Prevalencia de conductos en C de segundos molares mandibulares evaluados en tomografía de haz cónico / Prevalence of C-ducts of Mandibular Second Molars Evaluated on Cone Beam Tomography

Introducción: El conocimiento adecuado de la configuración de conductos radiculares es fundamental en endodoncia; la evaluación tomográfica permite una correcta evaluación de su disposición radicular. Objetivo: Determinar la prevalencia de conductos en C de segundos molares mandibulares, evaluados en tomografía de haz cónico. Métodos: Se realizó un estudio descriptivo y de corte transversal; la muestra estuvo conformada por 200 segundos molares mandibulares permanentes de una población peruana, observadas en tomografías cone beam, donde se registró la presencia del conducto en C, su configuración según la clasificación de Fan y el sexo del paciente. Resultados: La prevalencia de la configuración radicular en forma de C en segundos molares inferiores fue del 65,5 por ciento; según la Clasificación de Fan se observó mayor prevalencia en el tercio cervical del conducto radicular el tipo C1 con 85,7 por ciento; en el tercio medio el tipo C2 con 42,9 por ciento; a nivel apical fue el tipo C3C con 72,1 por ciento; según el sexo, el 65,2 por ciento de los conductos en C correspondió al femenino. Conclusión: La prevalencia de los conductos en C de los segundos molares mandibulares evaluados en tomografías de haz cónico fue de 65,5 por ciento con mayor predominio en el sexo femenino. La evaluación tomográfica permite una mejor identificación y configuración interna de los conductos radiculares(AU)

Introduction: Adequate knowledge of the configuration of root canals is fundamental in endodontics; tomographic evaluation allows a correct assessment of their radicular arrangement. Objective: To determine the prevalence of C-shaped canals in mandibular second molars, evaluated by cone beam tomography. Methods: A descriptive and cross-sectional study was carried out; the sample consisted of 200 permanent mandibular second molars from a Peruvian population, observed in cone beam tomography, where the presence of the C-shaped canal, its configuration according to Fan's classification and the patient's gender were recorded. Results: The prevalence of the C-shaped root canal configuration in lower second molars was 65.5 percent; according to the Fan classification, the highest prevalence was observed in the cervical third of the root canal, type C1 with 85.7 percent; in the middle third, type C2 with 42.9 percent; at the apical level it was type C3C with 72.1 percent; according to gender, 65.2 percent of the C-shaped canals corresponded to females. Conclusion: The prevalence of C-shaped canals in mandibular second molars evaluated in cone beam tomography was 65.5% with a higher predominance in the female gender. The tomographic evaluation allows a better identification and internal configuration of the root canals(AU)

Atypical Radicular Anatomy in Permanent Human Teeth: A Systematic Review.

The aim of the present study is to classify and quantify the anatomical variations of teeth in terms of form and number of root canals reported in human teeth employing the classification systems proposed previously. An electronic (PubMed) and manual search were performed to identify case reports noting any of the anatomical variations. Each alteration was studied independently. The electronic search was performed using the following keywords: anatomical aberration, root canal, permanent Dentition, case report, c-shaped canal, dens invaginatus, palato-radicular groove, palato-radicular groove, palato-gingival groove, radix entomolaris, dental fusion, dental gemination, taurodontism, dilaceration. The initial search revealed 1497 papers, of which 938 were excluded after analyzing the titles and abstracts. Therefore, 559 potential papers were considered. Of those, 140 articles did not meet the inclusion criteria. For the final revision, 419 papers were considered. We found that the mandibular first premolar had the highest prevalence of C-shaped canals. Dens invaginatus was more frequently found in the mandibular lateral incisor. Taurodontism was more prevalent in the maxillary first molar and in the mandibular first molar. Dilaceration was not clearly associated with a particular tooth. The classifications systems used in this review allowed for the better understanding and analysis of the many anatomical variations present in teeth. The variations in shape most found were dens invaginatus and radix entomolaris. The most frequently reported anatomical variation was in the number of canals.

