Root Of Second Molar Research Articles

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.

CORELATION BETWEEN PREOPERATIVE PATHOSES, POSITION OF IMPACTED MANDIBULAR THIRD MOLAR AND DEMOGRAPHIC CHARACTERISTICS

Third mandibular molars mainly appear to be in an inappropriate position in dental arch, so become the teeth which barely erupt or stay impacted in jaws. The aim of this study is to analyze the correlation between the preoperative pathologies with the position of the impacted third mandibular molar, sex and age of the patients. The sample of the study consisted of a total of 80 patients, of both sexes, diagnosed with fully or partially impacted third mandibular molars, who were followed up after the surgery for a three-month period. All the patients were clinically examined and for each of them was registered a panoramic radiography, to analyze the factors causing the pathology, which leads to the surgical extraction of the teeth. The most manifested preoperative pathologies correlating to the position of impacted mandibular third molars were: resorption of distal root of mandibular second adjacent molar, caries of second adjacent molar, pericoronitis, periodontal disease, frontal incisal mandibular crowding. All the pathologies were associated with the tooth position, some differed by age and gender. We conclude that preoperative complaints related to the position of the impacted third mandibular molar are in positive proportion to the age of the patients, i.e. subjective complaints increase with age: pain, limited opening of the mouth, local inflammation of the gingiva and paresthesia. The position of the impacted third mandibular molar affects the occurrence of preoperative pathologies: pericoronitis was most prevalent in impacted third mandibular molars with vertical position, class II, A position and partial impaction; periodontal diseases of second adjacent mandibular molar are most prevalent in impacted third mandibular molar with mesioangular position, class III, B position and partial impaction.

Cone-beam computed tomographic analysis of canal convolution in mesial root of mandibular second molars and a proposed new classification.

The aim is to evaluate the anatomical characteristics of mesiolingual and mesiobuccal canals in mandibular second molars particularly in terms of its exit direction, distance of confluence from the minor constriction, and the angle of confluence. The cone-beam computed tomography images of hundred mandibular second molars were analyzed. Endodontically treated teeth and those with anatomical variations such as C-shaped canal configuration were excluded from this study. The distance of the confluence from the minor constriction, angle of confluence, and the exit direction of the mesiobuccal and the mesiolingual canals were assessed. Data were analyzed using an independent t-test. The course of the mesiobuccal and mesiolingual canals beyond the confluence was towards the center of the root. The average angle of confluence was 32.75°-35.28°. The average distance of confluence from the minor constriction was 2.19 to 2.68 mm. The mesiolingual canal was straighter whereas the mesiobuccal canal had a tortuous course. Considering the results of the present study, a new classification has been proposed for the root canal morphology of the mesial root of mandibular second molars. The variation in the morphology of mandibular second molars highlights that the mesiolingual canal presented a mild curvature through and beyond the confluence when compared to the mesiobuccal canal which exhibited a tortuous course through the confluence.

Solitary primary intraosseous xanthoma of the mandible in a 15-year-old boy: a case report

BackgroundA xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor.Case reportA 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods.ConclusionThe diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.

Morphometric analysis of the relationship between maxillary posterior teeth and maxillary sinus floor in central Indian population: A cone-beam computed tomography study.

