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RADICULAR GROOVE OF MAXILLARY PREMOLAR: IS A “DANGER ZONE"?

Year 2022, Volume: 25 Issue: Supplement, 7 - 12, 25.03.2022

Deniz Yanık Ahmet Mert Nalbantoğlu

https://doi.org/10.7126/cumudj.1024538
Cited By: 2

Abstract

Objectives: To evaluate the presence of radicular groove and dentin thickness on the palatal aspect of the buccal root of maxillary first premolars using cone-beam computed tomography (CBCT).
Materials and methods: Images of 312 maxillary first premolars belonging to 187 patients (between 18-69 years, 94 females and 93 males) who were referred to the clinic were retrospectively reviewed. Root canal treatment, periapical lesion, and post-core were excluded. One and three-rooted premolars were also excluded. CBCT images were viewed on the axial plane to detect grooves. The concave area on the palatal aspect of the buccal root was recorded as a groove. Buccal and palatal dentin thicknesses were measured by two observers at the level of 3 mm below furcation. Statistical analyses were performed.
Results: Buccal and palatal thicknesses were 1.28(±0.25) and 0.87(±0.13) mm, respectively. According to Student’s t-test, buccal dentin thickness was statistically higher than palatal dentin (p=0.016). The prevalence of groove was 82.05%. While palatal thickness without groove was 0.93(±0.14) mm, palatal thickness corresponding to groove was 0.82(±0.12) mm. One-way ANOVA showed palatal and buccal thickness in group 1 (18-35 years) was statistically lower than group 3 (>65 years) (p=0.012 and p=0.003). No statistical difference in thickness was observed between sex and left or right side (p>0.05).
Conclusions: Palatal thickness related to groove can be considered a “danger zone” for post-core and endodontic treatment. Considering the high prevalence (82.05%) and thin dentin of the groove, more conservative canal and post space preparation and CBCT examination are recommended to avoid perforation.

Keywords

Cone-beam computed tomography Dentin Endodontics Root canal preparation Root canal therapy

