Root Canal Configuration Research Articles

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.

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 < 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.

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Syrian subpopulation

AimTo investigate the root number and morphology of the maxillary second molars in the Syrian population besides bilateral symmetry, and the effect of gender.Methods250 Cone Beam Computed Tomography (CBCT) images (140 females, 110 males) were examined by two endodontists. The detailed analysis included the number of roots, the number of canals and their configurations, bilateral symmetry, and relation to gender. The evaluation was made according to Vertucci classification by analyzing the CBCT images at all levels (Axial, Coronal, Sagittal, Oblique, and 3D). The Chi-square statistical analysis was performed to compare the canals’ morphologies and bilateral symmetry in both genders via SPSS.ResultThe most common shape of the upper second molars is three roots (90.4%). There were significant differences between males and females regarding the symmetry of the number of roots (P < 0.05). The root canal configuration was mainly Vertucci type I classification in the Distobuccally (93.4%) and palatal root (99.6%). The most common type in the mesial root was type I (29.5%), showing all varieties of Vertucci classifications (except VII, and VIII) percentage of MB2 of 70.5%. The ratio of symmetry was (59.6%) with no significant statistical difference between the genders (P = 0.708).ConclusionMost maxillary second molars in the examined Syrian population were types (II) (associated with MB2 cases with three roots and four canals). In terms of symmetry, the number of roots surpassed the canal configuration. Males had a greater symmetrical tendency in the number of roots than females.

Quantitative statistical evaluation of maxillary and mandibular incisor root canal morphology in Saudi patients

Abstract Introduction: Clinical practice demands understanding the complexity of the root canal system to achieve desired treatment goals. The statistically detailed morphology of the tooth and root canal morphology is very important to know. Therefore, the present study aims to investigate the statistical analysis of root canal morphology and morphological variations of maxillary and mandibular incisor teeth using cone-beam computed tomography (CBCT) in Saudi patients attending King Saud University Dental Hospital. Materials and Methods: CBCT images of 480 patients were selected. Number of roots and root canal configuration were identified and categorized according to Vertucci’s classification. Tooth length, distance from cementoenamel junction (CEJ) to the area of canal division, and width of the canal at the area of division were also evaluated. Bilateral symmetry and association between gender and age with the different variables were investigated. Data were analyzed using Chi-square, multiple linear regression, and McNemar’s tests. Results: A total of 3412 teeth were evaluated. All maxillary teeth had one root with Type I canal configuration. For mandibular teeth, all exhibited one root with the majority having Type I canal configuration in central (71.2%) and lateral (75%) incisor teeth. There was a statistically significant association between number of canals and age in mandibular incisor teeth observed only in females (P &lt; 0.001), while no association was observed between canal configuration and gender (P = 0.900 and P = 0.721, respectively). Multiple regression analyses showed that age and gender significantly explain the difference of the variance in tooth length (P &lt; 0.001). Moreover, bilateral symmetry was observed in 98.1% of mandibular central and 97.6% of lateral incisor teeth with no statistically significant association (P = 1 and P = 0.058, respectively). Conclusion: All maxillary and most mandibular incisor teeth present with one root and Type I canal configuration. In general, males have longer teeth than females, with a significant decrease in length with each year increase in age. Mandibular lateral incisor teeth exhibited the highest mean distance from CEJ to point of canal separation and highest mean width in the area of canal division.

Root canal configuration of human permanent anterior teeth: A cross-sectional study using cone-beam computed tomography in the Pakistani population.