Taurodontism.

Taurodontism was hitherto considered to be a marker of oro-facial disorders. Since then, it has been reported with a moderately high-to-high prevalence on panoramic radiographs in case series of otherwise normal individuals in Brazilian, Middle Eastern and East Asian communities. This now understood higher than-formerly expected prevalence is important to the endodontist, orthodontist and restorative dentist. Therefore, the oral and maxillofacial radiologists should be aware of this phenomenon and its measurements to advise better their clinical colleagues.

Dens in dente Tipo III A: relato de caso / Dens invaginatus type III A: case report

Introdução: dens in dente é uma anomalia rara de desenvolvimento, caracterizada pela invaginação dos tecidos dentários, podendo variar de um ligeiro aumento da fosseta do cíngulo a um profundo sulco, que pode se estender até o ápice dentário. Objetivo: o objetivo do presente artigo foi relatar um caso clínico e descrever as peculiaridades dos achados clínicos e radiográficos de um dens in dente Tipo III A, com ênfase na descrição de sua morfologia completamente atípica, além das dificuldades que foram encontradas no diagnóstico e durante o tratamento endodôntico. Caso clínico: o paciente compareceu ao ambulatório de uma clínica de Endodontia com queixa de dor e leve edema. Ao exame clínico e radiográfico, observou-se imagem sugestiva de dens in dente no elemento #22, sendo, então, proposto tratamento endodôntico convencional, com estudo tomográfico. Resultados: após 1 ano e 6 meses de acompanhamento, o paciente encontrava-se assintomático. Notou-se reparo satisfatório, com formação óssea, apesar da sobre-extensão do cone. Conclusão: foi possível perceber a importância da tomografia computadorizada de feixe cônico como auxiliar no diagnóstico e planejamento da conduta frente a casos de dens in dente, principalmente por aumentar as chances de sucesso, evitando a perda precoce de elementos dentários (AU).

Introduction: Dens invaginatus is a rare dental anomalycharacterized by invagination of dental tissues, which maybe from a slight increase in the pit of the cingulum to a deep groove that may extend to the tooth apex. This report describes clinical and radiographic findings and the morphology of a completely atypical and unique anomaly, and discusses the difficulties in the diagnosis and endodontic treatment of the root canal of teeth with this complex anatomy. Clinical case: Patient seen in the outpatient clinic of the Endodontic Service with a complaint of pain and mild edema. Clinical and radiographic examinations were suggestive of invagination itooth #22, and conservative endodontic treatment and CT scans were indicated. Results: Patient was asymptomatic and had no functional disorders at 18 months of follow-up. Repair and new bone formation were satisfactory, despite cone overextension. Conclusion: Cone-beam CT seems to be an important method of diagnosis and treatment planning in cases of dens invaginatus, especially because it increases the chances of treatment success and prevents the early loss of teeth (AU).

Tratamento com MTA Repair HP de extensa perfuração radicular após iatrogenia: relato de caso / Treatment with MTA Repair HP of extensive root perforation after iatrogeny: case report

Objetivo: relatar um caso clínico de perfuração radicular causada por iatrogenia, em terço cervical e médio de um incisivo central superior, dente 21, com presença de lesão óssea periapical. Relato de caso: clinicamente, pôde-se constatar ausência de edema e fístula. Na avaliação da condição pulpar e dos tecidos perirradiculares, o dente apresentou dor na palpação, ausência de mobilidade e de dor em percussão vertical e horizontal. Após os exames de imagem obtidos por meio de tomografia computadorizada de feixe cônico (TCFC; Prexion 3D), constatou-se lesão perirradicular extensa, canal radicular obliterado e perfuração radicular em face vestibular após tentativa de acesso cirúrgico. Como escolha de tratamento, optou-se por recuperar o trajeto original do canal de maneira a obter acesso intracanal, realização do preparo químico-mecânico e obturação pela técnica do cone único, para posteriormente promover o selamento adequado da perfuração com MTA Repair HP (Angelus, Londrina, PR, Brasil). Após seis meses, o dente apresentava-se assintomático e, radiograficamente, observou-se o reparo da lesão periapical. Considerações finais: o correto planejamento, o conhecimento dos materiais utilizados e a abordagem terapêutica foram de suma importância para o manejo adequado do caso. (AU)

