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The aim of this study was to identify the prevalence of missed second mesio-buccal (MB2) root canal in root canal treated (RCT) maxillary first (MFM) and second molars (MSM) by means of cone-beam computed tomography (CBCT) and the association between missed MB2 and apical periodontitis (AP). Material and method. We analyzed 539 CBCT scanned maxillary molars (MM), from patients who visited two private offices over a period of five years. Results. The prevalence of RCT was 40.25%. The prevalence of AP among MM with RCT was 44.23%. The overall prevalence of missed MB2 canals was 52.53%. The overall prevalence of AP among MM with missed MB2 canals was 53.5%. 63.54% for MM with RCT and AP had missed MB2. Conclusions. There was a high prevalence of AP among endodontically treated maxillary molars. Also, there was a high prevalence of missed MB2 canal for these group of teeth and, consequently for the AP associated with a missed root canal.

To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P <.05) and higher percentages of four-rooted configurations (P >.05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P >.05). The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the prevalence of missed second mesio-buccal (MB2) root canal in root canal treated (RCT) maxillary first (MFM) and second molars (MSM) by means of cone-beam computed tomography (CBCT) and the association between missed MB2 and apical periodontitis (AP). Material and method. We analyzed 539 CBCT scanned maxillary molars (MM), from patients who visited two private offices over a period of five years. Results. The prevalence of RCT was 40.25%. The prevalence of AP among MM with RCT was 44.23%. The overall prevalence of missed MB2 canals was 52.53%. The overall prevalence of AP among MM with missed MB2 canals was 53.5%. 63.54% for MM with RCT and AP had missed MB2. Conclusions. There was a high prevalence of AP among endodontically treated maxillary molars. Also, there was a high prevalence of missed MB2 canal for these group of teeth and, consequently for the AP associated with a missed root canal. [ABSTRACT FROM AUTHOR]

Background: The relationship between the maxillary sinus (MS) and the root apices of posterior teeth is of significant clinical relevance as it influences the diagnosis and treatment planning when operating in the posterior areas of the maxilla. The aim of this study, therefore, is to assess this anatomic relationship and evaluate the propensity of roots of posterior maxillary teeth to be intruded into the MS space using cone-beam computed tomography (CBCT) scanning. Materials and Methods: One thousand CBCT scans of patients, aged 20 years or above, were analyzed in the study. The distance from the MS floor to the root apices of the posterior teeth was measured and the relationship between the MS and the posterior teeth roots were recorded, based on Kwak's and Didilescu's classification. Results: Based on Kwak's classification, type I configuration was frequently observed in the maxillary posterior teeth, followed by type II. Based on Didilescu's classification, the longest distance, among premolars, was observed between the palatal root of the left 1st premolar and MS, i.e., 8.2467 mm. Among molars, the longest distance was observed between mesiobuccal root of the right first molar and MS, i.e., 5.8966 mm. The shortest distance, among premolars, was observed between the buccal root of the left second premolar and MS, i.e., 3.5500 mm, and among molars, the shortest distance was between the mesiobuccal root of the left second molar and MS, i.e., 1.3556 mm. Conclusion: From the present study, it may be concluded that, among the central Indian population, mesiobuccal root of the second molars and buccal root of the second premolars show the closest proximity to the MS floor. Therefore, any surgical or endodontic intervention in the vicinity of these roots must be performed with utmost care. [ABSTRACT FROM AUTHOR]

Background: Maxillary molar endodontic treatments require the right post and core system. This study tested cast metal, glass fiber with composite resin, carbon fiber with composite resin, and zirconia post and core materials. Materials and Methods: Sixty removed human maxillary teeth were randomly divided into four post and core material groups (n = 15 per group). The teeth acquired their post and core system after normal endodontic treatment. Fracture resistance, cyclic fatigue resistance, and microleakage analyses were statistically assessed. Results: The zirconia post and core material had the highest fracture resistance (mean: 900 N), followed by carbon fiber with composite resin, cast metal, and glass fiber with composite resin. Zirconia had the highest mean cycles to failure (120,000), followed by carbon fiber with composite resin (100,000), cast metal (110,000), and glass fiber with composite resin (90,000). Zirconia had the lowest mean microleakage score (1.8), and glass fiber with composite resin, the highest (3.0). Conclusion: The zirconia post and core material outperformed the others in fracture resistance, cyclic fatigue resistance, and sealing. The cast metal has better fracture and cycle fatigue resistance than glass fiber with composite resin. These findings help doctors choose maxillary molar endodontic post and core materials.

Background: Maxillary molar endodontic treatments require the right post and core system. This study tested cast metal, glass fiber with composite resin, carbon fiber with composite resin, and zirconia post and core materials. Materials and Methods: Sixty removed human maxillary teeth were randomly divided into four post and core material groups (n = 15 per group). The teeth acquired their post and core system after normal endodontic treatment. Fracture resistance, cyclic fatigue resistance, and microleakage analyses were statistically assessed. Results: The zirconia post and core material had the highest fracture resistance (mean: 900 N), followed by carbon fiber with composite resin, cast metal, and glass fiber with composite resin. Zirconia had the highest mean cycles to failure (120,000), followed by carbon fiber with composite resin (100,000), cast metal (110,000), and glass fiber with composite resin (90,000). Zirconia had the lowest mean microleakage score (1.8), and glass fiber with composite resin, the highest (3.0). Conclusion: The zirconia post and core material outperformed the others in fracture resistance, cyclic fatigue resistance, and sealing. The cast metal has better fracture and cycle fatigue resistance than glass fiber with composite resin. These findings help doctors choose maxillary molar endodontic post and core materials. [ABSTRACT FROM AUTHOR]

Copyright of Selcuk Dental Journal is the property of Selcuk Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim and Objectives: The purpose of this study was to use cone bar CT to investigate the root trench morphology of two-hundred mesiobuccal permanent first molars in the maxilla. Materials and Methods: The distobuccal and palatal roots were removed at the furcation in 250 maxillary first molars. The mesiobuccal roots were then imaged using cone beam computed tomography on all specimens. The specimens were analyzed and compared to one another.” This study looked into the following factors. How Many Canals There Are and What Shape Those Canals Take Errors such as lateral canals, apical delta, calcified segments, and others. Result: Vertucci's trench configuration, kinds I, II, III, IV, V, and VII, were seen in 30%, 20%, 5%, 6%, 7%, and 2.5% of the teeth, respectively. Calcified sections were found in the coronal third of the MB1 trench for eight of the samples, and in the central third for two of the samples. The MB1 trench did not have any calcifications at its very end. The coronal 33 percent of the MB2 trench was calcified in eight samples, but no calcifications were seen in the middle or upper thirds. Conclusion: Noninvasively and with little radiation, a cone beam CT scan can help you learn about your root canal setup.

