Assessment of root canal anatomy of maxillary and mandibular canine teeth: a cone-beam computed tomography study / Evaluación de la anatomía del canal radicular de caninos maxilares y mandibulares: un estudio de tomografía computarizada de haz cónico

Abstract To investigate the root canal anatomy of permanent maxillary and mandibular canines in a Turkish subpopulation using cone beam computed tomography (CBCT). Retrospective CBCT data of 300 patients admitted to our clinic between 2016 and 2018 were screened and evaluated. A total of 235 patients, 100 males and 135 females, aged 14-76 years (mean age 37.27±13.40) were included in this study. A total of 191 (44,8%) maxillary canine teeth and 235 (55,2%) mandibular canine teeth were examined. The number of roots and root canal morphology according to Vertucci's classification, the presence of accessory canals, and the position of the apical foramen of the root were analyzed. The effect of gender and age on the incidence of root canal morphology was also investigated. The majority of the teeth had a Type I canal configuration in both maxillary canines (100%) and mandibular canines (92,8%). In the mandibular canines the other canal patterns found were Type III (6,8%), and Type II (0,4%). Apical foramen was centrally positioned in the majority of the teeth, 70,2% and 66,8% in maxillary and mandibular canines, respectively. The occurrence of two roots in mandibular canines was 3,8% and the root canal separation was found 53,8% and 46,2% in the middle and cervical third of the root, respectively. No significant statistical difference was observed effect of gender and age on the incidence of the root canal morphology and the position of the apical foramen. Due to the diverse morphology and the potential presence of a second canal for canine teeth among the Turkish subpopulation, dentists should perform endodontic treatments with greater care. CBCT is an accurate tool for the morphological assessment of the root canals.

Resumen Investigar la anatomía del conducto radicular de los caninos maxilares y mandibulares permanentes en una subpoblación turca utilizando la tomografía computarizada de haz cónico (CBCT). Se examinaron y evaluaron los datos CBCT retrospectivos de 300 pacientes ingresados en nuestra clínica entre 2016 y 2018. Un total de 235 pacientes, 100 hombres y 135 mujeres, de entre 14 y 76 años (edad media de 37,27±13,40) fueron incluidos en este estudio. Se examinaron un total de 191 (44,8%) dientes caninos maxilares y 235 (55,2%) dientes caninos mandibulares. Se analizó el número de raíces y la morfología del conducto radicular según la clasificación de Vertucci, la presencia de conductos accesorios y la posición del foramen apical de la raíz. También se investigó el efecto del sexo y la edad en la incidencia de la morfología del conducto radicular. La mayoría de los dientes tenían una configuración de conductos de tipo I tanto en los caninos maxilares (100%) como en los caninos mandibulares (92,8%). En los caninos mandibulares los otros patrones de conductos encontrados fueron el Tipo III (6,8%) y el Tipo II (0,4%). El foramen apical estaba situado en posición central en la mayoría de los dientes, 70,2% y 66,8% en los caninos maxilares y mandibulares, respectivamente. La ocurrencia de dos raíces en los caninos mandibulares es del 3,8% y la separación del conducto radicular se encontró en el tercio medio y cervical de la raíz en el 53,8% y el 46,2%, respectivamente. No se observó ninguna diferencia estadística significativa en el efecto del sexo y la edad sobre la incidencia de la morfología del conducto radicular y la posición del foramen apical. Debido a la diversa morfología y a la posible presencia de un segundo conducto en los dientes caninos entre la subpoblación turca, los odontólogos deberían realizar los tratamientos endodónticos con mayor cuidado. La CBCT es una herramienta precisa para la evaluación morfológica de los conductos radiculares.

Transmigración de canino mandibular: etiología, manejo quirúrgico y consideraciones especiales / Mandibular canine transmigration: etiology, surgical management and special considerations

En raras ocasiones, el canino mandibular derecho o izquierdo se coloca en el lado opuesto al habitual. Esta perturbación se define como la transmigración. Existen diversas teorías de su etiología, así como factores que la condicionan. La transmigración mandibular es un término que no está descrito en la literatura contemporánea y son pocos los casos reportados a nivel mundial. Presentamos un caso de trasmigración de canino mandibular derecho, posicionado por debajo del agujero mentoniano de lado izquierdo, cerca del borde basal mandibular, el cual se extrajo bajo anestesia general. Presentamos la etiología, técnica quirúrgica y consideraciones especiales en casos de trasmigración de canino mandibular (AU)

In rare occasions right or left mandibular canine is positionated at opposed side of habitual. This disturbance is defined as transmigration. There exist diverse theories about its etiology as well as conditioning factors. Mandibular transmigration is a non described term in modern literature and there are only a few reported cases at world level. We present one case of right canine transmigration positionated intimately below of left side mentonian hole near of mandibular basal edge which it was extracted under general anesthesia. We present also the etiology, surgical technique and special considerations of mandibular canine transmigration cases (AU)