The relationship between the maxillary sinus (MS) and the root apices of posterior teeth is of significant clinical relevance as it influences the diagnosis and treatment planning when operating in the posterior areas of the maxilla. The aim of this study, therefore, is to assess this anatomic relationship and evaluate the propensity of roots of posterior maxillary teeth to be intruded into the MS space using cone-beam computed tomography (CBCT) scanning. One thousand CBCT scans of patients, aged 20 years or above, were analyzed in the study. The distance from the MS floor to the root apices of the posterior teeth was measured and the relationship between the MS and the posterior teeth roots were recorded, based on Kwak's and Didilescu's classification. Based on Kwak's classification, type I configuration was frequently observed in the maxillary posterior teeth, followed by type II. Based on Didilescu's classification, the longest distance, among premolars, was observed between the palatal root of the left 1st premolar and MS, i.e., 8.2467 mm. Among molars, the longest distance was observed between mesiobuccal root of the right first molar and MS, i.e., 5.8966 mm. The shortest distance, among premolars, was observed between the buccal root of the left second premolar and MS, i.e., 3.5500 mm, and among molars, the shortest distance was between the mesiobuccal root of the left second molar and MS, i.e., 1.3556 mm. From the present study, it may be concluded that, among the central Indian population, mesiobuccal root of the second molars and buccal root of the second premolars show the closest proximity to the MS floor. Therefore, any surgical or endodontic intervention in the vicinity of these roots must be performed with utmost care.

FREQUENCY OF SECOND MESIOBUCCAL CANAL IN PERMANENT MAXILLARY SECOND MOLARS AT A TERTIARY CARE CENTRE OF NEPAL

Background: The success of endodontic treatment relies on the precise identification of root canals followed by cleaning, shaping, and obturating the canals. Mesiobuccal root of maxillary second molar teeth present wide variations with regard to the number and type of root canals. The complexity of the root canal varies widely in different ethnic groups. The study aimed to determine the prevalence of second mesiobuccal canal (MB2 canal) in maxillary second molar. Methods: A descriptive cross-sectional study was conducted at Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa. A total of 100 permanent maxillary second molar undergoing endodontic treatments were studied. After access cavity preparation ultrasonic tips and magnification loupes were used to open the subpulpal groove in a direction from first mesiobuccal (MB1) canal towards the palatal canal to locate the second mesiobuccal (MB2) canal. Radiovisiography (RVG) was taken to confirm the presence of MB2 canals. Results: MB2 canals were detected in 52 teeth out of 100 teeth that were studied. It was found that the younger adult (18-35 years) tends to have a higher proportion of MB2 canals (65.6%) as compared to the middle-aged elderly (36-55years) in whom it could be identified only 33.4% of the time. Conclusions: Based on this study, it can be concluded that the prevalence of MB2 canal in mesiobuccal root of the permanent maxillary second molar is high.

Root and canal morphology of mandibular second molar

Background: The mandibular second molar is the main chewing tooth and often suffer from pulp damage due to the misalignment of the mandibular third molar. In addition, it’s C-shaped root canal system is a challenge for endodontic treatment. This emphasizes the significance of tooth morphology and root canal system study which can contribute to anthropology, as well as Odonto-Stomatology. Purpose: The objective of this study was explore the morphology and root canal system of the mandibular second moalar in order to provide indicators dentistry applications. Materials and methods: Preclinical (in vitro) study was conducted on 48 mandibular socond molars which was collected in Thua Thien Hue province from December 2021 to June 2022. The teeth were measured externally and determine the shape of the roots. The canal system was examined with two methods including clearing technique and Cone Beam CT. Results: The average length of mandibular second molar was 20.37 ± 1.28 mm. 81.2% of teeth had one root, and 18.8% had two. The teeth with C-shaped roots accounted for 31.2%. The majority of distal roots possessed a simple type I (single canal) configuration. While the canal system of mesial roots was more complex which contained two canals, of which type I, II, III, IV were the most prevalent. C-shaped canal morphology was observed in 31.2% of the examined teeth. Conclusion: The root canall system of mandibular second molar was complex, the percentage of C-shaped canal was high (31.2%). There was similarlu results of two methods of clearing technique and Cone Beam CT in examining the root canal system of mandibular second molars. Key words: mandibular second molar, root canal system, C-shaped root, C-shaped root canal.

