It is a basic prerequisite for the successful completion of endodontic treatment to thoroughly understand the root canal space anatomy. With the development of dental devices in dentistry, the root canal morphology of the mandibular first premolars can be presented in more detail. Before conducting root canal therapy on the mandibular first premolar with complex root canal morphology, it should be necessary to evaluate the potential difficulties and risks for making an appropriate treatment plan. The present paper reviews the research progress on the diversities of root canal morphology in mandibular first premolars in recent years, and then makes technologic recommendations based on the morphology diversities.
Humans ; Dental Pulp Cavity/diagnostic imaging* ; Bicuspid/anatomy & histology* ; Mandible ; Tooth Root/anatomy & histology* ; Root Canal Therapy

Constriction, Pathologic ; Humans ; Root Canal Obturation ; methods ; Root Canal Preparation ; methods ; Tooth Apex ; anatomy & histology ; pathology ; Tooth Diseases ; pathology ; therapy

OBJECTIVEThis study aims to identify the effects of corticotomy-assisted orthodontic premolar intrusion andevaluate the changes of root resorption and the alveolar bone.

METHODSBoth sides of the mandible of eight male Beagle dogswere randomly assigned into experimental and control groups. The third (P3) and fourth (P4) premolars were intruded withboth mini-screw implant anchorage (MIA) and corticotomy on the experimental side. By contrast, P3 and P4 were intrudedwith MIA alone on the control side. During pre-operation and after 2, 4, 8, and 12 weeks of orthodontic force applications,cone beam computed tomography was performed on every dog. The distance of tooth intrusion and root resorption of furcation, as well as the apex and height changes of the alveolar bone were measured and analyzed.

RESULTSThe intrusion distanceof premolars on the experimental side was greater than that on the control side (P < 0.05). The root of furcation and apex onboth sides occurred in root resorption, and the root resorption of the apex on the experimental side was lighter than that onthe control side after 12 weeks of force application (P < 0.05). The alveolar bone height decreased, and the height reductiondistance on the experimental side was greater than that on the control side after 8 and 12 weeks of force application (P < 0.05).

CONCLUSIONCorticotomy accelerates orthodontic molarintrusion and reduces root resorption.

Animals ; Bicuspid ; anatomy & histology ; Bone Screws ; Cone-Beam Computed Tomography ; Dogs ; Male ; Mandible ; Root Resorption ; Tooth Movement Techniques ; Tooth Root

Dental Pulp Cavity ; anatomy & histology ; Humans ; Male ; Maxilla ; Middle Aged ; Molar ; anatomy & histology ; Odontometry ; Tooth Root ; anatomy & histology

This experiment was aimed to shed light on the correlation and quantitative relationships between the width of bovine periodontal ligament (PDL) and the elastic modulus and, more over, between the width of bovine PDL and the capacity ratio of collagen fibers. The width and length of periodontal ligament of PDL were determined by stereomicroscope, and the elastic modulus by the materials testing systems. The collagen fibers in cross section of the specimen were stained with 1% Sirius Red F3B in saturated carbazotic acid, and the photo of stained PDL was collected by stereomicroscope. Image pro plus6.0 image analysis software was used to measure and calculate the capacity ratio of collagen fibers. It was found that there is a negative correlation between the width of bovine periodontal ligament and elastic modulus. The correlation coefficient is -0.21 and the simple linear regression model is Y = 71. 681-0.021x (Width of PDL); there is a positive correlation between capacity ratio of collagen fibers and elastic modulus. The coefficient correlation is 1.583 and the simple linear regression model is Y = -34.944 + 1.583x (The percentage of collagen fibers). Thus, the elastic modulus of bovine PDL increases while the width of bovine PDL decreases, and it increases while the capacity ratio of collagen fibers increases.
Animals ; Cattle ; Collagen ; chemistry ; Elastic Modulus ; Periodontal Ligament ; physiology ; Tensile Strength ; Tooth Root ; anatomy & histology

