Signs of a missed root canal
https://doi.org/10.36377/1683-2981-2023-21-3-205-211
Abstract
Aim. To describe the radiological signs of a "missed" root canal when using CBCT based on verified clinical cases.
Materials and methods. The study is based on the analysis of cases of endodontic treatment, which are associated with the detection of a "missed" root canal detected intraoperatively at the stage of primary endodontic treatment or at the stage of endodontic revision (repeated endodontic intervention). Clinical cases were verified by detecting the root canal during endodontic treatment using a microscope.
Results. During the endodontic treatment of 2149 teeth, 506 "missed" canals were identified and verified using a microscope. Based on the comparison of cone-beam computed tomography data and clinical data obtained during the examination of teeth under a microscope, 7 signs of the presence of a "missed" root canal are described. General recommendations are given to improve the quality of root canal system diagnostics.
Conclusions. The presented information contributes to improving the accuracy of diagnosis, proper planning and improving the effectiveness of endodontic treatment not only in endodontic revision (repeated root canal treatment), but also in primary endodontic treatment.
About the Authors
M. Yu. Pokrovsky
Scientific Center of additional professional Education «Sadko»
Russian Federation
Russian Federation
Mikhail Yu. Pokrovsky – Candidate of Medical Sciences, leading specialist dentist
Nizhny Novgorod
O. A. Aleshina
National Research Lobachevsky State University of Nizhny Novgorod
Russian Federation
Russian Federation
Olga A. Aleshina – Candidate of Medical Sciences, Associate Professor of the Department of Propaedeutic Dentistry
Nizhny Novgorod
T. P. Goryacheva
National Research Lobachevsky State University of Nizhny Novgorod
Russian Federation
Russian Federation
Tatiana P. Goryacheva – Candidate of Medical Sciences, Senior Lecturer at the Department of Propaedeutic Dentistry
Nizhny Novgorod
A. M. Pokrovskiy
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Andrew M. Pokrovskiy – student
Nizhny Novgorod
References
1. Davies A, Mannocci F, Mitchell P, Andiappan M, Patel S. The detection of periapical pathoses in root filled teeth using single and parallax periapical radiographs versus cone beam computed tomography – a clinical study. Int Endod J. 2015 Jun;48(6):582-92. doi: 10.1111/iej.12352.
2. Abuabara A, Baratto-Filho F, Aguiar Anele J, Leonardi DP, Sousa-Neto MD. Efficacy of clinical and radiological methods to identify second mesiobuccal canals in maxillary first molars. Acta Odontol Scand. 2013 Jan;71(1):205-9. doi: 10.3109/00016357.2011.654262.
3. De Carlo Bello M, Tibúrcio-Machado C, Dotto Londero C, Branco Barletta F, Cunha Moreira CH, Pagliarin CML. Diagnostic Efficacy of Four Methods for Locating the Second Mesiobuccal Canal in Maxillary Molars. Iran Endod J. 2018 Spring;13(2):204-208. doi: 10.22037/iej.v13i2.16564.
4. Dalili Kajan Z, Taramsari M, Khosravi Fard N, Kanani M. Accuracy of Cone-beam Computed Tomography in Comparison with Standard Method in Evaluating Root Canal Morphology: An In Vitro Study. Iran Endod J. 2018 Spring;13(2):181-187. doi: 10.22037/iej.v13i2.18614
5. Chogle S, Zuaitar M, Sarkis R, Saadoun M, Mecham A, Zhao Y. The Recommendation of Cone-beam Computed Tomography and Its Effect on Endodontic Diagnosis and Treatment Planning. J Endod. 2020 Feb;46(2):162-168. doi: 10.1016/j.joen.2019.10.034.
6. Mota de Almeida FJ, Knutsson K, Flygare L. The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics. Dentomaxillofac Radiol. 2014;43(4):20130137. doi: 10.1259/dmfr.20130137.
7. Reit C, Hollender L. Radiographic evaluation of endodontic therapy and the influence of observer variation. Scand J Dent Res. 1983 Jun;91(3):205-12. doi: 10.1111/j.1600-0722.1983.tb00803.x.
8. Venskutonis T, Plotino G, Tocci L, Gambarini G, Maminskas J, Juodzbalys G. Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography. J Endod. 2015 Feb;41(2):190-6. doi: 10.1016/j.joen.2014.10.017.
9. Pokrovsky M.Y., Aleshina O.A., Goryacheva T.P. Missed root canal as a factor affecting the periapical status. Endodontics Today. 2022. 20(4). 292-296. doi: 10.36377/1683-2981-2022-20-4-292-296.
10. Ruzhilo-Kalinovskaya I., Ruzhilo T.Three-dimensional tomography in dental practice. GalDent.2012:584.
11. Krasner P, Rankow HJ. Anatomy of the pulp-chamber floor. J Endod. 2004 Jan;30(1):5-16. doi: 10.1097/00004770-200401000-00002.
12. Ahmed HMA, Dummer PMH. A new system for classifying tooth, root and canal anomalies. Int Endod J. 2018 Apr;51(4):389-404. doi: 10.1111/iej.12867.
13. Peikoff MD, Perry JB, Chapnick LA. Endodontic failure attributable to a complex radicular lingual groove. J Endod. 1985 Dec;11(12):573-7. doi: 10.1016/S0099-2399(85)80205-3.
14. Lara VS, Consolaro A, Bruce RS. Macroscopic and microscopic analysis of the palato-gingival groove. J Endod. 2000 Jun;26(6):345-50. doi: 10.1097/00004770-200006000-00009.
15. Oehlers F.A. Dens invaginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol. 1957. 10(11). 1204-1218 contd. doi: 10.1016/0030-4220(57)90077-4.
16. OEHLERS FA. Dens invaginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol. 1957 Nov;10(11):1204-18 contd. doi: 10.1016/0030-4220(57)90077-4.
17. Karabucak B, Bunes A, Chehoud C, Kohli MR, Setzer F. Prevalence of Apical Periodontitis in Endodontically Treated Premolars and Molars with Untreated Canal: A Cone-beam Computed Tomography Study. J Endod. 2016 Apr;42(4):538-41. doi: 10.1016/j.joen.2015.12.026.
18. Chang SW, Lee JK, Lee Y, Kum KY. In-depth morphological study of mesiobuccal root canal systems in maxillary first molars: review. Restor Dent Endod. 2013 Feb;38(1):2-10. doi: 10.5395/rde.2013.38.1.2.
19. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984 Nov;58(5):589-99. doi: 10.1016/0030-4220(84)90085-9.
20. Pereira B, Martins JNR, Baruwa AO, Meirinhos J, Gouveia J, Quaresma SA, Monroe A, Ginjeira A. Association between Endodontically Treated Maxillary and Mandibular Molars with Fused Roots and Periapical Lesions: A Cone-beam Computed Tomography Cross-sectional Study. J Endod. 2020 Jun;46(6):771-777.e1. doi: 10.1016/j.joen.2020.03.003.
Review
For citations:
Pokrovsky M.Yu., Aleshina O.A., Goryacheva T.P., Pokrovskiy A.M. Signs of a missed root canal. Endodontics Today. 2023;21(3):205-211. (In Russ.) https://doi.org/10.36377/1683-2981-2023-21-3-205-211
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