To analyse and document internal root morphological variations in permanent anterior teeth using conebeam computed tomography. The cross-sectional, retrospective study was conducted from January 21 to June 19, 2021, at Jinnah Magnetic Resonance Imaging and Body Scan, and comprised data from July to December 2020 related to all the patients who had been referred to the centre for dental cone-beam computed tomography scan. The scans were evaluated at the Radiology Department of the School of Dentistry at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. The morphology of the roots and root canals in all permanent anterior teeth was examined. Root canal configuration was categorised using Vertucci's classification. Data was analysed using SPSS 20. Of the 211 patients, 116(55%) were females and 95(45%) were males. The overall mean age was 39.9±1.02 years (range: 15-65 years). All the permanent anterior teeth exhibited a single root, with the exception 2(0.9%) mandibular right and 4(1.9%) left canines which had double roots. Type I root canals were observed in all 211 (100%) maxillary right central incisors, maxillary left central incisors and maxillary left canines. Among maxillary right canines, 208(98.6%) had type-I root canals, and the corresponding value for maxillary right lateral incisors was 209(99.1%), and for maxillary left lateral incisors, the value was 210(99.5%). Root canal polymorphism had no significant association with gender (p>0.05). The presence of type-I root canal was common in permanent anterior teeth, and there was significant association of root canal polymorphism with gender.

Accuracy of Cone-beam Computed Tomography in diagnosing root canal configuration: a literature review

Objectives: This review article aims to describe the accuracy of cone-beam computed tomography (CBCT) in diagnosing root canal configuration. Review: This study is a literature review consisting of English articles about the accuracy of cone-beam computed tomography in diagnosing root canal configuration, published in 2013 – 2023. The article search databases used were Pubmed and Science Direct with the keyword “(cone-beam computed tomography[MeSH Terms]) AND (configuration, root canal[MeSH Terms]).” The selected articles were screened by checking the publication year, duplicating articles, reading the titles and abstracts, and the entire article's contents. The total search results for articles based on keywords obtained were 205 and only seven were included. In order to successfully perform root canal treatment, thorough knowledge of the root canal configuration is essential. Cone-beam computed tomography (CBCT) can improve our understanding of root canal configuration. The development of CBCT has brought to light the disadvantages of conventional radiography, which include the compression of three-dimensional anatomy, geometric distortion, and anatomical noise. Conclusion: Radiology is essential in treatment planning, disease monitoring, and assessmen t of treatment outcomes. The development of cone-beam computed tomography (CBCT) offers three-dimensional accuracy with a reasonable cost, no geometric distortion and anatomical noise, and the ability to create cross-sectional images, revolutionizing the imaging of dentomaxillofacial structures. This imaging system has been shown to overcome some of the limitations of conventional radiography.

Evaluation of Root Canal Configuration of Mandibular Premolars Using CBCT in a Defined Population of North India

Evaluation of Root Canal Configuration of Mandibular Premolars Using CBCT in a Defined Population of North India

Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study

BackgroundUnderstanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation.MethodThis cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05.ResultsThe distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females.ConclusionThis study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.

Efficacy of Different Irrigation Needles and Ultrasonic Activation on Calcium Hydroxide Removal: A Micro-CT Study Using 3D-Printed Endodontic Models

IntroductionThe aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)2 from an endodontic model that duplicated a root canal configuration of a human natural tooth. MethodsAn extracted human maxillary premolar was subjected to root canal preparation and scanned with microcomputed tomography. A 3-dimensional reconstruction model of the natural tooth was printed to endodontic models using a polyjet printer. The root canals of the models were filled with Ca(OH)2 paste and divided into 2 groups based on the irrigation protocol: conventional syringe-needle irrigation (conventional group) and passive ultrasonic irrigation (PUI) group. Each group was subdivided into 3 groups (n = 10) according to the type of needle: half-cut, side-vented, and TruNatomy irrigation needle. Microcomputed tomographyimaging was used to assess the percentage of reduction of Ca(OH)2. Data were analyzed using two-way analysis of variance test (α = .05). ResultsThe side-vented and TruNatomy irrigation needles showed significantly higher percentage reductions than the half-cut needle (P < .05) in the conventional irrigation group. The PUI group showed significantly higher percentage reductions of Ca(OH)2 than the conventional group regardless of the type of needle (P < .05). However, no significant difference was found among the needles in the PUI group. ConclusionsThe type of irrigation needle and the use of PUI influenced the removal efficacy of Ca(OH)2. PUI enhanced the removal of Ca(OH)2 regardless of the type of irrigation needle.