Quantitative Measurement of Buccal Cortical Bone Thickness in Infrazygomatic Crest Area at Different Alveolar Bone Heights and Insertion Angles of Infrazygomatic Crest Screws: A CBCT Study

Introduction Skeletal anchorage devices for the efficient orthodontic treatment mechanics can be placed at various interradicular and extraradicular sites intra orally. However, their placement in the infrazygomatic crest area can broaden the horizon of orthodontic treatment. The bone thickness in the infrazygomatic crest (IZC) area can vary at different heights and insertion angles during the placement of IZC screws between maxillary second premolar and second molar region. Aims and objectives The purpose of our study was to evaluate the variation in bone thickness in the IZC area at different insertion angles along the mesiobuccal root of maxillary first molar and at different heights from the crest of the alveolar bone in the apical direction between maxillary second premolar and second molar region using cone beam computed tomography, so as to determine the best possible site where the bone thickness will be maximum that will suit to a particular size of IZC screw. Materials and Methods CBCT images of 50 subjects were analyzed by a single observer, the bone thickness in the IZC area was measured and interpreted at different heights from the alveolar crest in the apical direction, that is, 5 mm, 7 mm, 9 mm, 11 mm at six regions between maxillary second premolar and second molar. Bone thickness was also measured at different insertion angles ranging from 55º to 75º to occlusal plane of permanent maxillary first molar along its mesiobuccal root. Results The bone thickness in the IZC area was 4.5 mm–3.5 mm, when it was measured at different angles ranging from 55º to 75º to the occlusal plane of maxillary first molar along its mesiobuccal root with maximum bone thickness at 75° with a mean ± SD of 4.56 ± 1.4. Statistically significant differences in bone thickness were found between maxillary first and second molar on both right and left sides at different heights with maximum bone thickness at 11 mm apical from the alveolar crest with a mean ± SD of 2.03 ± 0.76 and 1.91 ± 0.88, respectively, and along the mesial root of maxillary second molar on right and left sides at 11 mm apical from the alveolar crest with a mean ± SD of 2.12 ± 0.80 and 1.95 ± 0.75, respectively. Conclusions The best site and safe zone for miniscrew insertion in IZC area is at 7 mm to 9 mm distance from the alveolar crest apically along the mesial root of maxillary second molar and at an angle of 55°–75º to the occlusal plane of maxillary first molar, so as to ensure the adequate stability of the miniscrew and without causing any damage to the adjacent anatomical structures.

Three-dimensional visualization of Hertwig's epithelial root sheath during tooth root development with the miniTESOS tissue clearing method.

Hertwig's epithelial root sheath (HERS) acts as a signaling center that regulates the size, shape, and number of tooth roots. Therefore, understanding the anatomical changes in HERS during development is crucial for investigating its effect on root formation. However, the three-dimensional morphology of HERS and its changes during tooth root development remain largely unknown due to the limitations of traditional histological techniques. We developed an improved tissue clearing method for mouse embryonic and early postnatal mandibles, designated as a mini Transparent Embedding Solvent System (miniTESOS), based on the Transparent Embedding Solvent System (TESOS). We applied this method to the K14-Cre;Ai14 mouse line to systematically investigate the spatiotemporal dynamics of HERS at the cellular level during the development of the roots of mandibular first molars (MM1) and mandibular second molars (MM2). Additionally, using MM1 as a model, we quantitatively investigated the spatiotemporal changes in HERS in the root bifurcation region during the development of two-rooted teeth. In the early stages of root development, differences in growth rates and developmental patterns between MM1 and MM2 were observed in the mesiodistal and buccolingual directions, from the initiation to the fusion of buccal and lingual HERS. In the elongation stage of two-rooted teeth, continuous HERS was found exclusively at the leading edge of the root, gradually decreasing in length as the root extended. In the root bifurcation area, HERS undergoes four developmental stages: initiation, elongation, contact, and complete fragmentation, each characterized by specific morphological features. This study improves the understanding of the alterations in HERS during root development and summarizes its developmental pattern in the root bifurcation region. The miniTESOS tissue clearing method provides a new strategy to investigate tooth development.

Prevalence of Isthmi and Root Canal Configurations in Mandibular Permanent Teeth Using Cone-Beam Computed Tomography.

