Three-Dimensional Volumetric/ Linear Analysis and Axial Classification of Root Resorptions Using Cone Beam Computed Tomography: A Retrospective Study
Abstract
Objectives: The purpose of this study was to investigate the volumetric-linear analysis and to present a new axial classification of root resorptions using cone-beam computed tomography (CBCT).
Materials and Methods: A total of 43 teeth with root resorption (external cervical resorption (ECR) (n=27), external replacement resorption (ERR) (n=4) and internal root resorption (IRR) (n=12)) from 34 patients were included in this study. On CBCT images of teeth, the volume of total tooth and resorption for the volumetric analysis, the widest lengths of resorptions and the amount of thinnest dentin thickness around them for the linear analysis were measured, and volumetric/linear measurements were compared according to age and gender. In addition, the eight regional axial classification was performed, and these regions were compared. Data were evaluated using Shapiro-Wilk, Pearson’s r., Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner post-hoc tests. Significance was set at p=0.05 for statistical analysis.
Results: No significant difference was found between the volumetric and linear measurements of ECRs, ERRs, and IRRs. No difference between genders in volumetric and linear measurements of ECRs and IRRs, except total tooth volume, was higher in males than in females in ECRs (p<0.05). With increasing age in ECRs, buccal dentin thickness increased, and bucco-lingual length and total tooth volume decreased (p<0.05). In axial classification, ECRs were mostly found in lingual, while IRRs and ERRs did not show regional differences.
Conclusions: Although root resorptions had different localizations and classifications, they did not differ in terms of volumetric and linear measurements due to having similar nature. Using CBCT imaging, the volumetric/linear analysis and axial classification of resorptions, and demographic differences according to these parameters can help clinicians in understanding the nature of resorption and in determining appropriate management.
References
- Heithersay GS. Invasive cervical resorption. Endod Topics 2004;7:73−92.
- Patel S, Ricucci D, Durak C, Tay F. Internal root resorption: A Review. J Endod 2010;36:1107–1121.
- Patel S, Ford TP. Is the resorption external or internal? Dent Update 2007;34:218–229.
- Patel S, Dawood A, Wilson R, Horner K, Mannocci F. The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography – an in vivo investigation. Int Endod J 2009;42:831–838.
- Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical resorption in vital teeth. J Endod 2016;42:1737–1751.
- Alamadi E, Alhazmi H, Hansen K, Lundgren T, Naoumova J. A comparative study of cone beam computed tomography and conventional radiography in diagnosing the extent of root resorptions. Prog Orthod 2017;18:37.
- Owmann-Moll P, Kurol J. Root resorption after orthodontic treatment in high- and low-risk patients: analysis of allergy as a possible predisposing factor. Eur J Orthodont 2000;22:657–663.
- Bernardes RA, de Paulo RS, Pereira LO, Duarte MAH, Ordinola-Zapata R, de Azevedo JR. Comparative study of cone beam computed tomography and intraoral periapical radiographs in diagnosis of lingual-simulated external root resorptions. Dent Traumatol 2012;28:268–272.
- de Azevedo Vaz SL, Vasconcelos TV, Neves FS, de Freitas DQ, Haiter-Neto F. Influence of cone-beam computed tomography enhancement filters on diagnosis of simulated external root resorption. J Endod 2012;38:305–308.
- Scarfe WC, Farman AG. Cone-beam computed tomography. In: White SC, Pharoah MJ (eds). Oral Radiology Principles and Interpretation. 6th ed. St. Louis: Mosby 2004:225-241.
- Heithersay GS. Invasive cervical resorption: an analysis of potential predisposing factors. Quintessence Int 1999;30:83–95.
- Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three‐dimensional classification. Int Endod J 2018;51:206-214.
- Goodell KB, Mines P, Kersten DD. Impact of cone-beam computed tomography on treatment planning for external cervical resorption and a novel axial slice–based classification system. J Endod 2018;44:239-244.
- Matny LE, Ruparel NB, Levin MD, Noujeim M, Diogenes A. A volumetric assessment of external cervical resorption cases and ıts correlation to classification, treatment planning, and expected prognosis. J Endod 2020;46:1052-1058.
- Shemesh A, Levin A, Hadad A, Itzhak JB, Solomonov M. CBCT analyses of advanced cervical resorption aid in selection of treatment modalities: a retrospective analysis. Clin Oral Invest 2019;23:1635–1640.
- Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, Lemberg K. European Society of Endodontology position statement: the use of CBCT in endodontics. Int Endod J 2014;47:502-504.
- AAE and AAOMR Joint Position Statement: Use of cone-beam computed tomography in endodontics 2015 update. J Endod 2015;41:1393-1396.
- Heithersay GS. Clinical, radiologic, and histopathologic features of invasive cervical resorption. Quintessence Int 1999;30:27–37.
