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1.
Rev. ADM ; 79(3): 146-151, mayo-jun. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1378372

ABSTRACT

Introducción: La finalidad del tratamiento de conductos es conseguir la máxima desinfección, conformación y sellado tridimensional. Objetivo: Comparar la capacidad del sellado apical entre dos técnicas de obturación en conductos mesiales de molares inferiores con limas fracturadas en tercio apical. Material y métodos: Se utilizaron 60 raíces mesiales de molares inferiores, instrumentados con Protaper Universal, se desgastó 4 milímetros la parte activa del instrumento y se fracturó intencionalmente en tercio apical. Se formaron dos grupos de 30 raíces mesiales (n = 30) cada uno y se utilizaron dos técnicas de obturación: grupo 1: condensación lateral clásica y grupo 2: Obtura II. Las muestras se sumergieron en tubos de ensayo y en su interior contenían 5 mL de tinta china, se diafanizaron y observaron con un microscopio estereoscópico (LEICA, EZ4D) a 35x para medir la penetración de tinta china dentro del conducto radicular. Resultados: Se encontró una mayor microfiltración apical con suficiente evidencia estadística en el grupo de Obtura II comparado con el grupo de condensación lateral clásica (p < 0.002). Conclusiones: Ambos grupos presentaron microfiltración apical; sin embargo, en el grupo que se utilizó el sistema de obturación termoplastificada Obtura II se detectó mayor filtración apical comparada con el grupo de condensación lateral clásica (AU)


Introduction: The purpose of root canal treatment is to achieve maximum disinfection, shaping and three-dimensional sealing. Objective: To compare the apical sealing capacity between two obturation techniques in mesial canals of mandibular molars with broken files in the apical third. Material and methods: 60 mesial roots of lower molars were used, instrumented with Protaper Universal, the active part of the instrument was worn by 4 millimeters and it was intentionally broken in the apical third. Two groups of 30 mesial roots (n = 30) each were formed and two filling techniques were used: group 1: classic lateral condensation and group 2: Obtura II. The samples were immersed in test tubes and contained 5 mL of Chinese ink inside, they were clear and observed with a stereomicroscope (LEICA, EZ4D) at 35x to measure the penetration of Chinese ink into the root canal. Results: A higher apical microfiltration with sufficient statistical evidence was found in the Obtura II group compared to the classic lateral condensation group (p < 0.002). Conclusions: Both groups presented apical microfiltration, however, in the group that used the Obtura II thermoplastic obturation system, greater apical filtration was detected compared to the classic lateral condensation group (AU)


Subject(s)
Root Canal Obturation/methods , Dental High-Speed Equipment/adverse effects , Dental Leakage , In Vitro Techniques , Cross-Sectional Studies , Dental Restoration Failure , Dental Pulp Cavity/anatomy & histology , Molar
2.
Rev. Asoc. Odontol. Argent ; 109(2): 81-85, ago. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1348364

ABSTRACT

Objetivo: Comparar el tiempo empleado por los instrumen- tos TruNatomy Medium y ProTaper Next X3 para penetrar hasta la longitud de trabajo la masa de obturaciones realizadas con Gut- taCore Primary y sellador en conductos curvos simulados. Materiales y métodos: Se prepararon 20 conductos curvos simulados con instrumentos rotatorios WaveOne Gold Primary y se obturaron con GuttaCore Primary y AH Plus. Las muestras fueron divididas en dos grupos de 10 cada uno. Grupo 1: El material de obturación fue penetrado hasta la lon- gitud de trabajo con instrumentos TruNatomy Medium. Gru- po 2: El material de obturación fue penetrado hasta la longitud de trabajo con instrumentos ProTaper Next X3. Se registraron los tiempos de penetración requeridos para cada grupo y los valores obtenidos fueron analizados mediante la prueba t de Student. Resultados: Los instrumentos ProTaper Next X3 pe- netraron la masa del material de obturación más rápidamente que los instrumentos TruNatomy MediumTM. Las diferencias observadas entre ambos instrumentos fueron estadísticamente significativas (P <0.01). Conclusión: Si bien los instrumentos ProTaper Next X3 y TruNatomy MediumTM penetraron la masa de Gutta- Core Primary de manera eficiente, ProTaper Next X3 penetró hasta la longitud de trabajo más rápidamente (AU)


Aim: Compare the time required by the instruments TruNatomy Medium and ProTaper Next X3 to penetrate up to the working length the mass of fillings made with GuttaCore Primary and sealant in simulated curved canals. Materials and methods: The simulated canals of 20 EndoTraining Blocks were prepared with WaveOne Gold Pri- mary and obturated with GuttaCore Primary and AH Plus. The sample was divided into two groups of 10 each. Group 1: The sealing material was penetrated up to working length with TruNatomy Medium. Group 2: The sealing material was penetrated up to working length with ProTaper Next X3. The penetration time was recorded in each group and the obtained values were statistically analyzed with the Student's t test. Results: ProTaper Next X3 instruments penetrated the sealing material mass faster than TruNatomy Medium. Statis- tically significant differences were observed between the two instruments (P <0.01). Conclusion: While the ProTaper Next X3 and TruNat- omy Medium penetrated the GuttaCore mass to the working length efficiently, the ProTaper Next X3 did it in less time (AU)


