Bilge Gülsüm Nur

A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population

Abstract Aim. The aim of this study was to evaluate the root canal number and configuration of maxillary and mandibular premolar teeth by gender, intervals for decades, tooth position and unilateral or bilateral occurrence in a Turkish population using Cone Beam Computed Tomography(CBCT) scanning. Methodology. CBCT images of 5496 maxillary and mandibular premolars from 849 patients were evaluated. The following was evaluated in all the images: numbers of roots and root canals, the morphology of the root canal configuration according to the Vertucci classification, male–female differences in the tooth position and male–female differences in unilateral or bilateral occurrence. The reliability data were analyzed with a chi-square test. Results. The most prevalent root canal frequency was the two canals (86.2%) and type IV (76.9%) configuration for maxillary first premolar, one canal (59.7%) and type I (54.5%) canal configuration for second premolar. The incidence of one canal was higher in females and the occurrence of two or three canals was more common in males. The incidence of one canal was higher on the left side of maxillary premolars and the incidence of two canals was higher on the right side. Most mandibular first (93.5%) and second (98.5%) premolars had one canal. In general, females had one root canal of the mandibular premolar, whereas males had two or three canals. The type I configuration was most common and the incidence was higher on the right side. There were some differences found in the frequency distribution of the number of root canals and configuration of maxillary and mandibular premolar teeth according to intervals for decades. Conclusion. CBCT scanning provides comprehensive information about the root canal morphology of maxillary and mandibular premolar teeth. These data may help clinicians in root canal treatment of premolar teeth.

A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population.

Objective: The aim of this study was to determine the root and canal morphology of the maxillary and mandibular anterior teeth in a Turkish population by analyzing cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images of 417 females and 410 males with a mean age of ranging from 14 to 70 years were examined in this study. A total of 1453 maxillary central incisors, 1504 maxillary lateral incisors, 1523 maxillary canines, 1582 mandibular central incisors, 1603 mandibular lateral incisors, and 1604 mandibular canines were analyzed. The number of root canals and the canal configurations were investigated and then were classified according to Vertucci′s classification. The data were analyzed with the Pearson Chi-square test. Results: The Type 1 canal configuration was most prevalent in the maxillary anterior teeth (96.8-99.7%). The Types 2, 3, 4, and 5 canal configurations were observed within the range of 0-1.3%, 0-0.8%, 0-0.7%, and 0-1.8%, respectively. In the mandibular anterior teeth, the Type 1 canal configuration was most prevalent (77-95%). The Types 2, 3, 4, and 5 canal configurations were observed within a range of 0.2-2.7%, 0.2-1.6%, 0.9-5.9%, and 1.8-14.4%, respectively. The prevalence of two canals was higher in males than in females both in the maxillary and mandibular anterior teeth (P < 0.05). Conclusions: Type 1 was the most prevalent canal configuration of maxillary and mandibular anterior teeth in the Turkish population. Type 5 was the most frequently observed canal configuration of the two canalled teeth. The incidence of root canal numbers and configurations differed with sex.

Evaluation of the root and canal morphology of mandibular permanent molars in a south-eastern Turkish population using cone-beam computed tomography

Objective: The aim of this retrospective study was to determine the root and canal morphology of the mandibular first and second permanent molars in a Turkish population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of mandibular first (n = 966) and second molar (n = 1165) teeth from 850 Turkish patients were evaluated. The root canal configurations were classified according to the method of Vertucci. The data were analyzed by Pearson′s Chi-square test. Results: The majority of mandibular molars were two rooted with three canals; however, three roots were identified in 0.05% of the first molars and 0.01% of the second molars, and 100% of the additional root canals were of type I configuration. Mesial roots had more complex canal systems with more than one canal, whereas most distal roots had a type I configuration. Conclusions: Within the limitations of this study, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a Turkish population. This study may help clinicians in the root canal treatment of mandibular molars.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

Effectiveness of different irrigation solutions on triple antibiotic paste removal from simulated immature root canal

