Surgical Endodontic Parameters in the Mandibular Premolars Area: An Anatomic Evaluation with Cone -Beam Computed Tomography
Journal of "Regeneration, Reconstruction & Restoration" (Triple R),
Vol. 5 (2020),
24 March 2020
Introduction: This study aimed to evaluate the relationship between mandibular premolars and the surrounding critical anatomical structures for endodontic surgery using cone-beam computed tomography (CBCT).
Materials and Methods: In this cross sectional study, 170 CBCT images were evaluated in the sagittal, coronal, and axial planes to measure the buccal bone thickness (BBT) covering each root, the diameter of the premolars in the buccolingual and mesiodistal dimensions, besides the total amount of tissue needed to be resected for endodontic surgery; these measurements were performed at the 3mm level of the apex. Also, the distances from the superior border of mental foramen (MF) to premolars apex and alveolar crest (AC) were measured. Moreover, the position of MF in relation to adjacent teeth was evaluated. Descriptive statistics, independent-sample T-test and Wilcoxon test were used in the SPSS 26 to analysis of the data (α=.05).
Results: The mean values of BBT for the first and second premolars were measured 1.18 mm and 1.57 mm, respectively. The root diameters of the first and second premolars were measured 4.02 mm and 3.98 mm in the buccolingual dimension, and 2.74 mm and 2.98 mm in the mesiodistal dimension. The total amount of tissue needed to be resected for endodontic surgery in the second premolar has a higher amount with a mean of 5.55 mm. The second premolar was recorded as the tooth with the closest root apex to MF with a mean value of 3.97 mm. The mean distance between MF and AC was measured 13.88 mm, and MFs in most cases (44.11 %) were positioned in line with the second premolar long axis.
Conclusion: According to findings of the present study, the CBCT imaging evaluation is recommended for each patient before the surgical endodontic operation.
- Cone-Beam Computed Tomography, Endodontic Surgery, Mandible, Premolar
How to Cite
2. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 1984;58(5):589-99.
3. Lu T-Y, Yang S-F, Pai S-F. Complicated root canal morphology of mandibular first premolar in a Chinese population using the cross section method. Journal of endodontics. 2006;32(10):932-6.
4. Kvist T, Reit C. Results of endodontic retreatment: a randomized clinical study comparing surgical and nonsurgical procedures. Journal of endodontics. 1999;25(12):814-7.
5. Slowey R. Root canal anatomy: road map to successful endodontics. Dent Clin North Am. 1979;23:555-73.
6. Kang M, Jung HI, Song M, Kim SY, Kim H-C, Kim E. Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clinical oral investigations. 2015;19(3):569-82.
7. Kim S, Baek S. The microscope and endodontics. Dental Clinics. 2004;48(1):11-8.
8. Setzer F, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. Journal of dental research. 2014;93(1):19-26.
9. Setzer FC, Shah SB, Kohli MR, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature—part 1: comparison of traditional root-end surgery and endodontic microsurgery. Journal of endodontics. 2010;36(11):1757-65.
10. Rubinstein RA, Kim S. Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and Super-EBA as root-end filling material. Journal of Endodontics. 1999;25(1):43-8.
11. Huang S, Chen N-N, Victoria S, Lim HA, Lui J-N. Long-term success and survival of endodontic microsurgery. Journal of Endodontics. 2020;46(2):149-57. e4.
12. Khojastepour L, Mirbeigi S, Mirhadi S, Safaee A. Location of mental foramen in a selected Iranian population: a CBCT assessment. Iranian endodontic journal. 2015;10(2):117.
13. Knowles KI, Jergenson MA, Howard JH. Paresthesia associated with endodontic treatment of mandibular premolars. Journal of endodontics. 2003;29(11):768-70.
14. Di Lenarda R, Cadenaro M, Stacchi C. Paresthesia of the mental nerve induced by periapical infection: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2000;90(6):746-9.
15. Rud J, Andreasen J. A study of failures after endodontic surgery by radiographic, histologic and stereomicroscopic methods. International Journal of Oral Surgery. 1972;1(6):311-28.
16. Mainkar A, Zhu Q, Safavi K. Incidence of Altered Sensation after Mandibular Premolar and Molar Periapical Surgery. Journal of endodontics. 2020;46(1):29-33.
17. Aminoshariae A, Su A, Kulild JC. Determination of the location of the mental foramen: a critical review. Journal of endodontics. 2014;40(4):471-5.