Subject(s)
Root Canal Filling Materials , Root Canal Preparation/instrumentation , Retreatment , Gutta-Percha , Time Factors , Dental High-Speed Equipment , Dental Instruments , Dental Pulp Cavity/anatomy & histology
3.
Rev. Asoc. Odontol. Argent ; 109(1): 9-19, ene.-abr. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1255416

ABSTRACT

Objetivo: Estimar y comparar la eficacia de diferentes técnicas de obturación para impedir el flujo de colorante a través de los conductos laterales. Materiales y métodos: Se emplearon 50 premolares inferiores extraídos y conservados en formol neutro al 5% hasta el momento de su uso, a los cuales se les realizaron conductos laterales artificiales. Una vez instrumentados los conductos principales, los dientes fueron divididos al azar en 5 grupos (n=10) para ser obturados con cuatro técnicas distintas: A) System B + inyección de gutapercha termoplástica del sistema Elements, Extruder; B) obturadores de Thermafil, ProTaper Universal; C) técnica híbrida y D) obturación con inyección de gutapercha termoplástica del sistema Elements, Extruder. Inmersos en tinta china y diafanizadas las raíces, se evaluó la longitud de penetración de la tinta en los conductos laterales. Se empleó el análisis de la varianza para detectar diferencias significativas (P<0,05) entre los niveles medios de penetración del colorante según las técnicas de obturación y las zonas del diente, y se efectuaron pruebas de rango múltiple (HSD de Tukey) para realizar comparaciones dos a dos, manteniendo fija la tasa de error por familia. Resultados: A la técnica B le correspondió el valor medio más bajo (30,63%) de penetración de tinta china. Los valores medios más elevados (54,52% y 51,74%) correspondieron a las técnicas A y C, respectivamente. Conclusión: Ninguna de las técnicas de obturación del conducto radicular empleadas ha sido capaz de impedir la filtración del colorante en los conductos laterales (AU)


Aim: To estimate and compare the different obturation techniques to avoid the flow of colorant through lateral canals. Materials and methods: 50 extracted lower premolars preserved in 5% neutral formol until the moment of use, had artificial lateral canals made. Once canals were instrumented, the teeth were randomly divided into 5 groups (n=10) to be filled with four different techniques: A) System B + injection of thermoplastic gutta-percha, Elements system, Extruder; B) Thermafil, ProTaper Universal obturators; C) hybrid technique, and D) injection of thermoplastic gutta-percha, Elements system, Extruder. Having immersed the premolars in India ink and diaphanized the roots, the penetration length of the India ink inside the canals was assessed. Analysis of variance was used to detect significant differences (P<0.05) between the mean levels of dye penetration according to the filling techniques and tooth areas, and multiple range tests (Tukey's HSD) were performed for two-to-two comparisons, keeping the error rate per family fixed. Results: Technique B had the lowest mean value (30.63%) of penetration. The highest mean values (54.52% and 51.74%) corresponded to techniques A and C, respectively. Conclusion: No obturation technique of the root canal used was able to avoid filtration of colourant in the lateral canals (AU)


Subject(s)
Humans , Root Canal Obturation , Dental Leakage/diagnosis , Gutta-Percha , Root Canal Filling Materials/chemistry , Bicuspid/anatomy & histology , Transillumination/methods , Data Interpretation, Statistical , Dental Pulp Cavity/anatomy & histology
4.
Article in English | LILACS, BBO | ID: biblio-1351208

ABSTRACT

ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients' were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Root Canal Obturation/instrumentation , Root Canal Therapy/instrumentation , Students, Dental , Radiography, Dental/instrumentation , Dental Pulp Cavity/anatomy & histology , Saudi Arabia/epidemiology , Chi-Square Distribution , Cross-Sectional Studies/methods , Retrospective Studies
5.
Article in English | LILACS, BBO | ID: biblio-1351219

ABSTRACT

ABSTRACT Objective: To determine in vitro the frequency, shape, type, diameter, and patency of accessory canals in the primary molars pulp chamber floor. Material and Methods: Sixteen healthy primary molars were evaluated by micro-computed tomography and scanning electron microscopy. Descriptive analyses of the frequency, shape (round, oval, or irregular), type (blind, true, or hidden), patency and diameter of the accessory canals were performed. Results: Half of the teeth presented accessory canals, 62.5% of which were located in the upper molars and 37.5% in the lower molars. The most frequent shape was irregular. In three-dimensional analysis, blind accessory canals (12.5%) and with patency (18.7%) of the teeth were observed. The average accessory canal diameter was 51.97 µm (± 26.03 µm). Conclusion: Upper molars showed a higher frequency of accessory canals with larger diameters. The irregular shape was the most frequent. 18.7% of accessory channels showed patency.


