OBJECTIVETo investigate the incidence of the second mesiobuccal canal (MB2) in the mesiobuccal root of the maxillary first and second molars in Chinese population using three techniques, including the clearing technique, spiral CT scanning and serial root sections.

METHODSA total of 216 extracted human first and 334 second maxillary molars were randomly divided into two groups respectively: group A and B. The teeth in group A were cleared. The specimens in group B were subjected to spiral CT scanning, and then the roots were cross-sectioned every 1 mm from the root apex. Under the Dental operating microscope (DOM), the incidence of MB2 were recorded.

RESULTS(1) The incidence of MB2 in the first and the second maxillary molars were 81.48% and 49.70% respectively by clearing, and 77.78% and 47.31% from S-CT scanning, 88.89% and 53.89% respectively from serial root section. The occurrence of MB2 in maxillary first molars was statistically higher than in maxillary second molars (P < 0.05, chi square test). (2) There was no significant difference among the three approaches for detecting the MB2 canal (P > 0.05, chi square test).

CONCLUSIONSBoth the maxillary first molars and the second molars have high incidence of MB2.

Dental Pulp Cavity ; anatomy & histology ; diagnostic imaging ; Humans ; In Vitro Techniques ; Molar ; anatomy & histology ; diagnostic imaging ; Radiography

OBJECTIVETo investigate different angle projection technique for clinical judgment of obturation quality of molars with multiple root canals.

METHODSEighty-seven maxillary first molars with second mesiobuccal canal (MB2) and 105 mandibular first molars were selected. The canals were instrumented by Ni-Ti rotary instruments and obturated with lateral condensation technique. To judge the obturation quality of the root canals, the radiograph was taken at a horizontal angles of 0 and 20 - 30 degrees from distal direction of the tooth after the treatment.

RESULTSFor maxillary first molars, periapical radiographs showed 23.0% of MB2. Distally angulated radiographs showed 81.6% of MB2. For mandibular first molars, periapical radiographs showed 38.1% of mesiobuccal and mesiolingual canals, and distally angulated radiographs showed 90.5% of two mesial root canals.

CONCLUSIONSMost buccal-lingual distributed root canals of the first molar can be shown more clearly by distally angulated radiographs.

Dental Pulp Cavity ; diagnostic imaging ; Humans ; Molar ; diagnostic imaging ; Radiography ; Root Canal Obturation

Objectives: To evaluate the diagnostic consistency of working lengths by observing endodontic files in root canals and periapical subtle structures in digital intraoral radiographs presented in two smartphones, a tablet and a laptop computer. Methods: A dried human skull embedded in an acrylic compound was used for exposing radiographs of the upper and lower second premolars and first molars with two endodontic files (Kerr files size 10 and 15) positioned to the full length of the roots or 1.5 mm short of apexes. A total of 100 radiographs were taken for each of the file sizes. Five observers were asked to assess all the 200 digital radiographs according to a 5-category scale in smartphone A (HUAWEI P9 Plus), smartphjone B (Apple iPhone 7), tablet (Apple iPad 2018) and laptop computer (Lenovo Thinkpad E480), respectively. The gold standard for receiver operating characteristic curve (ROC) analysis was determined with the endodontic Kerr file size 20. A total of 150 roots with files were radiographed, 75 of which with files reaching the radiographic apexes of the respective roots and 75 of which with files 1.5 mm short of the radiographic apexes for each endodontic file size. Results from ROC analysis was analyzed with one-way ANOVA and independent sample t test. Results: For the Kerr file size 10, the area under the ROC curve for laptop, tablet and two smartphones were 0.891±0.037, 0.869±0.037, 0.870±0.017 and 0.849±0.037, while for the Kerr file size 15 the ROC values were 0.957±0.02, 0.961±0.02, 0.961±0.01 and 0.961±0.02, respectively. There were no significant differences for diagnostic accuracy for observing endodontic file positions among digital radiographs presented in the two smartphones, one tablet and one laptop devices (endodontic file size 10: F=1.39, P=0.281; endodontic file size 15: F=0.05, P=0.985). A significant difference was found in the diagnostic accuracy of endodontic file positions between size 10 and 15 files in different display devices (t=-10.65, P<0.001). Conclusions: There was a high diagnostic consistency in the determination of working length and periapical subtle structures of roots by observing digital radiographs displayed on smartphones, tablet and laptop computer.
Dental Instruments ; Dental Pulp Cavity/diagnostic imaging* ; Electronics ; Humans ; Molar ; Observer Variation ; Root Canal Preparation

OBJECTIVETo investigate the prevalence and configuration of the isthmuses in the apical 6 mm of the mesial and distal roots of Chinese mandibular first molar by means of micro-computed tomography.

