The evolution of traditional techniques toward modern endodontic surgical procedures was discusse... more The evolution of traditional techniques toward modern endodontic surgical procedures was discussed in Part 1 of this series. The clinical procedures usually comprise exposure of the involved area, root-end resection and preparation and placement of root-end filling material. This article is a review of the literature which has been published on those materials that have been suggested for clinical use as root end fillers and on the shift towards the current materials of choice.
INTRODUCTION This study assessed the prevalence of radix entomolaris and two canals at the distal... more INTRODUCTION This study assessed the prevalence of radix entomolaris and two canals at the distal aspect of mandibular first molars amongst different geographic regions by means of cone-beam computed tomography (CBCT). METHODS Pre-calibrated observers from 23 worldwide geographic locations followed a standardized screening protocol to assess 5,750 CBCT images of mandibular first molars (250 per region) gathering demographic data and recording the presence of radix entomolaris and a second canal at the distal aspect of teeth. Intra- and inter-rater reliability tests were conducted and comparisons amongst groups were performed using proportions and odds ratio forest plots. Significance level was set at 5%. RESULTS Results of intra- and inter-rater tests were above 0.79. The prevalence of radix entomolaris varied from 0.9% in Venezuela (0%-1.9%, CI 95%) to 22.4% in China (17.2%-27.6%, CI 95%). Regarding the proportion of a second distal canal, it ranged from 16.4% in Venezuela (11.8%-21.0%, CI 95%) to 60.0% in Egypt (53.9%-66.1%, CI 95%). East Asia subgroup was associated with significantly higher prevalence of an extra distolingual root, while America subgroup, American native ethnic group and elderly patients were linked to significantly lower percentages of a second canal at the distal aspect of teeth. No significant differences were noted between male or female patients. CONCLUSIONS The overall worldwide prevalence of radix entomolaris and a second canal at the distal aspect of the mandibular first molar were 5.6% and 36.9%, respectively. East Asia geographic region and Asian ethnic group had higher prevalence of a second distal root.
Aim: The purpose of this in-vitro study was to compare the sealing ability of White ProRoot® MTA,... more Aim: The purpose of this in-vitro study was to compare the sealing ability of White ProRoot® MTA, MTA Plus?, Biodentine? and Permite Amalgam when used as rootend filling materials. Materials and methods: 120 single rooted, extracted teeth were endodontically treated. The apical 3 mm of each root was resected, and 3 mm deep root-end cavities were prepared.Specimens were divided into four groups (n=30) and filled with the following materials: ProRoot® MTA, MTA Plus?, Biodentine?, and Permite Amalgam. Specimens were submerged in Indian Ink for 48 hours, and sectioned horizontally in one millimetre increments from the apical end. Dye penetration was measured using a stereomicroscope. Results: Data for different groups was summarised as percentages. Pairwise comparisons between the calcium silicate materials to amalgam were done at the 0.017 level of significance, using Fisher's exact test. Amalgam showed significantly more leakage than the calcium silicate materials (ProRoot® MTA, M...
The discipline of endodontics has seen vast improvements in technology and clinical techniques ov... more The discipline of endodontics has seen vast improvements in technology and clinical techniques over the past several years. One of the areas that has been characterized by new developments is the way in which endodontic surgery is performed. The gap between biological concepts and the ability to achieve clinically successful results has been narrowed down with the use of microsurgical and ultrasonic instruments, new retrograde materials and the use of the Dental Operating Microscope. This article will review the indications and contraindications for endodontic surgery, the use of Cone Beam Computed Tomography for diagnosis and treatment planning, and finally outline the modern technique for endodontic microsurgery.
The evolution of traditional techniques toward modern endodontic surgical procedures was discusse... more The evolution of traditional techniques toward modern endodontic surgical procedures was discussed in Part 1 of this series. The clinical procedures usually comprise exposure of the involved area, root-end resection and preparation and placement of root-end filling material. This article is a review of the literature which has been published on those materials that have been suggested for clinical use as root end fillers and on the shift towards the current materials of choice.
