C-shaped Canal System in Maxillary Molars Evaluated by Cone- Beam Computed Tomography in an Argentine subpopulation / Conductos en C en molares superiores evaluados mediante tomografía cone-beam en una sub-población Argentina

ABSTRACT The aim of the present study was to evaluate the presence of maxillary first and second molars with a C-shaped canal system in an Argentine subpopulation, and to classify them. Materials and Method: Of the 332 CBCTs initially evaluated, 120 met the selection criteria. Once the presence of a C-shaped canal system had been established, the teeth were classified following Martins et al. Data were expressed as absolute frequencies, percentages with of 95% confidence intervals, according to the score test. Comparisons were analyzed by Chi-square test and Fisher' exact test, with 5% significance level. Results: It was found that 5 out of 120 first molars (4%) and 17 out of 152 second molars (11%) had a C-shaped canal system. Regarding the classification applied, of 5 C-shaped first molars, 2 corresponded to type E2 (40%), 2 corresponded to type C (40%), and 1 corresponded to type B1 (20%). Of 17 C-shaped second molars, 4 resembled a type A (24%), 7 resembled a type B1 (41%), 5 resembled a type B2 (29%), and 1 resembled a type C (6%). UC1 and UC2 configurations were the most common at all levels except apical level. Conclusion: The prevalence of C-shaped canal system pattern in maxillary first and second molars was estimated for the first time in an Argentine subpopulation, in vivo. Knowledge of these data should help clinicians during endodontic treatment.

RESUMEN El objetivo del presente estudio fue evaluar la presencia de conductos en C en primeros y segundos molares superiores, en una subpoblación de Argentina. Materiales y Método: Se observaron 332 CBCTs, de las cuales 120 cumplieron los criterios de selección. Una vez determinada la presencia de conducto en C se clasificaron según Martins et al. Los datos fueron descriptos mediante frecuencias absolutas y porcentajes, con intervalos de confianza al 95% (IC95), según método score. Las comparaciones fueron analizadas mediante la prueba de Chi-cuadrado o exacta de Fisher con un nivel de significación del 5%. Resultados: De 120 primeros molares, 5 presentaron conductos en C, es decir un 4% y de 152 segundos molares, 17 presentaron conductos en C, es decir un 11%. Según la clasificación aplicada, de 5 primeros molares en C, 2 correspondieron al tipo E2 (40%), 2 al tipo C (40%) y 1 al tipo B1 (20%). De 17 segundos molares en C, 4 pertenecieron al tipo A (24%), 7 al tipo B1 (41%), 5 al tipo B2 (29%) y 1 al tipo C (6%). Las clasificaciones UC1 y UC2 fueron las más representativas en todos los niveles, excluyendo el tercio apical. Conclusión: La prevalencia de conductos en C en primeros y segundos molares superiores, fue estimada por primera vez en una subpoblación Argentina, in vivo. Los datos obtenidos en el presente estudio, resultan de interés para el abordaje de los tratamientos endodónticos.

Resolution of Odontogenic Sinus Pathosis by Endodontic Microsurgery.

A case report is presented, in which a tooth with a chronic apical abscess that has caused a maxillary sinusitis was treated with an endodontic microsurgery. A 65-year-old female patient reported discomfort in a maxillary tooth gingiva. Clinically, a dental metal-ceramic bridge with adequate marginal adaptation, involving teeth from maxillary right canine to maxillary right second molar, was observed. The periapical radiograph showed the adequate adaptation of the crown and post in the maxillary right first premolar, an apical lesion, and the heavy thickening of the maxillary sinus floor mucosa. The diagnosis established in the maxillary right first premolar was of a previously treated tooth and a chronic apical abscess. Considering the accurate fixed prosthesis adaptation and the impossibility of disassembling the five-piece-metal-ceramic bridge to perform a new endodontic treatment and the prosthetic restoration, an endodontic microsurgery of this tooth was performed. The post-treatment follow-up of 12-month recall showed a normal thickness sinus membrane and a regenerating cortical bone. The proposed microsurgery has enabled the maintenance of the existing prosthetic rehabilitation of the tooth that caused the sinus pathosis.