18. Rosen E. Nerve injury during endodontic surgical procedures. Complications in endodontic surgery: Springer; 2014. p. 137-51.
19. Shahbazian M, Vandewoude C, Wyatt J, Jacobs R. Comparative assessment of periapical radiography and CBCT imaging for radiodiagnostics in the posterior maxilla. Odontology. 2015;103(1):97-104.
20. Kiarudi AH, Eghbal MJ, Safi Y, Aghdasi MM, Fazlyab M. The applications of cone-beam computed tomography in endodontics: a review of literature. Iranian endodontic journal. 2015;10(1):16.
21. Kamburoğlu K, Kolsuz E, Kurt H, Kılıç C, Özen T, Paksoy CS. Accuracy of CBCT measurements of a human skull. Journal of digital imaging. 2011;24(5):787-93.
22. Bornstein MM, Lauber R, Sendi P, Von Arx T. Comparison of periapical radiography and limited cone-beam computed tomography in mandibular molars for analysis of anatomical landmarks before apical surgery. Journal of endodontics. 2011;37(2):151-7.
23. Timock AM, Cook V, McDonald T, Leo MC, Crowe J, Benninger BL, et al. Accuracy and reliability of buccal bone height and thickness measurements from cone-beam computed tomography imaging. American journal of orthodontics and dentofacial orthopedics. 2011;140(5):734-44.
24. Santini A, Alayan I. A comparative anthropometric study of the position of the mental foramen in three populations. British dental journal. 2012;212(4):E7.
25. Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. Journal of periodontology. 2006;77(12):1933-43.
26. Aydın ZU, Bulut DG. Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis. Clinical oral investigations. 2019;23(9):3637-44.
27. dos Santos Oliveira R, Rodrigues Coutinho M, Kühl Panzarella F. Morphometric Analysis of the Mental Foramen Using Cone-Beam Computed Tomography. International journal of dentistry. 2018;2018.
28. Zahedi S, Mostafavi M, Lotfirikan N. Anatomic study of mandibular posterior teeth using cone-beam computed tomography for endodontic surgery. Journal of endodontics. 2018;44(5):738-43.
29. Jin G-C, Kim K-D, Roh B-D, Lee C-Y, Lee S-J. Buccal bone plate thickness of the Asian people. Journal of endodontics. 2005;31(6):430-4.
30. Abella F, de Ribot J, Doria G, Duran-Sindreu F, Roig M. Applications of piezoelectric surgery in endodontic surgery: a literature review. Journal of endodontics. 2014;40(3):325-32.
31. Tilk MA, Lommel TJ, Gerstein H. A study of mandibular and maxillary root widths to determine dowel size. Journal of endodontics. 1979;5(3):79-82.
32. San Chong B, Gohil K, Pawar R, Makdissi J. Anatomical relationship between mental foramen, mandibular teeth and risk of nerve injury with endodontic treatment. Clinical oral investigations. 2017;21(1):381-7.
33. Yildiz MS, Gunpinar S. Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study. Clinical oral investigations. 2019;23(4):1845-54.
34. Von Arx T, Friedli M, Sendi P, Lozanoff S, Bornstein MM. Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography. Journal of endodontics. 2013;39(12):1522-8.
35. Kalender A, Orhan K, Aksoy U. Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone‐beam computed tomography images reconstructed from a volumetric rendering program. Clinical anatomy. 2012;25(5):584-92.
36. Haktanır A, Ilgaz K, Turhan-Haktanır N. Evaluation of mental foramina in adult living crania with MDCT. Surgical and radiologic anatomy. 2010;32(4):351-6.
37. Moiseiwitsch JR. Position of the mental foramen in a North American, white population. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1998;85(4):457-60.
38. Guo JL, Su L, Zhao JL, Yang L, Lv DL, Li YQ, et al. Location of mental foramen based on soft-and hard-tissue landmarks in a Chinese population. Journal of Craniofacial Surgery. 2009;20(6):2235-7.
39. Gupta T. Localization of important facial foramina encountered in maxillo‐facial surgery. Clinical anatomy. 2008;21(7):633-40.
40. Shankland 2nd W. The position of the mental foramen in Asian Indians. The Journal of oral implantology. 1994;20(2):118.
- Abstract Viewed: 50 times
- PDF Downloaded: 35 times