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Comparison of limited- and large-volume cone-beam computed tomography using a small voxel size for detecting isthmuses in mandibular molars

  • Received : 2020.06.10
  • Accepted : 2020.09.23
  • Published : 2021.03.31

Abstract

Purpose: This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. Materials and Methods: Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). Results: The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat(P<0.05). Conclusion: Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.

Keywords

References

  1. Pecora JD, Estrela C, Bueno MR, Porto OC, Alencar AH, SousaNeto MD, et al. Detection of root canal isthmuses in molars by map-reading dynamic using CBCT images. Braz Dent J 2013; 24: 569-74. https://doi.org/10.1590/0103-6440201302380
  2. Estrela C, Rabelo LE, de Souza JB, Alencar AH, Estrela CR, Sousa Neto MD, et al. Frequency of root canal isthmi in human permanent teeth determined by cone-beam computed tomography. J Endod 2015; 41: 1535-9. https://doi.org/10.1016/j.joen.2015.05.016
  3. Mannocci F, Peru M, Sherriff M, Cook R, Pitt Ford TR. The isthmuses of the mesial root of mandibular molars: a microcomputed tomographic study. Int Endod J 2005; 38: 558-63. https://doi.org/10.1111/j.1365-2591.2005.00994.x
  4. Tahmasbi M, Jalali P, Nair MK, Barghan S, Nair UP. Prevalence of middle mesial canals and isthmi in the mesial root of mandibular molars: an in vivo cone-beam computed tomographic study. J Endod 2017; 43: 1080-3. https://doi.org/10.1016/j.joen.2017.02.008
  5. Srivastava S, Alrogaibah NA, Aljarbou G. Cone-beam computed tomographic analysis of middle mesial canals and isthmus in mesial roots of mandibular first molars - prevalence and related factors. J Conserv Dent 2018; 21: 526-30. https://doi.org/10.4103/jcd.jcd_205_18
  6. de Pablo OV, Estevez R, Peix Sanchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 2010; 36: 1919-31. https://doi.org/10.1016/j.joen.2010.08.055
  7. Carr GB, Schwartz RS, Schaudinn C, Gorur A, Costerton JW. Ultrastructural examination of failed molar retreatment with secondary apical periodontitis: an examination of endodontic biofilms in an endodontic retreatment failure. J Endod 2009; 35: 1303-9. https://doi.org/10.1016/j.joen.2009.05.035
  8. Amoroso-Silva PA, Ordinola-Zapata R, Duarte MA, Gutmann JL, del Carpio-Perochena A, Bramante CM, et al. Micro-computed tomographic analysis of mandibular second molars with C-shaped root canals. J Endod 2015; 41: 890-5. https://doi.org/10.1016/j.joen.2015.01.021
  9. Tolentino ES, Amoroso-Silva PA, Alcalde MP, Honorio HM, Iwaki LC, Rubira-Bullen IR, et al. Accuracy of high-resolution small-volume cone-beam computed tomography in detecting complex anatomy of the apical isthmi: ex vivo analysis. J Endod 2018; 44: 1862-6. https://doi.org/10.1016/j.joen.2018.08.015
  10. Tolentino ES, Amoroso-Silva PA, Alcalde MP, Honorio HM, Iwaki LC, Rubira-Bullen IR, et al. Limitation of diagnostic value of cone-beam CT in detecting apical root isthmuses. J Appl Oral Sci 2020; 28: e20190168. https://doi.org/10.1590/1678-7757-2019-0168
  11. Domark JD, Hatton JF, Benison RP, Hildebolt CF. An ex vivo comparison of digital radiography and cone-beam and micro computed tomography in the detection of the number of canals in the mesiobuccal roots of maxillary molars. J Endod 2013; 39: 901-5. https://doi.org/10.1016/j.joen.2013.01.010
  12. Villas-Boas MH, Bernardineli N, Cavenago BC, Marciano M, Del Carpio-Perochena A, de Moraes IG, et al. Micro-computed tomography study of the internal anatomy of mesial root canals of mandibular molars. J Endod 2011; 37: 1682-6. https://doi.org/10.1016/j.joen.2011.08.001
  13. Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: combining digital technologies. Imaging Sci Dent 2019; 49: 179-90. https://doi.org/10.5624/isd.2019.49.3.179
