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Proximity of maxillary molar apexes to the cortical bone surface and the maxillary sinus

  • Han Shin Lee (Department of Conservative Dentistry, School of Dentistry, Kyungpook National University) ;
  • Dokyung Kim (Department of Conservative Dentistry, School of Dentistry, Kyungpook National University) ;
  • Sung Kyo Kim (Department of Conservative Dentistry, School of Dentistry, Kyungpook National University)
  • Received : 2022.02.14
  • Accepted : 2022.07.06
  • Published : 2022.08.31

Abstract

Objectives: This study aimed to analyze the proximity of maxillary molar roots to their overlying cortical bone surfaces and the maxillary sinus. Materials and Methods: Cone-beam computed tomographic images of 151 patients with completely erupted upper molars that had 3 separate roots were studied. The following distances were measured: from the root apex to the cortical plate and maxillary sinus floor, and from the apical 3-mm level of the root to the cortical plate. Differences between groups were analyzed with 1-way analysis of variance and the Scheffé post hoc test, the significance of differences between cone-beam computed tomography views with the paired t-test, and the significance of differences among age groups with linear regression analysis. The significance level was set at p < 0.05. Results: The mesiobuccal and distobuccal root apexes of maxillary second molars were more distant from the buccal cortical plate than the maxillary first molars (p < 0.05). The apical 3-mm level of the mesiobuccal root of the first molar was closer to the buccal cortical bone than the second molar (p < 0.05). In the maxillary first molars, the thickness of the buccal cortical bone decreased in all roots with age (p < 0.05). In all root apexes of both molars, the difference in the vertical level between the maxillary sinus floor and the root apex increased with age (p < 0.05). Conclusions: Awareness of the anatomical profile of maxillary molar apices in relation to the cortical bones and maxillary sinus will be beneficial for apical surgery.

