A critical analysis of laboratory and clinical research methods to study root and canal anatomy

Ahmed, Hany Mohamed Aly

doi:10.1111/iej.13702

Cited by 36 publications

(58 citation statements)

References 258 publications

(454 reference statements)

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“…Micro-computed tomography may have yielded a higher resolution and allowed observation of finer details in comparison to CBCT. However, this modality is expensive, time-consuming, and cannot be used on living subjects [33].…”

Section: Discussionmentioning

confidence: 99%

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems

et al. 2022

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Purpose: An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans. Methods: Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05). Results: Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al.1 MP 1 ) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created. Conclusion: Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems

et al. 2022

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“…Therefore, care should be taken before drawing conclusions related to the presented results and invasive and unnecessary procedures should be avoided [ 33 ]. A recent study showed that CBCT studies can be present with limitations associated with the image resolution (voxel size, focal distance, FOV), artifacts created by filling or restorations, and the possible movement of patients during scanning [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study

et al. 2022

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Objectives This study aimed to evaluate the prevalence of apical periodontitis (AP) in the mesiobuccal roots of root canal-treated maxillary molars. Materials and Methods One thousand cone-beam computed tomography images of the teeth were examined by 2 dental specialists in oral radiology and endodontics. The internal anatomy of the roots, Vertucci’s classification, quality of root canal treatment, and presence of missed canals were evaluated; additionally, the correlation between these variables and AP was ascertained. Results A total of 1,000 roots (692 first molars and 308 second molars) encompassing 1,549 canals were assessed, and the quality of the root canal filling in the majority (56.9%) of the canals was satisfactory. AP was observed in 54.4% of the teeth. A mesiolingual canal in the mesiobuccal root (MB2 canal) was observed in 54.9% of the images, and the majority (83.5%) of these canals were not filled. Significant associations were observed between the presence of an MB2 canal and the quality of the root canal filling and the presence of AP. Conclusions AP was detected in more than half of the images. The MB2 canals were frequently missed or poorly filled.

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“…reducing the likelihood of any potential imaging artefact. There is no superimposition of soft or hard tissue (which can be removed before scanning with micro-CT) that could impair image interpretation in a clinical setting (59). Endodontic research employing extracted teeth yields comprehensive and reliable information regarding a certain anatomy.…”

Section: Type Of Studymentioning

confidence: 99%

“…[SMI]) clinical implementations (59). Researchers and clinicians are highly encouraged to collaborate and conduct laboratory studies with clinical translation (such as methods of detection and preparation of different canal configurations), transferring such important relevant information into a clinical setting.…”

Section: Future Directionsmentioning

confidence: 99%

Root and canal anatomy of mandibular first molars using micro-computed tomography: A systematic review

AL-Rammahi

Chai

Nabhan

et al. 2023

Preprint

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Background A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT based literature about the anatomy of root and canal system in permanent mandibular first molars. Method An electronic search was performed on Web of science, PubMed, and Scopus. Published micro-CT journal articles in English that present the root and canal anatomy of permanent 2-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted following the PRISMA statement guidelines. Risk of bias assessment of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables or figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. Results Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential risk of bias was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. Conclusion There is a considerable heterogeneity in the methodological procedures used to study root canal anatomy in micro-CT studies, however, all involved studies showed that the root canal anatomy of the permanent mandibular first molar is highly variable. Protocol and registration The protocol of this systematic review was prospectively registered in the Open Science Framework database (https://osf.io) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.

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A critical analysis of laboratory and clinical research methods to study root and canal anatomy

Cited by 36 publications

References 258 publications

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems

Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study

Root and canal anatomy of mandibular first molars using micro-computed tomography: A systematic review

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