Use of Cone-Beam Computed Tomography to Identify Root Canal Systems In Vitro

doi:10.1016/j.joen.2007.10.016

Journal of Endodontics

Volume 34, Issue 1, January 2008, Pages 87-89

https://doi.org/10.1016/j.joen.2007.10.016 Get rights and content

Abstract

This study investigated the use of cone-beam computed tomography (CBCT) as a diagnostic tool for identifying root canal systems (RCSs) when compared with images obtained by using charged coupled device (CCD) and photostimulable phosphor plate (PSP) digital radiography in vitro. Seventy-two extracted teeth were exposed with CCD, PSP, and CBCT radiography. Specimens included 24 maxillary molars, mandibular premolars, and mandibular incisors each. Tooth-type selections were based on the greater possibility of multiple RCSs. Three board-certified endodontists evaluated CCD and PSP images to determine the number of RCSs. CBCT images were used to establish “ground truth” for the comparisons and were evaluated by a board-certified oral and maxillofacial radiologist who determined the number of RCSs. Descriptive statistical analysis revealed that the endodontists consistently agreed among themselves. When compared with CBCT evaluation, the endodontists, on average, failed to identify 1 or more RCSs in 41% of the teeth with CCD and 40% of the time with PSP. CBCT evaluations identified an average of 3.58 RCSs per maxillary molar, 1.21 per mandibular premolar, and 1.5 per mandibular incisor. Evaluation of CCD images demonstrated an average number of 1.0 RCSs per mandibular incisor, 1.0 per mandibular first premolar, and 3.1 per maxillary molar. Evaluation of PSP images demonstrated an average number of 1.3 RCSs per mandibular incisor, 1.1 per mandibular first premolar, and 3.0 per maxillary molar. In summary, endodontist evaluators with either CCD or PSP methods failed to identify at least 1 RCS in approximately 4 of 10 teeth, which can result in a less optimal healing outcome if a missed RCS is left uninstrumented and unobturated.

Section snippets

Materials and Methods

Seventy-two extracted human teeth, gathered from oral surgery practices and stored at 100% humidity, were collected and randomly inserted into 4 foam arches in groups of 18 teeth each. Each arch consisted of 6 maxillary first molars, 6 mandibular first premolars, and 6 mandibular incisors. Tooth types were selected because of the likelihood of possessing multiple RCSs (12, 13, 14). Specimens were placed in close contact to each other to simulate their natural alignment in a dental arch. An

Results

The percentages of RCSs identified with CCD and PSP images compared with CBCT are listed in Table 1. For CCD, the endodontist evaluators correctly identified the number of RCSs 80%, 78%, and 77% of the time, respectively, when compared with CBCT. For PSP, endodontist evaluators correctly identified the number of RCSs 81%, 76%, and 84% of the time, respectively, when compared with CBCT. The endodontist evaluators missed approximately 1 of 5 RCSs with CCD and PSP when compared with CBCT. The

Discussion

In this study, endodontic evaluators only identified between 76%–84% of RCSs with CCD and PSP digital radiography when compared with the number of RCSs identified by the OMFR with CBCT. For individual teeth, the endodontist evaluators with CCD and PSP methods failed to identify at least 1 or more RCS in at least 4 of 10 teeth, which might decrease the prognosis because RCSs might remain undiscovered. These radiographically undiscovered RCSs might be discovered with the aid of appropriate

Acknowledgements

The authors appreciate assistance provided by Drs Edward Grimes, James Dryden, and Ronald Riley, Department of Endodontics, UMKC School of Dentistry.

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Introduction: Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. Aim: To understand the importance of root morphology in endodontic treatment. Methodology: A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. Results: CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. Conclusion: The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.
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There is variability in the results of dental morphological studies between different ethnic populations. This study aimed to investigate the root canal morphology of mandibular anterior teeth in a Saudi subpopulation in the Riyadh region.
We examined a total of 1,769 cone-beam computed tomography (CBCT) images of the mandibular anterior teeth, including the central incisors (n = 587), lateral incisors (n = 590), and canines (n = 592). The number and configuration of the root canals were determined. Fisher's exact and Pearson’s chi-square tests were used to assess the differences between sexes and age groups, with a level of statistical significance was set at p < 0.05.
Overall, Type I canal was the most frequent configuration among the mandibular anterior teeth (76.1%). However, the prevalence of Type III canal configuration in the central and lateral incisors was 36.5% and 31%, respectively. Additionally, the mandibular canines were mainly Type I canals (98.4%). The prevalence of canal configuration was predominantly Type I (95.7%), followed by Type III (2.7%), Type IV (0.4%), and Type V (1.2%). There was a statistically significant difference in the canal configurations between men and women (p = 0.02). Females more often had Type I root canals (60.6%), while Type III was more frequent in males (57.2%). However, there were no statistically significant differences between the age groups in canal configuration.
The mandibular anterior teeth of the Saudi subpopulation had mainly one root canal. However, almost one-third of the central and lateral incisors had two canals. CBCT is a useful tool that can be used, if available, to investigate root canal morphology before root canal treatment.
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Abstract

Section snippets

Materials and Methods

Results

Discussion

Acknowledgements

References (16)

Digital and advanced imaging in endodontics: a review

J Endod

How does signal fade on photo-stimulable storage phosphor imaging plates when scanned with a delay and what is the effect on image quality?

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Computed tomography

Dent Clin North Am

X-ray microtomography: nondestructive three-dimensional imaging for in-vitro endodontic studies

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Differential diagnosis of large periapical lesions using cone-beam computed tomography measurements and biopsy

J Endod

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

Root canal configuration of the mandibular first premolar

J Endod

Root canal anatomy of the mandibular anterior teeth

J Am Dent Assoc

Cited by (261)

The importance of cone-beam computed tomography in endodontic therapy: A review

Cone-beam computed tomographic evaluation of root canal morphology of mandibular anterior teeth in a Saudi subpopulation, retrospective In-Vivo study

Distolingual root prevalence in mandibular first molar and complex root canal morphology in incisors: a CBCT analysis in Indian population

An Experimental Anatomic CBCT Study on the Correlations Between MB1 and MB2 of the Mesio-Vestibular Root of the Upper First Molars

THE INCIDENCE OF UNFILLED SECOND MESIOBUCCAL CANALS AND PERIAPICAL LESIONS IN MAXILLARY MOLARS BY CONE-BEAM COMPUTED TOMOGRAPHY E-VOL DX SOFTWARE

Navigating complexity: Endodontic management of a mandibular canine with tri canal confluence in a single root

Basic research—technologyUse of Cone-Beam Computed Tomography to Identify Root Canal Systems In Vitro

Abstract

Section snippets

Materials and Methods

Results

Discussion

Acknowledgements

J Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Dent Clin North Am

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Endod

J Endod

J Endod

J Am Dent Assoc

Basic research—technology
Use of Cone-Beam Computed Tomography to Identify Root Canal Systems In Vitro