The aim of this study was to analyze the specific influence of root canal anatomy on the accessibility of working length during root canal therapy. Four hundred seventy-six root canal therapy cases (amounting to a total of 1 005 root canals) were examined. The anatomy risk factors assessed in each case included: tooth type (tooth location), root canal curvature, and root canal calcification, as well as endodontic retreatment. The investigation examined the correlation between each of these anatomic factors and the working length, with statistical analysis consisting of Chi-square tests and multiple logistic regression analysis. In an independent factor analysis, tooth type (tooth location), root canal curvature, canal calcification, and endodontic retreatment were determined to be the primary risk factors. In a multiple-factor regression model, root curvature and canal calcification were found to most significantly influence root canal working length accessibility (P<0.05). Root canal anatomy increases the difficulty of root canal preparation. Appropriate consideration of tooth anatomy will assist in accurate determination of preparation difficulty before instrumentation. This study alerts clinical therapists to anatomical factors influencing the working length accessibility, and allows for a direct estimate of success rate given in situ measurements of tooth factors during the root canal treatment procedure.
Chi-Square Distribution ; Dental Pulp Calcification ; pathology ; Dental Pulp Cavity ; anatomy & histology ; diagnostic imaging ; Humans ; Logistic Models ; Odontometry ; Radiography ; Retreatment ; Risk Factors ; Root Canal Preparation ; instrumentation ; Tooth Apex ; Tooth Root ; anatomy & histology

OBJECTIVETo evaluate the alveolar bone thickness and root length changes of anterior teeth with cone-beam computed tomography (CBCT).

METHODSCBCT scans were taken for 12 skeletal Class III patients who accepted the improved corticotomy (IC) procedures during pre-surgical orthodontics. The CBCT data in T1 (the maxillary dental arch was aligned and leveled) and T2 (extraction space closure) were superimposed and the alveolar bone thickness at root apex level and root length measurements were done.

RESULTSFrom T1 to T2, the buccal alveolar bone thickness for the upper lateral incisors increased from (1.89±0.83) to (2.47±1.02) mm (P<0.05), and for central incisors and for canines from (2.32±0.71) to (2.68±1.48) mm and from (2.28±1.08) to (2.41±1.40) mm, respectively. According to Sharpe Grading System, the root resorption grade for 69 teeth of 72 was located in Grade 1, two teeth in Grade 2, one tooth in Grade 3.

CONCLUSIONSThe improved corticotomy had the potential to increase the buccal alveolar bone thickness and the root resorption in most teeth was in Grade 1 according to Sharpe grading system.

Alveolar Process ; anatomy & histology ; diagnostic imaging ; surgery ; Cone-Beam Computed Tomography ; Cuspid ; Humans ; Incisor ; Malocclusion, Angle Class III ; diagnostic imaging ; surgery ; Root Resorption ; pathology ; Tooth Root ; Zygoma

OBJECTIVETo investigate the anatomic features of the root apexes of permanent three-rooted mandibular first molars.

METHODSA total of 122 permanent mandibular first molars of Han Chinese patients were collected. Twenty three-rooted and 25 two-rooted molars were scanned by micro-CT and then reconstructed three-dimensionally. The apical anatomy of the tooth models were analyzed in software Mimics 10.01. The long and short diameters of the apical constriction (AC), the distances between AC, apical foramen (AF) and apex were measured. One-way ANOVA and LSD-t tests were used to compare the groups in relation to AC diameter and the distances between the AC, AF and apex.

RESULTSThe AF of the mesiobuccal (MB) canals most frequently presented at the distal side of the apex (10 cases in three-rooted and 6 cases in two-rooted group), and of the mesiolingual (ML) canals, most often at the lingual side (8 cases in each group). The AF of the distobuccal (DB) roots were frequently located at the distolingual (DL) side (10 cases), and those of the DL roots and distal canals of two-rooted molars were most often at the buccal (7 cases) and distal (11 cases) sides, respectively. The percentage of the "classical" singular AC was 53% (80/151). The average long(D) and short(d) diameters of the AC of the DB canals were (0.32 ± 0.09) mm and (0.25 ± 0.05) mm, respectively, significantly larger than the DL canals [D = (0.27 ± 0.08) mm, d = (0.22 ± 0.06) mm, P < 0.05] and the ML canals [D = (0.24 ± 0.06) mm, d = (0.19 ± 0.06) mm, P < 0.01). In three-rooted group, the mean distances between AC and AF, AF and apex, and AC and apex were (0.67 ± 0.32), (0.49 ± 0.28) and (1.01 ± 0.34) mm, respectively.

