Mandibular pre-molars endodontic anatomy and role in sex dimorphism for Western Asia population using CBCT 3d imaging technique / Anatomía endodóntica de premolares mandibulares y papel en el dimorfismo sexual para la población de Asia Occidental utilizando la técnica de imagen 3d CBCT

SUMMARY: Cone Beam Computerized Tomography (CBCT) imaging technique can be used for identifying the root canal anatomy and its use in determining sexual dimorphism. The aim of current study was to identify the commonly found root canal morphology and gender dimorphism for mandibular pre-molars in Western Asia population according to Vertucci's classification using CBCT 3D imaging technique. On ethical approval 470 patients from Western Asia population with intact healthy mandibular first and second pre-molars were included in the study. The selected patients were sent to radiology department of Riyadh Elm University, Saudi Arabia for CBCT images. The observations recorded included: i) number of roots; and ii) type of root canal morphology based on Vertucci's classification. All the mandibular first and second pre-molars had single root both in males and females. The type of Vertucci's classification commonly observed was Type I both in males (88.94 %) and females (100 %) in mandibular first pre-molars. Similarly Type I was identified as a common root canal configuration in mandibular second pre-molars for males (82.77 %) and females (100 %). The two canal configurations Type IV and V were only observed in the males. It can be concluded from the results mandibular first and second pre-molars in the Western Asia population are single rooted with common Vertucci's Type I canal configuration in the females with rare evidence of two canals in males. Additionally CBCT is an effective technique and should be used for detection of root canals in the mandibular pre-molars which can aid dentists in providing a successful endodontic therapy.

RESUMEN: La imagen de la tomografía computarizada de haz cónico (CBCT) se puede utilizar para identificar la anatomía del conducto radicular y para determinar el dimorfismo sexual. El objetivo del estudio fue identificar la morfología del conducto radicular y el dimorfismo de sexo, comúnmente encontrados en los premolares mandibulares en la población de Asia occidental, de acuerdo con la clasificación de Vertucci, utilizando la técnica de imágenes CBCT 3D. Tras la aprobación ética, se incluyeron en el estudio 470 pacientes de la población de Asia occidental con primeros y segundos premolares mandibulares sanos intactos. Los pacientes seleccionados fueron enviados al departamento de radiología de la Universidad de Riyadh Elm, Arabia Saudita, para las imágenes CBCT. Las observaciones incluyeron: i) número de raíces; y ii) tipo de morfología del conducto radicular según la clasificación de Vertucci. Se observó solamente una raíz en los primeros y segundos premolares mandibulares tanto en hombres como en mujeres. El tipo de clasificación de Vertucci comúnmente observado fue Tipo I tanto en hombres (88,94 %) como en mujeres (100 %) en los primeros premolares mandibulares. El Tipo I se identificó como una configuración común del conducto radicular en los segundos premolares mandibulares para hombres (82,77 %) y mujeres (100 %). Ambas configuraciones de canal Tipo IV y V solo se observaron en los varones. Se puede concluir a partir de los resultados de los primeros y segundos premolares mandibulares en la población de Asia occidental, que éstos tienen una sola raíz con una configuración de canal de Vertucci Tipo I común en mujeres con una evidencia de dos canales infrecuente en los hombres. La CBCT es una técnica eficaz y debe usarse para la detección de conduc- tos radiculares en los premolares mandibulares, lo que puede ayu- dar a los dentistas a proporcionar una terapia endodóntica exitosa.

Cone-beam computed tomography study of C-shaped root canal of mandibular premolars / 口腔疾病防治

Objective@#To investigate the incidence and morphology of C-shaped root canals in mandibular premolars by cone-beam computed tomography (CBCT) imaging, which provides a reference for clinical diagnosis and treatment.@*Methods @#The CBCT scanning data of 964 mandibular first premolars and 907 mandibular second premolars in 508 cases were collected, and the root canal morphology, incidence of C-shaped root canals, bilateral symmetry and location of radicular grooves were analyzed.@*Results@#The incidence of C-shaped root canals in mandibular first premolars was 4.1% and that in mandibular second premolars was 0.6%. The incidence of C-shaped root canals of mandibular first premolars was significantly higher than that of mandibular second premolars (χ2=25.775, P < 0.001). The symmetrical ratio of C-shaped root canals in the mandibular first premolars was 29%. There were no symmetrical C-shaped root canals in the mandibular second premolars. There were significant differences in the distribution of the C-shaped root canal configuration in the root canal (P < 0.001). The C-shaped configuration mainly existed in the middle axial and apical level of the mandibular premolars. The C2 type was more common. No C-shape was found in the coronal level of the mandibular premolars. Vertucci I single tube type was the most common type of root canal for the mandibular premolars included in this study; the incidences were 81.7% and 98.3% for the mandibular first and second premolars, respectively, and the difference was statistically significant (χ2=140.544, P < 0.001). The other root canal types of mandibular first premolars were more than those of mandibular second premolars. The incidences of Vertucci Ⅱ, Ⅲ, Ⅳ, and Ⅴ and C-shaped root canals in mandibular first premolars were significantly higher than those in mandibular second premolars. C-shaped root canal mandibular premolars had radicular grooves, and most of them were located at the mesiolingual side.@*Conclusion@# The morphology of the C-shaped root canal in mandibular premolars was complicated. CBCT can provide direct and accurate imaging evidence for clinical diagnosis and treatment.