References

  • 1. Silva LR, de Lima KL, Santos AA, Leles CR, Estrela C, de Freitas Silva BS, Yamamoto-Silva FP. Dentin thickness as a risk factor for vertical root fracture in endodontically treated teeth: a case-control study. Clin Oral Investig 2021;25:1099-1105.
  • 2. De-Deus G, Rodrigues EA, Belladonna FG, Simoes-Carvalho M, Cavalcante DM, Oliveira DS, Paciornik S. Anatomical danger zone reconsidered: a micro-CT study on dentine thickness in mandibular molars. Int Endod J 2019;52:1501-1507.
  • 3. Ordinola-Zapata R, Martins JNR, Versiani MA, Bramante CM. Micro-CT analysis of danger zone thickness in the mesiobuccal roots of maxillary first molars. Int Endod J 2019;52:524-529.
  • 4. Heyse JD, Ordinola-Zapata R, Gaalaas L, McClanahan SB. The effect of rotary instrumentation on dentin thickness in the danger zone of the MB2 canal of maxillary first molars. Aust Endod J 2021;5:8-166.
  • 5. Xu J, He J, Yang Q, Huang D, Zhou X, Peters OA, Gao Y. Accuracy of cone-beam computed tomography in measuring dentin thickness and its potential of predicting the remaining dentin thickness after removing fractured instruments. J Endod 2017;43:1522-1527.
  • 6. Pinheiro TN, Cintra LTA, Azuma MM, Benetti F, Silva CC, Consolaro A. Palatogingival groove and root canal instrumentation. Int Endod J 2020;53:660-670.
  • 7. Shemesh A, Lalum E, Ben Itzhak J, Levy DH, Lvovsky A, Levinson O, Solomonov M. Radicular grooves and complex root morphologies of mandibular premolars among Israeli population. J Endod 2020;46:1241-1247.
  • 8. Tamse A, Katz A, Pilo R. Furcation groove of buccal root of maxillary first premolars—A morphometric study. J Endod 2000;26:359-363.
  • 9. Kfir A, Mostinsky O, Elyzur O, Hertzeanu M, Metzger Z, Pawar AM. Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study. Sci Reports 2020;10:1-8.
  • 10. Lammertyn PA, Rodrigo SB, Brunotto M, Crosa M. Furcation groove of maxillary first premolar, thickness, and dentin structures. J Endod 2009;35:814-817.
  • 11. Booker BW, Loughlin DM. A Morphologic Study of the mesial root surface of the adolescent maxillary first bicuspid. J Periodontol 1985;56:666-670.
  • 12. Joseph I, Varma BRR, Bhat KM. Clinical significance of furcation anatomy of the maxillary first premolar: a biometric study on extracted teeth. J Periodontol 1996;67:386-389.
  • 13. Awawdeh L, Abdullah H, Al-Qudah A. Root form and canal morphology of jordanian maxillary first premolars. J Endod 2008;34:956-961.
  • 14. Katz A, Wasenstein-Kohn S, Tamse A, Zuckerman O. Residual dentin thickness in bifurcated maxillary premolars after root canal and dowel space preparation. J Endod 2006;32:202-205.
  • 15. Liu X, Gao M, Bai Q, Ruan J, Lu Q. Evaluation of palatal furcation groove and root canal anatomy of maxillary first premolar: A CBCT and micro-CT study. Biomed Res Int 2021;1:8862956. 16. Li J, Li L, Pan Y. Anatomic study of the buccal root with furcation groove and associated root canal shape in maxillary first premolars by using micro–computed tomography. J Endod 2013;39:265-268.
  • 17. Mihaela Gheorghiță L, Elena Amza O, Diaconu C, Gheorghiță M, Diaconu OA, Georgescu RV, POpescu SM, Petcu C, Tuculina MJ. Root form and root canal morphology in maxillary first premolars-in vitro study. Rom J Oral Rehabil 2020;12:216-233.
  • 18. Al-Shahrani SM, Al-Sudani D, Almalik M, Gambarini G, AlRumaihi FA. Microcomputed tomographic analysis of the furcation grooves of maxillary first premolars. Ann Stomatol (Roma) 2013;4:142.
  • 19. Gher ME, Vernino AR. Root morphology--clinical significance in pathogenesis and treatment of periodontal disease. J Am Dent Assoc 1980;101:627-633.
  • 20. Elnaghy AM, Elsaka SE. Evaluation of root canal transportation, centering ratio, and remaining dentin thickness associated with protaper next instruments with and without glide path. J Endod 2014;40:2053-2056.
  • 21. Lim SS, Stock CJR. The risk of perforation in the curved canal:anticurvature filing compared with the stepback technique. Int Endod J 1987;20:33-39.
  • 22. Raiden G. Radiographic measurement of residual root thickness in premolars with post preparation. J Endod 2001;27:296-298.
  • 23. Mattuella LG, Mazzoccato G, Vier FV, Só MVR. Root canals and apical foramina of the buccal root of maxillary first premolars with longitudinal sulcus. Braz Dent J 2005;16:23-29.
  • 24. Cate A Ten. Oral histology: development, structure, and function. In:Nanci A (ed.). Elsevier, 2017. 25. Leknes KN, Lie T, Selvig KA. Root Grooves: A risk factor in periodontal attachment loss. J Periodontol 1994;65:859-863.
  • 26. Bellucci C, Perrini N. A study on the thickness of radicular dentine and cementum in anterior and premolar teeth. Int Endod J 2002;35:594-606.
  • 27. Ahmad IA, Alenezi MA. Root and root canal morphology of maxillary first premolars: a literature review and clinical considerations. J Endod 2016;42:861-872.
  • 28. Bower RC. Furcation Morphology Relative to periodontal treatment: furcation root surface anatomy. J Periodontol 1979;50:366-374.
  • 29. Testori T, Badino M, Castagnola M. Vertical root fractures in endodontically treated teeth: A clinical survey of 36 cases. J Endod 1993;19:87-90.
  • 30. Pilo R, Shapenco E, Lewinstein I. Residual dentin thickness in bifurcated maxillary first premolars after root canal and post space preparation with parallel-sided drills. J Prosthet Dent 2008;99:267-273.
  • 31. Plotino G, Grande NM, Mercade M. Photodynamic therapy in endodontics. Int Endod J 2019;52:760-774.

Maksiller premolar bukkal kök oluğu: bir “tehlikeli bölge” mi?