Subject(s)
Humans , Male , Female , Child , In Vitro Techniques/methods , Microscopy, Electron, Scanning/instrumentation , Root Canal Preparation/instrumentation , X-Ray Microtomography/instrumentation , Molar , Brazil/epidemiology , Statistics, Nonparametric , Dental Pulp Cavity/anatomy & histology
6.
Rev. Fac. Odontol. (B.Aires) ; 36(84): 7-11, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1363431

ABSTRACT

El tratamiento endodóntico del primer premolar inferior, cuando presenta varios conductos o varias raíces puede ser un gran desafío. En el presente trabajo se describe un caso clínico de un paciente de sexo masculino de 60 años de edad que concurre al Servicio de Guardia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA). Al examen clínico y radiográfico se descubre la presencia de dos trayectos fistulosos que corresponden a la misma pieza dentaria con diagnóstico de absceso alveolar crónico. Concluimos que el operador debe realizar un minucioso diagnóstico, y analizar y conocer las diferentes configuraciones anatómicas para tratarlas adecuadamente, aumentando así las probabilidades de éxito del tratamiento (AU)


Endodontic treatment of the first lower premolar when it has multiple ducts or multiple roots can be a challenge. This paper describes a clinical case of a 60-year-old male patient who attends the on-call service of the School of Dentistry of the University of Buenos Aires (FOUBA). Upon clinical and radiographic examination, the presence of two sinusal tracts that corresponded to the same dental piece with a diagnosis of chronic alveolar abscess was discovered. We conclude that the operator must carry out a thorough diagnosis and analyze and understand the different anatomical configurations in order to properly treat them, thus increasing the probability of treatment success (AU)


Subject(s)
Humans , Male , Middle Aged , Periapical Abscess , Bicuspid/diagnostic imaging , Dental Pulp Cavity/anatomy & histology , Argentina , Root Canal Therapy , Schools, Dental , Clinical Diagnosis , Chronic Disease
7.
Int. j. morphol ; 38(6): 1571-1576, Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134480

ABSTRACT

SUMMARY: The aim of the present study was to determine the accuracy, sensitivity, and specificity of the clinical and radiographic examination (CRE) method compared to the examination with the dental operating microscope (DOM) on the detection of anatomical features of mesiobuccal canals in maxillary first molars. One hundred maxillary first molars were selected to assess the number of canals orifice entrances, accessibility, and ending of their mesiobuccal canals using the CRE method and the examination with the DOM. The diagnostic tests of the CRE exhibited, in general, high levels of accuracy, sensitivity, and specificity. However, low levels of these outcomes occurred, mainly, on the detection of the number of canals entrance orifices of the mesiobuccal root. The statistically significant differences (p<0.05) occurred for accessibility and ending of canals in 61 of the 62 cases (out of 100) when two of them were present: 2 accessible root canals (48 cases; 77.42 %), and 1 accessible and 1 inaccessible canals (13 cases; 20.97 %); 1 foramen after fusion (18 cases; 29.03 %), 2 foramens (30 cases; 48.39 %), and 1 foramen and 1 blind foramen (13 cases; 20.97 %). This study proves that the clinical and radiographic method (still the most commonly used worldwide) can't be trusted absolutely in situations of complex internal anatomy regarding the mesiobuccal root canals of maxillary first molars.


RESUMEN: El objetivo del presente estudio fue determinar la precisión, sensibilidad y especificidad del método de examen clínico y radiográfico (ECR) en comparación al examen con el microscopio quirúrgico dental (MQD) en la detección de características anatómicas de los canales mesiovestibulares en primeros molares maxilares.Se seleccionaron 100 primeros molares maxilares para evaluar el número de entradas de los canales, la accesibilidad y la terminación de sus canales mesiovestibulares utilizando el método ECR y el examen con el MQD.Las pruebas de diagnóstico del ECR exhibieron, en general, altos niveles de precisión, sensibilidad y especificidad. Sin embargo, también hubo niveles bajos de estos resultados, principalmente, en la detección del número de orificios de entrada a los canales de las raíces mesiovestibulares. Hubo diferencias estadísticamente significativas (p<0,05) para la accesibilidad y terminación de los canales en 61 de los 62 casos (del total de 100), cuando dos de ellos estaban presentes: 2 canales radiculares accesibles (48 casos, 77,42 %), y 1 accesible y 1 inaccesible (13 casos, 20,97 %). Después de la fusión, un orificio (18 casos, 29,03 %), 2 orificios (30 casos, 48,39 %) y 1 orificio más otro, ciego (13 casos, 20,97 %). Este estudio demuestra que no se puede confiar plenamente en el método clínico y radiográfico (todavía el más utilizado en todo el mundo), cuando existe una anatomía interna compleja de los canales de la raíz mesiovestibular de los primeros molares superiores.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Molar/anatomy & histology , Molar/diagnostic imaging , Radiography, Dental , Sensitivity and Specificity , Maxilla , Microscopy/methods , Microsurgery
8.
Int. j. morphol ; 38(5): 1266-1270, oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134435