Correlation between root canal anatomy of mandibular incisors and premolars in Western Uttar Pradesh population of India - A cross sectional study

ABSTRACT Aim: This study aimed to evaluate the correlation between the presence of two canals in mandibular incisors and multiple canals in mandibular premolars in the Western Uttar Pradesh population of India using cone-beam computed tomography (CBCT). Methods: CBCT scans with 0.125-mm voxel size and 50 mm × 50 mm field of view of 800 patients were evaluated for the parameters; a number of canals, root canal configurations (according to Vertucci’s classification), unilateral/bilateral occurrences, and correlation between presence of two canal configuration in mandibular incisors and multiple canals (&gt;1 canal) in mandibular premolars. The data obtained were subjected to statistical analysis using the SPSS statistical program version 22.0 using the Chi-square test. The significance level was set as 5%. Results: According to the current analysis, the prevalence of mandibular incisors with one canal was 68.1% and two canals were 31.9% whereas in mandibular premolars prevalence of one canal was 71.5%, two canals were 27.2%, and three canals were 1.3%. The incidence of Vertucci type I canal configuration (68.1% mandibular incisors and 71.5% mandibular premolars) was more prevalent than the other types. The incidence of C-shaped canals was 2.6%. The prevalence of bilateral occurrence of the same canal configuration was 16.6%. A positive correlation was found between the presence of two canals in mandibular incisors with multiple canals in mandibular premolars (20.4%). Conclusion: The root canal morphology of mandibular premolar teeth of the Western Uttar Pradesh Indian population is complex. Two canals in mandibular incisors are frequently associated with multiple canals in mandibular premolars.

Root anatomy and canal configuration of human permanent maxillary third molar - systematic review.

Knowledge of the root canals configuration is essential for the success of endodontic treatment. The main aim of the systematic review is to determine the number of roots and the number of root canals in maxillary third molars, in addition, where possible, to determine the Vertucci classification. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. The study protocol was registered and approved on the International Prospective Register of Systematic Reviews PROSPERO (Reg. No: CRD42022366444) before the start of the study. Twelve studies were included in the analysis, differing in sample origin and methodology. The combined studies were analyzed based on the number of roots, number of canals, and root canal configurations, and the findings were compared with those of other international studies. Analyzing the available research results regarding the root anatomy and canal configuration of the third maxillary molar, the most commonly maxillary third molars had 3 roots (59.00%). Single-rooted teeth (24.20%) or double-rooted teeth (13.80%) were less common. In addition, it was observed that maxillary third molars typically possessed three root canals (47.28%) and the MB (mesiobuccal), DB (distobuccal), and P (palatal) canals most often showed Vertucci Type I (59.53%, 95.83% and 98.61%, respectively) in three-rooted form. Due to the small number of available studies, it is necessary to conduct further analyses taking into account demographic and ethnic differences that may affect the anatomical and morphological structure of the teeth.

Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis

IntroductionTo evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. MethodsResearchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. ResultsThe prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05). ConclusionsThe proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.

Micro-computed tomographic analysis of the morphology of maxillary lateral incisors

ObjectiveThis study aimed to investigate the morphology of maxillary lateral incisors (MxLI) using micro-computed tomography (micro-CT).Materials and methodsThe root canal configurations (RCC) of maxillary lateral incisors (MxLI) of a mixed Swiss-German population were examined using micro-CT, 3D imaging, and a 4-digit system code indicating the main root canal from coronal to apical thirds and the main foramina number.ResultsThe most frequently observed RCC of MxLI were 1-1-1/1 (Vertucci I/Ve I, 80.0%), 1-1-2/2 (Ve V, 7.3%), 1-2-1/1 (Ve III, 6.4%), 2-1-1/1 (Ve II, 1.8%), and 1-1-1/2 (1.8%)(n = 110). Three additional RCC were observed less frequently (0.9%). The MxLI showed one physiological foramen in 89.1%, two in 9.1%, and seldom three (1.8%). Most accessory canals were identified in the apical third of a root (20.0%), and no accessory canals in 72.7% of the samples.ConclusionsDetailed information on the internal morphology of MxLI of a Swiss-German population is given. The most frequently observed RCC of MxLI is 1-1-1/1 (Ve I). However, accessory canals may occur in all apical thirds, and 20% of all teeth investigated showed a challenging RCC for clinical treatment.Clinical relevanceThis study offers clinicians comprehensive data on MxLI morphology, emphasizing the significance of understanding varied RCC and accessory canal presence for improving root canal treatment outcomes. Over 25% of teeth exhibited complex RCC or accessory canals, influencing decisions during root canal treatment.