Sensibilidad y Especificidad Clínica del Indice Mandibular Canino y del Ancho Mesiodistal del Diente Canino Para Estimar el Sexo: Ajuste de un Modelo Predictivo / Clinical Sensitivity and Specificity of Mandibular Canine Index and Mesiodistal Canine Width to Estimate Sex: Adjustment of a Predictive Model

Los dientes son un excelente material de investigación en personas vivas y cadáveres, en el ámbito antropológico, genético, odontológico y forense, por sus características (dureza, resistencia al ataque químico, fuego y descomposición). El diente canino mandibular es el menos afectado por enfermedad periodontal, menos extraído, más resistente a traumas severos y el que presenta mayor dimorfismo sexual. Se puede usar para la estimación de sexo, calculando el Índice Mandibular Canino (IMC). El propósito de este estudio es determinar la certeza del IMC en la estimación de sexo respecto al ancho mesiodistal del canino. El estudio fue realizado en 150 sujetos (H:M= 65:85), entre 18­24 años. El ancho mesiodistal del canino y la distancia canina fueron medidos en los modelos obtenidos y el IMC fue calculado. Se calculó la sensibilidad y especificidad para cada uno de los índices en cuestión. El IMC tuvo una sensibilidad del 33,85 % y una especificidad de 75,29 % en la estimación de sexo. El ancho mesiodistal del canino tuvo una sensibilidad de 66,15 % y una especificidad de 84,71 %. El ancho mesiodistal del canino tiene mayor sensibilidad y especificidad que el IMC en la estimación médicolegal de sexo.

Teeth are an excellent research material in living persons and in corpses, in the anthropological, genetic, dental and forensic fields, because of their characteristics (hardness, resistance to chemical attack, fire and decay). Mandibular canine teeth are the least affected by periodontal disease, the least extracted teeth, are more resistant to severe trauma and have a greater sexual dimorphism. They can be used for sex estimation, through the Mandibular Canine Index (MCI). The purpose of this study is to determine the accuracy of the MCI in sex estimation, compared to the mesiodistal canine width method. The study was conducted on 150 subjects (M:F= 65:85), aged 18­24. The mesiodistal width of canine and the intercanine distance were measured on the obtained models, and the MCI was calculated. The sensitivity and specificity for each of the two indexes were also calculated. MCI had a sensitivity of 33.85% and a specificity of 75.29 % in sex estimation. The mesiodistal width of canine had a sensitivity of 66.15 % and a specificity of 84.71 %. The mesiodistal width of canine has a higher sensitivity and specificity than the MCI in the medicolegal estimation of sex.

A case series of unusual root canal morphology

Aim: The thorough knowledge of tooth morphology and its variations is essential for successful endodontic treatment. Case report: This article reports an unusual root canal configuration that was detected in a maxillary central incisor with two root canals , mandibular canine with two canals and mandibular canine with two roots and root canals. Conclusions: These case reports increase the awareness of clinicians on variations in the root canal anatomy so that complete disinfection and obturation of the root canal system is possible.

Bilateral two-rooted mandibular canines in the same individual: a case report / Caninos mandibulares birradiculares bilaterales en el mismo individuo: presentación de un caso

The normal anatomy of canines teeth comprises one root and one large canal centered through its axis; however some canines may present two roots and two canals. Thus, the knowledge of normal root canal anatomy and their variations is essential to minimize the possibility of occurrence of accidents during the development of dental treatments. In this report we describe a case of bilateral mandibular canines with two roots and two canals found radiographically in the same individual.

La anatomía normal de los dientes caninos comprende una raíz y un gran canal centrado a través de su eje, sin embargo algunos dientes canino pueden presentar dos raíces y dos canales. Así, el conocimiento de la anatomía normal de canal de la raíz y sus variaciones son esenciales para minimizar la posibilidad de accidentes durante el desarrollo de tratamientos dentales. En este informe se describe el caso de dientes caninos mandibulares con dos raíces y dos canales bilateralmente hallados radiográficamente en el mismo individuo.

Canino mandibular con dos raíces / Mandibular canine with two roots

El canino inferior es un diente con raíz larga y ancha que le permite una adecuada implantación en el arco dentario. Es considerado un pilar valioso en muchos tratamientos rehabilitadores. Con la finalidad de mantener este elemento dentario es necesario realizar un correcto diagnóstico, para lo que se tendrá en cuenta el conocimiento de las variaciones anatómicas. El objetivo del artículo es presentar un caso de canino mandibular con dos raíces con sus respectivos canales radiculares .Paciente femenina de 21 años, que acudió a la Clínica de Radiología de la Facultad de Odontología de Piracicaba con indicación de una radiografía panorámica para valorar cirugía de terceros molares. Llamó la atención una configuración inusual de las raíces de los caninos mandibulares. En el examen de tomografía computarizada de haz cónico se observó que el canino mandibular del lado derecho presentaba dos raíces separadas, cada una con sus respectivos canales radiculares. Se concluyó que a pesar de la baja prevalencia de las variaciones anatómicas, estas pueden ocurrir en el número de raíces y canales de los caninos mandibulares, tal como se presenta en este reporte de caso(AU)