The aim of this study was to use Cone-beam Computed Tomography (TCHC) to investigate the anatomical configuration, prevalence, and distribution of the Second Mesiobuccal (MB2) canal in upper molars of a Chilean subpopulation, considering variables such as the presence of MB2 canal, Vertucci classification, gender, and age. Cross-sectional observational study. The sample consisted of TCHC scans taken at the dental clinic of Universidad Andrés Bello (Viña del Mar). The sample size was calculated using the formula for known population, resulting in 262 scans. The examiners were calibrated using Cohen's Kappa coefficient, then the variables were analyzed through an imaging study using I-CAT Vision software. 439 first and second upper molars were analyzed. The prevalence of MB2 canal in first molars was 63.74 %, while in second molars, it was 20.04 %. The prevalence in first molars was higher in males (73.86 %) than in females (58.62 %), while in second molars, it was 15.81 % in females and 28.41 % in males. Regarding age, in first molars the difference was significant between the age range of 18 to 40 years (66.49 %). Regarding the type of configuration according to Vertucci, 70 % of the first molars had Type II configuration, and 23.65 % had Type IV, with similar results in second molars. The present study demonstrated that MB2 canals are frequent in the analyzed population, especially in first molars, and Type II configuration is the most prevalent. Additionally, a higher prevalence was observed in males and in the age range of 18 to 40 years. These findings provide relevant information about root anatomy in the studied population and can contribute to improving treatment outcomes. [ABSTRACT FROM AUTHOR]

Aim and Objectives: The purpose of this study was to use cone bar CT to investigate the root trench morphology of two-hundred mesiobuccal permanent first molars in the maxilla. Materials and Methods: The distobuccal and palatal roots were removed at the furcation in 250 maxillary first molars. The mesiobuccal roots were then imaged using cone beam computed tomography on all specimens. The specimens were analyzed and compared to one another." This study looked into the following factors. How Many Canals There Are and What Shape Those Canals Take Errors such as lateral canals, apical delta, calcified segments, and others. Result: Vertucci's trench configuration, kinds I, II, III, IV, V, and VII, were seen in 30%, 20%, 5%, 6%, 7%, and 2.5% of the teeth, respectively. Calcified sections were found in the coronal third of the MB1 trench for eight of the samples, and in the central third for two of the samples. The MB1 trench did not have any calcifications at its very end. The coronal 33 percent of the MB2 trench was calcified in eight samples, but no calcifications were seen in the middle or upper thirds. Conclusion: Noninvasively and with little radiation, a cone beam CT scan can help you learn about your root canal setup. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the maxillary molar root canal morphology in individuals from the Shandong province, China, using cone-beam computed tomography (CBCT) and classify it based on Ahmed et al. (2017) classification system to obtain a reference for clinical diagnosis and treatment. From December 2020 to June 2021, we screened CBCT data of 1,619 patients at the Jinan Stomatological Hospital who had been indicated for CBCT because of various oral abnormalities. The root and root canal morphologies of all teeth were statistically analyzed, and the root canal morphology was classified based on Ahmed et al. (2017) classification system. In the maxillary molars, three roots were the most common, accounting for 99.24 % and 74.61 % of all maxillary first and second molars, respectively. Two roots were the second most common, accounting for 0.66 % and 17.29 % of all maxillary first and second molars, respectively. Root morphology variation, e.g., fusion or furcation defect, was present in 22 (0.76 %) maxillary first molars and 765 (25.39 %) maxillary second molars, with the most common being mesiobuccal and distobuccal root fusion. Detection rates of a second mesiobuccal canal (MB2) in the maxillary first and second molars were 48.5 % and 26.5 %, respectively. Among age groups, the frequency of MB2 was the highest in the 15-24-year-old group and lowest in the 55-64-year-old group. Bilateral MB2 root canals were present in 64.8 % and 48.4 % of the maxillary first and second molars, respectively. Men and women accounted for 60.6 % and 67.8 % of the maxillary first molars, respectively, and 51.7 % and 45.6 % of the maxillary second molars, respectively. According to Ahmed et al. (2017) classification of root canal morphology, 18 and 22 root canal configurations were found in 1,453 right maxillary first molars and 1,444 left maxillary first molars, respectively. The right maxillary first molars showed three two-rooted, 14 three-rooted, and one four-rooted type. The left maxillary first molars showed two one-rooted, six two-rooted, and 14 three-rooted types. According to Ahmed et al. (2017) classification of root canal morphology, 43 and 45 root canal configurations were found in 1,507 right maxillary second molars and 1,506 left maxillary second molars, respectively. The right maxillary second molars showed 17 one-rooted, 16 tworooted, eight three-rooted, and two four-rooted types. The left maxillary second molars showed 19 one-rooted, 13 two-rooted, 12 threerooted, and one four-rooted type. This study showed that the maxillary molar root canal morphology is diverse in the Shandong province. Ahmed et al. (2017) classification system provides a clear description of the root canal morphology. CBCT can be used to study complex root and root canal morphologies. [ABSTRACT FROM AUTHOR]

This retrospective cone‐beam computed tomography study aimed to investigate the possible associations of apical periodontitis (AP) with missed/unmissed second mesiobuccal (MB2) canals. MB2 canals and AP were investigated in 257 endodontically treated and 673 untreated maxillary molars, and the former were analyzed regarding missed/unmissed MB2 canals. The chi‐squared test and odds ratio (OR) were used for statistics. The prevalence of MB2 canals in maxillary first molars was higher than that in second molars (p = 0.001). MB2 canals were 1.751 times more common in males than in females (OR: 1.751; 95% CI: 1.334–2.297), with a significant difference in the 18–39 age groups (p = 0.005). The risk for AP was 5.5 times greater in endodontically treated maxillary molars with missed MB2 canals than in those with unmissed MB2 canals (p = 0.012) (OR: 5.5, 95% CI: 1.549–19.527). The findings of this study reveal that the likelihood of the MB2 canal is higher in the maxillary first molars of young adult males. [ABSTRACT FROM AUTHOR]

Background and Objectives: The proper assessment of the relation between the roots of the maxillary posterior teeth and the maxillary sinus floor represents a real concern for dental practitioners when conducting any procedure in the involved region. Many imaging techniques have been employed to assess this relation. This study aimed to (1) compare the accuracy of digital periapical radiographs with that of cone-beam computed tomography images in assessing the relationship between the maxillary molar roots and the maxillary sinus floor and (2) determine periapical radiographic features (if present) that could indicate the actual protrusion of roots into the sinus cavity. Materials and Methods: This observational analytical in vivo study was carried out on 23 Egyptian patients. Cone-beam computed tomography and digital periapical images were obtained for each patient and assessed by three oral radiologists. Results were statistically analyzed in terms of accuracy, specificity, and sensitivity in addition to the McNemar-Bowker and Fleiss's Kappa test. Results: Despite the presence of a significant difference between the results of both techniques, periapical radiography demonstrated 73% accuracy in displaying the sinus-root relation. Moreover, the continuity of the lamina dura suggests (with more than 70% accuracy) that the root is located outside the sinus and vice versa. Conclusion: The digital periapical technique is considered an accurate method of assessing the sinus-root relation especially when the root is located outside the sinus. One of the most indictive periapical features of root intrusion into the maxillary sinus is the discontinuity of the lamina dura.