Maxillary first molar second mesiobuccal (MB2) root canal prevalence may change among different p... more Maxillary first molar second mesiobuccal (MB2) root canal prevalence may change among different populations. The aim of this study was to analyze the worldwide prevalence of the MB2 root canal and understand its possible relation with sex, age, side, and root configuration using in vivo cone-beam computed tomographic (CBCT) assessment. Observers from 21 regions were calibrated to achieve a similar CBCT assessment methodology and instructed to collect data from 250 maxillary first molars in previously existing examinations. Intra- and interrater reliability tests were performed. The sample size included 5250 molars and was defined by way of a preliminary trial. Data collected included MB2 presence, sex, age, side, number of roots per tooth, and mesiobuccal root configuration. The z test for proportions in independent groups was used to analyze the differences among subgroups. P < .05 was considered significant. The worldwide CBCT-assessed MB2 prevalence was 73.8%, ranging from 48....
INTRODUCTION The presence of multiple root canals is an important morphological aspect of mandibu... more INTRODUCTION The presence of multiple root canals is an important morphological aspect of mandibular premolars. This study aimed to perform a worldwide analysis on the prevalence of a lingual canal in mandibular premolars and evaluate its influence on patients' demographics of 23 countries using CBCT images. METHODS Observers from 23 countries were instructed to evaluate CBCT images of 300 first and 300 second premolars (13,800 teeth) regarding the presence of a lingual canal, canal configuration, and data related to patients' ethnicity, age and gender, following a standardized screening methodology. Intra- and inter-rater evaluations were performed using Cohen's kappa test and intraclass correlation coefficient (ICC). Proportion and odds ratio forest plots were calculated in order to compare groups. Statistical significance was set at 5%. RESULTS Both kappa and ICC values were above 0.60 and percentage of agreement was 94.9% (first premolar) and 97.8% (second premolar). A significant statistical difference was observed between the worldwide proportion of a lingual canal in mandibular first (23.8%; 12.0-32.7%) and second (5.3%; 1.0%-15.3%) premolars (P < .05). Asians and patients over 60 years-old were associated with the lowest proportions of a lingual canal (P < .05), while Africans and younger groups with the highest (P < .05). Prevalence of a lingual canal in males (27.9%) was higher than females (20.0%) for the first premolar only (P < .05). Males were associated with 1.533 and 1.597 higher odds of presenting a lingual root canal in the first and second premolars, respectively. CONCLUSIONS The worldwide proportion of a lingual root canal was 23.6% and 5.3% for first and second premolars, respectively. Ethnicity, geographic region, age and gender had influence in the outcomes.
The evolution of traditional techniques toward modern endodontic surgical procedures was discusse... more The evolution of traditional techniques toward modern endodontic surgical procedures was discussed in Part 1 of this series. The clinical procedures usually comprise exposure of the involved area, root-end resection and preparation and placement of root-end filling material. This article is a review of the literature which has been published on those materials that have been suggested for clinical use as root end fillers and on the shift towards the current materials of choice.
INTRODUCTION This study assessed the prevalence of radix entomolaris and two canals at the distal... more INTRODUCTION This study assessed the prevalence of radix entomolaris and two canals at the distal aspect of mandibular first molars amongst different geographic regions by means of cone-beam computed tomography (CBCT). METHODS Pre-calibrated observers from 23 worldwide geographic locations followed a standardized screening protocol to assess 5,750 CBCT images of mandibular first molars (250 per region) gathering demographic data and recording the presence of radix entomolaris and a second canal at the distal aspect of teeth. Intra- and inter-rater reliability tests were conducted and comparisons amongst groups were performed using proportions and odds ratio forest plots. Significance level was set at 5%. RESULTS Results of intra- and inter-rater tests were above 0.79. The prevalence of radix entomolaris varied from 0.9% in Venezuela (0%-1.9%, CI 95%) to 22.4% in China (17.2%-27.6%, CI 95%). Regarding the proportion of a second distal canal, it ranged from 16.4% in Venezuela (11.8%-21.0%, CI 95%) to 60.0% in Egypt (53.9%-66.1%, CI 95%). East Asia subgroup was associated with significantly higher prevalence of an extra distolingual root, while America subgroup, American native ethnic group and elderly patients were linked to significantly lower percentages of a second canal at the distal aspect of teeth. No significant differences were noted between male or female patients. CONCLUSIONS The overall worldwide prevalence of radix entomolaris and a second canal at the distal aspect of the mandibular first molar were 5.6% and 36.9%, respectively. East Asia geographic region and Asian ethnic group had higher prevalence of a second distal root.
