Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates

Abstract

This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.

Effect of Passive Ultrasonic Irrigation over Organic Tissue of Simulated Internal Root Resorption

“…is may be related to many factors including the endodontic instrument taper, mechanical properties [12,13], and the preliminary diagnosis [14][15][16].…”

Correlation between Tooth Position Parameters and Apical Fenestration: A Cone-Beam Computed Tomography Study

“…Given the potential clinical significance of apical fenestrations, any observed instances should be subject to confirmation through CBCT scans. This preference for CBCT scans is grounded in their well-documented efficacy in diagnosing and executing treatments, as substantiated by previous research [17]. The consequences of misdiagnosis can be severe, leading to repetitive, ineffective treatments and persistent pain, all while jeopardizing the long-term health of the affected tooth [29].…”

“…This enhances precision in evaluating small alveolar bone defects and their locations. The shift to CBCT signifies a significant improvement in diagnostic capabilities, enabling more accurate assessment of apical fenestration compared to traditional radiographic methods and thereby facilitating better-informed treatment decisions in dental care [17].…”

Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix

“…The adequate treatment planning demands an accurate diagnosis [ 23 ]; for this, CBCT scans were used in this case report due to its high resolution and its effectivity in determining the relationship between the root apexes and the adjacent anatomical structures [ 24 ], beside its capacity to localize the perforations' sites. In this case report, both furcation and postdrill perforations were closed by 5MO silicate-based cement using the mediate technique because of the presence of lesions associated to these perforations.…”