Objective: to report a clinical case of root perforation, caused by iatrogeny in the cervical and middle third of an upper central incisor, tooth 21, with presence of periapical bone lesion. Case report: clinically, there was no edema and fistula. Facing the evaluation of the pulp condition and the periradicular tissues, the tooth presented pain on palpation, absence of mobility and pain on vertical and horizontal percussion. After the imaging exams, obtained by cone-beam computed tomography (CBCT; Prexion 3D), extensive periradicular lesion, obliterated root canal and root perforation were observed in the buccal face after attempted surgical access. As a choice of treatment, we chose to recover the original path of the canal in order to obtain intracanal access, chemicomechanical preparation and obturation by the single-cone technique to later promote proper sealing of the perforation with MTA Repair HP (Angelus, Londrina, PR, Brazil). After six months, the tooth was asymptomatic and, radiographically, the repair of the periapical lesion was observed. Final considerations: the correct planning, knowledge of the materials used and therapeutic approach were of paramount importance for the proper management of the case. (AU)

Novel dental phenotype in non-syndromic Pierre Robin Sequence: A retrospective study.

OBJECTIVE: The objective was to investigate dental phenotypes in individuals with non-syndromic Pierre Robin Sequence (ns-PRS) and compare the prevalence of these phenotypes with subjects with non-syndromic cleft palate (ns-CP) and a control group with subjects without any craniofacial anomalies. METHODS: A total of 760 panoramic radiographs of 330 individuals (110 with ns-PRS; 110 with ns-CP and 110 without any malformations) were digitized and evaluated regarding the diagnosis of taurodontism, tooth agenesis, root dilaceration and tooth transposition. Chi-square test was applied to compare the occurrence of dental phenotypes between groups. A P value of less than 0.05 was considered statistically significant. RESULTS: Total prevalence of dental phenotypes was 94.5% of ns-PRS; 54.5% of ns-CP and 59.1% of the control group subjects with a statistically significant difference for the ns-PRS when compared to the other two groups. Two dental phenotypes, taurodontism and dental agenesis were identified with statistically significant higher prevalences in subjects with ns-PRS when compared with the ns-CP group and the control group (p < 0.001). Taurodontism was the most prevalent dental phenotype, with 92.73% in the ns-PRS group, 40.91% for ns-CP and 44.55% in the control group. Tooth agenesis had a prevalence of 22.7% for ns-PRS, 4.5% for ns-CP and no case in the control group. For the prevalence of root dilaceration and tooth transposition, no statistically significant differences were observed between the three groups. CONCLUSIONS: Due to the high frequency of taurodontism in individuals with ns-PRS, we suggested that this novel phenotype would be important in the phenotypic screening of ns-PRS and could be considered as a phenotype associated with ns-PRS.

Comparison of canal transportation and centering ability of Xp Shaper, WaveOne and Oneshape: a cone beam computed tomography study of curved root canals.

The aim of the present study was to investigate the shaping abilities of XP Shaper and compare it with other single file rotary NiTi systems utilizing full rotation and reciprocation motion, by cone beam computed tomography. Mesiobuccal canals of forty-five mandibular first molars, were allocated into three equal groups (n=15) according to the rotary system applied; WaveOne, OneShape and XP shaper. Pre-and post-instrumentation images were obtained at 3mm, 5mm and 7mm from the apex using cone beam computed tomography and assessed to determine canal transportation and centering ability. Data were analyzed using Kruskal-Wallis test to compare the three systems and Friedman's test to compare the root levels. Results showed that WaveOne and OneShape rotary systems produced greatest mean transportation with no statistically significant difference between them, while XP Shaper produced the lowest statistically significant mean transportation. Canal centering ability differed significantly among the three systems used. It was concluded that XP shaper preserved the original canal anatomy better than WaveOne and OneShape rotary systems.