ABSTRACT

SUMMARY: The root canal system of the maxillary first premolar (MFP), present a high rate of variation, especially at apical level. This complicates the action of antiseptic solutions and endodontic instruments at this level. The object of this in vivo study was to analyse by Cone Beam Computed Tomography (CBCT) the radicular and canalicular morphology of MFP in a Chilean sub-population. We carried out a cross sectional, descriptive and observational in vivo study with CBCT examinations of 70 MFP, both left and right. The data were analysed using descriptive statistics (mean (M), standard deviation (SD), with a confidence interval of 95 %), and one-factor ANOVA was used to relate the sections observed. Tooth 1.4 presented one root in 64.86 % of cases and two roots in 35.15 %. Tooth 2.4 presented one root in 66.67 % of cases and two roots in 33.33 %. The frequency of one and two canals was observed to be 30 % and 70% respectively. The walls with the smallest cementodentinal thickness were the mesial (1.11±0.55) and distal (1.08±0.52). The thickest dentinal wall was the palatine (2.07±1.29), followed by the buccal (1.6±1.0). No statistical differences between males and females were found in the thickness of the root wall, nor in the location of the premolar in the maxilla (p>0.05). In conclusion, the root morphology of the MFP is highly variable. Care must be taken not to over-instrument the proximal walls to avoid perforations or fractures. CBCT has proved to be a useful and effective diagnostic tool for in vivo study of dental morphology.


RESUMEN: El sistema de canal radicular del primer premolar maxilar (MFP) presenta una alta tasa de variación, especialmente a nivel apical. Esto complica la acción de las soluciones antisépticas y los instrumentos endodónticos a este nivel. El objetivo de este estudio in vivo fue analizar mediante tomografía computarizada de haz cónico (CBCT) la morfología radicular y canalicular de la MFP en una subpoblación chilena. Realizamos un estudio transversal, descriptivo y observacional in vivo con exámenes CBCT de 70 MFP, tanto a la izquierda como a la derecha. Los datos se analizaron mediante estadística descriptiva (media (M), desviación estándar (DE), con un intervalo de confianza del 95 %) y se utilizó ANOVA de un factor para relacionar las secciones observadas. El diente 1.4 presentó una raíz en el 64,86% de los casos y dos raíces en el 35,15 %. El diente 2.4 presentó una raíz en el 66,67 % de los casos y dos raíces en el 33,33 %. Se observó que la frecuencia de uno y dos canales era del 30 % y 70%, respectivamente. Las paredes con el espesor cementodentinal más pequeño fueron mesial (1,11 ± 0,55) y distal (1,08 ± 0,52). La pared dentinaria más gruesa fue la palatina (2,07 ± 1,29), seguida de la vestibular (1,6 ± 1,0). No se encontraron diferencias estadísticas entre machos y hembras en el grosor de la pared de la raíz, ni en la ubicación del premolar en el maxilar (p> 0,05). En conclusión, la morfología de la raíz de la MFP es muy variable. Se debe tener cuidado de no sobre-instrumentar las paredes proximales para evitar perforaciones o fracturas. CBCT ha demostrado ser una herramienta de diagnóstico útil y efectiva para el estudio in vivo de la morfología dental.


Subject(s)
Humans , Male , Female , Bicuspid/diagnostic imaging , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography , Maxilla/diagnostic imaging , Bicuspid/anatomy & histology , Confidence Intervals , Chile , Cross-Sectional Studies , Analysis of Variance , Dental Pulp Cavity/anatomy & histology , Maxilla/anatomy & histology
9.
Int. j. odontostomatol. (Print) ; 14(3): 387-392, 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1114912

ABSTRACT

Los objetivos principales del tratamiento de endodoncia no quirúrgico son la prevención y/o tratamiento de periodontitis apical junto con la resolución de signos y síntomas de las lesiones pulpares irreversibles. Debido a la compleja morfología del sistema de conductos radicular, la persistencia de un conducto no tratado puede mantener la contaminación y sintomatología pulpar y periapical. La prevalencia para MV2 reportado a nivel mundial para el primer molar superior varía ampliamente según las técnicas in vivo o ex vivo empleadas en cada estudio, es por esto que el presente trabajo tiene por objetivo evaluar la prevalencia de MV2 en primeros molares superiores en base a cuatro técnicas diagnósticas aplicadas ex vivo. Se realizó un estudio transversal observacional en 101 primeros molares superiores extraídos bajo consentimiento informado para determinar la prevalencia del conducto MV2 y su morfología en base a las técnicas de radiografía ortoradial, tomografía Cone Beam, apertura coronaria con microscopio quirúrgico (16x) y cortes radiculares axiales de aplicación ex vivo. La prevalencia encontrada para MV2 por cada técnica fue de 81,1 % para cortes radiculares y tomografía Cone Beam, 59,4 % para la apertura coronal con microscopio (16x) y 32,6 % con radiografía ortoradial. En el 3,96 % de la muestra se encontró un tercer conducto mesiovestibular en base a la técnica de corte radicular. La morfología interna del sistema de conductos radiculares fue de 36 % clase II, 19 % clase I y 16 % clase IV de Vertucci. Los resultados del presente estudio están en concordancia con lo reportado en la literatura y confirman la mayor prevalencia reportada en estudios ex vivo para esta situación. La presencia de MV2 en el primer molar superior es una condición frecuente que el endodoncista debe considerar, empleando técnicas imagenológicas y tecnologías de magnificación para asegurar el éxito terapéutico en estos dientes.