Tooth Agenesis and Delay in Patients with Agenesis of Mandibular Second Premolars / 대한소아치과학회지

Tooth agenesis is a common human dental anomaly and the agenesis of mandibular second premolars has been proven to be the most frequently observed. The aim of this study is to investigate tooth agenesis and delayed tooth development in patients with agenesis of mandibular second premolars.This study reviewed 9 to 15 year-old patients with agenesis of mandibular second premolars who visited the department of pediatric dentistry of Yonsei University Dental Hospital and took panoramic radiographs from January 2014 to December 2016. On panoramic radiographs, agenesis of teeth was observed and developmental delay of teeth was evaluated by the Nolla method. Among 125 patients with agenesis of mandibular second premolars, 58 patients (46.4%) showed agenesis of other teeth and 38 patients (30.4%) showed delayed tooth development. In this study, patients with agenesis of mandibular second premolars were more likely to have tooth agenesis or delayed eruption of other teeth.

Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report

This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year-old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year-old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

Prevalence of the two variants of mandibular second premolars in Kerala population / Prevalencia de las dos variantes de segundos premolares mandibulares en población Kerala

Mandibular second premolars, though generally are included under bicuspids, are of two types, the 2 cusp and 3 cusp varients. The aim was to determine the prevalence of the two varieties of mandibular second premolars in Kerala population, South India. This descriptive investigation was undertaken in two dental colleges of Kerala, India. A total of 2500 mandibular second premolars were examined for cuspal variations, groove patterns and gender predilection. A slight predilection (52.8 percent) for 2-cusp variety was noticed. The most frequent occlusal configuration were crescent shaped and Y groove patterns for 2 cusp and 3 cusp varieties of second premolars respectively...

Los segundos premolares mandibulares, aunque por lo general se clasifican como bicuspídeos, tienen dos tipos de variantes, de 2 y 3 cúspides. El objetivo de esta investigación fue determinar la prevalencia de las dos variedades de segundos premolares mandibulares en población Kerala, en el sur de la India. Esta investigación descriptiva se realizó en dos Universidades dentales de Kerala, India. En un total de 2500 segundos premolares mandibulares se examinaron las variaciones cuspídeas, patrones de surcos y la predilección según sexo. Se observó una ligera predilección [52,8 por ciento] para la variedad de 2 cúspides. Las configuraciones oclusales de los segundos premolares más frecuentes fueron los patrones de surco en forma de media luna y en forma de Y para las variantes de 2 y 3 cúspides, respectivamente...

Endodontic Miscellarny : A Mandibular Second Bicuspid With Three Root Canals.

The main objective of endodontic therapy is the restoration of the tooth to its proper form and function. In recent years increasing emphasis is laid on retaining pulpally involved teeth by dentists. To achieve satisfactory root canal therapy, a proper and in-depth knowledge of complex and abnormal root canal morphology is essential. Recognition of abnormal configuration enables the operator to better debride and obturate the root canal space to afford greater success in endodontics. Mandibular second premolar has a number of variations; one among them is having three root canals. This article describes a case of mandibular second bicuspid with unusual canals that is treated successfully.

Two-Rooted Mandibular First Premolar : Case Report.

Abnormalities in the root canal anatomy are a commonly occurring phenomenon. A thorough knowledge of the root canal anatomy and its variations is necessary for successful completion of the endodontic treatment. Mandibular second premolars usually have a single root and a single root canal. The incidence of two separate roots itself in this tooth is quite rare. Mandibular premolars are known for having an aberrant anatomy. Often considered an enigma to the endodontist, the mandibular first premolar with dual canals dividing at various levels of the root can generate complex mechanical problems.Reports about the incidence of extra roots in these teeth are quite rare. This paper attempts at explaining a rare case of successful endodontic management of a two-rooted mandibular second premolar with awareness of data pertaining to the number of canals, knowledge of canal morphology, correct radiographic interpretation, and tactile examination of canal walls which are important in detecting the presence of multiple canals.

Root canal treatment of a mandibular second premolar with three separate root canals / 대한치과보존학회지

Mandibular premolars show a wide variety of root canal anatomy. Especially, the occurrence of three canals with three separate foramina in mandibular second premolars is very rare. This case report describes the root canal treatment of an unusual morphological configuration of the root canal system and supplements previous reports of the existence of such configuration in mandibular second premolar.