C-shaped Canal System in Maxillary Molars Evaluated by Cone- Beam Computed Tomography in an Argentine subpopulation.

The aim of the present study was to evaluate the presence of maxillary first and second molars with a C-shaped canal system in an Argentine subpopulation, and to classify them. MATERIALS AND METHOD: Of the 332 CBCTs initially evaluated, 120 met the selection criteria. Once the presence of a C-shaped canal system had been established, the teeth were classified following Martins et al. Data were expressed as absolute frequencies, percentages with of 95% confidence intervals, according to the score test. Comparisons were analyzed by Chi-square test and Fisher' exact test, with 5% significance level. RESULTS: It was found that 5 out of 120 first molars (4%) and 17 out of 152 second molars (11%) had a C-shaped canal system. Regarding the classification applied, of 5 C-shaped first molars, 2 corresponded to type E2 (40%), 2 corresponded to type C (40%), and 1 corresponded to type B1 (20%). Of 17 C-shaped second molars, 4 resembled a type A (24%), 7 resembled a type B1 (41%), 5 resembled a type B2 (29%), and 1 resembled a type C (6%). UC1 and UC2 configurations were the most common at all levels except apical level. CONCLUSION: The prevalence of C-shaped canal system pattern in maxillary first and second molars was estimated for the first time in an Argentine subpopulation, in vivo. Knowledge of these data should help clinicians during endodontic treatment.

El objetivo del presente estudio fue evaluar la presencia de conductos en C en primeros y segundos molares superiores, en una subpoblación de Argentina. Materiales y Método: Se observaron 332 CBCTs, de las cuales 120 cumplieron los criterios de selección. Una vez determinada la presencia de conducto en C se clasificaron según Martins et al. Los datos fueron descriptos mediante frecuencias absolutas y porcentajes, con intervalos de confianza al 95% (IC95), según método score. Las comparaciones fueron analizadas mediante la prueba de Chi-cuadrado o exacta de Fisher con un nivel de significación del 5%. Resultados: De 120 primeros molares, 5 presentaron conductos en C, es decir un 4% y de 152 segundos molares, 17 presentaron conductos en C, es decir un 11%. Según la clasificación aplicada, de 5 primeros molares en C, 2 correspondieron al tipo E2 (40%), 2 al tipo C (40%) y 1 al tipo B1 (20%). De 17 segundos molares en C, 4 pertenecieron al tipo A (24%), 7 al tipo B1 (41%), 5 al tipo B2 (29%) y 1 al tipo C (6%). Las clasificaciones UC1 y UC2 fueron las más representativas en todos los niveles, excluyendo el tercio apical. Conclusión: La prevalencia de conductos en C en primeros y segundos molares superiores, fue estimada por primera vez en una subpoblación Argentina, in vivo. Los datos obtenidos en el presente estudio, resultan de interés para el abordaje de los tratamientos endodónticos.

Maxillary incisor internal root anatomy evaluated by cone-beam computed tomography in a population of the Autonomous City of Buenos Aires, Argentina.

In the field of anthropology, discrete traits are considered as minimal epigenetic variations. However, they can elicit complications in endodontic therapy. Thorough understanding of root canal morphology is essential to achieving predictable results in endodontic practice, and may be attained by using cone-beam computed tomography (CBCT) scans. The aim of the present study was to research the internal root anatomy of maxillary central and lateral incisors in vivo and quantify its variation in a population of the Autonomous City of Buenos Aires, Argentina. A total 697 CBCT scans from a pre-existing database were observed, and the configuration type for each tooth was determined according to Vertucci's classification. The data were described by absolute frequencies and percentages with 95% confidence intervals (CI). The CI was estimated by the Wilson Score method. Chi-square test (χ2) was used for comparing frequencies, with a 5% significance level. 238 CBCT scans met the inclusion criteria, resulting in 761 teeth assessed. Vertucci Type I configuration was observed in 760 teeth (99.9%) and the Type II was found in only one tooth (0.1%), in which the anatomy was compatible with dens in dente. When differences were analyzed according to sex, all the teeth in all women had Vertucci Type I configuration. In men, all maxillary central incisors were Vertucci Type I. Of 151 maxillary lateral incisors, 150 had Vertucci Type I configuration (99.3%) and 1 had Type II (0.7%). Conclusions: Maxillary incisor internal root anatomy prevalence was estimated from CBCT scans for the first time in an Argentine population. 99.9% of the sample presented Vertucci Type I configuration, and 0.1% had Vertucci Type II configuration. The clinical finding of maxillary incisors with anatomical complexity should be considered as a possibility in endodontic practice.