METHODSThirty-six extracted human mandibular first molars were selected. Specimens were subject to micro-CT and a slice thickness of 30 microm was obtained in the apical 6 mm of the roots examined. The number of sections showing isthmuses at each apical level was recorded. Three-dimensional images of isthmuses of mandibular first molars were reconstructed and observed.

RESULTSThe mesial roots of human mandibular first molars had a high incidence of isthmus. The isthmus incidence was greatest 4-6 mm from the apex in human mandibular first molar, with prevalence figures of 49.5%-66.1% and 17.3%-17.8% in mesial and distal roots, respectively. The chi-square test indicated a significant difference in the distribution of isthmuses between the two roots (P < 0.01).

CONCLUSIONSThe mesial roots of human mandibular first molars have a high incidence of isthmus, which may have clinical implications especially when surgical endodontics is performed on the mesial roots of mandibular molars.

Adult ; Dental Pulp Cavity ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Mandible ; diagnostic imaging ; Molar ; diagnostic imaging ; Root Canal Therapy ; Tooth Root ; diagnostic imaging ; X-Ray Microtomography

Dental Pulp Diseases ; diagnostic imaging ; Diagnosis, Differential ; Humans ; Periapical Diseases ; diagnostic imaging ; Problem Solving ; Radiography ; X-Rays

Cone-Beam Computed Tomography ; Dental Pulp Cavity ; diagnostic imaging ; Humans ; Root Canal Therapy ; instrumentation

Dental Pulp Cavity ; diagnostic imaging ; pathology ; Humans ; Radiography ; Root Canal Therapy

Dental Pulp Cavity ; anatomy & histology ; diagnostic imaging ; Humans ; Radiography ; Root Canal Therapy ; methods

Dens invaginatus (DI) is a developmental anomaly as a result of a deepening or invagination of the enamel organ into the dental papilla during tooth development. In addition, DI is a malformation with varying anatomical features, which poses numerous challenges to treatment. Endodontic treatment of dens in dente is one of the most complica-ted cases of DI. Herein, an immature lateral incisor that employed regenerative endodontic treatment was presented. The mentioned tooth was diagnosed with DI, pulp necrosis, and chronic apical periodontitis. Hence, a favorable prognosis has been shown by a 2-year review with cone beam computed tomography. The tooth was functional with normal periodontal parameters and exhibited a normal response to the electric pulp sensibility test. Thus, regenerative endodontic treatment can also be recommended to endodontists for teeth with DI.
Humans ; Regenerative Endodontics ; Incisor/diagnostic imaging* ; Dens in Dente ; Dental Pulp Necrosis/therapy* ; Odontogenesis

Root canal therapy and endodontic surgery are conventional treatments for pulpal and periapical diseases. Compared with naked-eye operations, the application of dental operating microscope has enhanced the procedural accuracy and prognosis efficiently. However, root canals with pulp calcification/obliteration, apical lesions with thick cortical bone or adjacent to important anatomic structures are even challenging for experienced operators to achieve predictable clinical outcomes. Recently, with the advances in the field of digitalized information sciences, the above mentioned complicated endodontic cases can be solved under static and dynamic guidance. Before the treatment begins, virtual path is designed from data collected by cone-beam CT and oral image scanning using guidance software. Afterwards, root canal therapy and endodontic surgery can be performed precisely under the assistance of three-dimensional printed guide or dynamic guidance system. The present review describes the classification, features and clinical applications of the guided endodontics.
Cone-Beam Computed Tomography ; Dental Pulp Cavity ; Endodontics ; Humans ; Periapical Diseases/diagnostic imaging* ; Root Canal Therapy