DETERMİNİNG THE RELATİONSHİP BETWEEN ANGLE OF ROOTS, CROWN FURCATİON ROOF ANGLE, AND FURCATİON DEFECTS USİNG CONE BEAM COMPUTERİZED TOMOGRAPHY

Year 2013, Volume: 23 Issue: 1, 9 - 15, 01.01.2013

Yrd. Doç. Dr. Abdullah Seçkin Ertuğrul Dt Alihan Bozoğlan D T. Yasin Tekin Dt. Hacer Şahin Dt. Ahu Dikilitaş Dt. Nazlı Zeynep Alpaslan Yrd. Doç. Dr. Sami Kara

Abstract

Objective: Furcation defects are complex and difficult periodontal problems to treat. This study analyzes the relationship between the angle of roots and crown furcation roof angle with different furcation defects at mandibular first molars using cone beam computerized tomography. Material and Methods: Cone beam computerized tomography was taken from a total of 1042 patients. The measurements taken from all patients were divided into 3 groups according to their furcation defects. In the first group (G-1), horizontal defect depth was ≤3 mm; in the second group (G-2), horizontal defect depth was >3 mm, and in the third group (G-3), horizontal defect depth was greater than the tooth’s width. Results: A total of 1042 patients (530 women and 512 men) were included in the study. The average patient age was 37.2. G-1 has 539 patients, G-2 has 301 patients, and G-3 has 202 patients. The angle of roots was measured for each of the three groups at 16.2o , 15.4 o , and 12.9o , respectively. The crown furcation roof angle was measured for the three groups at 105.1o , 110.3 o , and 121.9o , respectively. Conclusion: Furcation defects can be more destructive as the angle of roots decreases and the crown furcation roof angle increases. Therefore, when the angle of root is less than 16.2o and crown furcation roof angle is higher than 105.1o , it is thought that mandibular molar teeth are susceptible to furcation defects, and that the furcation defects can be prevented by reducing the time between maintenance periods.

Keywords

Angle of roots, crown furcation roof angle, furcation defects, cone beam computerized tomography.

KÖKLER ARASI AÇI, KRON-FURKASYON ÇATISI ARASI AÇI VE FURKASYON DEFEKTLERİNİN BİRBİRLERİ İLE OLAN İLİŞKİLERİNİN KONİK İŞİNLI BİLGİSAYARLI TOMOGRAFİ İLE BELİRLENMESİ

Abstract

Amaç: Furkasyon defektleri anatomik ve morfolojik özellikleri nedeniyle kompleks periodontal sorunlardır ve periodontal tedavileri zordur. Bu çalışmanın amacı diş kökler arası açı, kron-furkasyon çatısı arası açı ve furkasyon defektlerinin birbirleri ile olan ilişkilerinin mandibular birinci molar dişlerde konik işinlı bilgisayarlı tomografi yöntemi kullanılarak belirlemektir. Gereç ve Yöntemler: Konik işinlı bilgisayarlı tomografi 652 bayan, 590 erkekten oluşan toplam 1042 bireyden alınmıştır. Alınan konik işinlı bilgisayarlı tomografi’lerde her bireyin mandibular birinci molar dişlerde kökler arası açı, kron-furkasyon çatısı arası açı ölçülmüş ve furkasyon bölgesi radrolojik olarak değerlendirilmiştir. Yapılan ölçümlerde bireyler furkasyon defektlerine göre 3 gruba ayrılmıştır. 1. grup: horizontal defekt derinliği ≤3mm, 2. grup: horizontal defekt derinliği >3 mm, 3. grup: horizontal defekt derinliği diş genişliğinden fazla olarak belirlenmiştir. Bulgular: Çalışmaya yaş ortalaması 37.2 olan toplam 1042 birey dâhil edilmiştir. Grup 1’de 539 hasta, Grup 2’de 301 hasta ve Grup 3’de 202 hasta bulunmaktadır. Kökler arası açı 1., 2. ve 3. gruplarda sırasıyla 16.2o 15.4 o -12.9 o olarak kron-furkasyon çatısı arası açısı ise 1., 2. ve 3. gruplarda sırasıyla 105.1o -110.3o -121.9o olarak ölçülmüştür. Sonuç: Konik işinlı bilgisayarlı tomografi gün geçtikçe dental kliniklerde kullanımı artan radyoloji görüntüleme yöntemlerindendir. Birçok periodontal hastalığın teşhisinde ve furkasyon problemlerinin belirlenmesinde konik işinlı bilgisayarlı tomografi kullanılabilmektedir. Furkasyon problemleri, kökler arası açı azaldığı zaman ve kron-furkasyon çatısı arası açı arttığı zaman daha yıkıcı hal alabilmektedir. Kökler arası açı 17.6o ’denküçük olduğu ve kron-furkasyon çatısı arası açı 103,4o ’denbüyükolduğu birinci mandibular molar dişlerin furkasyon problemleri oluşmasına yatkın oldukları, bu özellikteki dişlerin idame sürelerinin kısa tutulması ile furkasyon problemi oluşmadan önlenebileceği düşünülmektedir.

