mg/mL dexamethasone. After 30 minutes, patients received an inferior alveolar nerve block with 2% lidocaine and 1:80,000 epinephrine. The teeth were tested with electric pulp testing after 10 minutes. In case of a positive response, the anesthesia was considered as “failed.” If the electric test response was negative, a rubber dam was applied, and endodontic treatment was started. Any pain during the treatment was recorded. The anesthesia was considered successful if the patients experienced no pain or faint/weak/mild pain during root canal access preparation and instrumentation (Heft-Parker visual analog scale score <55 mm). The effect of intraligamentary injections on maximum heart rates was also recorded. The anesthetic success rates were analyzed with the Pearson chi-square test at 5% significance. ResultsThe control, diclofenac sodium, and dexamethasone groups had anesthetic success rates of 32%, 37%, and 73%, respectively. Dexamethasone was significantly more successful than the control and diclofenac sodium groups (P < .001, χ22 = 14.7). There were no differences between the control and diclofenac groups (P > .05). All the solutions did not significantly affect heart rates. ConclusionsThe administration of an intraligamentary injection of dexamethasone before endodontic intervention of mandibular molars with symptomatic irreversible pulpitis increases the success rates of an inferior alveolar nerve block with 2% lidocaine.

Quantitative Analysis of the Anatomy of Mesial Roots of Mandibular First Molars with Vertucci Type I Root Canal Configuration by Means of Micro-Computed Tomography

Aim: This study aimed to evaluate root canal morphology of Vertucci type I root canal configuration detected in mesial roots of mandibular first molar teeth using micro-computed tomography (Micro-CT).&#x0D; Methodology: Micro-CT datasets of 269 specimens were evaluated for the detection of specimens with Vertucci type I root canal configuration for further analysis. Major and minor diameter, area, perimeter and roundness of root canal cross-sections at the beginning and midline of each root thirds were measured and recorded. The presence of apical delta, accessory canals, and deviation of major apical foramen from anatomical apex were investigated. Data was analyzed using descriptive analysis, ANOVA-Tukey and Kruskal-Wallis H-Wilcoxon signed-rank tests.&#x0D; Results: Vertucci type I canal configuration was present in the 4.46% of the specimens. The specimens often showed accessory root canals (50%) and apical deltas (41,6%). From the visual analysis of the 3D and 2D images, significant differences were detected among coronal, middle and apical thirds of the specimens regarding major and minor diameter, area, perimeter and roundness (P &lt; 0.05).&#x0D; Conclusion: Three- and two-dimensional analyses of mesial roots with Vertucci type I canal configuration indicated that this type of configuration presents large buccolingual diameters with long oval shape and has isthmus at coronal and middle thirds. At the apical third the root canals often terminate in an oval cross sectional shape.&#x0D; &#x0D; How to cite this article: Keles A, Keskin C. Quantitative analysis of the anatomy of mesial roots of mandibular first molars with Vertucci type I root canal configuration by means of micro-computed tomography. Int Dent Res 2020;10(1):17-21. https://doi.org/10.5577/intdentres.2020.vol10.no1.4&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chitosan, Chlorhexidine and Their Combinations Against Enterococcus Fecalis and Candida Albicans Using Quantitative Real Time Polymerase Chain Reaction – An In Vitro Study

Bacterial invasion of root canal system is crucial for the onset and maintenance of periapical diseases. Hence, one of the goals of the endodontic treatment is to kill micro-organisms in the root canal system. Although, biomechanical preparation and root canal shaping effictively reduces the microbiota, these procedures do not completely eliminate bacteria in the lateral and accessory root canals, isthmi, and apical deltas. Thus, intracanal medication between appointments is recommended to further reduce bacteria in the root canal system.

Radicular cyst involving maxillary sinus: A report of rare case

A pathological cavity lined by epithelium containing either fluid or semifluid substance is termed as cyst. The cyst associated with the teeth is called as odontogenic cyst. The periapical cyst or Radicular cyst is one among the odontogenic cysts which is most prevalent and associated with a dead or non-vital tooth. The epicentre of these cysts is mostly the apices of the involved non-vital teeth, however they may also be found on the lateral aspects of the roots in relation to lateral accessory root canals. They are inflammatory in nature. Most of the radicular cysts are small in size, but sometimes it can extend to displace maxillary sinus. In this situation, careful examination with the use of computed tomography (CT) helps you to distinguish the pathology arising from maxillary sinus itself or is it odontogenic origin causing displacement of the sinus. This article is highlighting the importance of advanced diagnostic aids like computed tomography in managing a rare case of massive radicular cyst involving the maxillary sinus in 52 year female which was treated surgically. Keywords : Radicular cyst, Maxillary sinus, Computed tomography.