CONCLUSIONSThe AF of three-rooted mandibular molars frequently deviate from the root apex, and the AC of the DB canal is wider than those of the other canals. The mean distances between AC, AF and the apex suggest that root canal therapy should terminate at 1 to 1.5 mm short of the radiographic apex.

Asian Continental Ancestry Group ; Humans ; Imaging, Three-Dimensional ; Molar ; anatomy & histology ; diagnostic imaging ; Tooth Apex ; anatomy & histology ; diagnostic imaging ; Tooth Root ; anatomy & histology ; diagnostic imaging ; X-Ray Microtomography ; methods

OBJECTIVETo investigate the importance of root information in diagnosis set-up by constructing three-dimensional (3D) digital models with individual anatomic roots.

METHODSPretreatment cone-beam CT (CBCT) and laser scanning data were collected from two patients (extraction and non-extraction each) with skeletal Class I malocclusion. Threshold segmentation of the CBCT was performed to generate a 3D digital model which has individually isolated tooth. This model and the scan model were superimposed to generate an integrated model (Mo) composed of high-resolution surface scan crowns sutured to the CBCT roots. Pretreatment dentition plaster model were made into set-up model. The diagnosis model set-up was performed successively by three orthodontists and one senior orthodontic technician. Set-up model scan of each patient after tooth alignment was obtained. The isolated composite teeth were individually superimposed onto the set-up model surface scan to creat set-up model (Ma, Mb, Mc, Md) containing root position. These isolated composite teeth were also superimposed onto the posttreatment surface scan depicting the posttreatment model (M). In order to observe whether diagnosis model set-up would cause exposure of the root, Ma-Md were compared with Mo, which showed the true positions of alveolus. In order to validate the accuracy of the expected root position setup, Ma-Md were compared with the true root position represented by M. Color displacement maps generated to measure the discrepancies of root positions.

RESULTSNonparallel and exposure of the root was found in all setup models. Color displacement maps through molar superimpositions showed maximum differences of 8.79 mm for the maxillary teeth and 9.96 mm for the mandibular teeth.

CONCLUSIONSDiagnosis model set-up based only on crown can not absolutely ensure the good alignment of roots without root exposure. It is necessary to construct the integrated model including root for diagnosis during tooth arrangement process.

Cone-Beam Computed Tomography ; Dental Casting Technique ; Humans ; Image Processing, Computer-Assisted ; Lasers ; Malocclusion, Angle Class I ; diagnosis ; Molar ; Pilot Projects ; Tooth ; Tooth Crown ; anatomy & histology ; diagnostic imaging ; Tooth Root ; anatomy & histology ; diagnostic imaging

OBJECTIVECurved canal preparation is much difficult in root canal therapy(RCT). Step back technique and routine technique are still regular methods in curved canal preparation. The purpose of this study was to introduce a new method reverse flaring technique, and to investigate its preparation efficiency in intermediate-curvature canals.

METHODS48 cases of lower first molars RCT were collected, which were first treated because of pulpitis or apical periodontitis in West China College of Stomatology, Sichuan University from Nov. 2001 to Aug. 2003, mesial canal curvature was intermediate (30 degrees-60 degrees), determined by Schineider method. Cases were divided into two groups, in reverse flaring technique group, canal preparation in 27 cases were finished by reverse flaring technique, 21 cases by step back technique as control. In working length determination and fitting master cone stages, cases in two groups which fit full working length were recorded, determined by radiograph, and analyzed by chi 2 test.

RESULTSIn working length determination stage, cases which fit full working length in reverse flaring technique group were significantly more than that of step back technique group (P < 0.05), in fitting master cone stage, cases which fit full working length in reverse flaring technique group were also significantly more than that of step back technique group(P < 0.05).

CONCLUSIONIn working length determination stage, cases which fit full working length in reverse flaring technique group were significantly more than that of step back technique group (P < 0.05), in fitting master cone stage, cases which fit full working length in reverse flaring technique group were also significantly more than that of step back technique group(P < 0.05).

Adult ; Dental Pulp Cavity ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Molar ; Periodontitis ; diagnostic imaging ; therapy ; Pulpitis ; diagnostic imaging ; therapy ; Radiography ; Root Canal Preparation ; instrumentation ; methods ; Root Canal Therapy ; Tooth Apex ; anatomy & histology ; diagnostic imaging