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Non-surgical Retreatment Utilizing Cone Beam Computed Tomography

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3D Imaging in Endodontics

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Abstract

Successful discovery and localization of all roots and potential canal spaces are critical to favorable endodontic outcomes and therapies. This is especially challenging in the retreatment environment, where the native anatomy within the chamber has been altered or destroyed, and conventional radiographs are inconclusive. The use of the Cone Beam Computed Tomography (CBCT) has proven indispensable in these instances, focusing any excavation in the proper dimension and direction to facilitate a more thorough treatment delivery. The exceptional analysis of these difficult presentations afforded by the use of this technology is illustrated using various clinical case scenarios, including anomalous root morphologies, additional canal spaces, and insights into eccentric periapical pathologies.

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References

  1. Grossman LIOS, Del Rio CE. Endodontic Practice. Eleventh ed. Philadelphia, PA: Lea & Febiger; 1988. p. 182–90.

    Google Scholar 

  2. Weine F. Endodontic therapy. Saint Louis, MO: The C.V. Mosby Company; 1972.

    Google Scholar 

  3. Krasner P, Rankow HJ. Anatomy of the pulp-chamber floor. J Endod. 2004 Jan;30(1):5–16.

    Article  PubMed  Google Scholar 

  4. Schwarze T, Baethge C, Stecher T, Geurtsen W. Identification of second canals in the mesiobuccal root of maxillary first and second molars using magnifying loupes or an operating microscope. Aust Endod J. 2002 Aug;28(2):57–60.

    Article  PubMed  Google Scholar 

  5. Kulild JC, Peters DD. Incidence and configuration of canal systems in the mesiobuccal root of maxillary first and second molars. J Endod. 1990 Jul;16(7):311–7.

    Article  PubMed  Google Scholar 

  6. Stropko JJ. Canal morphology of maxillary molars: clinical observations of canal configurations. J Endod. 1999 Jun;25(6):446–50.

    Article  PubMed  Google Scholar 

  7. Suter B, Lussi A, Sequeira P. Probability of removing fractured instruments from root canals. Int Endod J. 2005 Feb;38(2):112–23.

    Article  PubMed  Google Scholar 

  8. Roda RS. Root perforation repair: surgical and nonsurgical management. Pract Proced Aesthet Dent: PPAD. 2001;13(6):467–72. quiz 74

    PubMed  Google Scholar 

  9. Koch K. The microscope. Its effect on your practice. Dent Clin N Am. 1997 Jul;41(3):619–26.

    Article  PubMed  Google Scholar 

  10. Hess W. The anatomy of the root canals of the teeth of the permanent dentition. London: John Bale, Sons & Danielsson Ltd; 1925.

    Google Scholar 

  11. FJ V. Root canal anatomy of the mandibular anterior teeth. JADA. 1974;89(2):369–71.

    Google Scholar 

  12. Neaverth EJ, Kotler LM, Kaltenbach RF. Clinical investigation (in vivo) of endodontically treated maxillary first molars. J Endod. 1987 Oct;13(10):506–12.

    Article  PubMed  Google Scholar 

  13. Bellizzi R, Hartwell G. Radiographic evaluation of root canal anatomy of in vivo endodontically treated maxillary premolars. J Endod. 1985 Jan;11(1):37–9.

    Article  PubMed  Google Scholar 

  14. Fogel HM, Peikoff MD, Christie WH. Canal configuration in the mesiobuccal root of the maxillary first molar: a clinical study. J Endod. 1994 Mar;20(3):135–7.

    Article  PubMed  Google Scholar 

  15. Niemczyk S. CBCT: The Virtual Surgery© in Endodontic Diagnosis. Dental economics–oral hygiene. 2012 (February):80–1.

    Google Scholar 

  16. Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod. 2010 Jul;36(7):1187–90.

    Article  PubMed  Google Scholar 

  17. Baratto Filho F, Zaitter S, Haragushiku GA, de Campos EA, Abuabara A, Correr GM. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod. 2009 Mar;35(3):337–42.

    Article  PubMed  Google Scholar 

  18. Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of cone-beam computed tomography to identify root canal systems in vitro. J Endod. 2008 Jan;34(1):87–9.

    Article  PubMed  Google Scholar 

  19. Badole GP, Warhadpande MM, Shenoi PR, Lachure C, Badole SG. A rare root canal configuration of bilateral maxillary first molar with 7 root canals diagnosed using cone-beam computed tomographic scanning: a case report. J Endod. 2014 Feb;40(2):296–301.

    Article  PubMed  Google Scholar 

  20. Llena C, Fernandez J, Ortolani PS, Forner L. Cone-beam computed tomography analysis of root and canal morphology of mandibular premolars in a Spanish population. Imaging Sci Dent. 2014 Sep;44(3):221–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Silva EJ, Nejaim Y, Silva AI, Haiter-Neto F, Zaia AA, Cohenca N. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod. 2014 Feb;40(2):173–6.