Characterizing the Root Canal Configuration of Mandibular Incisors in a Western Saudi Arabian Sub-population Using Cone Beam Computed Tomography.

Aim This study aimed to explore the morphology and complexity of mandibular anterior teeth in a Western Saudi Arabian sub-population using cone beam computed tomography (CBCT). Methodology CBCT scans from 818 patients were evaluated, and 3193 mandibular anterior teeth were analyzed for the number of roots, canal, canal configurations, separation level, bilateral symmetry, and gender associations. Results The results showed that all examined central and lateral incisors had a single root, and the majority exhibited a single canal. The prevalence of two canals in mandibular central and lateral incisors was 20.1% and 23.2%, respectively, resulting in an overall prevalence of 21.7% for two root canals in mandibular anterior teeth. The separation level of the two canals was predominantly located in the middle third of the root. Type I canal configuration was the most common, followed by type III. A high degree of bilateral symmetry in the number of canals and canal configurations was noted. Conclusion The findings contribute to the understanding of root canal anatomy in the Saudi population and provide valuable information for endodontic treatment planning.

Factors Influencing Non-Surgical Root Canal Treatment Outcomes in Mandibular Second Molars: A Retrospective Cone-Beam Computed Tomography Analysis.

Background/Objectives: This study aimed to investigate the influence of the root canal morphology and various treatment variables on the outcomes of root canal treatments (RCTs) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 of previously treated root canals with normal apices in the mandibular second molars. CBCT was utilized to evaluate the root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore the correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p = 0.05). Factors influencing endodontic treatment outcomes included missing canals (p = 0.018), underfilling or overfilling (p = 0.045), and inadequate coronal restoration (p = 0.006). Missing a canal was identified as the variable most significantly associated with periapical lesions (OR = 3.103). Inhomogeneous root canal obturation was more commonly observed in C-shaped root canals (p < 0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.

A Cross-Sectional Cone-Beam Computed Tomography Study of Root Canal Morphology and Configuration of Mandibular Premolars in Saudi and Sudanese Subpopulations

Abstract Objective To evaluate and compare the root canal morphology of mandibular premolars in Saudi and Sudanese subpopulations and between males and females within each group using cone-beam computed tomography (CBCT). Materials and Methods A cross-sectional study was done between May 2022 and July 2023. Six hundred premolars from Saudi and Sudanese subpopulations were evaluated using CBCT for their number of roots, type of root canal configuration based on Vertucci's classification, and average canal length measured from the buccal cusp tip to the root end. Statistical Analysis Statistical comparisons were made between males and females within each subpopulation and the two subpopulations using the chi-square test for root number and type of root canal configuration and an independent sample t-test for the canal length. Results Most mandibular premolars in both subpopulations had a single root, with type I root canal configuration. However, Sudanese showed various canal configurations (I, II, III, IV, and V) compared with Saudis, which was statistically significant in the first canal of the first mandibular premolar (p &lt; 0.05). Also, there were statistically significant differences in canal length between Saudi males and females (p &lt; 0.05) and between Saudis and Sudanese (p &lt; 0.05) in the first and second premolars. Conclusion Although most mandibular premolars in Saudi and Sudanese subpopulations exhibited a single root and type I canal configuration, variations exist between and within the groups, highlighting ethnic and gender differences and emphasizing the need for dentists' attention.