الملخص: أهداف البحث: تظل الطرق الفعالة للسيطرة على خلل التنسج العمودي مصدر قلق لأطباء تقويم الأسنان. تهدف هذه الدراسة إلى مقارنة الضغط على الأضراس العلوية الأولى مع تغيير ارتفاع وسادة الاكريليك الحلقية لجهاز قوس الحنك وجهاز التثبيت الرأسي اثناء البلع بإستخدام تحليل العناصر المحددة. طرق البحث: تم التقاط تصوير مقطعي للرأس والرقبة لمرضى أسنان الفك العلوي المستوية والمحاذية لإعادة البناء ثلاثي الأبعاد. تم بناء ستة نماذج تتكون من الفك العلوي مع الأضراس ورباط دواعم السن المحيطة مع ارتفاعات مختلفة من وسادة الاكريليك الحلقية للأجهزة. تم تطبيق قوة مقدارها 112 جم / سم٢ على وسادة الاكريليك الحلقية لكلا الجهازين لمحاكاة متوسط ضغط اللسان. تم تحديد توزيع ضغط التشويه الأقصى الواقع في رباط دواعم السن بسبب ضغط اللسان في منطقة العنق، والمنفرق، والشدقي الوحشي، والإنسي الشدقي، وقمم الجذر الحنكي. قام الأشخاص الذين يحتاجون إلى جهاز قوس الحنك وجهاز التثبيت الرأسي بمختلف الارتفاعات أثناء علاج تقويم الأسنان بتقييم مدى راحتهم مع الجهاز على مقياس النظير البصري. النتائج: أظهر جهاز التثبيت الرأسي قيم ضغط أعلى على جميع ارتفاعات أرضية الحنك مقارنة بالارتفاعات المقابلة لجهاز قوس الحنك. وجد أن نموذج 8 مم من جهاز التثبيت الرأسي فعال بشكل خاص وظيفيا. كما كان ينظر إلى هذا الارتفاع على أنه مقبول من قبل معظم المرضى على مقياس النظير البصري. الاستنتاجات: عندما تحفظ وسادة الأكريليك الخاصة بجهاز التثبيت الرأسي على مسافة 8 مم من قاع الحنك، فإنها تعزز الكفاءة الوظيفية للجهاز مع توفير راحة مقبولة للمريض. Abstract: Objectives: An effective method for controlling vertical dysplasia remains a concern for orthodontists. This study aims to compare the stresses on the maxillary first molars while changing the height of the loop/acrylic pad of the transpalatal arch (TPA) and vertical holding appliance (VHA) during swallowing using finite element analysis. Methods: Head and neck computed tomography (CT) of a patient with levelled and aligned maxillary teeth was taken for a three-dimensional reconstruction. Six models comprising the maxilla, molars, and surrounding periodontal ligament (PDL) with different heights of loop/acrylic pads of the appliances were constructed. A force of 112 g/cm2 was applied to the loop/acrylic pads of both appliances to simulate the average tongue pressure. The distribution of von Mises stresses occurring at the PDL due to the tongue pressure was mapped at the cervical area, furcation, distobuccal, mesiobuccal, and palatal root apices. Separately, subjects requiring TPA and VHA at different heights during orthodontic treatment were asked to rate their comfortability with the appliance on the visual analogue scale (VAS). Results: The VHA demonstrated higher values of stresses at all heights from the palatal floor compared to the corresponding heights of the TPA. The 8 mm model of VHA was found to be functionally effective. This height was also perceived to be acceptable for most patients on the VAS. Conclusions: The acrylic pad of VHA when kept at a distance of 8 mm from the palatal floor enhances the functional efficiency of the appliance with an acceptable comfortability for the patient.

Abstract Introduction The aim of this study was to evaluate the prevalence and characteristics of C-shaped root canals in maxillary first (MFMs) and second (MSMs) molars in a Southwestern Chinese population using cone-beam computed tomographic (CBCT). Methods CBCT images of MFMs (n = 1488) and MSMs (n = 1547) from 1508 subjects enrolled in Guiyang Hospital of Stomatology between July 2018 to February 2021 were evaluated for the incidence and types of C-shaped root canals. Differences by age, sex, left or right side, and bilateral symmetry were also evaluated. Results C-shaped root canals were present in 2.93% MFMs and MSMs (n = 3035) in the Southwestern Chinese population. A significant higher incidence was observed in the MSMs (5.24%) than in the MFMs (0.54%). Increased incidences were noted in teeth with fused root. Two major types and 5 subtypes of C-shaped canal system of maxillary molars were defined, and the most common type of C-shaped canals is fusion of mesial-buccal (MB) and distal-buccal (DB) canals (Type I subtype C). No significant gender and age differences were noted in the prevalence of C-shaped root canals in this population, and no significant difference was seen in its incidence in the left or right MFMs and MSMs. The bilateral occurrence was observed in 1.27% of the patients. Conclusion C-shaped root canals are more frequently present in MSMs than in MFMs in the Southwestern Chinese population, with Type I subtype C (MB-DB canal fusion) as the most common subtype and low incidence of bilateral symmetry.

