Morphological changes of the root apex in anterior teeth with periapical periodontitis: an in-vivo study.

INTRODUCTION: The aim was to analyze the morphological changes of root apex in anterior teeth with periapical periodontitis. METHODS: 32 untreated anterior teeth with periapical periodontitis were enrolled, compared with the healthy contralateral teeth. Two-dimensional measurement of Cone-beam computed tomography was used to determine the location and measure diameter of the apical constriction according to Schell's methods. An open-source software (3D Slicer) was used to reconstruct the teeth. The apical constriction form was analysis according to Schell's topography. The distances of apical constriction to apical foramen and anatomical apex were measured respectively. RESULTS: The difference value between buccolingual and mesiodistal diameter was (0.06 ± 0.09) mm and (0.04 ± 0.04) mm in periapical periodontitis and controls (p < 0.05). The mean distance between apical constriction and anatomical apex was significantly shorter in periapical periodontitis than controls, so was the mean distance of apical constriction to apical foramen. The most common form of apical constriction was flaring (65.6%) in periapical periodontitis. CONCLUSIONS: The anterior teeth with periapical periodontitis had shorter distances of apical constriction to anatomical apex and apical foramen, bigger disparities between the diameters of buccolingual and mesiodistal, and higher proportion of flaring apical constriction.

[Comparative study of root canal morphology of mandibular incisors by cone-beam CT and canal staining and clearing technique].

PURPOSE: To compare the root canal morphology of mandibular incisors by using cone-beam CT (CBCT) and canal staining and clearing technique. METHODS: Sixty-one extracted mandibular incisors with complete dental root and apex which received no endodontic treatment and no post crown restoration were selected. Each tooth was radiographed with CBCT, and the root canal system was stained by canal staining and clearing technique. The consistency of the number of root canal, root canal Vertucci type of mandibular permanent incisors between the two methods were compared, and the differences of the detection rate on root canal branch structure between the two methods were analyzed. The results were statistically analyzed with SPSS 17.0 software package. RESULTS: The Kappa value of single and double root canal types between CBCT and canal staining and clearing technique was 0.847 (P<0.001). The Kappa value of Vertucci root canal types between CBCT and canal staining and clearing technique was 0.861 (P<0.001). The detection rates of root canal branch structure were 8.19% and 22.95%, respectively, with significant difference between the two methods (P=0.025). The canal staining and clearing technique was significantly better than CBCT in detection of root canal branch structure. CONCLUSIONS: CBCT can reflect the root canal types nearly perfectly, but inferior to canal staining and clearing technique in detection of root canal branch structure, CBCT is a relatively accurate clinical diagnosis tool of root canal morphology.