The mandibular canine is a robust and long tooth which allows an adequate implantation in the dental arch. It is considered a valuable pillar in many rehabilitating treatments. In order to maintain this important dental element, it is necessary to make a correct diagnosis, for which the knowledge of the different anatomic variations should be kept in mind. The objective of this article is to present a case of a mandibular canine with two roots with their respective root canals. A 21-year-old female patient went to the Radiology Clinic at the Faculty of Odontology of Piracicaba with the indication of a panoramic radiography for preoperative third molars surgery. An unusual root configuration of the mandibular canines was observed. In the cone beam CT, it was observed that the right mandibular canine presented two separate roots, each one with their respective radicular canals. It was concluded that, despite of the low prevalence of anatomical variations, these can occur in the root system of the mandibular canines, as presented in this case report(AU)

Microcomputed tomography analysis of the root canal morphology of single-rooted mandibular canines.

AIM: To investigate the anatomy of single-rooted mandibular canine teeth using microcomputed tomography (µCT). METHODOLOGY: One hundred straight single-rooted human mandibular canines were selected from a pool of extracted teeth and evaluated using µCT. The anatomy of each tooth (length of the roots, presence of accessory canals and apical deltas, position and major diameter of the apical foramen and distance between anatomical landmarks) as well as the two- and three-dimensional morphological aspects of the canal (area, perimeter, form factor, roundness, major and minor diameter, volume, surface area and structure model index) were evaluated. The results of the morphological analysis in each canal third were compared statistically using Friedman's test (α = 0.05). RESULTS: The length of the roots ranged from 12.53 to 18.08 mm. Thirty-one specimens had no accessory canals. The location of the apical foramen varied considerably. The mean distance from the root apex to the major apical foramen was 0.27 ± 0.25 mm, and the major diameter of the major apical foramen ranged from 0.16 to 0.72 mm. Mean major and minor diameters of the canal 1 mm short of the foramen were 0.43 and 0.31 mm, respectively. Overall, the mean area, perimeter, form factor, roundness, major and minor diameters, volume, surface area and structure model index (SMI) were 0.85 ± 0.31 mm(2) , 3.69 ± 0.88 mm, 0.70 ± 0.09, 0.59 ± 0.11, 1.36 ± 0.36 mm and 0.72 ± 0.14 mm, 13.33 ± 4.98 mm(3) , 63.5 ± 16.4 mm(2) and 3.35 ± 0.64, respectively, with significant statistical difference between thirds (P < 0.05). CONCLUSIONS: The anatomy and morphology of the root canal of single-rooted canines varied widely in different levels of the root.

Bilateral mandibular canines with two roots and two separate canals: case report

The mandibular canine is usually considered a single-rooted tooth with a single root canal. However, two canals and more rarely two roots may also occur. This paper reports the case of a patient with bilateral mandibular canines with two roots and two root canals. The initial periapical radiographs of the mandibular right and left canines for endodontic treatment revealed the presence of two roots in each tooth. After coronal opening, the cervical third was prepared with a SX file of the ProTaper® system and root canal length was confirmed using Root ZX electronic apex locator. Root canal preparation was completed with the series of ProTaper® instruments and the root canal was filled with gutta-percha and an epoxy resin-based endodontic sealer according to Tagger's hybrid technique. The final radiographs showed two well-obturated canals ending at the electronically located apexes. The 6-month posttreatment follow-up showed apparent clinical and radiographic success. Clinicians should always consider the presence of anatomical variations in the teeth during endodontic treatments. Despite the low prevalence, variations may occur in the number of roots and root canals of mandibular canines, as demonstrated in this case report.

O canino inferior é tido como um dente unirradiculado e com apenas um canal. Todavia, pode ocorrer o aparecimento de dois canais e, mais raramente, duas raízes. Este artigo apresenta o caso clínico de uma paciente com ambos os caninos inferiores apresentando duas raízes e dois canais radiculares. A radiografia inicial periapical dos caninos mandibulares inferiores direito e esquerdo para tratamento endodôntico revelou a presença de duas raízes em cada um deles. Uma vez realizada a abertura coronária, o preparo do terço cervical foi feito com a lima SX do sistema ProTaper® e a odontometria foi determinada e confirmada eletronicamente com o localizador apical eletrônico Root ZX. O preparo foi finalizado com a série de instrumentos do sistema ProTaper® e a obturação foi realizada com cones de guta-percha e cimento obturador resinoso sob a técnica Híbrida de Tagger. As radiografias finais mostraram dois canais bem obturados terminando nos limites apicais estabelecidos pelos localizadores apicais eletrônicos. O controle de 6 meses mostrou sucesso clínico e radiográfico do tratamento endodôntico. Os clínicos devem sempre considerar a presença de variações anatômicas em todo tratamento endodôntico. A despeito da baixa prevalência, pode haver variações no número de raízes e canais de caninos inferiores, como demonstrado neste caso clínico.