The main objectives of non-surgical endodontic treatment are the prevention and / or treatment of apical periodontitis, as well as resolving signs and symptoms of irreversible pulpal lesions. Considering the complex morphology of the root canal system, the a canal left untreated, can generate contamination, pulp and periapical symptoms. The prevalence for MV2 reported worldwide for the upper first molar, varies depending on the ex vivo or ex vivo techniques used in each study. Consequently, the present work aims to assess the prevalence of MV2 in first upper molars based on four ex vivo diagnostic techniques applied. An observational crosssectional study was performed in 101 upper first molars extracted under informed consent to determine the prevalence of the MV2 duct and its morphology based on orthoradial radiography, Cone Beam tomography, coronary opening with a surgical microscope (16x), and axial root cuts applied ex vivo. The prevalence found for MV2 by each technique was 81.1 % for root cuts and Cone Beam tomography, 59.4 % for coronal opening with a microscope (16x) and 32.6 % with orthoradial radiography. In 3.96 % of the sample, a third mesiovestibular canal was found based on the root cutting technique. The internal morphology of the root canal system was 36 % Vertucci´s class II, 19 % class I and 16 % class IV. The results of the present study coincide with that reported in the literature, and confirm the higher prevalence reported in ex vivo studies for this situation. The presence of MV2 in the upper first molar is a frequent condition that the endodontist must consider, using imaging techniques and magnification technology to ensure therapeutic success in these teeth.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Molar/anatomy & histology , Chile , Prevalence , Cross-Sectional Studies
10.
Rev. Fac. Odontol. (B.Aires) ; 35(81): 57-65, 2020. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1222866

ABSTRACT

El objetivo fue evaluar mediante tomografía computarizada de haz cónico (CBCT), la prevalencia y tipología de conductos en C en molares inferiores. Se analizaron 422 CBCT y 1105 molares inferiores de pacientes de ambos géneros, mayores de 10 años, obtenidas en 2018. Variables registradas: género, número de pieza, y tipología, según clasificación anatómica de Fan, en los tres tercios. Se observaron cortes coronario, medio y apical. Se compararon frecuencias observadas con frecuencias esperadas bajo suposición de independencia, se utilizó prueba de bondad de ajuste de Chi-cuadrado. La comparación de pares de porcentajes se realizó con prueba de diferencia de proporciones de Pearson Chi-cuadrado con p-valores simulados por prueba de Monte Carlo. Según los resultados, el molar en C no se distribuyó homogéneamente en las tomografías analizadas. Chi-cuadrado (X2=264.13 p-valor <2,2) (p-valor dos colas <0.001), tampoco se distribuyó homogéneamente en el total de piezas dentarias Chi-cuadrado (X2=1011,1, p-valor <2.2e-16) (p-valor dos colas <0.001). Las variables género y presencia de molar en C no se distribuyeron independientemente, Chi-cuadrado (X2=4.7367, p-valor =0,042) (p-valor<0,05). Las variables tipología y piezas dentarias no se distribuyeron independientemente, Pearson Chi-cuadrado (p-valor<0.001), al igual que las variables tipología y tercios, Pearson Chi-cuadrado (p-valor<0.001). En conclusión, la CBCT es valiosa para identificar estas anatomías. Haber encontrado mayor prevalencia de tipología I confirma lo establecido en la literatura. Tienen alta prevalencia en las poblaciones asiáticas pero en caucásica son poco frecuentes (3%) (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Tomography, X-Ray Computed , Dental Pulp Cavity/anatomy & histology , Molar/anatomy & histology , Chi-Square Distribution , Biotypology , Cross-Sectional Studies , Data Interpretation, Statistical , Asians , Age and Sex Distribution , Mandible
11.
Braz. oral res. (Online) ; 34: e056, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132692

ABSTRACT

Abstract This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods , X-Ray Microtomography/methods , Reference Values , Risk Factors
12.
Braz. oral res. (Online) ; 34: e039, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1100935

ABSTRACT

Abstract To compare the shaping ability of different single-file systems in the preparation of mesial curved canals of mandibular molars using micro-CT technology. Fifteen mesial roots of mandibular molars with two independent and curved canals (n = 30) were selected, scanned at a resolution of 26.7 μm anatomically matched, and distributed into three groups (n = 10), according to the preparation system: WaveOne 25.08, Reciproc 25.08, and OneShape 25.06. A final micro-CT scanning was performed, data sets were registered with their respective counterparts, and compared regarding the three-dimensional (volume, surface area, and structure model index - SMI) and two-dimensional (perimeter, area, roundness, major and minor diameters) parameters, as well as, canal transportation, using ANOVA and post hoc Tukey tests (α = 5%). Overall, no difference was observed between groups regarding area, perimeter, volume, surface area, and canal transportation (p > 0.05). Within group, no canal transportation was significantly higherobserved in the apical third (0.10 ± 0.05 mm) compared to coronal (0.08±0.040 mm) and middle (0.07 ± 0.03 mm) thirds (p < 0.05). Structure model index (SMI) was statistically higher after preparation with OneShape instrument (0.36 ± 0.26) compared to other systems (p < 0.05). Within the parameters of this study, similar shaping ability was observed in the preparation of mesial curved root canals of mandibular molars with Reciproc, OneShape and WaveOne systems.