To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of irrigation solutions on removal of triple antibiotic paste (TAP) from root canals of the simulated immature teeth. Fifty single-rooted teeth were used. TAP was placed into each root canal, and specimens were stored in distilled water for 4 weeks at 37°C. After 4 weeks, the temporary coronal seal was removed and the samples were randomly divided into five groups as follows: (i) saline; (ii) ultrasonic activation of saline; (iii) NaOCl; (iv) ultrasonic activation of NaOCl; (v) chlorhexidine digluconate (CHX). The amount of remaining TAP on the canal walls was measured under stereomicroscope with 30× magnification. The data were analyzed using a one-way ANOVA and post-hoc Tukey test at a significance level of 0.05. There were statistically differences among CHX and ultrasonic activation of NaOCl and other groups (p < 0.05). There were no significant differences among the ultrasonic activation of saline, NaOCl, and saline groups (p > 0.05). Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove the triple antibiotic paste from simulated immature root canals. Ultrasonic activation of the NaOCl gave the best and CHX was the worst results.

Fracture strength of roots instrumented with three different single file systems in curved root canals

Objective: The aim of this study was to compare the fracture strength of roots instrumented with three different single file rotary systems in curved mesial root canals of maxillary molars. Materials and Methods: Curvatures of 25°-35° on mesial roots of 60 maxillary molar teeth were sectioned below the cementoenamel junction to obtain roots 11 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameter and weight. They were distributed into three experimental groups and one control group (no instrumentation) (n = 15): Reciproc rotary file (R25, VDW, Munich, Germany), WaveOne Primary rotary file (Dentsply Tulsa Dental Specialties, Tulsa, UK) and OneShape (Micro-Mega, Besancon, France) rotary file. Vertical load was applied until fracture occurred. Data were statistically analyzed using one-way analysis of variance test (P < 0.05). Results: The mean fracture load was 412 ± 72 Newton (N) for the control group, 395 ± 69 N for the Reciproc group, 373 ± 63 N for the WaveOne group and 332 ± 68 N for the OneShape group. The fracture load differences among three experimental groups were not statistically significant (P > 0.05.) Whereas, the fracture loads of control and OneShape groups were significantly different (P = 0.012). Conclusions: Fracture resistance of the roots instrumented with WaveOne and Reciproc file systems were similar to the control group whereas it was observed that OneShape rotary file systems enhance the fracture strength of standardized curved roots when compared with the control group.

Localization of the mandibular foramen of 8-18 years old children and youths with cone-beam computed tomography

The aim of this study was to determine the location of mandibular foramen (MF) of 8-18 years old Turkish individuals by analyzing cone-beam computed tomography (CBCT) images. CBCT images of 63 females and 64 males with an age range of 8-18 years were examined. The distance of the MF to the anterior border of the ramus (A), posterior border of the ramus (P), inferior point of the mandibular incisura (MI), superior point of the curvature of the mandibular notch (MN), and the straight line of the cusps of the mandibular permanent molars (O) were measured and recorded. Data were analyzed by one-way analysis of variance (ANOVA), the Bonferroni test, independent t-test, and Student′s t-test at a significance level of P < 0.05. The MN-MF, MI-MF, A-MF, and MN-MF values of females aged 9, 13, 14, and 18 were statistically higher than those of males aged 9, 13, 14, and 18 (P < 0.05). There were no significant differences in the O-MF values or A-MF values among the age groups (P > 0.05); however, the P-MF, MI-MF, and MN-MF values increased with age (P < 0.05). This study concluded that the location of the MF is just posterior to the middle of the ramus, 2.5-3.6 mm above the occlusal plane of the molars. The P-MF, MI-MF, and MN-MF values increase with age.

Metabolic Control and Periodontal Treatment Decreases Elevated Oxidative Stress in the Early Phases of Type 1 Diabetes Onset