- Lindskog SF, Dreyer CW, Pierce AM, Torabinejad M, Shabahang S. Osteoclastic activity. In: Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. 4th ed. Oxford, UK: Blackwell Munksgaard 2007:137-171.
- Patel S, Mavridou AM, Lambrechts P, Saberi N. External cervical resorption-part 1: histopathology, distribution and presentation. Int Endod J 2018;51:1205-1223.
- Patel S, Foschi F, Condon R, Pimentel T, Bhuva B. External cervical resorption: part 2 – management. Int Endod J 2018;51:1224-1238.
- Patel K, Mannocci F, Patel S. The assessment and management of external cervical resorption with periapical radiographs and cone-beam computed tomography: a clinical study. J Endod 2016;42:1435–1440.
- Mavridou AM, Bergmans L, Barendregt D, Lambrechts P. Descriptive analysis of factors associated with external cervical resorption. J Endod 2017;43:1602–1610.
- Nilsson E, Bonte E, Bayet F, Lasfargues JJ. Management of internal root resorption on permanent teeth. Int J Dent 2013;2013:929486.
- Fuss Z, Tsesis I, Lin S. Root resorption: diagnosis, classification and treatment choices based on stimulation factors. Dent Traumatol 2003;19:175–182.
- Malmgren B. Ridge preservation/decoronation. J Endod 2013;39:67–72.
- Gulsahi A, Kulah CK, Bakirarar B, Gulen O, Kamburoglu K. Age estimation based on pulp/tooth volume ratio measured on cone-beam CT images. Dentomaxillofac Radiol 2018;47:20170239.
- American Association of Endodontists (AAE) [homepage]. Chicago: Glossary of endodontic terms; 2010 [cited 2020 Jun 10]. Available from: https://www.aae.org/specialty/clinical-resources/glossary-endodontic-terms/
- Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical tooth resorption patterns in endodontically treated teeth. Int Endod J 2017;50:1116–1133.
Abstract
Amaç: Bu çalışmanın amacı, konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak kök rezorpsiyonlarının hacimsel-lineer analizini araştırmak ve yeni bir aksiyel sınıflandırma sunmaktır.
Gereç ve Yöntemler: Çalışmaya 34 hastanın toplamda 43 kök rezorpsiyonlu dişi (eksternal servikal rezorpsiyon (ESR) (n=27), eksternal replasman rezorpsiyon (ERR) (n=4), internal kök rezorpsiyonu (İKR) (n=12)) dahil edildi. Dişlerin KIBT görüntülerinde, hacimsel analiz için toplam diş hacmi ve rezorpsiyon hacimleri, lineer analiz için rezorpsiyonların en geniş uzunlukları ve bunların etrafındaki en ince dentin kalınlığı miktarları ölçüldü ve hacimsel/lineer ölçümler yaş ve cinsiyete göre karşılaştırıldı. Ek olarak, aksiyel kesitte sekizli bölgesel sınıflama uygulandı ve bu bölgeler karşılaştırıldı. Veriler Shapiro-Wilk, Pearson’s r., Kruskal-Wallis ve Dwass-Steel-Critchlow-Fligner post-hoc testleri kullanılarak değerlendirildi. İstatistiksel analiz için anlamlılık p=0.05 olarak belirlendi.
Bulgular: ESR, ERR ve İKR'lerin hacimsel ve lineer ölçümleri arasında anlamlı bir fark bulunamadı. ESR bulunan erkek hastaların dişinin toplam hacmi kadınlara göre daha yüksek olması dışında (p<0.05), ESR ve İKR’lerin hacimsel ve lineer ölçümlerinde cinsiyetler arasında fark yoktu. ESR'lerde yaş arttıkça bukkal dentin kalınlığı arttı, bukko-lingual uzunluk ve dişin toplam hacmi azaldı (p<0.05). Aksiyel sınıflandırmada, ESR'ler çoğunlukla lingual bölgede bulunurken, ERR ve İKR'lerde bölgesel farklılık gözlenmedi.
Sonuçlar: Kök rezorpsiyonları farklı lokalizasyon ve sınıflandırmalara sahip olsalar da benzer yapıya sahip olduklarından dolayı hacimsel ve lineer ölçümler açısından farklılık göstermediler. KIBT görüntüleme kullanılarak, rezorpsiyonların hacimsel/lineer analizi, aksiyel sınıflandırması ve bu parametrelere göre demografik farklılıkları klinisyenlerin rezorpsiyon doğasını anlamalarına ve uygun yönetimi belirlemelerine yardımcı olabilir.
References
- Heithersay GS. Invasive cervical resorption. Endod Topics 2004;7:73−92.
- Patel S, Ricucci D, Durak C, Tay F. Internal root resorption: A Review. J Endod 2010;36:1107–1121.
