Skip to main content
Top
Published in: Clinical Oral Investigations 3/2024

Open Access 01-03-2024 | Digital Volume Tomography | Research

Diagnostic value of cone beam computed tomography for root canal morphology assessment – a micro-CT based comparison

Authors: Mariana Pires, Jorge N.R. Martins, Mário Rito Pereira, Isabel Vasconcelos, Rui Pereira da Costa, Isabel Duarte, António Ginjeira

Published in: Clinical Oral Investigations | Issue 3/2024

Login to get access

Abstract

Objectives

The aim of this study was to assess cone beam computed tomography (CBCT) as a root canal anatomy diagnostic tool by comparison with micro-CT gold-standard.

Materials and methods

216 two-rooted mandibular molars were first scanned in a CBCT device (200 μm voxel size) and posteriorly in a micro-CT scanner (19.61 μm). The volumes were sequentially screened to classify main root canal anatomy according to Vertucci classification, and for the presence of lateral canals and apical deltas, in both mesial and distal roots.

Results

Both methods revealed a higher prevalence of Vertucci Type II and IV in the mesial root, and Vertucci Type I in the distal root. The percentage of agreement for main root canal anatomy classification between CBCT and micro-CT scores was high (85.2%).

Conclusion

Sensibility to detect both lateral canals and apical deltas with CBCT was low. These results attest to the fact that minor anatomical changes might be difficult to identify with CBCT imaging, hampering its diagnostic value.
Literature
1.
go back to reference Martins JNR, Versiani MA (2018) CBCT and Micro-CT on the study of root canal anatomy. In: Versiani M, Basrani B, Sousa-Neto M (eds) The Root Canal anatomy in Permanent Dentition, 1st edn. Springer, Cham, pp 89–180 Martins JNR, Versiani MA (2018) CBCT and Micro-CT on the study of root canal anatomy. In: Versiani M, Basrani B, Sousa-Neto M (eds) The Root Canal anatomy in Permanent Dentition, 1st edn. Springer, Cham, pp 89–180
2.
go back to reference Ahmed HMA (2022) A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 55(Suppl 2):229–280MathSciNetCrossRefPubMed Ahmed HMA (2022) A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 55(Suppl 2):229–280MathSciNetCrossRefPubMed
3.
go back to reference Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C (2019) Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J 52(8):1138–1152CrossRefPubMed Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C (2019) Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J 52(8):1138–1152CrossRefPubMed
4.
go back to reference Pinto JC, Wanderley VA, de Faria Vasconcelos K, Leite AF, Pauwels R, Nadjmi M, Jacobs R (2021) Evaluation of 10 cone-beam computed tomographic devices for endodontic assessment of fine anatomic structures. J Endod 47(6):947–953CrossRefPubMed Pinto JC, Wanderley VA, de Faria Vasconcelos K, Leite AF, Pauwels R, Nadjmi M, Jacobs R (2021) Evaluation of 10 cone-beam computed tomographic devices for endodontic assessment of fine anatomic structures. J Endod 47(6):947–953CrossRefPubMed
5.
go back to reference Versiani MA, Ordinola-Zapata R, Keles¸ A, Alcin H, Bramante CM, Pécora JD, Sousa-Neto MD (2016) Middle mesial canals in mandibular first molars: a micro-CT study in different populations. Arch Oral Biol 61:130–137CrossRefPubMed Versiani MA, Ordinola-Zapata R, Keles¸ A, Alcin H, Bramante CM, Pécora JD, Sousa-Neto MD (2016) Middle mesial canals in mandibular first molars: a micro-CT study in different populations. Arch Oral Biol 61:130–137CrossRefPubMed
6.
go back to reference Vasconcelos I, Pereira M, Ginjeira A, Franco M, Morouço P, Alves N (2019) Evaluation of root canal filling with a bioceramic sealer using micro-computed tomography: a pilot study. Appl Mech Mater 890:275–282CrossRef Vasconcelos I, Pereira M, Ginjeira A, Franco M, Morouço P, Alves N (2019) Evaluation of root canal filling with a bioceramic sealer using micro-computed tomography: a pilot study. Appl Mech Mater 890:275–282CrossRef
7.
go back to reference Ordinola-Zapata R, Bramante CM, Versiani MA, Moldauer BI, Topham G, Gutmann JL, Nuñez A, Duarte MA, Abella F (2017) Comparative accuracy of the clearing technique, CBCT and micro-CT methods in studying the mesial root canal configuration of mandibular first molars. Int Endod J 50:90–96CrossRefPubMed Ordinola-Zapata R, Bramante CM, Versiani MA, Moldauer BI, Topham G, Gutmann JL, Nuñez A, Duarte MA, Abella F (2017) Comparative accuracy of the clearing technique, CBCT and micro-CT methods in studying the mesial root canal configuration of mandibular first molars. Int Endod J 50:90–96CrossRefPubMed