While root canal anatomy in Middle Eastern populations is well-studied, research on isthmi in mandibular permanent teeth from this region is limited. This retrospective study used cone-beam computed tomography (CBCT) to examine isthmi prevalence and location, as well as root canal morphologies (per Vertucci's classification) in mandibular permanent teeth from a subpopulation in Ardabil, Iran. The study is aimed at enhancing our understanding of dental anatomical variations in Middle Eastern populations. A total of 3566 teeth from 384 CBCT scans were evaluated in this retrospective study. Mandibular teeth were evaluated on sagittal, coronal, and axial sections regarding the presence of isthmus and root morphology (Vertucci's classification). CBCT scans of 197 males (51.3%) and 187 females (48.7%) were evaluated, with a mean age of 41.1 ± 11.4 years. Isthmi were most prevalent in molar mesial roots, typically located in the middle third for anterior teeth and first premolars and cervical third for posterior teeth. While gender did not play a significant role, the presence of an isthmus in the mesial root of the left second molars was associated with a younger mean patient age (p < 0.05). Root morphology varied across tooth types. Central and lateral incisors predominantly showed Vertucci's Types I and III. Canines and premolars were mostly Type I, with some variation. Molar mesial roots frequently exhibited Types IV and II, while distal roots were predominantly Type I. Statistically significant differences were found between morphology and gender in the first left premolar (Type I more common in women; Type V in men; p < 0.001) and in the right canine (Type I more prevalent in men; Types III and V more prevalent in women; p < 0.001). The results revealed wide variations in root canal morphology and a relatively high prevalence of isthmi in the study population. Our findings suggest a potential difference in tooth anatomy based on sex and a relationship between age and the presence of isthmi.

Evaluation of Root and Canal Morphology of Maxillary First and Second Molars by Cone Beam Computed Tomography in a Northern Iranian Population

Evaluation of Root and Canal Morphology of Maxillary First and Second Molars by Cone Beam Computed Tomography in a Northern Iranian Population

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

BackgroundThe goal of the present research was to employ CBCT imaging to assess the root and canal anatomy of maxillary second molars in a population from the Hail province of Saudi. The effects of gender and side were taken into account. MethodsThe investigation included a sample size of 499 completely developed right and left untreated maxillary second molars obtained from 250 Saudi people. The root morphology of each tooth was evaluated. The examination also included an analysis of the canal morphology for each tooth, utilizing Vertucci's categorization. The effect of genders as well as sides was recorded. Results were analyzed using the Chi-square test. Results464 teeth had three roots (93.0%), whereas 20 teeth (4.0%) had two roots. One root was recorded in 7 (1.4%) of the study sample, whilst 8 (1.6%) had four roots. Although there were no significant differences between the left and right sides (p = .075), gender had a significant influence on the number of roots (p = .030). 240 M (48.1%) had three canal orifices, and 247 (49.5%) had four root canal orifices. Eight molars (1.6%) had two canal orifices, while one and five canal orifices were found in 3 (0.6%) and one (0.2%), respectively. Gender had a significant impact on the number of root canal orifices (p = .039). The observed differences in the orifices of the root canals between the left and right sides were not statistically significant (p = .059). The prevalence of MB2 in maxillary second molars was found to be 49.7%. In the mesiobuccal root, the Vertucci type I configuration had the highest canal frequency (50.3%), followed by the Vertucci types II (14.4%), IV (13.8%), V (12.0%), and III (7.6%), and VI (1.8%). The prevalence of Vertucci type I canal configurations was found to be higher in the distobuccal root (99.4%) and palatal root (98.2%) of maxillary second molars. ConclusionsSignificant variations in root canal anatomy were observed within the Saudi population. The majority of the subjects from Saudi Arabia in this study exhibited the presence of maxillary second molars with three roots. Approximately half of the sample under investigation exhibited the presence of the four canals.