Year 2022, Volume: 25 Issue: Supplement, 7 - 12, 25.03.2022

Deniz Yanık Ahmet Mert Nalbantoğlu

https://doi.org/10.7126/cumudj.1024538
Cited By: 2

Abstract

Amaç: Bu çalışmanın amacı maksiller birinci premolardaki bukkal kökün palatinalinde bulunan oluğun prevalansının ve ayrıca bukkal ve palatinal dentin kalınlığının konik-ışınlı bilgsayarlı tomografi kullanarak (KIBT) incelenmesidir.
Yöntem: Çalışmaya, kliniğe başvuran 187 hastaya ait (18-69 yaş arası, 94 kadın ve 93 erkek) 312 premolar dişin KIBT görüntüsü dahil edildi. Kanal tedavili, post uygulanmış, tek veya üç köklü premolar dişler çalışma dışı bırakıldı. Kök oluğunu tespit edebilmek için KIBT görüntüleri aksiyel kesitte incelendi. Bukkal kökün palatinalindeki konkav alanlar oluk olarak kaydedildi. Bukkal ve palatinal dentin kalınlıkları iki gözlemci tarafından, furkasyonun 3 mm altından ölçüldü. İstatistiksel analiz yapıldı.
Bulgular: Bukkal ve palatinal dentin kalınlıkları sırasıyla 1.28(±0.25) ve 0.87(±0.13) olarak bulundu. Student’s t-testine göre, bukkal dentin kalınlığı palatinaldeki dentin kalınlığına göre istatististiksel olarak anlamlı derecede fazla bulundu (p=0.016). Bukkal oluk prevalansı %82.05 olarak kaydedildi. Oluk bulunmayan palatinal dentin kalınlığı 0.93(±0.14) mm iken oluk bulunan palatinal dentin kalınlığı 0.82(±0.12) mm olarak tespit edildi. Tek yönlü ANOVA testine göre, palatinal ve bukkal kalınlık grup 1(18-35 yaş)’de istatistiksel olarak anlamlı derecede grup 3 (>65 yaş)’e göre daha inceydi (p=0.012 ve p=0.003). Cinsiyet ve sağ-sol arasında dentin kalınlığı açısından bir farklılık gözlenmedi (p>0.05).
Sonuç: Kök oluğu bulunan bölgedeki dentin kalınlığı kanal tedavisi ve özellikle kök dentininde kayba sebep olan post uygulamaları açısından “tehlikeli bölge” olarak düşünülebilir. Kök oluğunun yüksek prevalansı ve kök oluğundaki ince dentin varlığı düşünüldüğünde, klinikte perforasyon oluşumu engellemek için, işlem öncesi üç boyutlu inceleme ve ayrıca daha konservatif kanal şekillendirmesi ve post boşluğu hazırlığı önerilir.

Keywords

Konik ışınlı bilgisayarlı tomografi Dentin Endodonti Kök kanalını hazırlama kök kanal tedavisi

