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Micro-CT assessment of radicular pulp calcifications in extracted maxillary first molar teeth

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Abstract

Objectives

The present study aimed to evaluate the frequency, position, and length of radicular pulp calcifications in three-rooted maxillary first molars using micro-computed tomography.

Materials and methods

Two hundred three-rooted maxillary first molars were scanned at a pixel size of 10 µm and reconstructed using similar parameters. Three-dimensional models of the mesiobuccal (MB1, MB2, MB3), distobuccal (DB), and palatal (P) canals were qualitatively evaluated for discontinuity in the canal path. Transaxial and sagittal cross-sectional images of the roots were further screened, and the complete obliteration of the canal lumen by pulp calcification was identified when the canal had similar radiodensity to the surrounding dentine. Then, the number, position, and length of the calcifications were recorded for each root. Intra-observer agreement was performed using Cohen’s kappa test, while one-way ANOVA and Duncan tests compared the lengths of calcifications among the canals, with α = 5%.

Results

Intra-observer agreement was perfect for identification of pulp calcifications (ĸ = 1.0; p = 0.000). MB2 and MB3 canals accounted for the highest percentage frequency of calcifications distributed throughout the canal path. In the MB1, DB, and P canals, they occurred mainly at the apical third. Lengths of calcifications were greater in the MB3 (0.89 ± 0.81 mm) and MB2 (0.82 ± 0.93 mm) canals than in the MB1 (0.39 ± 0.32 mm), DB (0.34 ± 0.22 mm), and P (0.28 ± 0.22 mm) canals (p < 0.05).

Conclusion

MB2 and MB3 canals accounted for the highest frequency and length of radicular pulp calcifications. In the MB1, DB, and P canals, calcifications occurred mostly at the apical third, while in the MB2 and MB3, most of calcifications were observed at the orifice level and along the canal path.

Clinical relevance

In maxillary first molars, radicular pulp calcifications are mainly located at the apical third of the MB1, DB, and P canals, while in the MB2 and MB3 canals, most of them are at the orifice level or along the canal path.

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Funding

This study was supported by the Scientific and Technological Research Council of Turkey-TUBİTAK (grant no. 117S139).

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Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, 55400, Turkey

    Ali Keleş & Cangül Keskin

  2. Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil

    Marco Aurélio Versiani

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  1. Ali Keleş
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  2. Cangül Keskin
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  3. Marco Aurélio Versiani
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Correspondence to Cangül Keskin.

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The study protocol was approved by the local university clinical research ethical board with the approval number KAEK 2015/408.

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Informed consent was obtained from each patient.

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Keleş, A., Keskin, C. & Versiani, M.A. Micro-CT assessment of radicular pulp calcifications in extracted maxillary first molar teeth. Clin Oral Invest 26, 1353–1360 (2022). https://doi.org/10.1007/s00784-021-04109-x

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