El objetivo del presente trabajo fue investigar la capacidad de tallado apical de XP Shaper y compararla con dos sistemas de NiTi, rotatorio y reciprocante, mediante tomografías computarizadas de haz cónico. Se analizaron los canales mesio vestibulares de cuarenta y cinco primeros molares inferiores. Los dientes fueron divididos en tres grupos experimentales (n=15): WaveOne, OneShape and XP shaper. Se obtuvieron imágenes pre y post instrumentación a 3mm, 5mm y 7 mm del ápice utilizando tomografías computadas de haz cónico para determinar la presencia de transporte apical y la capacidad de conservación de la anatomía original del conducto. Se utilizó el test deKruskal-Wallis para comparar los tres sistemas de intrumentación y el test de Friedman para comparar las mediciones en los tres niveles de raíz. XP Shaper mostró la menor cantidad de transporte apical estadísticamente significativa mientras que WaveOne y OneShape mostraron el mayor transporte apical sin diferencia estadísticamente significativa entre los dos grupos. XP shaper permitió conservar la anatomía del canal original mejor que WaveOne y OneShape.

Five canals on mandibular first molar successfully managed by undergraduate dental student: an educational case report

Undergraduate dental student's eligibility and ability to treat difficult endodontic cases is a new area open for debate. a fifth year undergraduate dental student managed to perform a successful root canal treatment (RCT) on a 42 year old male patient diagnosed as a rare case of mandibular first molar with five root canals. as an educational case report, in a country like Sudan, close supervision and clinical training of undergraduate students in treating difficult endodontic cases is recommended.

Taurodontism and its forensic value: a case report.

Taurodontism is an anomaly that affects posterior teeth, vertically increasing the size of the pulp chamber, mimicking the shape of bovine teeth, being only evidenced in diagnostic images. This report describes a case of taurodontism in a mandibular second molar, highlighting the forensic importance of this dental anomaly with relevant potential for human identification, not only for its morphological aspect but also for its relatively low frequency in mandibular second molars. In the case under study, the individual did not have any restored teeth. Thus, the set of diverse imaging modalities is fundamental to identify the anatomy of teeth and roots, the only information that could be used in a hypothetical identification situation, assigning to this anomaly an exceptional relevance as a potential characteristic for positive identification.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis

ABSTRACT Introduction: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). Methods: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. Results: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). Conclusion: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar a prevalência de anomalias dentárias em uma subpopulação de pacientes ortodônticos com agenesia de incisivos laterais superiores (ILS). Material e Métodos: o material do presente estudo incluiu os registros de 1964 pacientes ortodônticos. Radiografias panorâmicas e modelos de estudo foram usados para analisar outras anomalias dentárias associadas, incluindo a agenesia de outros dentes, dens invaginatus, dens evaginatus, ILS conoides, taurodontismo, calcificação pulpar, dilaceração radicular e impacção do canino superior. Resultados: dos 1964 pacientes examinados, constatou-se que 90 tinham agenesia do ILS, o que representa uma prevalência de 4,6%. As anomalias associadas mais comumente encontradas foram a agenesia de outros dentes (23,3%), ILS conoides (15,6%), taurodontismo (42,2%) e dentes com dilaceração (18,9%). Conclusão: a agenesia de dentes permanentes, o taurodontismo, incisivos laterais superiores conoides e dilaceração radicular estão frequentemente associados à agenesia de incisivos laterais superiores.