Subject(s)
Humans , Root Canal Preparation/instrumentation , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Reference Values , Materials Testing , Analysis of Variance , Statistics, Nonparametric , Dental Instruments , Equipment Design , X-Ray Microtomography/methods , Molar/anatomy & histology
13.
J. appl. oral sci ; 28: e20190103, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056583

ABSTRACT

Abstract Objective This study aimed to assess the association between tooth size and root canal morphology by using CBCT analysis. Methodology In this retrospective study, tooth anatomic lengths (crown and root lengths, buccolingual and mesiodistal dimensions) of 384 patients were assessed and correlated with Vertucci's root canal morphology classification. Data was analyzed for gender-related differences using the independent sample t-test, ANOVA, and the Pearson's correlation for a possible relation between anatomic lengths and canal morphology. Results The maxillary first and second premolars showed a greater predilection for Type IV and II variants, respectively, while the mandibular first premolar showed a greater predilection for Type II canal system. The root canal system of the mandibular second premolar showed maximal diversity (47% Type I, 30% Type II, and 20% Type III). The dimensions were greater in men regardless of tooth type. The most significant relation (p<0.05) between the anatomic size and canal morphology was observed in the maxillary first premolars, followed by the mandibular canines (buccolingual dimension) and the lower second premolars (crown length). Negative correlations existed between the crown length and the patient's age for the anterior teeth and mandibular second premolar (r=−0.2, p<0.01). Conclusions The most common canal formation for anterior teeth was the Type I. The anatomic lengths had the strongest influence on the canal configuration of the maxillary first premolar, with Type IV being the most common root canal system. The mandibular second premolars showed maximal diversity in the canal classification terms and had a significant correlation with their crown lengths. Clinical Relevance The complex relationship between the canal morphology and anatomic tooth sizes need meticulous awareness and recognition during endodontic procedures, in conjunction with the demographic variabilities.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Tooth/diagnostic imaging , Dental Pulp Cavity/anatomy & histology , Cone-Beam Computed Tomography/methods , Reference Values , Tooth/anatomy & histology , United States , Sex Factors , Retrospective Studies , Analysis of Variance , Dental Pulp Cavity/diagnostic imaging , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imaging , Odontometry/methods
14.
J. appl. oral sci ; 28: e20190393, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056585

ABSTRACT

Abstract Objectives This study assessed the incidence and variability features of root canals system (RCS) and their ramifications according to Pucci & Reig (PR) (1944) and the American Association of Endodontists (AAE) (2017) by micro-computed tomography (μCT). Methodology 500 representative extracted human teeth of each tooth group (n=50) (maxillary/mandibular central and lateral incisors, canines, first and second premolars and molars) were scanned by μCT with a resolution of 26.70 μm. The reconstructed cross-sections images and the visualization of the continuous slices in the transversal axis were performed using DataViewer software. RCS were classified according to Pucci & Reig (main canal, collateral canal, lateral canal, secondary canal, accessory canal, intercanal, recurrent canal) and AAE (main canal, accessory canal, lateral canal). The apical deltas were assessed for both classifications. The prevalence of apical deltas was evaluated using the Chi-squared test (p<0.05). Results According to PR, a higher incidence of lateral canals was observed in maxillary canines (10%), central incisors (8%) and first premolars (6%). Using AAE, the highest incidence of lateral canals was observed in the mandibular first premolars (85%), first and second molars (84%), lateral incisors (67%), canines (59%), and in maxillary first premolars (52%). Regarding accessory canals, the PR showed a frequency in 2% of the maxillary lateral incisors and maxillary and mandibular first premolars and 3% of mandibular first and second molars. On the other hand, the AAE showed the highest incidence of accessory canals in 86% of the maxillary first premolars, 71% in mandibular lateral incisors, 69% in mandibular first premolars, 65% in mandibular canines, and 56% in maxillary canines. The PR showed the lowest incidence of apical deltas for all dental groups when compared with AAE (p=0.004). Interestingly, distal canals in maxillary molars showed a significant discrepancy between classifications (p=0.027). Conclusions μCT enabled accurately describing the RC system and related ramifications, adding to the PR and AAE classifications, with some discrepancies reported for maxillary molars. Clinical Relevance This μCT study enabled a thorough description of the variability among root canals and their ramifications, including clinically relevant details on the presence and location of lateral canals and accessories in all human tooth groups, beyond the currently existing classification systems.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , X-Ray Microtomography/methods , Reference Values , Statistics, Nonparametric , Tooth Apex/anatomy & histology , Tooth Apex/diagnostic imaging , Imaging, Three-Dimensional , Dental Pulp Cavity/diagnostic imaging , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imaging
15.
Int. j. odontostomatol. (Print) ; 13(3): 287-291, set. 2019. tab
Article in English | LILACS | ID: biblio-1012424