Keywords

References

  1. Maggiore F, Kim S. Chapter 7. Osteotomy. In: Kim S, Kratchman S, editors. Microsurgery in endodontics. Hoboken, NJ: Wiley Blackwell; 2018. p57-65.
  2. Punwutikorn J, Waikakul A, Pairuchvej V. Clinically significant oroantral communications--a study of incidence and site. Int J Oral Maxillofac Surg 1994;23:19-21. https://doi.org/10.1016/S0901-5027(05)80320-0
  3. Oberli K, Bornstein MM, von Arx T. Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:848-853. https://doi.org/10.1016/j.tripleo.2006.09.017
  4. Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: a review. Int Endod J 2002;35:127-141. https://doi.org/10.1046/j.0143-2885.2001.00524.x
  5. Ariji Y, Obayashi N, Goto M, Izumi M, Naitoh M, Kurita K, Shimozato K, Ariji E. Roots of the maxillary first and second molars in horizontal relation to alveolar cortical plates and maxillary sinus: computed tomography assessment for infection spread. Clin Oral Investig 2006;10:35-41. https://doi.org/10.1007/s00784-005-0020-5
  6. Bornstein MM, Wasmer J, Sendi P, Janner SF, Buser D, von Arx T. Characteristics and dimensions of the Schneiderian membrane and apical bone in maxillary molars referred for apical surgery: a comparative radiographic analysis using limited cone beam computed tomography. J Endod 2012;38:51-57. https://doi.org/10.1016/j.joen.2011.09.023
  7. Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, Zheng G, Wang H, Huang D. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod 2012;38:1069-1074. https://doi.org/10.1016/j.joen.2012.04.027
  8. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus. J Periodontol 2012;83:557-564. https://doi.org/10.1902/jop.2011.110376
  9. Shanbhag S, Karnik P, Shirke P, Shanbhag V. Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study. J Endod 2013;39:853-857. https://doi.org/10.1016/j.joen.2013.04.010
  10. Watzek G, Bernhart T, Ulm C. Complications of sinus perforations and their management in endodontics. Dent Clin North Am 1997;41:563-583. https://doi.org/10.1016/S0011-8532(22)00069-6
  11. Cotti E, Vargiu P, Dettori C, Mallarini G. Computerized tomography in the management and follow-up of extensive periapical lesion. Endod Dent Traumatol 1999;15:186-189. https://doi.org/10.1111/j.1600-9657.1999.tb00799.x
  12. Aggarwal V, Singla M. Use of computed tomography scans and ultrasound in differential diagnosis and evaluation of nonsurgical management of periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:917-923. https://doi.org/10.1016/j.tripleo.2009.12.055
  13. Dhamija R, Tewari S, Sangwan P, Duhan J, Mittal S. Impact of platelet-rich plasma in the healing of through-and-through periapical lesions using 2-dimensional and 3-dimensional evaluation: a randomized controlled trial. J Endod 2020;46:1167-1184. https://doi.org/10.1016/j.joen.2020.06.004
  14. Eslami E, Barkhordar H, Abramovitch K, Kim J, Masoud MI. Cone-beam computed tomography vs conventional radiography in visualization of maxillary impacted-canine localization: a systematic review of comparative studies. Am J Orthod Dentofacial Orthop 2017;151:248-258. https://doi.org/10.1016/j.ajodo.2016.07.018
  15. Low KM, Dula K, Burgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod 2008;34:557-562. https://doi.org/10.1016/j.joen.2008.02.022
  16. Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001;34:1-10. https://doi.org/10.1046/j.1365-2591.2001.00396.x
  17. Johnson BR, Fayad MI. Periradicular surgery. In: Hargreaves KM, Berman LH, editors. Cohen's pathways of the pulp. 11th ed. Philadelphia, PA: Elsevier Inc.; 2016. P387-446.
  18. Kim S. Chapter 9. Osteotomy and apical root resection. In: Color atlas of microsurgery in endodontics. Philadelphia, PA: Saunders; 2000.
  19. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58:589-599. https://doi.org/10.1016/0030-4220(84)90085-9
  20. Kim D, Ha JH, Jin MU, Kim YK, Kim SK. Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study. Restor Dent Endod 2016;41:182-188. https://doi.org/10.5395/rde.2016.41.3.182
  21. Degerness RA, Bowles WR. Dimension, anatomy and morphology of the mesiobuccal root canal system in maxillary molars. J Endod 2010;36:985-989. https://doi.org/10.1016/j.joen.2010.02.017
  22. Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol 1992;73:345-346. https://doi.org/10.1016/0030-4220(92)90133-B
  23. Jin GC, Kim KD, Roh BD, Lee CY, Lee SJ. Buccal bone plate thickness of the Asian people. J Endod 2005;31:430-434.
  24. Goltzman D. The aging skeleton. Adv Exp Med Biol 2019;1164:153-160. https://doi.org/10.1007/978-3-030-22254-3_12
  25. Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, Garcia-Delgado R, O'Valle F, Catena A, Galindo-Moreno P. Maxillary sinus dimensions decrease as age and tooth loss increase. Implant Dent 2017;26:288-295. https://doi.org/10.1097/ID.0000000000000551
  26. Kang SH, Kim BS, Kim Y. Proximity of posterior teeth to the maxillary sinus and buccal bone thickness: a biometric assessment using cone-beam computed tomography. J Endod 2015;41:1839-1846. https://doi.org/10.1016/j.joen.2015.08.011
  27. NIH Osteonecrosis and Related Bone Diseases National Resource Center. NIH Pub. No. 18-7891. Osteoporosis: peak bone mass in women. Bethesda, MD: National Institutes of Health; 2018.
  28. Timock AM, Cook V, McDonald T, Leo MC, Crowe J, Benninger BL, Covell DA Jr. Accuracy and reliability of buccal bone height and thickness measurements from cone-beam computed tomography imaging. Am J Orthod Dentofacial Orthop 2011;140:734-744. https://doi.org/10.1016/j.ajodo.2011.06.021
  29. De Deus QD, Horizonte B. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod 1975;1:361-366. https://doi.org/10.1016/S0099-2399(75)80211-1
  30. Seltzer S, Soltanoff W, Bender IB, Ziontz M. Biologic aspects of endodontics, I. Histologic observations of the anatomy and morphology of root apices and surrounding structures. Oral Surg Oral Med Oral Pathol 1966;22:375-385. https://doi.org/10.1016/0030-4220(66)90312-4
  31. Wada M, Takase T, Nakanuma K, Arisue K, Nagahama F, Yamazaki M. Clinical study of refractory apical periodontitis treated by apicectomy. Part 1. Root canal morphology of resected apex. Int Endod J 1998;31:53-56. https://doi.org/10.1046/j.1365-2591.1998.t01-1-00123.x
  32. Kim S. Principles of endodontic microsurgery. Dent Clin North Am 1997;41:481-497. https://doi.org/10.1016/S0011-8532(22)00063-5
  33. Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH. The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg 2005;132:429-434. https://doi.org/10.1016/j.otohns.2004.11.012
  34. Sharan A, Madjar D. Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants 2008;23:48-56.
  35. Louie AF. Surgical and radiologic anatomy for oral implantology. 1st ed. Hanover: Quintessence Publishing; 2013
  36. Pagin O, Centurion BS, Rubira-Bullen IR, Alvares Capelozza AL. Maxillary sinus and posterior teeth: accessing close relationship by cone-beam computed tomographic scanning in a Brazilian population. J Endod 2013;39:748-751. https://doi.org/10.1016/j.joen.2013.01.014
  37. Kilic C, Kamburoglu K, Yuksel SP, Ozen T. An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent 2010;4:462-467.
  38. Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD. Vestibular surgical access to the palatine root of the superior first molar: "low-dose cone-beam" CT analysis of the pathway and its anatomic variations. J Endod 2003;29:773-775. https://doi.org/10.1097/00004770-200311000-00021
  39. Rabiee H, McDonald NJ, Jacobs R, Aminlari A, Inglehart MR. Endodontics program directors', residents', and endodontists' considerations about CBCT-related graduate education. J Dent Educ 2018;82:989-999. https://doi.org/10.21815/JDE.018.098
  40. Kalender A, Aksoy U, Basmaci F, Orhan K, Orhan AI. Cone-beam computed tomography analysis of the vestibular surgical pathway to the palatine root of the maxillary first molar. Eur J Dent 2013;7:35-40. https://doi.org/10.1055/s-0039-1698993
  41. Kim SY, Kim BS, Woo J, Kim Y. Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals. J Endod 2013;39:1516-1521. https://doi.org/10.1016/j.joen.2013.08.015
  42. American Association of EndodontistsAmerican Acadamey of Oral and Maxillofacial Radiography. AAE and AAOMR joint position statement. Use of cone-beam-computed tomography in endodontics. Pa Dent J (Harrisb) 2011;78:37-39.