Endodontic retreatment of a mesotaurodontic mandibular first molar with C-shaped configuration in a patient with multiple taurodonts: A case report and review of literature

Abstract Taurodontism is a dental anomaly characterized by an apical displacement of the pulp chamber floor, resulting in a large pulp chamber with short roots. It can be associated with certain syndromes and abnormalities, although it is common to occur as an isolated characteristic. This anomaly can occur along with other root canal system anomalies such as C-type configuration. The aim of this report is to present the successful endodontic management of a C-shaped mesotaurodontic mandibular molar and review the literature available on this matter. A 23-year-old Persian female was referred by her dental surgeon to complete the root canal treatment of her right mandibular first molar (#46). Clinical examination showed a temporized cavity with no response to pulpoperiapical tests or visible pocket depth while an elongated root trunk with slight periodontal ligament widening, incomplete obturation of the root canal system, and periapical radiolucency was evident on the intraoral radiograph. Cone-beam computed tomography (CBCT) revealed a taurodontic and type III C-shaped root canal configuration. With a diagnosis of previous treatment and asymptomatic apical periodontitis, the patient was scheduled for root canal retreatment. The same anomaly was discovered in other molar teeth on the panoramic radiograph taken before the primary treatment of tooth #46. At a 2-month follow-up session, the tooth was found asymptomatic clinically and radiographically. The past publications about the management of nonsyndromic taurodontic molars were also reviewed. The review of 29 similar articles showed that preoperative CBCT, magnification with illumination, along with active irrigation are helpful items in managing such cases.

Reliability of Three-Dimensional Micro-Computed Tomography Root Canal Analysis Using Drishti Software: A Pilot Study

In recent years, micro-computed tomography (micro-CT) has become a promising tool for non-destructive imaging and the study of root canal morphology in endodontics. However, the reliability of such analyses heavily relies on the accuracy and consistency of the software used for image processing. Objective: This study aims to investigate the reliability of two different micro-CT voxel sizes using open-source three-dimensional (3D) software (Drishti v3.0) used to identify and quantify the Apical Foramen (AF) and Apical Constriction (AC) in mandibular premolars. Methods: Eight mandibular premolars were divided into two groups, with four samples in each group. Samples were scanned using a ZEISS X-Radia 520 Micro-CT system with two different voxel sizes of 23 µm (Group A) and 17 µm (Group B), respectively. The micro-CT data were reconstructed and transferred to Drishti Software, and individual image rendering was performed to visualize the images for data analysis. The position and measurement of AF and AC to the anatomical apex were measured individually and independently by single operators. Results: The reliability of the measurements assessed using Intraclass Correlation Coefficients (ICCs) between two voxel sizes was excellent and on par with previous research. This pilot study suggested that results for voxel sizes of 23 µm and 17 µm were comparable. Both voxel size 3D images demonstrated excellent and high-quality visualization of the root canal configuration, lateral and accessory canals, apical deltas, major AF, and AC. Conclusion: It is feasible and reliable to visualize and analyze 3D micro-CT images using open-source software (Drishti v3.0). Both voxel sizes of 23 µm and 17 µm are recommended for use in root canal study.

Root and canal morphology of the maxillary first molar: A micro-computed tomography-focused observation of literature with illustrative cases. Part 2: Internal root morphology

The complexity of root canal morphology can influence cleaning and shaping of the root canal system and, ultimately, treatment outcomes. Undiscovered root canal morphology can greatly reduce the prognosis of endodontic treatment due to the preservation of offending organisms and their by products. The maxillary first molar has been identified as one of the most challenging teeth to treat endodontically due to its complex internal anatomy, the presence of additional and accessory canals and intricate root canal configurations. This paper is the second of two that provide a micro computed tomography (micro-CT)-focused overview of available literature on various aspects of the root and canal morphology of the maxillary first permanent molar. The aim of this paper is to provide an overview of relevant aspects of the internal root morphology in different populations. The content is supported by illustrative micro-CT images and clinical cases or images.