Incidence of missed canals during endodontic treatment of maxillary first and second molars.

Untreated canals are a primary cause of persistent apical periodontitis, and the inability to identify and adequately treat canals has been considered a major cause of failure of root canal therapy in maxillary molars. The purpose of this retrospective study was to use cone beam computed tomography (CBCT) to quantify the number of missed canals in maxillary first and second molars needing endodontic retreatment after treatment by general dentists. A total of 401 CBCT scans of maxillary first and second molars were examined. A total of 214 scan sets (53.37% [95% CI, 48.48%-58.25%]) showed evidence of an untreated canal, with the highest rate (49.38%; n = 198) observed in the second mesiobuccal canal. Imaging revealed that multiple canals were missed in some patients, for a total of 225 missed canals. The examinations showed untreated first mesiobuccal canals in 2.99% of CBCT scan sets (n = 12), untreated distobuccal canals in 2.99% of CBCT scan sets (n = 12), and untreated palatal canals in 0.75% of CBCT scan sets (n = 3). Preoperative CBCT imaging should be considered prior to initial root canal treatment of maxillary molars. When the risks and limitations of CBCT are taken into consideration, the additional information it provides can improve diagnostic accuracy, increase confidence in decision-making, and positively impact treatment planning.

Maxillary first molar with 8 root canals detected by CBCT scanning: a case report.

Maxillary molars are prone to exhibit some of the most complex root canal configurations in endodontics. These complexities can result in diagnostic dilemmas, as well as management challenges. This case report illustrates how a cone beam computed tomography (CBCT) scan confirmed an unusual maxillary first molar with 3 root canals each in the mesiobuccal and distobuccal roots and 2 canals in the palatal root. This article illustrates how CBCT scanning and a dental operating microscope can facilitate a better understanding of complex root canal anatomies, ultimately allowing the dentist to clean, shape, and obturate root canal systems more efficiently.

Microscopic computerized tomographic evaluation of root canal transportation prepared with twisted or ground nickel-titanium rotary instruments.

OBJECTIVE: The aim of this study was to evaluate, ex vivo, canal transportation and the centering ability of nickel-titanium rotary instruments manufactured by twisting and by traditional grinding, with the use of microscopic computerized tomography (µCT). STUDY DESIGN: Fifteen mandibular molars were embedded in a rubber-based impression material and submitted to µCT before and after instrumentation. Images were reconstructed, and cross-sections corresponding to distances 1, 2, 3, 4, 5, 6, and 7 mm from the anatomic apex were selected for analysis. Statistical analysis was performed with Mann-Whitney test. RESULTS: Canal transportation and centering ability results were similar for both instruments. Statistically significant differences (P < .05) were observed only at the 3 and 4 mm cross-sections, with lower levels of apical transportation and a better centering ratio associated with twisted instruments than with ground instruments. CONCLUSIONS: Our findings showed that twisted and ground instruments behaved similarly, allowing the preparation of curved canals with little transportation, which occurred in both mesial and distal directions.

Avaliação da técnica anestésica local utilizada por alunos de graduação em odontologia / Evaluation of local anesthetic technique used by dental graduation students

Introdução: A anestesia local constitui etapa essencial para procedimentos odontológicos, visando o conforto e ausência de dor. Objetivos: Com o intuito de observar a técnica anestésica local realizada por alunos de graduação da PUC-Campinas, realizou-se um estudo observacional não intervencionista. Métodos: Para isso, preencheu-se 26 formulários nos quais foram observadas as seguintes questões: anestesia tópica, aspiração prévia do anestésico local, tempo de injeção, número de tubetes utilizados, conhecimento dos alunos em relação ao tipo de sal anestésico utilizado, peso e condição sistêmica do paciente. Resultados: Os resultados mostraram que 92,3% dos alunos avaliados utilizaram anestésico tópico, nenhum deles realizou aspiração prévia, apenas 3,85% tinham conhecimento sobre o peso do paciente e 69,23% dos alunos sabiam qual sal anestésico estava sendo utilizado sem consulta no tubete (p<0.0001 teste Qui-Quadrado para os resultados apresentados anteriormente). Conclusão: Concluiu-se que os alunos avaliados não cumpriram corretamente todas as etapas necessárias para a realização de uma correta técnica anestésica local na criança.

Introduction: Local anesthesia is an essential stage for dental procedures, with comfort and no pain. Objectives: In order to observe the local anesthetic technique performed by undergraduate students of PUC-Campinas, held a non-interventional observational study. Methods: For this, filled with 26 forms in which we observed the following issues: local anesthesia, aspiration prior local anesthetic injection time, number of tubes used, students? knowledge about the type of salt used anesthetic, weight and systemic condition of the patient. Results: The results showed that 92.3% of students assessed using topical anesthetic, none prior aspiration, only 3.85% had knowledge about the patient?s weight and 69.23% of the students knew which anesthetic salt was being used without consulting in tubete (p <0.0001 Chi-Square for the above results). Conclusion: Concludes that the evaluated graduation students didn?t meet properly all necessary steps to achieve a correct local anesthesia technique in children.