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Research Articles
Proximity of maxillary molar apexes to the cortical bone surface and the maxillary sinus
Han Shin Lee, Dokyung Kim, Sung Kyo Kim
Restor Dent Endod 2022;47(3):e33.   Published online August 8, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e33
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to analyze the proximity of maxillary molar roots to their overlying cortical bone surfaces and the maxillary sinus.

Materials and Methods

Cone-beam computed tomographic images of 151 patients with completely erupted upper molars that had 3 separate roots were studied. The following distances were measured: from the root apex to the cortical plate and maxillary sinus floor, and from the apical 3-mm level of the root to the cortical plate. Differences between groups were analyzed with 1-way analysis of variance and the Scheffé post hoc test, the significance of differences between cone-beam computed tomography views with the paired t-test, and the significance of differences among age groups with linear regression analysis. The significance level was set at p < 0.05.

Results

The mesiobuccal and distobuccal root apexes of maxillary second molars were more distant from the buccal cortical plate than the maxillary first molars (p < 0.05). The apical 3-mm level of the mesiobuccal root of the first molar was closer to the buccal cortical bone than the second molar (p < 0.05). In the maxillary first molars, the thickness of the buccal cortical bone decreased in all roots with age (p < 0.05). In all root apexes of both molars, the difference in the vertical level between the maxillary sinus floor and the root apex increased with age (p < 0.05).

Conclusions

Awareness of the anatomical profile of maxillary molar apices in relation to the cortical bones and maxillary sinus will be beneficial for apical surgery.

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Morphotypes of the apical constriction of maxillary molars: a micro-computed tomographic evaluation
Jeffrey Wen-Wei Chang, Kuzhanchinathan Manigandan, Lakshman Samaranayake, Chellapandian NandhaKumar, Pazhamalai AdhityaVasun, Johny Diji, Angambakkam Rajasekharan PradeepKumar
Restor Dent Endod 2022;47(2):e19.   Published online March 24, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e19
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate and compare the apical constriction (AC) and apical canal morphology of maxillary first and second molars, using micro-computed tomography (micro-CT).

Materials and Methods

The anatomical features of 313 root canals from 41 maxillary first molars and 57 maxillary second molars of patients with known age and sex were evaluated using micro-CT, with a resolution of 26.7 µm. The factors evaluated were the presence or absence of AC, the morphotypes, bucco-lingual dimension, mesio-distal dimension, and the profile (shape) of AC and the apical root canal. The apical root canal dimensions, location of the apical foramen (AF), AC to AF distance, and presence of accessory canals in the apical 5 mm were also assessed. Descriptive and analytical statistics were used for data evaluation.

Results

AC was present in all 313 root canals. Patients’ age and sex did not significantly impact either AC or the apical canal dimensions. The most common AC morphotype detected was the traditional (single) constriction (52%), followed by the parallel (29%) morphotype. The mean AC dimensions in maxillary first molars were not significantly different from those in maxillary second molars. Sixty percent of AF were located within 0.5 mm from the anatomic apex.

Conclusions

The most common morphotype of AC detected was the traditional constriction. Neither patients’ age nor sex had a significant impact on the dimensions of the AC or the apical root canal. The majority of AF (60%) were located within 0.5 mm from the anatomic apex.

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Morphological characteristics of the mesiobuccal root in the presence of a second mesiobuccal canal: a micro-CT study
Lucas P. Lopes Rosado, Matheus Lima Oliveira, Karla Rovaris, Deborah Queiroz Freitas, Frederico Sampaio Neves
Restor Dent Endod 2022;47(1):e6.   Published online January 18, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e6
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal.

Materials and Methods

Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student’s t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05).

Results

In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001).

Conclusions

The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

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A cone-beam computed tomography study of the prevalence and location of the second mesiobuccal root canal in maxillary molars
Seong-Ju Lee, Eun-Hye Lee, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Restor Dent Endod 2020;45(4):e46.   Published online September 3, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e46
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to investigate the incidence and location of the second mesiobuccal root (MB2) canal in maxillary molars with the aid of various measuring points and lines using cone-beam computed tomography (CT).

Materials and Methods

A total of 205 images of patients who underwent cone-beam CT examinations between 2011 and 2015 as part of their dental diagnosis and treatment were included. There were 76 images of the maxillary first molar and 135 images of the maxillary second molar. Canal orifices were detected at −1 mm from the top of the pulpal floor on cone-beam CT images. Image assessment was performed by 2 observers in reformatted image planes using software. Assessments included measurement of the distance between the MB1 and MB2 canals, and the angles between the lines connecting the MB1-MB2 and distobuccal (DB)-palatal (P) canals. The data were analyzed using the student's t-test.

Results

The prevalence of the MB2 canal was 86.8% in the first molar and 28.9% in the second molar. The angle between the lines connecting the MB1-MB2 and DB-P canals was 2.3° ± 5.7° in the first molar and −3.95° ± 7.73° in the second molar. The distance between the MB1 and MB2 canals was 2.1 ± 0.44 mm in the first molar and 1.98 ± 0.42 mm in the second molar.

Conclusions

The angles between the lines connecting the MB1-MB2 and DB-P canals was almost parallel. These findings may aid in the prediction of the location of the MB2 canal orifice.

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Fused roots of maxillary molars: characterization and prevalence in a Latin American sub-population: a cone beam computed tomography study
Maytté Marcano-Caldera, Jose Luis Mejia-Cardona, María del Pilar Blanco-Uribe, Elena Carolina Chaverra-Mesa, Didier Rodríguez-Lezama, Jose Hernán Parra-Sánchez
Restor Dent Endod 2019;44(2):e16.   Published online April 22, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e16
AbstractAbstract PDFPubReaderePub
Objectives

The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population.

Materials and Methods

A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion.

Results

Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped.

Conclusion

Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.

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Case Report
Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography
Evaldo Rodrigues, Antônio Henrique Braitt, Bruno Ferraz Galvão, Emmanuel João Nogueira Leal da Silva
Restor Dent Endod 2017;42(1):60-64.   Published online August 29, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.60
AbstractAbstract PDFPubReaderePub

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

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Research Article
Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography
Hyoung-Hoon Jo, Jeong-Bum Min, Ho-Keel Hwang
Restor Dent Endod 2016;41(1):55-62.   Published online January 29, 2016
DOI: https://doi.org/10.5395/rde.2016.41.1.55
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population.

Materials and Methods

Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test.

Results

Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001).

Conclusions

In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.

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