En el ámbito de la antropología, los rasgos discretos son considerados variaciones epigenéticas mínimas, pero pueden traer complicaciones en la terapia endodóntica. Comprender la morfología del conducto radicular es fundamental para lograr resultados predecibles en la práctica endodóntica, y esto puede lograrse mediante el uso de la tomografía cone-beam (CBCT). El objetivo de este trabajo fue investigar de manera in vivo la anatomía radicular interna de incisivos centrales y laterales superiores, y cuantificar su variación en una población de la Ciudad Autónoma de Buenos Aires, Argentina. 697 CBCTs de una base de datos preexistente fueron analizadas, y se consignó para cada pieza el tipo de configuración basada en la clasificación de Vertucci. Los datos se describieron mediante frecuencias absolutas y porcentajes con intervalos de confianza al 95% (IC95). Los IC95 fueron estimados mediante el método score de Wilson. Para la comparación de frecuencias se utilizó la prueba de Chi-cuadrado (χ2), con un nivel de significación de 5%. 238 CBCTs cumplieron con los criterios de inclusión, resultando en 761 piezas evaluadas. Se encontró un Vertucci tipo I en 760 piezas (99,9%) y se halló Vertucci tipo II en una sola pieza dentaria (0,1%), que mostraba anatomía compatible con dens in dente. Diferenciando por sexos, todas las mujeres para todas las piezas mostraron Vertucci tipo I. Los varones en sus incisivos centrales superiores poseían Vertucci tipo I en todas las piezas, y de los 151 incisivos laterales superiores, 150 mostraron tipo I de Vertucci (99,3%) y 1, tipo II (0,7%). Conclusión: La prevalencia de anatomía dentaria interna fue estimada por primera vez en una población argentina mediante CBCTs. El 99,9% de la muestra presentó un Vertucci tipo I, y el 0,1% un Vertucci tipo II. La aparición clínica de incisivos superiores con complejidad anatómica debe ser considerada posible en la práctica endodóntica.

C-Shaped canal system in mandibular premolars evaluated by cone-beam computed tomography in a population of the Autonomous City of Buenos Aires, Argentina.

OBJECTIVE: To evaluate cone-beam computed tomography images in an Argentine population in order to determine the presence of mandibular premolars with C-shaped canal system and classify them. METHODS: 697 images were observed, 170 of them fulfilling the selection criteria. Once established the presence of a C-shaped canal system, premolars were classified using Fan's criteria. Data description was made by frequencies and percentages rates, with a 95% confidence interval according to the score method. Comparisons were assessed by means of the Chi-square test with a significance level equal to 5%. RESULTS: Of 269 first premolars, 27 teeth showed C-shaped canal system, i.e. 10%, and of 231 second premolars, 4 presented C-shaped canal system, i.e. 2%. Out of 17 patients presenting first premolars in both sides, 6 showed a bilateral C-shaped canal system pattern and 11 did not present this condition. When the condition was unilateral (n = 15), 7 patients showed C-shaped canal in the tooth 3.4 and 8 patients showed C-shaped canal in the tooth 4.4. The second premolars showed C-shaped canals unilaterally. Along the canal, configuration variations at the three-thirds have been observed for the first and second mandibular premolars. CONCLUSION: The C-shaped canal system pattern prevalence in mandibular first and second premolars was estimated for the first time in an Argentine population, in vivo. The present report contributes to the epidemiological understanding of the anatomical variable of the inner dental configuration and its extrapolation to the clinical practice.