Effects of root canal enlargement on unprepared areas and coronal dentine thickness of three-rooted maxillary first premolars with different root configurations: A stepwise micro-CT study.

AIM: To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations. METHODOLOGY: Thirty three-rooted maxillary first premolars with three root configurations (n = 10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2) and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels and minimal dentine thickness. Statistical analyses were performed with one-way anova post hoc Tukey tests and paired sample t-test at a significance level of 5%. RESULTS: No statistical differences were observed amongst groups regarding the morphometric parameters and static voxels (p > .05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p < .05), whilst no differences were observed in the other roots (p > .05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction in dentine thickness was higher in the buccal roots than in the palatal root (p < .05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3. CONCLUSIONS: Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.

Prevalence of enamel pearls in teeth from a human teeth bank.

Enamel pearls are anatomical structures that can bring about clinical implications if associated with the retention of plaque, in turn resulting in periodontal disease. In an attempt to avoid periodontal disease, the removal and treatment of these enamel pearls, may be a necessity in some circumstances. A total of 45,785 extracted teeth from a human teeth bank were analyzed for the presence of enamel pearls. The most prevalent anatomical location of enamel pearls was the permanent maxillary first and second molar region. An association between the prevalence of enamel pearls and dental class (P < 0.001) was observed, most frequently in the maxillary molars. In the maxillary molars, the most prevalent anatomical location of enamel pearls in the first and second molars was the furcation between the distobuccal and palatal roots. Enamel pearls are a common observation in molars in general, but are most commonly found in maxillary molars.

Accuracy evaluation of computed tomography-derived stereolithographic surgical guides in zygomatic implant placement in human cadavers.

Presurgical planning is essential to achieve esthetic and functional implants. For implant planning and placement, the association of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques furnishes some advantages regarding tridimensional determination of the patient's anatomy and fabrication of both anatomic models and surgical guides. The goal of this clinical study was to determine the angular deviations between planned and placed zygomatic implants using stereolithographic surgical guides in human cadavers. A total of 16 zygomatic implants were placed, 4 in each cadaver, with the use of stereolithographic (SLA) surgical guides generated by computed tomography (CT). A new CT scan was made after implant insertion. The angle between the long axis of the planned and actual implants was calculated. The mean angular deviation of the long axis between the planned and placed implants was 8.06 ± 6.40 (mean ± SD) for the anterior-posterior view, and 11.20 ± 9.75 (mean ± SD) for the caudal-cranial view. Use of the zygomatic implant, in the context of this protocol, should probably be reevaluated because some large deviations were noted. An implant insertion guiding system is needed because this last step is carried out manually. It is recommended that the sinus slot technique should be used together with the CT-based drilling guide to enhance final results. Further research to enhance the precision of zygomatic implant placement should be undertaken.

Anatomical variation in the position of the greater palatine foramen.

The present study measured the position of the greater palatine foramen relative to adjacent anatomical landmarks in Brazilian skulls. The perpendicular distance of the greater palatine foramen to the midline maxillary suture in Brazilian skulls was about 14 mm and the distance of greater palatine foramen to the incisive foramen was approximately 36 mm. The distance of greater palatine foramen to the posterior border of the hard palate was approximately 3 mm, and the mean angle between the midline maxillary suture and the line from the incisive foramen and the greater palatine foramen was 22.71 degrees . In almost 70% of the cases, the greater palatine foramen opened in an anterior direction. The mean palatine length was approximately 52 mm. In the greater majority of the skulls (93.81%), the greater palatine foramina were opposite or distal to the maxillary third molar. These data will be helpful in comparing these skulls to those from various other regions as well as comparing skulls of different races. It can also provide professionals with anatomical references, in order to block the maxillary division of the trigeminal nerve through the greater palatine foramen. Our results would help clinicians locate the greater palatine foramen in patients with and without upper molars.