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      Variaciones anatómicas en primer y segundo molar permanente mandibular con tratamiento endodóntico, evaluadas con tomografía computarizada de haz cónico. Revisión narrativa Translated title: Anatomical variations in the first and second permanent mandibular molar with endodontic treatment, evaluated with cone-beam computed tomography. Narrative review

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          Abstract

          RESUMEN Introducción: Una de las dificultades de los tratamientos endodónticos son las variaciones anatómicas de las raíces y sistema de canales radiculares. Existe poca información sobre prevalencia y distribución espacial de estas variaciones en casos reportados con CBCT (del inglés Cone-Beam Computed Tomography). El propósito de la presente revisión fue analizar las variaciones anatómicas en primer y segundo molar permanente mandibular con tratamiento endodóntico evaluadas con CBCT. Materiales y métodos: Se seleccionaron artículos con casos de tratamiento endodóntico en primer o segundo molar permanente mandibular. Se determinaron el número, distribución espacial de variaciones anatómicas radiculares y canales. Además, el número y tipo de alteraciones de forma. Resultados: La mayor prevalencia del número y distribución espacial de raíces en primer molar fue de tres raíces [1M (mesial), 2D (distal)] con un 76,5% y cuatro raíces (2M, 2D) con un 55,6% en segundo molar. La mayor prevalencia del número y distribución de canales radiculares para el primer y segundo molar fue de cuatro canales: 1mesiovestibular, 1mesiolingual, 1distovestibular y 1distolingual, con un 30% y 90,9% de los casos seleccionados respectivamente. La distribución de alteraciones de forma fue de 8,7% para geminación y de 2,1% para taurodontismo. Conclusiones: La variación anatómica de raíces del primer y segundo molar inferior permanente con más frecuencia fue de tres y cuatro respectivamente. La variación anatómica de canales con más frecuencia fue de cuatro: 2M y 2D. El número de alteraciones de forma fueron poco frecuentes, presentando geminaciones y taurodontismo, solo en segundos molares.

          Translated abstract

          ABSTRACT Introduction: One of the difficulties of endodontic treatments is the anatomical variations of the roots and the root canal system. There is little information on the prevalence and spatial distribution of these variations in cases reported with CBCT (Cone-Beam Computed Tomography). The purpose of this review was to analyze the anatomical variations in the mandibular first and second permanent molars with endodontic treatment evaluated with CBCT. Materials and methods: Articles with cases of endodontic treatment in the first or second permanent mandibular molar were selected. The number, spatial distribution of anatomical variations of roots and canals were determined. The number and type of shape alterations were also determined. Results: The highest prevalence regarding number and spatial distribution of root in the first molar was three roots (1M (mesial), 2D (distal)) with 76.5% and four roots (2M, 2D) with 55.6% in second molar. The highest prevalence regarding number and distribution of root canals for the first and second molars was four channels: 1 mesiobuccal, 1 mesiolingual, 1 distobuccal and 1 distolingual, with 30% and 90.9% of the cases selected, respectively. The distribution of shape alterations was 8.7% for gemination and 2.1% for taurodontism. Conclusions: The anatomical variation of roots of the first and second permanent lower molars with the most frequency was three and four respectively. The most frequent anatomic variation of channels was four: 2M and 2D. The number of shape alterations were less frequent, presenting geminations and taurodontism, only in second molars.

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          Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review.

          The main goal of endodontic therapy is to prevent or heal apical periodontitis. However, root canal anatomy might present a clinical challenge directly related to the treatment outcome. The purpose of this study was to review published literature related to root anatomy and root canal configuration of the permanent mandibular first molar. An exhaustive search was undertaken to identify published literature related to the root anatomy and root canal morphology of the permanent mandibular first molar by using key words. The search of the MEDLINE database included all publications from 1966-May 2010. Selected articles were then obtained and reviewed. Data evaluated and summarized in the data sheet included methodology, population, number of teeth per study (power), number of root canals, type of root canal configuration, and identification of number of apical foramina. Forty-one studies were identified including a total of 18,781 teeth. The incidence of a third root was 13% and was strongly correlated with the ethnicity of the studied population. Three canals were present in 61.3%, 4 canals in 35.7%, and 5 canals in approximately 1%. Root canal configuration of the mesial root revealed 2 canals in 94.4% and 3 canals in 2.3%. The most common canal system configuration was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The presence of isthmus communications averaged 54.8% on the mesial and 20.2% on the distal root. The number of roots on the mandibular first molar is directly related to ethnicity. Root canal morphology and configuration might present the clinician with a complex anatomy requiring more diagnostic approaches, access modifications, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.
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            Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals.

