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Anatomical analysis of mandibular posterior teeth for endodontic microsurgery: a cone-beam computed tomographic evaluation

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Abstract

Objective

The purpose of this study was to analyze the anatomical structures relevant for endodontic microsurgery in the mandibular posterior teeth using a cone-beam computed tomography (CBCT).

Material and methods

A total of 963 mandibular posterior teeth were analyzed in CBCT scans from 133 patients. The buccolingual and mesiodistal dimensions of the root and the buccal bone thickness overlying the root were measured at the site of root resection (apical 3 mm). At this location, the relationship between the buccal cortical bone and root was classified into three types (separated, contact, and exposed), and the distance from the root apex to the mandibular canal was measured.

Results

The thickest buccolingual dimension of the roots was found in the mesial roots of first molars, at 5.59 ± 0.97 mm. The buccal bone thickness overlying the root became thicker in posterior tooth locations. In the first premolar and first molar mesial root, contact was the most common type of relationship between the buccal cortical bone and root. As the position of the teeth became more posterior, the distance from the apex to the mandibular canal became shorter.

Conclusions

As the position of the teeth became more posterior, the buccal bone thickness increased and the distance to the mandibular canal became closer; therefore, particular attention is required for posterior teeth. The first premolar and the first molar mesial root are often in contact with the buccal cortical bone, which may allow infections to spread to the buccal structure more easily and negatively affect for post-surgical healing.

Clinical relevance

When planning and performing endodontic microsurgery, understanding the anatomical structure of the surgical site will help minimize tissue damage and reduce complications.

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Funding

This work was supported by the Medical Device Technology Development Program No. 20006098, “Development of soft tissue diagnostic CT with 3lp/mm resolution using multisource and curved FPD” funded by the Ministry of Trade, Industry and Energy (MOTIE, Korea).

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Author notes

  1. Kug Jin Jeon and Chena Lee contributed equally to this work.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea

    Kug Jin Jeon, Chena Lee, Yoon Joo Choi & Sang-Sun Han

Authors
  1. Kug Jin Jeon
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  2. Chena Lee
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  3. Yoon Joo Choi
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  4. Sang-Sun Han
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Correspondence to Sang-Sun Han.

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The authors declare that they have no conflict of interest.

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This article does not contain data from any animal experiments performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Jeon, K.J., Lee, C., Choi, Y.J. et al. Anatomical analysis of mandibular posterior teeth for endodontic microsurgery: a cone-beam computed tomographic evaluation. Clin Oral Invest 25, 2391–2397 (2021). https://doi.org/10.1007/s00784-020-03562-4

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  • DOI: https://doi.org/10.1007/s00784-020-03562-4

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