  14. Miracle AC, Mukherji SK. Conebeam CT of the head and neck, part 1: physical principles. AJNR Am J Neuroradiol 2009; 30: 1088-95. https://doi.org/10.3174/ajnr.A1653
  15. Wrzesien M, Olszewski J. Absorbed doses for patients undergoing panoramic radiography, cephalometric radiography and CBCT. Int J Occup Med Environ Health 2017; 30: 705-13.
  16. Kamburoglu K, Onder B, Murat S, Avsever H, Yuksel S, Paksoy CS. Radiographic detection of artificially created horizontal root fracture using different cone beam CT units with small fields of view. Dentomaxillofac Radiol 2013; 42: 20120261. https://doi.org/10.1259/dmfr.20120261
  17. Hassan BA, Payam J, Juyanda B, van der Stelt P, Wesselink PR. Influence of scan setting selections on root canal visibility with cone beam CT. Dentomaxillofac Radiol 2012; 41: 645-8. https://doi.org/10.1259/dmfr/27670911
  18. Mchugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012; 22: 276-82. https://doi.org/10.11613/BM.2012.031
  19. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155-63. https://doi.org/10.1016/j.jcm.2016.02.012
  20. Harris SP, Bowles WR, Fok A, McClanahan SB. An anatomic investigation of the mandibular first molar using micro-computed tomography. J Endod 2013; 39: 1374-8. https://doi.org/10.1016/j.joen.2013.06.034
  21. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005; 10: 3-29. https://doi.org/10.1111/j.1601-1546.2005.00129.x
  22. Endal U, Shen Y, Knut A, Gao Y, Haapasalo M. A high-resolution computed tomographic study of changes in root canal isthmus area by instrumentation and root filling. J Endod 2011; 37: 223-7. https://doi.org/10.1016/j.joen.2010.10.012
  23. Van Dessel J, Huang Y, Depypere M, Rubira-Bullen I, Maes F, Jacobs R. A comparative evaluation of cone beam CT and micro-CT on trabecular bone structures in the human mandible. Dentomaxillofac Radiol 2013; 42: 20130145. https://doi.org/10.1259/dmfr.20130145
  24. Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Relationship between density variability and imaging volume size in cone-beam computerized tomographic scanning of the maxillofacial region: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 420-5. https://doi.org/10.1016/j.tripleo.2008.05.049
  25. Scarfe WC, Farman AG. What is cone-beam CT and how does it work? Dent Clin North Am 2008; 52: 707-30. https://doi.org/10.1016/j.cden.2008.05.005
  26. Kau CH, Richmond S, Palomo JM, Hans MG. Three-dimensional cone beam computerized tomography in orthodontics. J Orthod 2005; 32: 282-93. https://doi.org/10.1179/146531205225021285
  27. Hassan B, Metska ME, Ozok AR, van der Stelt P, Wesselink PR. Comparison of five cone beam computed tomography systems for the detection of vertical root fractures. J Endod 2010; 36: 126-9. https://doi.org/10.1016/j.joen.2009.09.013
  28. Hsu YY, Kim S. The resected root surface. The issue of canal isthmuses. Dent Clin North Am 1997; 41: 529-40. https://doi.org/10.1016/S0011-8532(22)00066-0
  29. Ordinola-Zapata R, Bramante CM, Versiani MA, Moldauer BI, Topham G, Gutmann JL, et al. Comparative accuracy of the clearing technique, CBCT and micro-CT methods in studying the mesial root canal configuration of mandibular first molars. Int Endod J 2017; 50: 90-6. https://doi.org/10.1111/iej.12593
  30. Marca C, Dummer PM, Bryant S, Vier-Pelisser FV, So MV, Fontanella V, et al. Three-rooted premolar analyzed by high-resolution and cone beam CT. Clin Oral Investig 2013; 17: 1535-40. https://doi.org/10.1007/s00784-012-0839-5
  31. Borges CC, Estrela C, Decurcio DA, Pecora JD, Sousa-Neto MD, Rossi-Fedele G. Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 2020; 34: e056. https://doi.org/10.1590/1807-3107bor-2020.vol34.0056
  32. Bueno MR, Estrela C, Azevedo BC, Diogenes A. Development of a new cone-beam computed tomography software for endodontic diagnosis. Braz Dent J 2018; 29: 517-29. https://doi.org/10.1590/0103-6440201802455