Introduction: The aim of this study was to evaluate the prevalence and characteristics of C-shaped root canals in maxillary first (MFMs) and second (MSMs) molars in a Southwestern Chinese population using cone-beam computed tomographic (CBCT). Methods: CBCT images of MFMs (n = 1488) and MSMs (n = 1547) from 1508 subjects enrolled in Guiyang Hospital of Stomatology between July 2018 to February 2021 were evaluated for the incidence and types of C-shaped root canals. Differences by age, sex, left or right side, and bilateral symmetry were also evaluated. Results: C-shaped root canals were present in 2.93% MFMs and MSMs (n = 3035) in the Southwestern Chinese population. A significant higher incidence was observed in the MSMs (5.24%) than in the MFMs (0.54%). Increased incidences were noted in teeth with fused root. Two major types and 5 subtypes of C-shaped canal system of maxillary molars were defined, and the most common type of C-shaped canals is fusion of mesial-buccal (MB) and distal-buccal (DB) canals (Type I subtype C). No significant gender and age differences were noted in the prevalence of C-shaped root canals in this population, and no significant difference was seen in its incidence in the left or right MFMs and MSMs. The bilateral occurrence was observed in 1.27% of the patients. Conclusion: C-shaped root canals are more frequently present in MSMs than in MFMs in the Southwestern Chinese population, with Type I subtype C (MB-DB canal fusion) as the most common subtype and low incidence of bilateral symmetry. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontologica Latinoamericana: AOL is the property of Acta Odontologica Latinoamericana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study tested the impact of troughing on the detection rates of MB2 canals with and without calcifications. Traditional access cavities were prepared and the detection of MB2 canals was recorded in 200 maxillary molars selected based on micro-CT scans. In specimens, the MB2 orifice was not detected; troughing was performed. The number of negotiated MB2 with and without troughing was compared with micro-CT using McNemar's test. After traditional access cavity preparation without troughing, the operator detected MB2 in 142 specimens (82%). Troughing of the remaining specimens led to the further identification of 16 MB2 canals, increasing detection rate to 91%. Troughing significantly improved the detection rate of non-calcified MB2s (p < 0.05) but did not significantly impact the detection of calcified MB2 canals (p > 0.05). While troughing is highly effective in enhancing MB2 canal detection in non-calcified canals, it may be limited in cases where calcification is present., (© 2025 Australian Society of Endodontology Inc.)

The maxillary sinus floor is formed by the alveolar process of the maxilla. Frequently, the roots of maxillary molars and premolars may protrude into the sinus cavity, with only a thin membrane separating them. Endodontic infections are characterized by mixed biofilms of anaerobic and proteolytic bacteria that can infect the root canal space and accessory anatomy of those teeth producing apical periodontitis. Due to the close relationship with the maxillary sinus, the persistence of apical periodontitis could potentially lead to odontogenic sinusitis. Understanding maxillary sinus anatomy and its relationship with the posterior maxillary dentition is crucial for diagnosing this entity., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aim: The purpose of the present descriptive study was to evaluate and depict the form of the coronal pulp chamber floor in the permanent maxillary first (pMFM) and second (pMSM) molars in an Indian population. Subjects and Methods: Five hundred freshly extracted pMFM (n = 250) and pMSM (n = 250) were acquired from a pool of freshly extracted teeth unrelated to the current study. The crowns were flattened occlusally till the pulpal anatomy was seen and were photographed using a stereomicroscope at ×4.5 magnification. The number of orifices, shapes of the orifices, incidence of mesiobuccal 2 (MB-2), incidence of discobuccal 2 (DB-2), incidence of palatal 2 (P-2), shape of the access cavity, incidence and shape of isthmus, location of extra orifice, and the shape of the pulp chamber floor according to the Pawar and Singh classification© (K, Y, I, and others) were observed. Statistical Analysis: The level of significance for descriptive and frequency statistics was determined at 5%, with 95% confidence intervals. Results: Three root canal orifices occurred predominantly in 50.4% pMFM and 69.2% pMSM. The root canal orifices in the MB and distobuccal roots were round, whereas palatal orifices were oval. The access cavities were triangular in 51.6% pMFM, 51.2% pMSM, rhomboid shaped in 34.8% pMFM, 20.4% pMSM, and others in 13.6% pMFM and 28.4% pMSM. The extra orifices in pMFM were in MB in 20.8%, distobuccal in 14%, and palatal in 8% roots. For the pMSM, extra orifices were in MB (7.2%), distobuccal (6.4%), and palatal (2.4%) roots. The K, Y, I, and other classification were seen in 18.4%, 55.2%, 12.8%, and 13.6%, respectively, for pMFM and in 3.6%, 61.6%, 23.6%, and 11.6%, respectively, for pMSM. Conclusion: Our study investigated and described the various anatomical patterns of the coronal pulp chamber floor in maxillary molars. The classification applied to the patterns of the pulp chamber floor architecture can help clinicians determine the total number of canals as well as their unique orifice position and better communication.

Introduction: Knowledge regarding the root canal morphology is a key for successful root canal therapy. Maxillary molars comprise a complex root canal system. Thus, this study aimed to evaluate the root morphology and root canal configurations of maxillary molars using cone-beam computed tomography (CBCT) radiographic analysis in a Saudi subpopulation. Materials and Methods: The CBCT images of 624 maxillary molar teeth from 208 patient records (age: 28.74 ± 9.56 years) were analyzed using i-Dixel three-dimensional imaging software. Sagittal, axial, and coronal serial sections were used to examine the number of roots, root canal configuration, the number of canals, and differences between the right and left sides. Frequencies and percentages were used to represent the results. Differences between both sides were determined by the Chi-square test, and the significance level was set at P < 0.05 for all statistical tests. Results: In the first molars, 85.8% of teeth had four canals, 14.2% had three canals, 48.2% mesiobuccal (MB) roots had Vertucci Type IV configuration, and both distobuccal and palatal roots had Vertucci Type I roots. In the second molars, three and four canals were present in 33.6% and 66.4% of the teeth, respectively. All the second molars had Vertucci Type I distobuccal and palatal roots, whereas the MB roots were present in 32.9% of the teeth. No significant difference was found between both sides (P > 0.05) for all parameters. Conclusions: Wide variations were found among the same population, and the presence of four canals in maxillary molars was commonly observed. Clinicians should be aware of such differences and use available diagnostic tools, such as CBCT and dental operative microscopy.

Aim: To assess the relations between the divergence angle of the maxillary molar roots and their proximity to the maxillary sinus floor using CBCT. Method: This study comprised CBCT scans of the maxilla, including at least the inferior one-third of the maxillary sinus and at least one molar present in any quadrant with complete eruption and root formation. Evaluation included the vertical relations between the maxillary molar root apices and the maxillary sinus floor (MSF), and the root divergence was measured from the root apices to the floor of the pulp chamber. The chi-square test was used for the associations between the study parameters. For the correlation between root divergence angles and MSF vertical relationship types, the Spearman test was used. A P-value 45⁰ angle groups, and a higher prevalence of the Type I relationship was found in the 21-45⁰ angle group. For the distobuccal-palatal angle groups, higher percentages of the MSF Type II relationship were found in the three angle groups. For all teeth, there was a significant positive correlation between the MSF vertical relationship and the mesiobuccal-palatal angle (r = 0.116; P = 0.039). Conclusion: There was a positive correlation between the divergence angle of the roots and their vertical relationship with the MSF. Clinicians should assess the divergence between the roots before performing extraction or endodontic treatments.