ABSTRACT

ABSTRACT: The apical limit of tooth roots for instrumentation and obturation is a controversial subject due to the high morphological complexity presented by the apical zone of the root. The development of electronic apex locators (EALs) has made working length (WL) determination more predictable, producing more accurate results; however, the interpretation mechanisms of different devices may affect measurements taken under different clinical conditions. One hundred premolars were used to compare the effectiveness of Propex II, Raypex 6, Propex Pixi and Root ZX II in locating the apical foramen (AF). No statistically significant differences were observed when the accuracy of measurement was compared between the different groups of EALs, however Root ZX II and Raypex 6 presented the best overall performance.


RESUMEN: El límite apical radicular para la instrumentación y obturación es un tema controversial, debido a la alta complejidad morfológica que presenta la zona apical de la raíz. El desarrollo de localizadores de ápice electrónicos (EALs) ha hecho la determinación de la longitud de trabajo (WL) más predecible y con resultados más precisos. Sin embargo, el mecanismo de interpretación de cada dispositivo puede afectar la determinación de las mediciones en diferentes condiciones clínicas. Cien premolares fueron utilizados para comparar la efectividad de Propex II, Raypex 6, Propex Pixi y Root ZX II en localizar el foramen apical (AF). No se observaron diferencias estadísticamente significativas cuando se comparó la precisión de medición entre los diferentes grupos de EALs, sin embargo, Root ZX II y Raypex 6 mostraron un mejor desempeño global.


Subject(s)
Humans , Root Canal Preparation/instrumentation , Tooth Apex/anatomy & histology , Dental Pulp Cavity/anatomy & histology , Electrical Equipment and Supplies/standards , Odontometry/instrumentation , Chile , Tooth Apex/diagnostic imaging , Dental Pulp Cavity/diagnostic imaging
16.
Braz. dent. j ; 30(1): 3-11, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-989432

ABSTRACT

Abstract This study discusses a method to determine the root canal anatomic dimension by using e-Vol DX software. The methodology consists in initially establishes the correct positions which will be measured, define the point on the edge of the anatomical structure, and next adjust the intermediate position in the grayscale of CBCT image. Afterward, thin sections (0.10 mm) are obtained from 3D reconstructed slices in the filter for the measurements, in order to determine the edge of the anatomical surface in the axial plane. A replication of positions in 3D mode is done in multiplanar reconstruction (MPR) of CBCT images, where the correct position is established with the aid of a positioning guide. The 3D density is adjusted so that it is in the same dimension as the 2D image, and a dimension calibration occurs to the point where there is a coincidence between 3D and 2D. This calibration is done only at the beginning of the measurement. Next, the intermediate position of the division between the grayscale is verified in the CBCT scan. Once one side has been completed, it is moved to the other side and follows the same guidelines described above. When setting the position of the courses in the other margin, being that 2D mode is used as reference. Thus, one obtains the required measure, being checked in the two points. The creation of this filter in the e-Vol DX software for measurement, and its appropriate management, allows more effective applications when it is desired to obtain diameters of anatomical structures.


Resumo Este estudo discute um método para determinar a dimensão anatômica do canal radicular usando o software e-Vol DX. A metodologia consiste em inicialmente estabelecer as posições corretas que serão medidas, definir o ponto na borda da estrutura anatômica e ajustar a posição intermediária na escala de cinza na imagem em tomografia computadorizada de feixe cônico (TCFC). A seguir, slices finos (0,10mm) são obtidos a partir de cortes 3D reconstruídos no filtro para as medidas, a fim de determinar a borda da superfície anatômica no plano axial. Uma replicação de posições no modo 3D é feita em reconstrução multiplanar (MPR) em imagens de TCFC, onde a posição correta é estabelecida com o auxílio de um guia de posicionamento. A densidade 3D é ajustada de modo a ficar na mesma dimensão da imagem 2D, e então realiza-se uma calibração de dimensão até o ponto em que há uma coincidência entre o modo 3D e 2D. Essa calibração é feita apenas no início da medição. Posteriormente, a posição intermediária da divisão entre a escala de cinza é verificada na TCFC. Uma vez que um lado tenha sido concluído, o guia é movido para o outro lado, e segue-se as mesmas diretrizes descritas. Define-se a posição do marcador na outra margem, sendo que o modo 2D usado como referência. Assim, obtém-se a medida necessária, sendo verificado nas duas margens do canal radicular. A criação deste filtro no software e-Vol DX para medição e seu uso apropriado permite aplicações eficazes quando se deseja obter diâmetros de estruturas anatômicas.


