Evaluation of Root Canal Anatomy of Maxillary Premolars Using Swept-Source Optical Coherence Tomography in Comparison with Dental Operating Microscope and Cone Beam Computed Tomography.

OBJECTIVE: This study aimed to evaluate the ability of swept-source optical coherence tomography (OCT) to detect internal anatomy of maxillary premolars in comparison with dental operating microscope (DOM) and cone beam computed tomography (CBCT). BACKGROUND DATA: The ability of OCT to observe the pulp horn during cavity preparation and assess the remaining dentin thickness (RDT) has been demonstrated, whereas validation of OCT in comparison with other imaging techniques seems required. METHODS: Ten extracted human maxillary premolars were sectioned perpendicular to the tooth axis from the occlusal surface at approximately 2 mm increments. OCT and DOM were performed after each cut, and microfocus X-ray computed tomography (micro-CT; reference standard) and CBCT were conducted before sectioning and after the first and second cuts. Three examiners evaluated all images for presence of the pulp horn/pulp chamber, isthmus, lateral canals, and the number of root canals. RDT was determined from OCT, micro-CT, and CBCT images. Correlations were analyzed with Pearson's correlation coefficient. RESULTS: OCT had a sensitivity and specificity of 0.90 and 0.80 in detecting the pulp horn/pulp chamber and 0.84 and 0.71 in detecting the isthmus, respectively. The three techniques showed strong correlations in detecting the number of root canals compared with micro-CT. OCT and DOM did not detect lateral canals. For RDT values, strong correlations were observed between micro-CT and CBCT, micro-CT and OCT, and CBCT and OCT (p < 0.01 for all). CONCLUSIONS: Under the present experimental condition, OCT accurately measured RDT and detected internal tooth anatomy such as the pulp horn, isthmus, and root canals.

Detection of a second mesiobuccal canal in maxillary molars by swept-source optical coherence tomography.

INTRODUCTION: The purpose of this study was to investigate the ability of swept-source optical coherence tomographic (SS-OCT) imaging to detect a second mesiobuccal canal (MB2) in maxillary molars compared with visual inspection (VI) and dental operating microscopy (DOM). METHODS: Forty extracted human maxillary molars were examined. After the removal of half the crown and access cavity preparation, the existence of MB2 canals was confirmed based on cross-sectional images of each tooth obtained by micro-computed tomographic scanning as the reference standard. Then, the pulp chamber floor was scanned by SS-OCT imaging. Three dentists independently evaluated the SS-OCT images and the pulp chamber floor under VI and DOM for the presence of MB2 canals. The detection rate of MB2 canals for SS-OCT imaging, VI, and DOM was calculated, and statistical analysis was performed. RESULTS: MB2 canals existed in 19 of 40 teeth (47.5%) using micro-CT imaging. Sensitivity of DOM (0.947) was significantly higher than that of SS-OCT imaging (0.632). Specificity of SS-OCT imaging (0.714) was significantly higher than that of DOM (0.333). No statistically significant differences were found for accuracy among the 3 methods. Kappa values of SS-OCT, VI, and DOM were 0.526, 0.417, and 0.326, respectively. CONCLUSIONS: SS-OCT imaging is noninvasive, involves no ionizing radiation, and is accurate for the detection of MB2 canals.

Effects of new adhesive resin root canal filling materials on vertical root fractures.

The aim of this study was to compare the fracture resistance of roots following root canal therapy using the RC Sealer system, the Epiphany system and the conventional system of gutta-percha and Sealapex. Fifty-six maxillary central incisors were divided into eight groups of seven teeth each, according to master apical file size and obturation systems. Obturation materials in the root canal were vertically loaded using a universal testing machine. Fracture loads were analysed by ANOVA and Tukey comparison, and fracture patterns were analysed with ordinal logistic regression. Master apical file size 80 had a significantly lower fracture load than size 40 (P < 0.05). The groups obturated using the Resilon Cone and the Epiphany Sealer had significantly lower fracture loads than the other groups (P < 0.05). There was no significant improvement in resistance to vertical root fractures using the examined adhesive resin root canal filling systems, compared with conventional gutta-percha and sealer.