Background: The current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population. Methods: Three-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using 3D Slicer. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MBMB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (-0.1° to -1.9°), II (-2° to -4°), III (>-4°). On the data tabulated a new Banga Vhorkate and Pawar's (BVP's) angular classification for maxillary molars was proposed. Results: The existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1-MB2 in maxillary 1st molar is seen to be 3.12-3.31 mm and this distance in maxillary 2nd molar is 2.8-3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06-5.22 mm in maxillary first molars and 4.9-5.8 mm in maxillary second molars. Conclusion: Accurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study aims to evaluate maxillary molars' root and root canal morphology among the Saudi population using Cone-Beam Computed Tomography scanning (CBCT). SUBJECTS AND METHODS: Retrospectively, the CBCT scans of 483 Saudi nationals were evaluated to identify the number of roots and root canals in maxillary first and second molars. The records were tabulated and classified according to Vertucci and a new system for root and canal classification given by Ahmed and Dummer. Fisher's exact test was used to analyze the data statistically. To check for symmetry, comparisons were made between all the maxillary first molars (MFM's) and maxillary second molars (MSM's) on opposing quadrants. Inter Observer variability was seen using Cohen's Kappa test. RESULTS: MFM's presented with three roots with Type II Vertucci canal configuration (VC) commonly seen among them. MSM's had more variations in the number of roots and canals, although three roots and Type I VC were predominantly seen. When comparing the two genders statistically significant difference was observed in both maxillary molars at a 5% level using Fisher's exact test. Three roots with four canals (3R4C) were predominantly observed in the MFM's (85.6%) and three roots with three canals (3R3C) identified in 51.95% were more common than 3R4C (43.55%) in MSM's. Both the maxillary molars bilaterally, exhibited a high percentage of symmetry in root and canal configurations. CONCLUSIONS: Identification of root canal morphology of molars would reduce the chances chances of root canal failures by making sure all canals are obturated. This study provides supplemental information about the root canals of maxillary molars in a Saudi Arabian subpopulation. [ABSTRACT FROM AUTHOR]

Background: We conducted a narrative review of studies analyzing the occlusal and mandibular plane angles after maxillary molar distalization using temporary skeletal anchorage devices (TADs). An original preliminary investigation was conducted on the occlusal and mandibular plane angle changes according to the design of TAD-supported distalization. Methods: We included 51 participants stratified into three groups (buccal TAD, lingual arch TAD, and pendulum TAD) who underwent lateral cephalography before and after treatment. The paired t-test and ANOVA were used to analyze the significant differences among the groups. Results: The pterygoid vertical to maxillary second molar (p < 0.01) significantly differed before and after treatment within each group (group 1, 1.29 ± 1.73 mm; group 2, 2.01 ± 1.46 mm; group 3, 1.12 ± 1.43 mm). The angle between the Frankfort horizontal and anatomical occlusal plane increased by 1.96 ± 2.88° (p < 0.05) and 2.51 ± 2.57° (p < 0.01) in groups 2 and 3, respectively. Conclusions: The measured variables did not significantly differ among the three groups. The Frankfort-mandibular plane angle and functional occlusal plane did not change after maxillary molar distalization. The anatomical occlusal plane is influenced by the anterior teeth and may be unrelated to maxillary molar distalization. Further studies are required to verify the exact relationship between maxillary molar distalization and occlusal plane angle. [ABSTRACT FROM AUTHOR]

The aim of this study was to measure the initial and remaining dentin thickness in the danger zone of the second mesiobuccal (MB2) canal of maxillary first molars after rotary instrumentation using cone beam computed tomography (CBCT) imaging. After determining initial dentin thickness, each sample was subjected to a standardized protocol of rotary instrumentation files: ProTaper Gold Sx Orifice Opener (maximum depth of 7 mm); Vortex Blue 15.04, 20.04, 25.04, ProTaper Gold S1, S2, F1, F2, and finally Vortex Blue 30.06. Subsequent CBCT measurements were made to compare changes in remaining dentin thickness in comparison to initial presentation. Preoperative dentin thickness in the danger zone had a mean of 0.82 ± 0.17mm. Significant levels of dentin removal in the danger zone were noted after all instrumentation groups when compared to the pre‐instrumentation mean (Sx P < 0.001, 25.04 P < 0.0006, F2 P < 0.0001, 30.06 P < 0.0001). It was concluded that a thin area of dentin exists along the distal wall of the MB2 (danger zone) from the furcation to 4 mm apically. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to analyze the canal configuration of mesiobuccal root (MBR) of the maxillary molars in the Saudi subpopulation using cone-beam computed tomography (CBCT) and to compare if there is any gender and arch variation. Methodology: In this cross-sectional retrospective evaluation study, analysis of CBCT scans of MBRs of 400 maxillary first and second molars was done that has undergone CBCT scanning for diagnostic/treatment purposes in the private clinic of Jeddah, KSA. Statistical analysis was performed using Student's t-test and Chi-square test. Results: Type I, II, and III canal configurations have been reported to be the most common morphologies in the MBR in both first and second molars, with the incidence of 20.25% (81), 17.25% (69), and 17.25% (69), respectively. Type I canals were significantly (P < 0.001) more common in tooth #17 and #27, Type II canals were significantly (P < 0.001) more seen in tooth #26, Type 3 canals were more seen in tooth #27, but there is no statistically significant association. Supplemental canal configurations which were classified by Gulabivala as Type I, Type II, and Type IV were also seen. Furthermore, 93 additional unclassified canal configurations were also found. Conclusion: The data indicate high prevalence of MB2 canals with varying canal configurations. Preoperative CBCT imaging should always be done in tooth-like maxillary molars, to understand the complex configurations and variations and to achieve higher success while performing root canal treatment. [ABSTRACT FROM AUTHOR]