    Article  PubMed  Google Scholar 

  22. Torres A, Jacobs R, Lambrechts P, Brizuela C, Cabrera C, Concha G, et al. Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples. Imaging Sci Dent. 2015 Jun;45(2):95–101.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mahendra M, Verma A, Tyagi S, Singh S, Malviya K, Chaddha R. Management of complex root canal curvature of bilateral radix entomolaris: three-dimensional analysis with cone beam computed tomography. Case reports in dentistry. 2013;2013:697323.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Low KM, Dula K, Burgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008 May;34(5):557–62.

    Article  PubMed  Google Scholar 

  25. 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. J Endod. 2011 Feb;37(2):151–7.

    Article  PubMed  Google Scholar 

  26. Witherspoon DE, Small JC, Regan JD. Missed canal systems are the most likely basis for endodontic retreatment of molars. Tex Dent J. 2013 Feb;130(2):127–39.

    PubMed  Google Scholar 

  27. Karapinar-Kazandag M, Basrani BR, Friedman S. The operating microscope enhances detection and negotiation of accessory mesial canals in mandibular molars. J Endod. 2010 Aug;36(8):1289–94.

    Article  PubMed  Google Scholar 

  28. Goel NK, Gill KS, Taneja JR. Study of root canals configuration in mandibular first permanent molar. J Indian Soc Pedod Prev Dent. 1991 Mar;8(1):12–4.

    PubMed  Google Scholar 

  29. Reeh ES. Seven canals in a lower first molar. J Endod. 1998 Jul;24(7):497–9.

    Article  PubMed  Google Scholar 

  30. Carabelli G. Systematiches Handbuch Der Zahnheikunde. 2nd ed. Vienna: Braumuller and Seidel; 1844.

    Google Scholar 

  31. Steelman R. Incidence of an accessory distal root on mandibular first permanent molars in Hispanic children. ASDC J Dent Child. 1986 Mar-Apr;53(2):122–3.

    PubMed  Google Scholar 

  32. de Souza-Freitas JA, Lopes ES, Casati-Alvares L. Anatomic variations of lower first permanent molar roots in two ethnic groups. Oral Surg Oral Med Oral Pathol. 1971 Feb;31(2):274–8.

    Article  PubMed  Google Scholar 

  33. Garg AK, Tewari RK, Kumar A, Hashmi SH, Agrawal N, Mishra SK. Prevalence of three-rooted mandibular permanent first molars among the Indian population. J Endod. 2010 Aug;36(8):1302–6.

    Article  PubMed  Google Scholar 

  34. Schafer E, Breuer D, Janzen S. The prevalence of three-rooted mandibular permanent first molars in a German population. J Endod. 2009 Feb;35(2):202–5.

    Article  PubMed  Google Scholar 

  35. De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004 Nov;37(11):789–99.

    Article  PubMed  Google Scholar 

  36. Hannah R, Kandaswamy D, Jayaprakash N. Endodontic management of a mandibular second molar with radix entomolaris: a case report. Restor Dent Endod. 2014 May;39(2):132–6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. De Moor RJ. C-shaped root canal configuration in maxillary first molars. Int Endod J. 2002 Feb;35(2):200–8.

    Article  PubMed  Google Scholar 

  38. Singla M, Aggarwal V. C-shaped palatal canal in maxillary second molar mimicking two palatal canals diagnosed with the aid of spiral computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jun;109(6):e92–5.

    Article  PubMed  Google Scholar 

  39. Carlsen O, Alexandersen V, Heitmann T, Jakobsen P. Root canals in one-rooted maxillary second molars. Scand J Dent Res. 1992 Oct;100(5):249–56.

    PubMed  Google Scholar 

  40. Alavi AM, Opasanon A, Ng YL, Gulabivala K. Root and canal morphology of Thai maxillary molars. Int Endod J. 2002 May;35(5):478–85.

    Article  PubMed  Google Scholar 

  41. Harris WE. Unusual root canal anatomy in a maxillary molar. J Endod. 1980 May;6(5):573–5.

    Article  PubMed  Google Scholar 

  42. Benenati FW. Maxillary second molar with two palatal canals and a palatogingival groove. J Endod. 1985 Jul;11(7):308–10.

    Article  PubMed  Google Scholar 

  43. Bond JL, Hartwell G, Portell FR. Maxillary first molar with six canals. J Endod. 1988 May;14(5):258–60.

    Article  PubMed  Google Scholar 

  44. Thews ME, Kemp WB, Jones CR. Aberrations in palatal root and root canal morphology of two maxillary first molars. J Endod. 1979 Mar;5(3):94–6.

    Article  PubMed  Google Scholar 

  45. Stone LH, Stroner WF. Maxillary molars demonstrating more than one palatal root canal. Oral Surg Oral Med Oral Pathol. 1981 Jun;51(6):649–52.