Aim: The purpose of this in-vitro study was to compare the sealing ability of White ProRoot® MTA,... more Aim: The purpose of this in-vitro study was to compare the sealing ability of White ProRoot® MTA, MTA Plus?, Biodentine? and Permite Amalgam when used as rootend filling materials. Materials and methods: 120 single rooted, extracted teeth were endodontically treated. The apical 3 mm of each root was resected, and 3 mm deep root-end cavities were prepared.Specimens were divided into four groups (n=30) and filled with the following materials: ProRoot® MTA, MTA Plus?, Biodentine?, and Permite Amalgam. Specimens were submerged in Indian Ink for 48 hours, and sectioned horizontally in one millimetre increments from the apical end. Dye penetration was measured using a stereomicroscope. Results: Data for different groups was summarised as percentages. Pairwise comparisons between the calcium silicate materials to amalgam were done at the 0.017 level of significance, using Fisher's exact test. Amalgam showed significantly more leakage than the calcium silicate materials (ProRoot® MTA, M...
The discipline of endodontics has seen vast improvements in technology and clinical techniques ov... more The discipline of endodontics has seen vast improvements in technology and clinical techniques over the past several years. One of the areas that has been characterized by new developments is the way in which endodontic surgery is performed. The gap between biological concepts and the ability to achieve clinically successful results has been narrowed down with the use of microsurgical and ultrasonic instruments, new retrograde materials and the use of the Dental Operating Microscope. This article will review the indications and contraindications for endodontic surgery, the use of Cone Beam Computed Tomography for diagnosis and treatment planning, and finally outline the modern technique for endodontic microsurgery.
The evolution of traditional techniques toward modern endodontic surgical procedures was discusse... more The evolution of traditional techniques toward modern endodontic surgical procedures was discussed in Part 1 of this series. The clinical procedures usually comprise exposure of the involved area, root-end resection and preparation and placement of root-end filling material. This article is a review of the literature which has been published on those materials that have been suggested for clinical use as root end fillers and on the shift towards the current materials of choice.
Maxillary first molar second mesiobuccal (MB2) root canal prevalence may change among different p... more Maxillary first molar second mesiobuccal (MB2) root canal prevalence may change among different populations. The aim of this study was to analyze the worldwide prevalence of the MB2 root canal and understand its possible relation with sex, age, side, and root configuration using in vivo cone-beam computed tomographic (CBCT) assessment. Observers from 21 regions were calibrated to achieve a similar CBCT assessment methodology and instructed to collect data from 250 maxillary first molars in previously existing examinations. Intra- and interrater reliability tests were performed. The sample size included 5250 molars and was defined by way of a preliminary trial. Data collected included MB2 presence, sex, age, side, number of roots per tooth, and mesiobuccal root configuration. The z test for proportions in independent groups was used to analyze the differences among subgroups. P < .05 was considered significant. The worldwide CBCT-assessed MB2 prevalence was 73.8%, ranging from 48....
INTRODUCTION The presence of multiple root canals is an important morphological aspect of mandibu... more INTRODUCTION The presence of multiple root canals is an important morphological aspect of mandibular premolars. This study aimed to perform a worldwide analysis on the prevalence of a lingual canal in mandibular premolars and evaluate its influence on patients' demographics of 23 countries using CBCT images. METHODS Observers from 23 countries were instructed to evaluate CBCT images of 300 first and 300 second premolars (13,800 teeth) regarding the presence of a lingual canal, canal configuration, and data related to patients' ethnicity, age and gender, following a standardized screening methodology. Intra- and inter-rater evaluations were performed using Cohen's kappa test and intraclass correlation coefficient (ICC). Proportion and odds ratio forest plots were calculated in order to compare groups. Statistical significance was set at 5%. RESULTS Both kappa and ICC values were above 0.60 and percentage of agreement was 94.9% (first premolar) and 97.8% (second premolar). A significant statistical difference was observed between the worldwide proportion of a lingual canal in mandibular first (23.8%; 12.0-32.7%) and second (5.3%; 1.0%-15.3%) premolars (P < .05). Asians and patients over 60 years-old were associated with the lowest proportions of a lingual canal (P < .05), while Africans and younger groups with the highest (P < .05). Prevalence of a lingual canal in males (27.9%) was higher than females (20.0%) for the first premolar only (P < .05). Males were associated with 1.533 and 1.597 higher odds of presenting a lingual root canal in the first and second premolars, respectively. CONCLUSIONS The worldwide proportion of a lingual root canal was 23.6% and 5.3% for first and second premolars, respectively. Ethnicity, geographic region, age and gender had influence in the outcomes.
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