Taurodontism, Root Dilaceration, and Tooth Transposition: A Radiographic Study of a Population With Nonsyndromic Cleft Lip and/or Palate.

OBJECTIVES: In an effort to contribute to proper dental planning and define possible dental phenotypes of nonsyndromic cleft lip and/or palate (CL/P), this study aimed to investigate the occurrence of taurodontism, root dilaceration, and tooth transposition in persons with nonsyndromic CL/P, specifically analyzing the differences among gender, cleft types, and the most affected teeth. DESIGN: This retrospective study analyzed 974 panoramic x-rays from nonsyndromic Brazilians older than 16 years and categorized into the following four groups: group 1, 250 persons with unilateral cleft lip and palate; group 2, 250 persons with unilateral cleft lip; group 3, 224 persons with cleft palate; and a control group of 250 persons without clefts. Radiographs were digitalized with a scanner and analyzed. RESULTS: In the Brazilian population studied, the prevalence of taurodontism was 60.4% in group 1, 62.4% in group 2, 67.0% in group 3, and 42.8% in the control group. Root dilacerations had a prevalence of 31.2% in group 1, 29.6% in group 2, 26.3% in group 3, and 27.2% in the control group. The teeth most affected by taurodontism were 17 and 27; whereas root dilacerations were most common in teeth 38 and 48. No tooth transpositions were found in any radiograph analyzed. CONCLUSIONS: Taurodontism is significantly more prevalent in Brazilians with nonsyndromic CL/P than in persons without clefts; whereas the prevalence of root dilaceration no different from that in the control group. However, root dilacerations in anterior teeth were increased in groups 1 and 2 when compared to the control group.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis.

INTRODUCTION:: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). METHODS:: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. RESULTS:: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). CONCLUSION:: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

Taurodontism in patients with nonsyndromic cleft lip and palate in a Brazilian population: a case control evaluation with panoramic radiographs.

OBJECTIVES: The purpose of this study was to evaluate the prevalence of taurodontism in patients with nonsyndromic cleft lip and palate (NSCLP) within a Brazilian population. STUDY DESIGN: The study was designed as an epidemiologic case-control single-center study. Three hundred eighty-eight patients were included: 88 had NSCLP, and 300 comprised the control group. The first and second permanent mandibular molars were included in this study. By using panoramic radiographs, taurodontism was categorized as mesotaurodontism, hypotaurodontism, and hypertaurodontism. RESULTS: Seventy patients (23.3%) from the control group and 36 patients (40.9%) from the case group presented taurodontism (P < .001). In the control group, 108 (9%) teeth showed taurodontism, whereas in the case group with cleft lip and palate (CLP), 64 (18.2%) teeth showed dental anomalies (P < .001). In both groups, most taurodontic teeth presented hypotaurodontism, followed by mesotaurodontism, while hypertaurodontism was found in only two teeth. The probability of taurodontism in patients with cleft lip (CL) was 2.36 (P = .010) times higher compared with those with CLP, whereas the occurrence of taurodontism in patients with cleft palate (CP) was 3.15 (P = .002) times greater than in patients with CLP. CONCLUSIONS: The results from this study indicate a close relationship between taurodontism and NSCLP and the possibility of different cleft subphenotypes.

Prevalence of dental anomalies on panoramic radiographs in a population of the state of Pará, Brazil.

INTRODUCTION: Dental anomalies (DAs) are the result of disorders that are able to modify the shape, number, size, and structure of teeth. This study aimed to evaluate the prevalence of DAs using panoramic radiographs in a population of the City of Belém, northern Brazil. MATERIALS AND METHODS: In this study, 487 panoramic radiographs were evaluated searching for DAs. Dental records were reviewed for diagnostic confirmation. DAs related to the shape, number, size, and structure of teeth were investigated. RESULTS: Our results showed a DA prevalence of 56.9%. The most prevalent DA was taurodontism, which was present in 27.19% of cases. Root dilaceration was the second most prevalent DA in adults, whereas hypodontia was the second most prevalent DA in children. A total of 13 DAs were found. CONCLUSIONS: Dental anomalies were present in over half of the sample, and most of them were related to the shape of the teeth. Although there was a high prevalence of shape-related DAs, these alterations are generally of lower severity, and most do not require specific treatment. However, in 19.25% of cases, DAs were found involving the number, size and structure of the teeth. These DAs should be diagnosed and treated early, avoiding thus more serious complications.