            To evaluate the root canal configuration of permanent mandibular first and second molar teeth in a Chinese subpopulation using cone-beam computed tomography (CBCT). Patients who required CBCT radiographic examinations as part of their routine examination, diagnosis and treatment planning, were enrolled. Cases where the anatomy was compromised by physiological or pathological processes and the original root canal morphology was not clear were excluded. A total of 389 healthy, untreated, fully developed mandibular molars in Chinese individuals were included. The following observations were recorded: (i) the number of roots and their morphology; (ii) the number of canals per root; (iii) the canal configuration; (iv) the frequency of distolingual roots in the mandibular first molars and (v) the frequency of C-shaped canals in the mandibular second molars. The root canal configurations were classified according to the method of Vertucci (Oral Surgery, Oral Medicine, and Oral Pathology58, 1984, 589). The majority of mandibular molars (70% of first molars, 76% of second molars) had two separate roots; however, three roots were identified in 29% of first molars. C-shaped roots occurred in 29% of second molars. Three canals were found in 56% of mandibular first molars and 43% had four canals. In the mandibular second molars, 46% had three canals and 38% had two canals. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal. There were seven variants of the root canal morphology amongst the mandibular first molars and eight variants amongst the mandibular second molars, without considering the various root types. Three-rooted mandibular first molars and C-shaped mandibular second molars occurred frequently in this Chinese population. CBCT is an effective tool for the detection of additional distolingual roots and C-shaped roots/canals, and it is a valuable aid for dentists providing root canal treatment. © 2011 International Endodontic Journal.
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              Validation of cone beam computed tomography as a tool to explore root canal anatomy.

              Cone beam computed tomography (CBCT) can provide dentists with high-quality 3-dimensional images of dental structures because of its high spatial resolution. The reconstructions of root canal systems given by the Kodak 9000 3D were compared with histologic sections to evaluate the reliability of the reconstructions. Nine intact freshly extracted teeth with closed apexes were scanned by using the Kodak 9000 3D (spatial resolution 76 microm and 14 bits contrast resolution). After reconstruction of the volumes, the outline of the root canals was defined by segmentation. Histologic sections were then made of each specimen at predetermined levels. After digitization (resolution, 0.5-1 microm), 2-dimensional cone beam reconstructions were compared with the outline of the canals obtained by histologic sections by using areas and Feret's diameters. The statistical analysis was performed by using the Pearson correlation coefficient. Strong to very strong correlation was found between the data acquired by using CBCT and histology: r (area) = 0.928; r (diameter) = 0.890. The Kodak 9000 3D appears to be a very interesting, reliable, noninvasive measuring tool that can be used in all spatial planes. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                March 2022
                : 38
                : 1
                : 21-29
                Affiliations
                [3] Talca Maule orgnameUniversidad de Talca Chile
                [1] Talca Maule orgnameUniversidad de Talca orgdiv1Escuela de Graduados Chile
                [2] Talca Maule orgnameUniversidad de Talca Chile
                Article
                S0213-12852022000100005 S0213-1285(22)03800100005
                f29431a5-5bf8-4022-b457-b2f8e8981cde

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 02 July 2020
                : 25 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 65, Pages: 9
                Product

                SciELO Spain

                Categories
                Artículos

                Molar,Cone Beam Computed Tomography,Endodontics,Raíz Dental,Tomografía Computarizada de Haz Cónico,Endodoncia,Dental Root

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