Keywords

Kökler arası açı, kron-furkasyon çatısı arası açı, furkasyon defektleri, konik işinlı bilgisayarlı tomografi.

References

• 1) Cattabriga M, Pedrazzoli V, Wilson TG Jr. The conservative approach in the treatment of furcation lesions. Periodontol 2000 2000;22:133 2) Müller HP, Eger T, Lange DE. Management of furcation-involved teeth. A retrospective analysis. J Clin Periodontol 1995;22:911-7. 3) Abitbol T, LoPresti J, Santi E. Influence of root anatomy on periodontal disease. Gen Dent 1997;45:186-9. 4) Wang HL, Burgett FG, Shyr Y, Ramfjord S. The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss. J Periodontol 1994;65:25-9. 5) Wang HL, O'Neal RB, Thomas CL, Shyr Y, MacNeil RL. Evaluation of an absorbable collagen membrane in treating Class II furcation defects. J Periodontol 1994;65:1029-36. 6) McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol 1996;67:666-74. 7) McGuire MK, Nunn ME. Prognosis versus actual outcome. II. The effectiveness of clinical parameters in developing an accurate prognosis. J Periodontol 1996;67:658-65. 8) Papapanou PN, Tonetti MS. Diagnosis and epidemiology of periodontal osseous lesions. Periodontol 2000 2000;22:8-21. 9) DeSanctis M, Murphy KG. The role of resective periodontal surgery in the treatment of furcation defects. Periodontol 2000 2000;22:154-68. 10) Ammons WF Jr, Harrington GW. Furcation: The problem and it’s management. In: Clinical periodontology , Ninth ed, Eds Newman MG, Takei HH, Carranza FA: WB Saunders Company, Philadelphia 2002. p. 825-39. 11) Vandersall DC, Detamore RJ. The mandibular molar class III furcation invasion: a review of treatment options and a case report of tunneling. J Am Dent Assoc 2002;133:55-60. 12) Patel S, Kubavat A, Ruparelia B, Agarwal A, Panda A. Comparative evaluation of guided tissue regeneration with use of collagen-based barrier freeze-dried dura mater allograft for mandibular class 2 furcation defects (a comparative controlled clinical study). J Contemp Dent Pract 2012;13:11 13) Rüdiger SG. Mandibular and maxillary furcation tunnel preparations--literature review and a case report. J Clin Periodontol 2001;28:1-8. 14) Anderegg CR, Metzler DG. Retention of multirooted teeth with class III furcation lesions utilizing resins. Report of 17 cases. J Periodontol 2000;71:1043-7. 15) Park JB. Hemisection of teeth with questionable prognosis. Report of a case with seven-year results. J Int Acad Periodontol 2009;11:214-9. 16) Tammisalo T, Luostarinen T, Vähätalo K, Neva M. Detailed tomography of periapical and periodontal lesions. Diagnostic accuracy compared with periapical radiography. Dentomaxillofac Radiol 1996;25:89-96. 17) Vandenberghe B, Jacobs R, Yang J. Detection of periodontal bone loss using digital intraoral and cone beam computed tomography images: an in vitro assessment of bony and/or infrabony defects. Dentomaxillofac Radiol 2008;37:252-60. 18) Whaites E, Essentials of Dental Radiography and Radiology, London, 2nd Edition. Churchill Livingstone, 1996. p. 143-51. 19) White SC, Pharoah MJ, Oral Radiology: Principles and Interpretation, St. Louis, Missouri, 5th Edition. Mosby, 2004. p. 191-255. 20) Ohman A, Kivijärvi K, Blombäck U, Flygare L. Preoperative radiographic evaluation of lower third molars with computed tomography. Dentomaxillofac Radiol 2006;35:30-5. 