• Journal of Dental Rehabilitation and Applied Science
• /
• v.30 no.4
• /
• pp.324-328
• /
• 2014

Aberrant anatomy of mandibular premolars is very rare in Korean, but aberration can contribute the endodontic failure as it makes difficult to remove the irritants during cleaning and shaping procedure. This case report describes the successful root canal treatment of a rare mandibular first premolar with C-shaped root canal as using a cone-beam computed tomography to understand the internal shape of root canal system and a dental operating microscope to improve the magnification and illumination.

• Restorative Dentistry and Endodontics
• /
• v.27 no.4
• /
• pp.421-431
• /
• 2002

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from radiographic examination. This study was done to get more informations about the root and canal configuration of C-shape root by 3-dimensionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Six photo images from occlusal, apical, mesial, distal, buccal, lingual directions and radiographic view were taken as preoperative ones to compare them with 3-D image. After crown reduction to the level of 1-2mm over pulpal floor was performed, teeth were stored in 5.25% sodium hypochlorite solution for the removal of pulp tissue and debris. They were cleaned under running water, allowed to bench dry and embedded in a self-curing resin. This resin block was serially ground with a microtome (Accutom-50, Struers, Denmark) and the image of each level was recorded by digital camera (FinePix S1-pro, Fuji Co., Japan). The thickness of each section was 0.25mm. Photographs of serial sections through all root canal were digitized using Adobe Photoshop 5.0 and then minimum thickness of open and closed sites were measured (open site is the surface containing occluso-apical groove closed site is oppsite). After dizitization using 3-D Doctor (Able software Corp, USA). 3D reconstruction of the outer surface of tooth and the inner surface of pulp space was made. Canal classsification of C-shaped roots was performed from this 3-D reconstructed image. The results were as follows : 1. Most C-shape rooted teeth showed lingual groove (28/30). 2 According to Vertuccis' calssification, type I, II, III, IV, VII were observed. but also new canal types suck as 2-3-2, 1-2-3-2. 2-3-2-1, 2-3-2-3 were shown. 3 There was little difference in minimum thickness on coronal and apical portions, but open site were thinner than closed site on mid portion. Conclusively, 3D reconstruction method could make the exact configurations of C-shape root possible to be visualized and analyzed from multi-directions. Data from minimum thickness recommend cleaning and shaping be more carefully done on dangerous mid portion.

• Restorative Dentistry and Endodontics
• /
• v.44 no.2
• /
• pp.18.1-18.9
• /
• 2019

Objective: This study evaluated the presence of residual root canal filling material after retreatment using micro-computed tomography (micro-CT). Materials and Methods: Extracted human teeth (single- and double-rooted, n = 21/each; C-shaped, n = 15) were prepared with ProFile and randomly assigned to three subgroups for obturation with gutta-percha and three different sealers (EndoSeal MTA, EndoSequence BC sealer, and AH Plus). After 10 days, the filling material was removed and the root canals were instrumented one size up from the previous master apical file size. The teeth were scanned using micro-CT before and after retreatment. The percentage of remaining filling material after retreatment was calculated at the coronal, middle, and apical thirds. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni post hoc correction. Results: The tested sealers showed no significant differences in the percentage of remaining filling material in single- and double-rooted teeth, although EndoSeal MTA showed the highest value in C-shaped roots (p < 0.05). The percentage of remaining filling material of AH Plus and EndoSeal MTA was significantly higher in C-shaped roots than in single- or double-roots (p < 0.05), while that of BC sealer was similar across all root types. EndoSeal MTA showed the highest values at the apical thirds of single- and double-roots (p < 0.05); otherwise, no significant differences were observed among the coronal, middle, and apical thirds. Conclusions: Within the limitations of this study, a large amount of EndoSeal MTA remained after retreatment, especially in C-shaped root canals.

• Imaging Science in Dentistry
• /
• v.45 no.4
• /
• pp.221-226
• /
• 2015

Purpose: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Materials and Methods: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Results: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. Conclusion: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.

• Restorative Dentistry and Endodontics
• /
• v.37 no.3
• /
• pp.175-179
• /
• 2012

The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

• Restorative Dentistry and Endodontics
• /
• v.49 no.1
• /
• pp.2.1-2.12
• /
• 2024

Objectives: This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods: Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results: The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions: In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.

• Restorative Dentistry and Endodontics
• /
• v.22 no.2
• /
• pp.731-738
• /
• 1997

A retrospective in vivo study of endodontically treated mandiblar molars was conducted. The radilographs and clinical records of mandibular molars that had been treated endodontically in the Dental hospital of Yonsei University from 1986 to July 1997 were reviewed and categorized. A total of 1751 cases were studied and following results were obtained. 1. The number of root canals in mandibular first permanent molar in a Korean population revealed three in 53.2 %, four in 23.0 %, two in 18.4 %, C-shaped canal in 5.0 %, and one in 0.4 %. 2. In mandibular second molar, three canals was observed in 53.2 %, four in 22.2 %, two in 14.9%, C-shaped canal in 9.1 %, and one in 0.6%. 3. In the results of the percentage of 4 canals of mandibular first molars at various age, before age 20, 37.7 % was obtained whereas 19.3 % after 30. 4. 7.94 % of mandibular first molars examined were found to have three roots. 5. The mandibular second molar had C-shaped canals in 9.1 %.

• Restorative Dentistry and Endodontics
• /
• v.40 no.2
• /
• pp.161-165
• /
• 2015

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

• Restorative Dentistry and Endodontics
• /
• v.9 no.1
• /
• pp.59-68
• /
• 1983

The purpose of this study was to examine the influence of canal irrigants and the method of canal filling on the quality of canal obturation. Sixty extracted human teeth with single root were selected and divided into three different groups; In group I (control); 5 cc normal saline irrigated after each instrumentation In group II; 2.5 cc-3% NaOCl in combination with 2.5 cc-3% $H_2O_2$ In group III; RC-Prep in combination with 5 cc-3% NaOCl All specimens were cleaned, shaped(#50 file size), irrigated and obturated by lateral condensation and automated thermatic condensation filling method of gutta-percha and AH-26. After all the specimens were immersed in 2% methylene blue dye solution in $37^{\circ}C$ for 7 days and the degree of dye penetration into the canals observed by magnifying glass(${\times}$20) and reflected light microscope The results were as follows: 1. All the the teeth showed some degree of the dye penetration. 2. There were no significant difference among three groups in the degree of the dye penetration in each canal filling method. 3. There were no significant difference of the dye penetration between each canal filling method in group I. 4. There were no statistically significant difference of the dye penetration between each canal filling method in group II and group III, but lateral condensation group was showed slightly more than automated thermatic condensation group.

• Restorative Dentistry and Endodontics
• /
• v.44 no.2
• /
• pp.16.1-16.12
• /
• 2019

Objectives: The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population. Materials and Methods: A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion. Results: Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped. Conclusion: Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.