Prevalence and characteristics of ectopic eruption of the first permanent molar and predictive factors for clinical outcome

Background: The primary objective of this study was to assess the occurrence, distribution, and features of ectopic first permanent molars (FPMs), as well as to investigate the clinical outcomes associated with ectopic eruption based on the degree of root resorption observed in primary second molars. Methods: This study was performed retrospectively by examining panoramic radiographs of 7070 patients aged 5 to 12 years. The gender and age of the patients, the number, location, and distribution mode of ectopic FPMs, the resorption degree of the distal roots of primary second molars, and the clinical outcome of ectopic eruption were evaluated. Descriptive statistics and chi-square test were performed on the obtained data using SPSS version 22 (SPSS Inc, Chicago, IL, USA). Results: In 144 of 7070 cases, a total of 221 ectopic permanent first molar teeth were detected (2% prevalence). The mean age of the 144 patients was 8.04 years. Ectopic eruption was most common in patients aged 7–8 years (48.63%), which was statistically significant (P&lt;0.05). Ectopic eruptions were more common in females (58.30%) than males (41.70%; P&lt;0.05). Of the ectopic permanent first molars, 78 (35.30%) were in the mandible, and 143 (64.70%) were in the maxilla. The relationship between the degree of resorption and the type of ectopic eruption was statistically significant (P&lt;0.05). Conclusion: The increase in the severity of root resorption in the primary second molars was a significant predictor for the prognosis of ectopic eruption in the present study. Early diagnosis and treatment of ectopic FPMs are of great importance to preventing premature loss of primary second molars resulting in malocclusion.

Three-Dimensional Assessment and Comparison of the Maxillary Tuberosity Between Skeletal and Dental Class I and Class II Adults in Maxillary Third Molar Agenesis Using Cone Beam Computed Tomography: A Descriptive Cross-Sectional Human Study.

The objective of this study was to assess and compare the dimensions (width (W), height (H), and length (L)) of the tuberosity distal to maxillary permanent second molar in individuals with skeletal and dental Class I and Class II malocclusions who had maxillary third molar agenesis. Cone beam computed tomography (CBCT) was used to measure the left (L) and right (R) anatomical tuberosity dimensions in three dimensions using the WillMaster software (HDX WILL Corporation, Korea). The measurements were compared between Class I (n = 35)and Class II (n = 35) normo-hypodivergent adult subjects. The dimensions were measured at regular 2 mm intervals from the cementoenamel junction (CEJ) and distovestibular root of the maxillary second molar in terms of the width (e.g., W1, W2, and W3), height (e.g., H1, H2, and H3), length (e.g., L1, L2, and L3) to the posterior limit of the tuberosity. Statistical analysis included descriptive statistics, Mann-Whitney U tests, and intraclass correlation coefficient tests. The width of the tuberosity at LW0, LW1, and LW2 was significantly higher in Class I compared to that in Class II. The right tuberosity in Class II showed significantly higher values in height at all reference points. The right tuberosity at RL0and RL1 exhibited significantly higher values in the length of the Class II group compared to the Class I group. The dimensions of the maxillary tuberosity (width, height, and length) varied between the Class I and Class II groups. Wider maxillary tuberosities were observed in the Class I group, while the Class II group had greater height and length dimensions of the tuberosity.

Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study

BackgroundThis study was using Cone beam computed tomography (CBCT) to examine the anatomical variations in mandibular second molars in an Egyptian sub-population.MethodsA total of 350 CBCT images (215 females and 135 males, aged 15–65 years) of mandibular second molars were evaluated. Samples were evaluated in terms of: number of roots, number of root canals, roots’ cross section as well as prevalence and configurations of C-shaped canals. Statistical analysis was done to highlight differences between different categories and their prevalence among genders (significance level was set at p < 0.05). Data were presented as frequency and percentage values and were analyzed using chi square test followed by pairwise comparisons utilizing multiple Fisher’s exact tests with Bonferroni correction. The significance level was set at p < 0.05 within all tests.ResultsOf the 350 mandibular second molars evaluated, 87.2% were non-C-shaped while 12.8% were C-shaped with no gender-based statistically significant differences (χ2 = 0.19, p = 0.656). Most samples had three root canals (80%) followed by two (16%), then one (3.2%), and finally four (0.8%) root canals. Among the non-C-shaped molars, presence of two roots was most common (83.4%) followed by presence of a single root (16.2%), and only one sample (0.2%) had three roots, and this had no correlation with gender (χ2 = 1.86, p = 0.431). In the mesial roots Type IV Vertucci was the most common configuration found (68.8%), while Type I was the most prevalent in the distal roots (91.8%). The long oval configuration was the most commonly found cross section in mesial roots while “oval” was the most prevalent in distal roots.ConclusionEgyptian sub-population shows highly variable morphological features in mandibular second molars, hence, CBCT is highly recommended on case-to-case conditions.

A CBCT Evaluation of the Proximity of Mandibular Molar Roots and Lingual Cortical Bone in Various Vertical Facial Patterns and Factors Related to Root-Cortical Bone Contact

The objective of this study was to assess the proximity of the mandibular molar roots and the lingual cortical bone in patients with various vertical facial patterns and determine factors related to root-cortical bone contact. A total of 145 patients (84 males, 61 females, mean age: 22.0 ± 1.76 years) were assigned to hypodivergent (36 patients), normovergent (80 patients) and hyperdivergent (29 patients) groups based on their facial height ratio. Cone-beam computed tomography (CBCT) images were used to measure the distance between the mandibular molar roots and the lingual cortical bone, and any instances of root-cortical bone contact were identified. The study investigated the correlation between the contact of the mandibular molar roots with the lingual cortical bone and several variables, including sex and cephalometric measurements. The distance between the mandibular molar roots and the lingual cortical bone was significantly shorter in the hyperdivergent group than in the hypodivergent group (p &lt; 0.05). Of the total root-cortical bone contact, 87.6% was observed in the mandibular second molars, and the distal roots of the mandibular second molars had the highest contact rate at 43.1% in the hyperdivergent group (p &lt; 0.05). Among the evaluated variables, only the distance between the distal root apex of the mandibular second molar and the mandibular plane was found to be associated with contact of the mandibular molar roots with the lingual cortical bone. An increase of 1 mm in this distance was associated with a 22% decrease in the likelihood of contact between the mandibular second molar roots and lingual cortical bone (p &lt; 0.001). Given the proximity and high contact ratio between the mandibular molar roots and lingual cortical bone, it is recommended that these structures be evaluated using CBCT before planning molar distalization or intrusion in hyperdivergent patients.

Two Cases of Kissing Molars

Kissing molars （KMs） are an extremely rare condition in which the occlusal surfaces of impacted molars contact each other, with roots pointing in opposite directions. KMs are classified according to the type of impacted molars, the contact style of the occlusal surface, and the presence or absence of a radiolucent area around the crown. We experienced two cases of Class Ⅱ true KMs without cystic variant. In these cases, second and third molars were impacted with occlusal surfaces facing each other, without a pericoronal radiolucency around the crowns. Case 1: A panoramic X-ray and computed tomography revealed complete impaction of the right mandibular second and third molars that had occlusal surfaces contacting each other. Both teeth were extracted under general anesthesia. Case 2: A panoramic X-ray and computed tomography revealed that the occlusal surfaces of the impacted left mandibular second and third molars were facing each other directly, and the root of this impacted second molar was close to the apical radiolucent lesion of the left mandibular first molar. Under general anesthesia, tooth extraction of the left mandibular first, second and third molars and periapical cystectomy of the left mandibular first molar were performed. The postoperative courses of both cases have been good.

Investigation of mandibular second molar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems.