Classification of bifid mandibular canals using cone beam computed tomography.

The objective of this study was to classify the morphology of bifid mandibular canals and to evaluate their relationship with the roots of third molars, using cone beam computed tomography (CBCT) scans. The CBCT scans of 75 patients were analyzed and the bifurcations were classified according to Langlais et al. (1985). The relationship of bifurcation and third molars was established according to the following classification: class A--uninvolved, class B--close relationship, class C--intimate relationship and class D--absence of third molars. Data were submitted to descriptive statistics, and the results indicated that the patients' mean age was 48.2 (± 13.2) years. Unilateral bifurcation (Type 1) was the most frequent type (72.6%), followed by unilateral Type 2 (19.3%). Class D was the most frequent (57.33%), followed by class C (21.33%), class B (13.33%) and class A (8%). It could be concluded that most cases presented unilateral bifid mandibular canals extending to the third molar or adjacent regions, and when present, the roots seemed to be a continuation of the bifid mandibular canal.

Classification of bifid mandibular canals using cone beam computed tomography

The objective of this study was to classify the morphology of bifid mandibular canals and to evaluate their relationship with the roots of third molars, using cone beam computed tomography (CBCT) scans. The CBCT scans of 75 patients were analyzed and the bifurcations were classified according to Langlais et al. (1985). The relationship of bifurcation and third molars was established according to the following classification: class A - uninvolved, class B - close relationship, class C - intimate relationship and class D - absence of third molars. Data were submitted to descriptive statistics, and the results indicated that the patients' mean age was 48.2 (± 13.2) years. Unilateral bifurcation (Type 1) was the most frequent type (72.6%), followed by unilateral Type 2 (19.3%). Class D was the most frequent (57.33%), followed by class C (21.33%), class B (13.33%) and class A (8%). It could be concluded that most cases presented unilateral bifid mandibular canals extending to the third molar or adjacent regions, and when present, the roots seemed to be a continuation of the bifid mandibular canal.

Incisivo lateral superior con dos raíces y dos conductos: caso clínico / Upper lateral incisor with two roots and two canals: a clinical case

Las anomalías en la morfología del incisivo lateral superior son de muy baja frecuencia. Las anomalías de desarrollo radicular pueden presentarse como alteraciones tanto en el número de conductos, como en el número de raíces, así como en ambas regiones a la vez. En el presente trabajo, se reporta el caso de un paciente que se presenta a la consulta con malestar en el incisivo lateral superior izquierdo. En laradiografía preoperatoria se detectó la presencia de dos conductos y dos raíces, sin anomalía morfológica de su corona clínica, con requerimiento de tratamiento endodóntico. Concluimos que una correcta interpretación de las imágenes radiográficas preoperatorias es esencial, para poder detectar estas variantes y tomar las consideraciones necesarias para el adecuado tratamiento endodóntico

Abnormalities in the morphology of the maxillary lateral incisor are very low frequency. Root development abnormalities can occur as alterations in the number of ducts and the number of roots, as well as two regions at once. In this paper, we report the case of a patient presenting with discomfort in the upper left lateral incisor. In preoperative radiography, we detected the presence of two channels and two roots, without morphological abnormality in clinical crown, with endodontic treatment requirement. We conclude that a correct interpretation of preoperative radiographic imaging is essential in order to detect these variants and take the necessary considerations for proper endodontic treatment.