21) Pawelzik J, Cohnen M, Willers R, Becker J. A comparison of conventional panoramic radiographs with volumetric computed tomography images in the preoperative assessment of impacted mandibular third molars. J Oral Maxillofac Surg 2002;60:979-84. 22) Walter C, Kaner D, Berndt DC, Weiger R, Zitzmann NU. Three-dimensional imaging as a pre-operative tool in decision making for furcation surgery. J Clin Periodontol 2009;36:250-7. 23) Walter C, Weiger R, Zitzmann NU. Accuracy of three-dimensional imaging in assessing maxillary molar furcation involvement. J Clin Periodontol 2010;37:436-41. 24) Vandenberghe B, Jacobs R, Yang J. Detection of periodontal bone loss using digital intraoral and cone beam computed tomography images: an in vitro assessment of bony and/or infrabony defects.
• Dentomaxillofac Radiol 2008;37:252-60. 25) Hu KS, Choi DY, Lee WJ, Kim HJ, Jung UW, Kim S. Reliability of two different presurgical preparation methods for implant dentistry based on panoramic radiography and cone-beam computed tomography in cadavers. J Periodontal Implant Sci 2012;42:39-44 26) de Faria Vasconcelos K, Evangelista KM, Rodrigues CD, Estrela C, de Sousa TO, Silva MA. Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Radiol 2012;41:64-9. 27) Hishikawa T, Izumi M, Naitoh M, et al. The effect of horizontal X-ray beam angulation on the detection of furcation defects of mandibular first molars in intraoral radiography. Dentomaxillofac Radiol 2010;39:85-90. 28) Walter C, Weiger R, Zitzmann NU. Periodontal surgery in furcation-involved maxillary molars revisited--an introduction of guidelines for comprehensive treatment. Clin Oral Investig 2011;15:9-20. 29) Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol. 2006;77:1261-6. 30) Çakur B, Sümbüllü MA. Konik işinli bilgisayarli tomografi ile submandibular tükürük bezi taşi görüntülemesi. Atatürk Üniv Dis Hek Fak Derg 2010;203:194-7. 31) Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol 1998;8:1558-64. 32) Schulze D, Heiland M, Thurmann H, Adam G. Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofac Radiol 2004;33:83-6. 33) Waerhaug J. The furcation problem. Etiology, pathogenesis, diagnosis, therapy and prognosis. J Clin Periodontol 1980;7:73-95. 34) Müller HP, Eger T. Furcation diagnosis. J Clin Periodontol 1999;26:485-98. 35) Santana RB, Uzel MI, Gusman H, Gunaydin Y, Jones JA, Leone CW. Morphometric analysis of the furcation anatomy of mandibular molars. J Periodontol 2004;75:824-9. 36) dos Santos KM, Pinto SC, Pochapski MT, Wambier DS, Pilatti GL, Santos FA. Molar furcation entrance and its relation to the width of curette blades used in periodontal mechanical therapy. Int J Dent Hyg 2009;7:263-9. 37) Otero-Cagide FJ, Long BA. Comparative in vitro effectiveness of closed root debridement with fine instruments on specific areas of mandibular first molar furcations. I. Root trunk and furcation entrance. J Periodontol 1997;68:1093-7. 38) Hou GL, Chen SF, Wu YM, Tsai CC. The topography of the furcation entrance in Chinese molars. Furcation entrance dimensions. J Clin Periodontol 1994;21:451-6. Yazışma Adresi: Abdullah Seçkin ERTUĞRUL
• Yuzuncu Yil University Faculty of Dentistry Department of Periodontology Campus, 65080 Van, TURKEY
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