• Cropped digital periapical image showing: Score 1 (Blue arrow), Score 2 (Orange arrow), and Score 3 (White arrow). • Cropped CBCT coronal cuts, a shows roots with Score 1, b shows roots with Score 2 and c shows roots with Score 3. • Digital periapical images showing: A = Interruption of the MSF, B = Discontinuity of the lamina dura, and C = Upward bending of the MSF to envelop the root. • Sensitivity, specificity, accuracy, false-positive rate, positive predictive value, and negative predictive value for each periapical feature separately, and then the combination of features (A = Interruption of the MSF, B = Discontinuity of the lamina dura, and C = Upward bending of the MSF). The proper assessment of the relation between the roots of the maxillary posterior teeth and the maxillary sinus floor represents a real concern for dental practitioners when conducting any procedure in the involved region. Many imaging techniques have been employed to assess this relation. This study aimed to (1) compare the accuracy of digital periapical radiographs with that of cone-beam computed tomography images in assessing the relationship between the maxillary molar roots and the maxillary sinus floor and (2) determine periapical radiographic features (if present) that could indicate the actual protrusion of roots into the sinus cavity. This observational analytical in vivo study was carried out on 23 Egyptian patients. Cone-beam computed tomography and digital periapical images were obtained for each patient and assessed by three oral radiologists. Results were statistically analyzed in terms of accuracy, specificity, and sensitivity in addition to the McNemar-Bowker and Fleiss's Kappa test. Despite the presence of a significant difference between the results of both techniques, periapical radiography demonstrated 73% accuracy in displaying the sinus-root relation. Moreover, the continuity of the lamina dura suggests (with more than 70% accuracy) that the root is located outside the sinus and vice versa. The digital periapical technique is considered an accurate method of assessing the sinus-root relation especially when the root is located outside the sinus. One of the most indictive periapical features of root intrusion into the maxillary sinus is the discontinuity of the lamina dura. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Purpose To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up. Methods Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded. Results Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn’t seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery. Conclusion Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.

Aim: The aim of the present study was to analyze the morphological variations and complexities in root canal systems of the maxillary second molars in South Indian population, using cone beam computed tomography (CBCT). Subjects and Methods: The CBCT images of 500 participants were examined at different slice thickness of 125 micrometers. Root canal systems of the 500 maxillary second molars were analyzed according to Vertucci, HMA Ahmed et al., and Kim et al. classifications in the Indian subpopulation. Statistical Analysis Used: Interobserver variability was analyzed using Kappa statistics. Results: Among the tooth analyzed, 63% had three roots, with a single canal in each root in 65.2% tooth. About 41.8% of the tooth had fusion of mesiobuccal and distobuccal roots. The most commonly found root canal configuration was Type I (65%) according to Vertucci's classification. According to HMA Ahmed et al. classification, 67.9% tooth had the configuration of 327 MB1 DB1 P1/317 MB1 DB1 P1. Nearly 20.8% tooth had MB2 canal. The most common isthmus type was Type II (55.2%) according to Kim's classification, and the prevalence of isthmus was 2–5 mm from the root apex. Conclusions: The number of roots, canals, their configuration, and occurrence of isthmus has not been reported in the South Indian population. The importance of understanding the knowledge of the anatomy of teeth during the treatment of maxillary second molars would contribute to successful endodontic outcomes.

Introduction  Molars have been known to display varied morphologies. Maxillary first molar is the tooth with the largest volume and most complex root and root canal anatomy; also, possibly the most treated and least understood posterior tooth. The present study aimed to investigate the occurrence and morphology of MB2 canals in maxillary first molars in an Indian subpopulation (Dakshina kannada) using cone beam CT (CBCT) imaging. Materials and Methods  A total of 330 maxillary molars were placed on "U-" shaped modelling wax template, mimicking the natural arch and digitally scanned, of which 196 scans met the inclusion criteria and were analyzed for unusual root canal anatomy by CBCT. To analyze the occurrence and morphology of the canals, the acquired data was examined by two endodontists and discussed till an agreement was reached. Results  The results were subjected to descriptive analysis. The majority of patients 103 (52.6%) teeth showed the presence of MB2 canals. As much as 83.5% of teeth depicted Vertucci's type II morphology, and 16.5% teeth presented with Vertucci's type IV morphology. Conclusion  CBCT overcomes the limitations of conventional radiography. However, the decision to use CBCT in the management of endodontic problems must be based on a case-by-case basis and only when sufficient diagnostic information is not obtained from diagnostic tests. [ABSTRACT FROM AUTHOR]

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aqeel Al-Saedi,1 Bahaa Al-Bakhakh,2 Riad G AL-Taee3 1Oral Diagnosis Department, College of Dentistry, University of Basrah, Basrah, Iraq; 2Conservative Dentistry Department, College of Dentistry, University of Basrah, Basrah, Iraq; 3Oral and Maxillofacial Surgery Department, College of Dentistry, University of Basrah, Basrah, IraqCorrespondence: Aqeel Al-Saedi Oral DiagnosisDepartment, College of Dentistry, University of Basrah Kut Al-Hujaj, Basrah 61004, IraqTel +964 7706910561Fax +964 7700636421Email Aqeel.lazim@uobasrah.edu.iqPurpose: This study aimed to determine the prevalence of the second mesiobuccal canal in maxillary first molar teeth in a sample of population from Basrah city in the south of Iraq.Patients and Methods: Cone-beam computed tomography (CBCT) images of 353 Iraqi patients from Basrah city were included in the study. These images revealed 691 maxillary first molars, but only 655 of them were included. The images were obtained using a Gendex (GXDP-7000) CBCT machine (Hatfield, PA, USA) and studied for the prevalence of second mesiobuccal canal in the mesiobuccal root canal configuration, according to Vertucci’s classification, by scrolling through the images. Pearson’s chi-square tests were used to correlate canal type distribution to gender and age. The distributions of canal type on the right and left sides were assessed using the Kendal tau correlation coefficient. A P-value < 0.001 was considered highly significant. For intra-examiner reliability analysis, Cohen’s kappa test was used.Results: The second mesiobuccal canal was identified in 81.68% of the Iraqi population sample. The most common type was type II (44.58%), followed by type IV (31.30%). Type I occurred in 18.32% of cases. Other types were less frequent.Conclusion: The second mesiobuccal canal occurred in most of the examined samples of the Iraqi population (81.68%), with the most common type being type II, followed by type IV.Keywords: maxillary molars, root canal anatomy, Vertucci’s classification, mesiobuccal root

Background/purpose: Understanding the root canal systems of molars and the association of root canal system in adjacent or contralateral molars is important for dental practice. This study aimed to use cone-beam computed tomography (CBCT) to analyze the morphology similarity of root canal systems in the maxillary first and second molars. Methods: CBCT images of 1741 maxillary molars in a total of 519 patients were blindly examined to analyze the correlation of root canal systems between maxillary first and second molars as well as the bilateral first and second molars. Results: The most common type in maxillary first molars is 3R4C (3 roots/4 canals), whereas in maxillary second molars is 3R3C.The symmetry in type of root canals in bilateral maxillary first and second molars were 87.36% and 79.85%, respectively. The similarities of root canal system in adjacent maxillary first and second molars were 53.07% (right side) and 52.58% (left side). The concurrence of MB2 canal in bilateral maxillary first molars is 77.8%, and 35.97% in maxillary second molars. In the 110 patients with MB2 canal in bilateral maxillary second molars, the chance of bilateral MB2 canals in their maxillary first molar is almost 100%. Conclusion: Maxillary first molars have higher prevalence of 3R4C than second molars. The symmetry in bilateral maxillary molars is higher than the similarity in adjacent maxillary first and second molars. Application of CBCT analysis of root canal system can improve endodontic treatment outcomes. The correlation of root canal system between teeth is useful for genetic linkage.