References

  • 1. Silva LR, de Lima KL, Santos AA, Leles CR, Estrela C, de Freitas Silva BS, Yamamoto-Silva FP. Dentin thickness as a risk factor for vertical root fracture in endodontically treated teeth: a case-control study. Clin Oral Investig 2021;25:1099-1105.
  • 2. De-Deus G, Rodrigues EA, Belladonna FG, Simoes-Carvalho M, Cavalcante DM, Oliveira DS, Paciornik S. Anatomical danger zone reconsidered: a micro-CT study on dentine thickness in mandibular molars. Int Endod J 2019;52:1501-1507.
  • 3. Ordinola-Zapata R, Martins JNR, Versiani MA, Bramante CM. Micro-CT analysis of danger zone thickness in the mesiobuccal roots of maxillary first molars. Int Endod J 2019;52:524-529.
  • 4. Heyse JD, Ordinola-Zapata R, Gaalaas L, McClanahan SB. The effect of rotary instrumentation on dentin thickness in the danger zone of the MB2 canal of maxillary first molars. Aust Endod J 2021;5:8-166.
  • 5. Xu J, He J, Yang Q, Huang D, Zhou X, Peters OA, Gao Y. Accuracy of cone-beam computed tomography in measuring dentin thickness and its potential of predicting the remaining dentin thickness after removing fractured instruments. J Endod 2017;43:1522-1527.
  • 6. Pinheiro TN, Cintra LTA, Azuma MM, Benetti F, Silva CC, Consolaro A. Palatogingival groove and root canal instrumentation. Int Endod J 2020;53:660-670.
  • 7. Shemesh A, Lalum E, Ben Itzhak J, Levy DH, Lvovsky A, Levinson O, Solomonov M. Radicular grooves and complex root morphologies of mandibular premolars among Israeli population. J Endod 2020;46:1241-1247.
  • 8. Tamse A, Katz A, Pilo R. Furcation groove of buccal root of maxillary first premolars—A morphometric study. J Endod 2000;26:359-363.
  • 9. Kfir A, Mostinsky O, Elyzur O, Hertzeanu M, Metzger Z, Pawar AM. Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study. Sci Reports 2020;10:1-8.
  • 10. Lammertyn PA, Rodrigo SB, Brunotto M, Crosa M. Furcation groove of maxillary first premolar, thickness, and dentin structures. J Endod 2009;35:814-817.
  • 11. Booker BW, Loughlin DM. A Morphologic Study of the mesial root surface of the adolescent maxillary first bicuspid. J Periodontol 1985;56:666-670.
  • 12. Joseph I, Varma BRR, Bhat KM. Clinical significance of furcation anatomy of the maxillary first premolar: a biometric study on extracted teeth. J Periodontol 1996;67:386-389.
  • 13. Awawdeh L, Abdullah H, Al-Qudah A. Root form and canal morphology of jordanian maxillary first premolars. J Endod 2008;34:956-961.
  • 14. Katz A, Wasenstein-Kohn S, Tamse A, Zuckerman O. Residual dentin thickness in bifurcated maxillary premolars after root canal and dowel space preparation. J Endod 2006;32:202-205.
  • 15. Liu X, Gao M, Bai Q, Ruan J, Lu Q. Evaluation of palatal furcation groove and root canal anatomy of maxillary first premolar: A CBCT and micro-CT study. Biomed Res Int 2021;1:8862956. 16. Li J, Li L, Pan Y. Anatomic study of the buccal root with furcation groove and associated root canal shape in maxillary first premolars by using micro–computed tomography. J Endod 2013;39:265-268.
  • 17. Mihaela Gheorghiță L, Elena Amza O, Diaconu C, Gheorghiță M, Diaconu OA, Georgescu RV, POpescu SM, Petcu C, Tuculina MJ. Root form and root canal morphology in maxillary first premolars-in vitro study. Rom J Oral Rehabil 2020;12:216-233.
  • 18. Al-Shahrani SM, Al-Sudani D, Almalik M, Gambarini G, AlRumaihi FA. Microcomputed tomographic analysis of the furcation grooves of maxillary first premolars. Ann Stomatol (Roma) 2013;4:142.
  • 19. Gher ME, Vernino AR. Root morphology--clinical significance in pathogenesis and treatment of periodontal disease. J Am Dent Assoc 1980;101:627-633.
  • 20. Elnaghy AM, Elsaka SE. Evaluation of root canal transportation, centering ratio, and remaining dentin thickness associated with protaper next instruments with and without glide path. J Endod 2014;40:2053-2056.
  • 21. Lim SS, Stock CJR. The risk of perforation in the curved canal:anticurvature filing compared with the stepback technique. Int Endod J 1987;20:33-39.
  • 22. Raiden G. Radiographic measurement of residual root thickness in premolars with post preparation. J Endod 2001;27:296-298.
  • 23. Mattuella LG, Mazzoccato G, Vier FV, Só MVR. Root canals and apical foramina of the buccal root of maxillary first premolars with longitudinal sulcus. Braz Dent J 2005;16:23-29.
  • 24. Cate A Ten. Oral histology: development, structure, and function. In:Nanci A (ed.). Elsevier, 2017. 25. Leknes KN, Lie T, Selvig KA. Root Grooves: A risk factor in periodontal attachment loss. J Periodontol 1994;65:859-863.
  • 26. Bellucci C, Perrini N. A study on the thickness of radicular dentine and cementum in anterior and premolar teeth. Int Endod J 2002;35:594-606.
  • 27. Ahmad IA, Alenezi MA. Root and root canal morphology of maxillary first premolars: a literature review and clinical considerations. J Endod 2016;42:861-872.
  • 28. Bower RC. Furcation Morphology Relative to periodontal treatment: furcation root surface anatomy. J Periodontol 1979;50:366-374.
  • 29. Testori T, Badino M, Castagnola M. Vertical root fractures in endodontically treated teeth: A clinical survey of 36 cases. J Endod 1993;19:87-90.
  • 30. Pilo R, Shapenco E, Lewinstein I. Residual dentin thickness in bifurcated maxillary first premolars after root canal and post space preparation with parallel-sided drills. J Prosthet Dent 2008;99:267-273.
  • 31. Plotino G, Grande NM, Mercade M. Photodynamic therapy in endodontics. Int Endod J 2019;52:760-774.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Deniz Yanık 0000-0001-5676-0293

Ahmet Mert Nalbantoğlu 0000-0002-0505-867X

Publication Date March 25, 2022
Submission Date November 16, 2021
Published in Issue Year 2022Volume: 25 Issue: Supplement

Cite

EndNote Yanık D, Nalbantoğlu AM (March 1, 2022) RADICULAR GROOVE OF MAXILLARY PREMOLAR: IS A “DANGER ZONE"?. Cumhuriyet Dental Journal 25 Supplement 7–12.

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How loss of tooth structure impacts the biomechanical behavior of a single-rooted maxillary premolar: FEA
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https://doi.org/10.1007/s10266-023-00829-6
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