To investigate the root and canal morphology of mandibular second molars, including anatomical variations, in a Black South African population using two classification systems. Cone-beam computed tomography images of 386 teeth were evaluated. The number of roots and canal configurations were categorized using the classifications of Vertucci (with modifications by Sert and Bayirli) and Ahmed et al. (including the modified Melton classification). Relationships between variables were assessed using Fisher's exact test (P < 0.05). Mandibular second molars were predominantly two-rooted (91.7%). The majority of teeth had three canals including Type IV mesial (41.2%) and Type I (75.1%) distal (Ahmed et al. configuration: 2MDM M2 D1). Three or more canals were present in almost one-fifth of mesial (n = 72/386, 18.6%) and a small number of distal (n = 21/386, 5.4%) roots. Males displayed additional canals more frequently in the distal root (P = 0.02). C-shaped anatomy was found in 5.7%. Among the C-shapes, the most common was Melton's Type III in the coronal (50%), middle (81%) and apical (72%) thirds. In this population, mandibular second molar teeth exhibited diverse morphology, which would have clinical significance for endodontic practitioners. The Ahmed et al. classification provided a better description than the Vertucci classification.

Impact of Autogenous Demineralized Dentin Matrix on Mandibular Second Molar after Third Molar Extraction: Retrospective Study.

The purpose of this retrospective study was to evaluate bone healing after autogenous demineralized dentin matrix (DDM) grafts, focusing on the distal root of the mandibular second molar after the extraction of the third. We included retrospective data from 20 patients who had undergone molar extractions (15 male, 41.9 ± 12.0 years) between January 2020 and September 2022 and had DDM grafts implanted on the extraction socket, immediately ("immediate graft") or 6 weeks ("delayed graft") after the first surgery without primary closure. Patients who underwent grafting on only one side were used as the control group (n = 4). Bone defects at the mandibular second molar were measured preoperatively and 4 months after the graft surgery using cone-beam computed tomography (CBCT). Improvement of bone defect (i.e., the change in the bony defect pre- vs. postoperatively) was compared between the control and graft groups using the Wilcoxon Signed Rank test, and the difference between immediate and delayed grafts was analyzed with the Mann-Whitney U test. Complications such as infections or graft failure did not occur. Although pre-operative defects were smaller in the control than in the graft group (2.98 ± 1.77 and 10.02 ± 3.22 mm, p = 0.001), post-operative defects were similar in both (2.12 ± 0.59 and 2.29 ± 1.67 mm, respectively). The improvement ratio was not statistically significant in the control group (22.68 ± 15.36%) but a difference was observed in the graft group (76.70 ± 15.36%, p = 0.001). The amount of improvement of bone defect was not affected by graft timing or patient sex. In conclusion, DDM can improve bone defect at the distal aspect of the mandibular second molar after third molar extraction.

Association of Mandibular Posterior Anatomic Limit with Skeletal Patterns and Root Morphology Using Three-Dimensional Cone Beam Computed Tomography Comprehensive Analysis.

This study aimed to clarify the relationship between the mandibular posterior anatomic limit (MPAL) and skeletal anteroposterior and vertical skeletal patterns, with consideration of factors that may be related. In total, 230 people were included: 49 Japanese, 122 Egyptian, and 59 Korean people. The MPAL was measured at 0, 2, 4, and 6 mm from the root furcation along the sagittal and cuspal lines at the distance from the distal root of the mandibular right second molar to the mandibular cortex of the lingual bone. Eight different MPALs were evaluated using multiple regression analysis with explanatory variables for anteroposterior and vertical skeletal patterns and qualitative variables for age, sex, population, the presence of third molars, number of roots, presence of C-shaped roots, and Angle malocclusion classification. The MPAL was significantly larger as the mandibular plane angle decreased. The MPAL near the root apex was significantly larger as the A-nasion-point B angle increased, and the MPAL near the root apex measured at the cuspal line was significantly larger for C-type roots. The present study showed that a C-shaped root affected the MPAL in addition to the anteroposterior and vertical skeletal patterns.