    Article  PubMed  Google Scholar 

  46. Cecic P, Hartwell G, Bellizzi R. The multiple root canal system in the maxillary first molar: a case report. J Endod. 1982 Mar;8(3):113–5.

    Article  PubMed  Google Scholar 

  47. Wong M. Maxillary first molar with three palatal canals. J Endod. 1991 Jun;17(6):298–9.

    Article  PubMed  Google Scholar 

  48. Cleghorn BM, Christie WH, Dong CC. The root and root canal morphology of the human mandibular first premolar: a literature review. J Endod. 2007 May;33(5):509–16.

    Article  PubMed  Google Scholar 

  49. Jain SD, Carrico CK, Bermanis I. 3-dimensional accuracy of dynamic navigation Technology in Locating Calcified Canals. J Endod. 2020 Jun;46(6):839–45.

    Article  PubMed  Google Scholar 

  50. Dianat O, Nosrat A, Tordik PA, Aldahmash SA, Romberg E, Price JB, et al. Accuracy and efficiency of a dynamic navigation system for locating calcified canals. J Endod. 2020 Nov;46(11):1719–25.

    Article  PubMed  Google Scholar 

  51. Jain SD, Saunders MW, Carrico CK, Jadhav A, Deeb JG, Myers GL. Dynamically navigated versus freehand access cavity preparation: a comparative study on substance loss using simulated calcified canals. J Endod. 2020 Nov;46(11):1745–51.

    Article  PubMed  Google Scholar 

  52. Rising DW, Goldman M, Brayton SM. Histologic appraisal of 3 experimental root canal filling materials. J Endod. 1975 May;1(5):172–7.

    Article  PubMed  Google Scholar 

  53. Spradling PM, Senia ES. The relative sealing ability of paste-type filling materials. J Endod. 1982 Dec;8(12):543–9.

    Article  PubMed  Google Scholar 

  54. Tanzilli JP, Nevins AJ, Borden BG. A histologic study comparing Hydron and gutta-percha as root canal filling materials in monkeys. J Endod. 1981 Sep;7(9):396–401.

    Article  PubMed  Google Scholar 

  55. van der Burgt TP, Plasschaert AJ. Bleaching of tooth discoloration caused by endodontic sealers. J Endod. 1986 Jun;12(6):231–4.

    Article  PubMed  Google Scholar 

  56. Schwandt NW, Gound TG. Resorcinol-formaldehyde resin "Russian red" endodontic therapy. J Endod. 2003 Jul;29(7):435–7.

    Article  PubMed  Google Scholar 

  57. Wu MKWM. Pink teeth resulting from Russian endodontic therapy. J Am Dent Assoc. 2000;131:1598–9.

    Article  Google Scholar 

  58. Sikri VKSP, Singh J, Manjri M, Khanna S. Clinical and experimental observations on resinifying therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 1986;62:441–8.

    Article  Google Scholar 

  59. Sikri VK, Sikri P, Singh J, Manjri M, Khanna S. Resinifying therapy in endodontics. II--Histological and bacteriological evaluation. Ind J Dent Res. 1996 Apr-Jun;7(2):51–3.

    Google Scholar 

  60. Kaminska-Litwin KWD. Clinicoradiographic evaluation of dental treatment using the extirpation method. Czas Stomatol. 1983;36:721–4.

    PubMed  Google Scholar 

  61. Vranas RN, Hartwell GR, Moon PC. The effect of endodontic solutions on resorcinol-formalin paste. J Endod. 2003 Jan;29(1):69–72.

    Article  PubMed  Google Scholar 

  62. Gambrel MG, Hartwell GR, Moon PC, Cardon JW. The effect of endodontic solutions on resorcinol-formalin paste in teeth. J Endod. 2005 Jan;31(1):25–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Albert Einstein Medical Center, Dental Department in Philadelphia, Philadelphia, PA, USA

    Stephen P. Niemczyk

  2. Walter Reed National Medical Center in Bethesda, Bethesda, MD, USA

    Stephen P. Niemczyk

  3. U. S. Army Endodontic Residency Program in Fort Gordon, Fort Gordon, GA, USA

    Stephen P. Niemczyk

Authors
  1. Stephen P. Niemczyk
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Editor information

Editors and Affiliations

  1. Department of Endodontics, University of Illinois Chicago, Chicago, IL, USA

    Mohamed I. Fayad

  2. Department of Endodontics, University of Illinois Chicago, Chicago, IL, USA

    Bradford R. Johnson

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Niemczyk, S.P. (2023). Non-surgical Retreatment Utilizing Cone Beam Computed Tomography. In: Fayad, M.I., Johnson, B.R. (eds) 3D Imaging in Endodontics. Springer, Cham. https://doi.org/10.1007/978-3-031-32755-1_6

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  • DOI: https://doi.org/10.1007/978-3-031-32755-1_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32754-4

  • Online ISBN: 978-3-031-32755-1

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