8.
go back to reference Zhang D, Chen J, Lan G, Li M, An J, Wen X, Liu L, Deng M (2017) The root canal morphology in mandibular first premolars: a comparative evaluation of cone-beam computed tomography and micro-computed tomography. Clin Oral Investig 21(4):1007–1012CrossRefPubMed Zhang D, Chen J, Lan G, Li M, An J, Wen X, Liu L, Deng M (2017) The root canal morphology in mandibular first premolars: a comparative evaluation of cone-beam computed tomography and micro-computed tomography. Clin Oral Investig 21(4):1007–1012CrossRefPubMed
9.
go back to reference Akhlaghi NM, Khalilak Z, Vatanpour M, Mohammadi S, Pirmoradi S, Fazlyab M, Safavi K (2017) Root canal anatomy and morphology of mandibular first molars in a selected Iranian population: an in vitro study. Iran Endod J 12(1):87–91 Akhlaghi NM, Khalilak Z, Vatanpour M, Mohammadi S, Pirmoradi S, Fazlyab M, Safavi K (2017) Root canal anatomy and morphology of mandibular first molars in a selected Iranian population: an in vitro study. Iran Endod J 12(1):87–91
10.
go back to reference Skidmore AE, Bjorndal AM (1971) Root canal morphology of the human mandibular first molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 32(5):778–784CrossRef Skidmore AE, Bjorndal AM (1971) Root canal morphology of the human mandibular first molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 32(5):778–784CrossRef
11.
go back to reference Dastgerdi AC, Navabi M, Rakhshan V (2019) Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study. Restor Dent Endod 45(1):e7CrossRef Dastgerdi AC, Navabi M, Rakhshan V (2019) Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study. Restor Dent Endod 45(1):e7CrossRef
12.
go back to reference Mazzi-Chaves JF, Silva-Sousa YTC, Leoni GB, Silva-Sousa AC, Estrela L, Estrela C, Jacobs R, Sousa-Neto MD Micro-computed tomographic assessment of the variability and morphological features of root canal system and their ramifications. J Appl Oral Sci 28: e20190393. Mazzi-Chaves JF, Silva-Sousa YTC, Leoni GB, Silva-Sousa AC, Estrela L, Estrela C, Jacobs R, Sousa-Neto MD Micro-computed tomographic assessment of the variability and morphological features of root canal system and their ramifications. J Appl Oral Sci 28: e20190393.
13.
go back to reference Martins JN, Mata A, Marques D, Caram?s J (2016) Prevalence of C-shaped mandibular molars in the Portuguesepopulation evaluated by cone-beam computed tomography. Eur J Dent 10: 529–535 Martins JN, Mata A, Marques D, Caram?s J (2016) Prevalence of C-shaped mandibular molars in the Portuguesepopulation evaluated by cone-beam computed tomography. Eur J Dent 10: 529–535
14.
go back to reference Sousa TO, Hassan B, Mirmohammadi H, Shemesh H, Haiter-Neto F (2017) Feasibility of cone-beam computed tomography in detecting lateral canals before and after root canal treatment: an ex vivo study. J Endod 43(6):1014–1017CrossRefPubMed Sousa TO, Hassan B, Mirmohammadi H, Shemesh H, Haiter-Neto F (2017) Feasibility of cone-beam computed tomography in detecting lateral canals before and after root canal treatment: an ex vivo study. J Endod 43(6):1014–1017CrossRefPubMed
15.
go back to reference Vasconcelos I, Franco M, Pereira M, Duarte I, Ginjeira A, Alves N (2021) 3D-printed multisampling holder for microcomputed tomography applied to life and materials science research. Micron 150:103142CrossRefPubMed Vasconcelos I, Franco M, Pereira M, Duarte I, Ginjeira A, Alves N (2021) 3D-printed multisampling holder for microcomputed tomography applied to life and materials science research. Micron 150:103142CrossRefPubMed
16.
go back to reference Vertucci FJ (1974) Root canal anatomy of the mandibular anterior teeth. J Am Dent Assoc 89:369–371CrossRefPubMed Vertucci FJ (1974) Root canal anatomy of the mandibular anterior teeth. J Am Dent Assoc 89:369–371CrossRefPubMed
17.
go back to reference American Association of Endodontics (2016) Glossary of endodontic terms, 9th edn. American Association of Endodontics, Chicago, IL American Association of Endodontics (2016) Glossary of endodontic terms, 9th edn. American Association of Endodontics, Chicago, IL
18.
go back to reference Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
19.
go back to reference Song M, Kim HC, Lee W, Kim E (2011) Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 37(11):1516–1519CrossRefPubMed Song M, Kim HC, Lee W, Kim E (2011) Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 37(11):1516–1519CrossRefPubMed
20.