Subject(s)
Humans , Software Design , Imaging, Three-Dimensional/methods , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods
17.
J. appl. oral sci ; 27: e20180689, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1012523

ABSTRACT

Abstract Objective The aim of this study was to evaluate the root canal preparation and apical enlargement of molar root canals with rotary or reciprocating heat-treated nickel-titanium (NiTi) instruments, by using micro-computed tomography (micro-CT). Methodology Mesial root canals (n=48) of mandibular molars, with a curvature between 20° and 40°, were prepared with ProDesign Logic (PDL) 25.01 and 25.06 in rotary motion, or ProDesign R (PDR) 25.06 in reciprocating motion (PDR). Apical enlargement was performed with PDL35.01 and PDL35.05 or PDR35.05. Scanning with 9 µm resolution was performed before and after preparation, and, after apical enlargement, by using micro-CT. The percentage of volume increase, debris and untouched root canal surface, transportation, centralization and preparation time were analyzed. ANOVA and Tukey or Kruskall-Wallis and Dunn statistical tests were conducted (α=.05). Results PDL promoted a higher apical percentage of volume increase, and lower percentage of debris and untouched root canal surface than PDR 25.06 preparation in entire canal and in all thirds (P<.05). Apical enlargement with PDL 35.05 and PDR 35.05 produced a higher percentage of volume increase in the apical region in relation to the initial preparation (P<.05). PDR 35.05 and PDL 35.05 showed similar results in relation to percentage of debris and untouched root canal surface in entire canal and in all thirds (P>.05). Centralization and transportation showed no difference (P>.05). PDR required less time to perform preparation and apical enlargement (P<.05). Conclusions The apical enlargement 35.05 with CM heat-treatment instruments using reciprocating and rotary motion reduced the percentage of debris and untouched root canal surface, without causing deviations or procedural errors. The protocol of greater apical enlargement favors the cleaning of the root canals in both kinematics. Preparation by the reciprocating system was faster than by the rotary system.


Subject(s)
Humans , Titanium , Root Canal Preparation/instrumentation , Dental Instruments , Dental Pulp Cavity/diagnostic imaging , Nickel , Reference Values , Surface Properties , Materials Testing , Reproducibility of Results , Analysis of Variance , Statistics, Nonparametric , Dental Pulp Cavity/anatomy & histology , Equipment Design , X-Ray Microtomography , Hot Temperature
18.
J. appl. oral sci ; 27: e20180700, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1012509

ABSTRACT

Abstract Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. Objective: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. Methodology: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). Results: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). Conclusion: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Oxides/therapeutic use , Zirconium/therapeutic use , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Dental Caries/therapy , Dental Cavity Lining/methods , Time Factors , Tooth, Deciduous , Radiography, Dental , Analysis of Variance , Follow-Up Studies , Treatment Outcome , Dental Caries/diagnostic imaging , Dental Cements/therapeutic use , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/drug effects , Dental Restoration, Permanent/methods , Drug Combinations
19.
Rev. Fac. Odontol. (B.Aires) ; 34(76): 17-23, 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1102448

ABSTRACT

Una de las variaciones anatómicas que pueden presentar los molares inferiores es una tercera raíz que ha sido denominada radix entomolaris o paramolaris dependiendo de su localización, ya sea lingual o vestibular respectivamente. Conocer las variaciones morfológicas de las piezas dentarias es un requisito fundamental para el éxito del tratamiento endodóntico. El objetivo de este artículo es la presentación de un caso clínico de una paciente con ambos primeros molares inferiores con presencia de radix entomolaris; en la pieza dentaria 4.6 se realizó tratamiento endodóntico y en 3.6 con una lesión endoperiodontal combinada verdadera se decidió su exodoncia (AU)


Subject(s)
Humans , Female , Aged, 80 and over , Dental Pulp Cavity/anatomy & histology , Molar/anatomy & histology , Root Canal Therapy , Tooth Extraction , Tooth Root/anatomy & histology , Radiography, Panoramic , Race Factors , Mandible
20.
Braz. oral res. (Online) ; 33: e082, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019606

ABSTRACT

Abstract The present study aimed to evaluate the internal configuration of the maxillary molars of a population from the Northeast region of Brazil. Cone-beam computed tomography (CBCT) exams from 512 patients (1501 teeth) were evaluated regarding the anatomical configuration of the root canal system, according to Vertucci's classification. The images were obtained using a Prexion 3D scanner operating at 90 kVp and 4 mA. The voxel size was 0.125 mm and the cut thickness was 1 mm. The images were then analyzed in the Prexion 3D Viewer software. The data were analyzed statistically by Pearson's chi-square test, with 5% of significance. The first and second molars presented three roots in 99.14% and 87.27% of the cases, respectively. In relation to the number of canals, the first and second molars had a significantly higher frequency of three and four root canals respectively, presenting a higher prevalence of types I and II (p < 0.001). The second mesiobuccal canal (MB2) was observed in 48.21% and 22.72% of the first and second molars, respectively (p < 0.001). The identification of the MB2 canal was greater in young and adult patients (p < 0.001), presenting a higher prevalence in male patients (p < 0.001). The internal configuration of the MB root was influenced by gender and by age, presenting a higher prevalence of the MB2 in male patients younger than 50 years of age.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods , Molar/anatomy & histology , Molar/diagnostic imaging , Reference Values , Brazil , Sex Factors , Age Factors , Sex Distribution , Age Distribution , Maxilla , Middle Aged
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