Objective: This randomized controlled clinical trial assessed the analgesic and anesthetic effects of precooling the injection site and administration of refrigerated 2% lignocaine HCl with 1:100,000 epinephrine (LE) in maxillary molars with symptomatic irreversible pulpitis (SIP). Materials and methods: Sixty patients diagnosed with SIP (preoperative pain score ≥ 85 mm) in maxillary first molars were randomly allocated to two groups. In group I (control), topical gel was applied for a minute followed by conventional LE infiltration, whereas in group II (experimental), topical ice application for 15 s and refrigerated (4–6 °C) LE administration was done prior to endodontic treatment. The primary outcome measure was anesthetic efficacy that was defined as none to weak pain (≤ 36 mm) as measured on Heft Parker visual analog scale (HP-VAS) following access cavity preparation. Pain on injection and onset constituted the secondary outcome measures. The pain on injection was measured using HP-VAS, whereas the onset of anesthesia was assessed using an electric pulp tester (EPT) which was applied on the experimental tooth every minute until no response was elicited. Mann–Whitney U test was performed to analyze the data (p < 0.01). Results: Experimental group reported a success rate of 86.6% when compared to control group (26.6%) and a statistically significant reduction on injection pain (20.0 mm vs 54.5 mm) (p < 0.01). The onset of anesthesia for experimental group was 2.4 min which was also significantly lower than control group (4.5 min) (p < 0.01). Conclusions: Cryotherapy can serve as an effective alternative to conventional anesthesia for achieving success, reduced pain, and faster onset during endodontic treatment of maxillary molars with SIP. Clinical relevance: Precooling the injection site and cold LE administration can result in effective pulpal anesthesia during endodontic management of maxillary molars in SIP patients. [ABSTRACT FROM AUTHOR]

To assess the relations between the divergence angle of the maxillary molar roots and their proximity to the maxillary sinus floor using CBCT. This study comprised CBCT scans of the maxilla, including at least the inferior one-third of the maxillary sinus and at least one molar present in any quadrant with complete eruption and root formation. Evaluation included the vertical relations between the maxillary molar root apices and the maxillary sinus floor (MSF), and the root divergence was measured from the root apices to the floor of the pulp chamber. The chi-square test was used for the associations between the study parameters. For the correlation between root divergence angles and MSF vertical relationship types, the Spearman test was used. A P-value < 0.05 was considered significant. A total of 100 scans were analyzed, including 316 permanent maxillary first and second molars. The MSF Type II vertical relationship was the most prevalent (39.6%), followed by Type I (31.3%). The highest divergence angle was found between the distobuccal and palatal roots (mean = 44.9 ± 10.5°). For the mesiobuccal-distobuccal angle groups, there were higher percentages of the MSF Type I and II relationships among the angle groups < 1° and 21-45°. For the mesiobuccal-palatal angle groups, a higher prevalence of the MSF Type II relationship was found in the <21⁰ and >45⁰ angle groups, and a higher prevalence of the Type I relationship was found in the 21-45⁰ angle group. For the distobuccal-palatal angle groups, higher percentages of the MSF Type II relationship were found in the three angle groups. For all teeth, there was a significant positive correlation between the MSF vertical relationship and the mesiobuccal-palatal angle (r = 0.116; P = 0.039). There was a positive correlation between the divergence angle of the roots and their vertical relationship with the MSF. Clinicians should assess the divergence between the roots before performing extraction or endodontic treatments. [ABSTRACT FROM AUTHOR]

A crucial understanding of teeth' internal and external anatomy is critical for the successful outcome of endodontic therapy. The presence of two palatal roots in maxillary molars, particularly in the second molar is rare. The present case report addresses this anatomical variation in an 18-year-old female patient with a chief complaint of severe pain in the upper left back teeth region since one week. Preoperative radiographic evaluation of maxillary second molar did not reveal the aberrant anatomy due to its location and impaction of maxillary third molar onto the roots of the second molar. After access opening, inspection of the pulp chamber floor revealed a slightly deviated location of the palatal canal and a bleeding point mesial to the palatal canal. Intensive exploration for determining any additional canals was done using David Green (DG) 16 endodontic explorer under 3X magnification using dental loupes. A narrow field of view Cone Beam Computed Tomography (CBCT) was obtained to evaluate the unusual root canal morphology. Following a thorough analysis of CBCT, root canal treatment was performed employing a standard protocol. This case report highlights the successful diagnosis and management of the bilateral maxillary second molar with two separate palatal roots. With CBCT and magnification, determining the root morphology and canal configuration will be more accurate, further improving the quality of root canal treatment.

Objective: The aim of this study was to compare the success rate of anaesthesia with 3% prilocaine and felypressin (0.03 IU/mL) in maxillary first and second molar teeth with irreversible pulpitis. Methods: The study population was 159 patients (53 males, 106 females) who had maxillary first or second molar teeth with irreversible pulpitis (84 first molars, 75 second molars). A buccal infiltration of 3% prilocaine with 0.03 IU/mL felypressin was used as the primary anaesthetic technique. In addition to using a categorised pain score, sound, eye movement and body motion were considered signs of anaesthesia efficacy. The data were analysed with independent t and Chi-square tests. Significance was set at a=0.05. Results: Overall, the success rate was 56.6% in maxillary molars, 53.6% in maxillary first molars, and 60% in maxillary second molars. There was no statistically significant difference between maxillary first and second molars in terms of anaesthesia success rate (P>0.05). The overall success rate of intraligament supplementary injections was 50%, and intrapulpal supplementary injections was 97.91%. No significant difference was found between maxillary first and second molars in terms of the success rate of the supplemental techniques (P>0.05). Conclusion: No significant difference was found between maxillary first and second molars in terms of anaesthesia success rate when 3% prilocaine with 0.03 IU/mL felypressin was used as an anaesthetic solution for the infiltration injection. [ABSTRACT FROM AUTHOR]