OBJECTIVE Recently, increasing concern has been focused on the contribution of oxidative stress in the pathology of periodontal disease and diabetes mellitus. Firstly, the present study aimed to analyze gingival crevicular fluid (GCF), salivary, and serum oxidative status in children with type 1 diabetes mellitus (T1DM) at diagnosis and systemically healthy children with and without gingivitis. Additionally, the diabetic patients were reevaluated after diabetes and periodontal treatment. DESIGN The study groups were composed of 32 T1DM patients at diagnosis, and age- and gender-matched thirty-six systemically healthy children with (G) and without (H) gingivitis. The diabetic patients who took insulin therapy (1.5 units/kg/day totally) and periodontal treatment (oral hygiene education with professional scaling) were reevaluated after 3 months. The levels of total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were recorded. RESULTS GCF, salivary, and serum OSI were elevated in group T1DM compared to the other groups at baseline (p<0.05), and decreased in group T1DM at reevaluation compared to baseline (p<0.05). GCF OSI was positively correlated with periodontal clinical parameters (p<0.05). Glycated hemoglobin was positively correlated with GCF TOS (r=0.302, p=0.007), GCF OSI (r=0.346, p=0.002), salivary TOS (r=0.326, p=0.046), and serum TOS (r=0.239, p=0.044). CONCLUSION The instability in the oxidative status that accompanies diabetes may be considered a significant pathogenic factor of diabetes-related periodontal inflammation.

İn Vitro Koşullarda Kalsiyum Hidroksit ve Ledermix Kanal İçi İlaçların Apikal Sızıntıya Etkisinin Değerlendirilmesi

ÖZET Amaç: Bu çalışmanın amacı kanal tedavilerinde kanal içi ilaç olarak kullanılan kalsiyum hidroksit ve Ledermix’in apikal sızıntı üzerine etkilerini incelemektir. Gereç ve Yöntemler: Çalışmada, 60 adet çürüksüz, kök gelişimini tamamlamış kök rezorpsiyonu olmayan alt çene küçük azı dişleri kullanıldı. Hazırlanan örnekler iki çalışma grubu (n=20), bir pozitif kontrol grubu (n=20) olmak üzere üç gruba ayrıldı. İki çalışma grubunda kalsiyum hidroksit ve Ledermix kök kanallarını tamamen dolduracak şekilde yerleştirildi. Kontrol grubu dişlerde kanallar boş bırakıldı. Hazırlanan deney ve kontrol grubu örnekleri 37°C’de %100 nemli ortamda 30 gün bekletildi. Otuz günün sonunda kanal içi ilaçlar sırasıyla %5,25 NaOCI, %19 EDTA ve serum fizyolojik ile yıkandı. Tüm gruplar kanal dolgu patı AH26 kullanılarak soğuk lateral kompaksiyon tekniğine göre gutta perka ile dolduruldu. Daha sonra örnekler 37°C etüvde %2’lik metilen mavisi boya solüsyonu içerisinde 72 saat boyunca bekletildi. Bulgular: Kalsiyum hidroksit grubunda istatistiksel farklılık oluşturacak şekilde Ledermix (p=0,020) ve kontrol grubuna (p=0,008) oranla daha fazla boya sızıntısı görüldü. Buna karşın Ledermix ve kontrol grupları arasında istatistiksel farklılık olmadığı saptandı (p=0,936). Sonuç: AH26 ile birlikte kullanılan kalsiyum hidroksit, kanal dolgulu dişlerde apikal sızıntıyı artırabilir. Ledermix kanal içi ilaç ile ilgili daha fazla klinik ve deneysel çalışma yapılmalıdır.

Three-Dimensional Analysis of Mandibular Foramen Location: A Cone Beam Computed Tomography Study

Purpose: The mandibular foramen (MF) is the beginning of the mandibular canal located on the internal surface of the ramus mandible. The authors aimed to determine the three-dimensional position of MF to guide clinician for inferior alveolar nerve block and surgical procedures. Methods: CBCT images of 571 mandibular foramens from 286 patients (146 female, 140 male) aged between 8-69 years were evaluated. Up to the age of 18 were considered as growth group, and the others as adult group. Distances from midpoint of the MF to anatomic landmarks measured. Mann-Whitney U test, univariate varience of analysis and Spearman’s correlation were performed for the statistical comparisons. Results: MF is positioned nearly 1.58 mm behind the midpoint of the ramus horizontally 4.27 mm above the midpoint vertically. There were a significant difference for location of MF among gender, and for width, height and distance to occlusal plane between growth and adult groups. Measured distances were significantly correlated with age only in growth group. Clinical Significance Taking into consideration the anatomy and age of the patient may help better locate the MF for promoting successful and safe treatment procedures with reduced complications.