go back to reference Grande NM, Plotino G, Gambarini G, Testarelli L, D’Ambrosio F, Pecci R, Bedini R (2012) Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology. Ann Ist Super Sanita 48(1):26–34PubMed Grande NM, Plotino G, Gambarini G, Testarelli L, D’Ambrosio F, Pecci R, Bedini R (2012) Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology. Ann Ist Super Sanita 48(1):26–34PubMed
21.
go back to reference de Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N (2010) Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 36(12):1919–1931CrossRefPubMed de Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N (2010) Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 36(12):1919–1931CrossRefPubMed
22.
go back to reference Mejàre IA, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Petersson A, Portenier I, Sandberg H, Tranaeus S, Bergenholtz G (2012) Diagnosis of the condition of the dental pulp: a systematic review. Int Endod J 45(7):597–613CrossRefPubMed Mejàre IA, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Petersson A, Portenier I, Sandberg H, Tranaeus S, Bergenholtz G (2012) Diagnosis of the condition of the dental pulp: a systematic review. Int Endod J 45(7):597–613CrossRefPubMed
23.
go back to reference Borges CC, Estrela C, Decurcio DA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G (2020) Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 19:34:e056CrossRef Borges CC, Estrela C, Decurcio DA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G (2020) Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 19:34:e056CrossRef
24.
go back to reference Nascimento EHL, Abrahão Elias MR, Vasconcelos VHF, Haiter-Neto F, Mendonça EF, Sousa TO (2019) Ex vivo detection of apical delta in premolars: a comparative study using periapical radiography, cone-beam computed tomography, and micro computed tomography. J Endod 45(5):549–553CrossRefPubMed Nascimento EHL, Abrahão Elias MR, Vasconcelos VHF, Haiter-Neto F, Mendonça EF, Sousa TO (2019) Ex vivo detection of apical delta in premolars: a comparative study using periapical radiography, cone-beam computed tomography, and micro computed tomography. J Endod 45(5):549–553CrossRefPubMed
25.
go back to reference Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse JM, Peyre A, Kahn JL, Sixou M (2012) Effect of Voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol 41(8):649–655CrossRefPubMedPubMedCentral Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse JM, Peyre A, Kahn JL, Sixou M (2012) Effect of Voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol 41(8):649–655CrossRefPubMedPubMedCentral
26.
go back to reference Ricucci D, Siqueira JF Jr (2010) Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. J Endod 36(1):1–15CrossRefPubMed Ricucci D, Siqueira JF Jr (2010) Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. J Endod 36(1):1–15CrossRefPubMed
27.
go back to reference Thönissen P, Ermer MA, Schmelzeisen R, Gutwald R, Metzger MC, Bittermann G (2015) Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery – a clinical trial. J Craniomaxillofac Surg 43(7):1284–1288CrossRefPubMed Thönissen P, Ermer MA, Schmelzeisen R, Gutwald R, Metzger MC, Bittermann G (2015) Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery – a clinical trial. J Craniomaxillofac Surg 43(7):1284–1288CrossRefPubMed
28.
go back to reference Szabo BT, Pataky L, Mikusi R, Fejerdy P, Dobo-Nagy C (2012) Comparative evaluation of cone-beam CT equipment with micro-CT in the visualization of root canal system. Ann Ist Super Sanita 48(1):49–52PubMed Szabo BT, Pataky L, Mikusi R, Fejerdy P, Dobo-Nagy C (2012) Comparative evaluation of cone-beam CT equipment with micro-CT in the visualization of root canal system. Ann Ist Super Sanita 48(1):49–52PubMed
29.
go back to reference Al-Jadaa A, Paqué F, Attin T, Zehnder M (2009) Necrotic pulp tissue dissolution by passive ultrasonic irrigation in simulated accessory canals: impact of canal location and angulation. Int Endod J 42(1):59–65CrossRefPubMed Al-Jadaa A, Paqué F, Attin T, Zehnder M (2009) Necrotic pulp tissue dissolution by passive ultrasonic irrigation in simulated accessory canals: impact of canal location and angulation. Int Endod J 42(1):59–65CrossRefPubMed
Metadata
Title
Diagnostic value of cone beam computed tomography for root canal morphology assessment – a micro-CT based comparison
Authors
Mariana Pires
Jorge N.R. Martins
Mário Rito Pereira
Isabel Vasconcelos
Rui Pereira da Costa
Isabel Duarte
António Ginjeira
Publication date
01-03-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 3/2024
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-024-05580-y

Other articles of this Issue 3/2024

Clinical Oral Investigations 3/2024 Go to the issue