Background: We conducted a narrative review of studies analyzing the occlusal and mandibular plane angles after maxillary molar distalization using temporary skeletal anchorage devices (TADs). An original preliminary investigation was conducted on the occlusal and mandibular plane angle changes according to the design of TAD-supported distalization. Methods: We included 51 participants stratified into three groups (buccal TAD, lingual arch TAD, and pendulum TAD) who underwent lateral cephalography before and after treatment. The paired t-test and ANOVA were used to analyze the significant differences among the groups. Results: The pterygoid vertical to maxillary second molar (p < 0.01) significantly differed before and after treatment within each group (group 1, 1.29 ± 1.73 mm; group 2, 2.01 ± 1.46 mm; group 3, 1.12 ± 1.43 mm). The angle between the Frankfort horizontal and anatomical occlusal plane increased by 1.96 ± 2.88° (p < 0.05) and 2.51 ± 2.57° (p < 0.01) in groups 2 and 3, respectively. Conclusions: The measured variables did not significantly differ among the three groups. The Frankfort-mandibular plane angle and functional occlusal plane did not change after maxillary molar distalization. The anatomical occlusal plane is influenced by the anterior teeth and may be unrelated to maxillary molar distalization. Further studies are required to verify the exact relationship between maxillary molar distalization and occlusal plane angle.

Numerous case reports emphasise the importance of thorough knowledge of the anatomic morphology in the maxillary molars for the success of root canal treatment. The aim of this paper was to present a case of a maxillary second molar with four roots (two palatal roots) and four distinct canals requiring root canal therapy. Root canal treatment was performed using nickel-titanium rotary files. In addition, the role of cone beam computed tomography as an objective tool for confirmatory diagnosis and successful treatment is demonstrated. Properly prepared access cavity and cone beam computed tomography (CBCT) scanning revealed unusual root morphology and led to a favourable outcome for root canal treatment. A thorough knowledge of possible variations in internal anatomy of human teeth is important for successful root canal treatment. [ABSTRACT FROM AUTHOR]

For successful clinical outcomes in endodontics, a thorough knowledge of root canal morphology, adequate clinical and radiographic assessment, and the use of newer diagnostic aids are required. This case report describes the diagnosis and endodontic management of a three-rooted left maxillary first molar which had three roots and seven canals (MB1, MB2, MB3, DB1, DB2, MP, and DP). This unusual morphology of the maxillary first molar was confirmed using a cone-beam computed tomography scan. This article discusses the morphology of the maxillary first molar and how to successfully diagnose and negotiate the extra canals using the most up-to-date techniques. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up. Methods: Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded. Results: Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn't seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery. Conclusion: Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review is to assess the treatment effects (amount of distalization, distal tipping and vertical movement) of buccally versus palatally placed temporary skeletal anchorage devices (TSADs) on maxillary first molars during distalization. Materials and methods: Medline and Scopus databases were searched up to September 2020 for randomized controlled trials (RCTs) and non-randomized prospective cohort studies on maxillary molar distalization using TSADs in patients with Class II malocclusion. After study selection, data extraction and risk of bias assessment, meta-analyses were performed for the amount of distalization, distal tipping and intrusion of first molars. Results: Nine studies (2 RCTs and 7 prospective studies) were included. The risk of bias of the RCTs was low to unclear. The non-randomized studies were of moderate quality. In five studies, the TSADs were placed in the infrazygomatic process while in two studies, they were placed in the buccal inter-radicular spaces, and in two studies, they were placed in the midpalatal region. The first molar distalization was 2.75 mm when buccal inter-radicular TSADs were used, but 4.07 and 4.17 mm with palatal and infrazgomatic TSADs. The palatal appliances were associated with 11.17° of distal tipping of the first molar while infrazygomatic and buccal inter-radicular TSADs resulted in 3.99° and 1.70° of tipping, respectively. Conclusions: Inter-radicular TSADs resulted in less distal tipping but also in less distalization. Palatal TSAD-supported appliances showed the greatest amount of distal tipping. Further RCTs or prospective studies on the effect of various designs of TSAD-supported distalization are warranted. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of molar distalization with clear aligners (CAs) on maxillary sinus parameters and its proximity to the root apices of maxillary molars using Cone Beam Computed Tomography (CBCT)., Methods: The study involved pre- and post-treatment CBCT images of 27 adult patients. MIMICS 21.0 software was used to measure maxillary sinus volume and surface area, while Invivo Dental 6.0 program was used to measure the sinus diameters and proximity of the maxillary molar root apices to the sinus floor., Results: Post-treatment, there was a marked increase in the average volume and surface area of the maxillary sinus on both sides; however, changes in dimensions were not statistically significant. Sinus proximity to the root apices of the maxillary molars showed statistically significant differences, particularly on the left side for all roots. Gender and age impacted the outcomes, with males and younger individuals showing more pronounced changes. No significant differences were observed between the left and right sinuses in all parameters., Conclusion: Molar distalization with CAs increases maxillary sinus parameters, more notably in younger and male patients. All molar teeth roots moved toward the sinus, particularly the mesiobuccal root of the maxillary second molar protruded to the sinus., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Objectives: Dental morphological characteristics are useful for providing information in phylogenic and genetic studies and also for understanding variations within and among species. Carabelli cusp is expressed in several degrees and in different frequencies among humans; thus, it is helpful in comparing and characterizing populations. The objective of this retrospective study was to evaluate Carabelli’s trait (CT) in a group of Turkish patients. Materials and Methods: In this study, 213 patients between age of 14-65 (mean age 29.99 ± 10.04) were analyzed retrospectively according to presence or absence of CT on permanent maxillary first and second molars. All data were statistically analyzed using the IBM SPSS version 22 program (IBM SPSS, Turkey) and the chi-squared test; p < 0.05 was considered as statistically significant. Results: Prevalence of CT was found to be 47.9% in the selected Turkish group. Incidence of CT in any of the teeth on #16/26 was 46.9% and 4.2% on #17/27. Incidence was detected more on #26 (43.2%) than on #16 (40.4%). Bilateral presence of CT on #16/26 was detected in 78%. CT was seen in 50.7% of females and in 42.9% of males. There was no statistically significant difference between genders (p > 0.05). Conclusions: Expression of CT can be placed in moderate prevalence group. There was no sexual dimorphism in its occurrence in the studied group. CT can be a valuable criterion to determine differences among various populations and a significant insight into the migratory patterns in a selected geographical area.