- Patel S, Ford TP. Is the resorption external or internal? Dent Update 2007;34:218–229.
- Patel S, Dawood A, Wilson R, Horner K, Mannocci F. The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography – an in vivo investigation. Int Endod J 2009;42:831–838.
- Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical resorption in vital teeth. J Endod 2016;42:1737–1751.
- Alamadi E, Alhazmi H, Hansen K, Lundgren T, Naoumova J. A comparative study of cone beam computed tomography and conventional radiography in diagnosing the extent of root resorptions. Prog Orthod 2017;18:37.
- Owmann-Moll P, Kurol J. Root resorption after orthodontic treatment in high- and low-risk patients: analysis of allergy as a possible predisposing factor. Eur J Orthodont 2000;22:657–663.
- Bernardes RA, de Paulo RS, Pereira LO, Duarte MAH, Ordinola-Zapata R, de Azevedo JR. Comparative study of cone beam computed tomography and intraoral periapical radiographs in diagnosis of lingual-simulated external root resorptions. Dent Traumatol 2012;28:268–272.
- de Azevedo Vaz SL, Vasconcelos TV, Neves FS, de Freitas DQ, Haiter-Neto F. Influence of cone-beam computed tomography enhancement filters on diagnosis of simulated external root resorption. J Endod 2012;38:305–308.
- Scarfe WC, Farman AG. Cone-beam computed tomography. In: White SC, Pharoah MJ (eds). Oral Radiology Principles and Interpretation. 6th ed. St. Louis: Mosby 2004:225-241.
- Heithersay GS. Invasive cervical resorption: an analysis of potential predisposing factors. Quintessence Int 1999;30:83–95.
- Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three‐dimensional classification. Int Endod J 2018;51:206-214.
- Goodell KB, Mines P, Kersten DD. Impact of cone-beam computed tomography on treatment planning for external cervical resorption and a novel axial slice–based classification system. J Endod 2018;44:239-244.
- Matny LE, Ruparel NB, Levin MD, Noujeim M, Diogenes A. A volumetric assessment of external cervical resorption cases and ıts correlation to classification, treatment planning, and expected prognosis. J Endod 2020;46:1052-1058.
- Shemesh A, Levin A, Hadad A, Itzhak JB, Solomonov M. CBCT analyses of advanced cervical resorption aid in selection of treatment modalities: a retrospective analysis. Clin Oral Invest 2019;23:1635–1640.
- Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, Lemberg K. European Society of Endodontology position statement: the use of CBCT in endodontics. Int Endod J 2014;47:502-504.
- AAE and AAOMR Joint Position Statement: Use of cone-beam computed tomography in endodontics 2015 update. J Endod 2015;41:1393-1396.
- Heithersay GS. Clinical, radiologic, and histopathologic features of invasive cervical resorption. Quintessence Int 1999;30:27–37.
- Lindskog SF, Dreyer CW, Pierce AM, Torabinejad M, Shabahang S. Osteoclastic activity. In: Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. 4th ed. Oxford, UK: Blackwell Munksgaard 2007:137-171.
- Patel S, Mavridou AM, Lambrechts P, Saberi N. External cervical resorption-part 1: histopathology, distribution and presentation. Int Endod J 2018;51:1205-1223.
- Patel S, Foschi F, Condon R, Pimentel T, Bhuva B. External cervical resorption: part 2 – management. Int Endod J 2018;51:1224-1238.
- Patel K, Mannocci F, Patel S. The assessment and management of external cervical resorption with periapical radiographs and cone-beam computed tomography: a clinical study. J Endod 2016;42:1435–1440.
- Mavridou AM, Bergmans L, Barendregt D, Lambrechts P. Descriptive analysis of factors associated with external cervical resorption. J Endod 2017;43:1602–1610.
- Nilsson E, Bonte E, Bayet F, Lasfargues JJ. Management of internal root resorption on permanent teeth. Int J Dent 2013;2013:929486.
- Fuss Z, Tsesis I, Lin S. Root resorption: diagnosis, classification and treatment choices based on stimulation factors. Dent Traumatol 2003;19:175–182.
- Malmgren B. Ridge preservation/decoronation. J Endod 2013;39:67–72.
- Gulsahi A, Kulah CK, Bakirarar B, Gulen O, Kamburoglu K. Age estimation based on pulp/tooth volume ratio measured on cone-beam CT images. Dentomaxillofac Radiol 2018;47:20170239.
- American Association of Endodontists (AAE) [homepage]. Chicago: Glossary of endodontic terms; 2010 [cited 2020 Jun 10]. Available from: https://www.aae.org/specialty/clinical-resources/glossary-endodontic-terms/
- Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical tooth resorption patterns in endodontically treated teeth. Int Endod J 2017;50:1116–1133.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | May 31, 2021 |
| Submission Date | March 3, 2021 |
| Published in Issue | Year 2021 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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