Research Article
BibTex RIS Cite

Root canal length measurement of molar teeth using cone-beam computed tomography (CBCT): comparison of two-dimensional versus three-dimensional methods

Year 2021, Volume: 55 Issue: 2, 94 - 98, 28.06.2021
https://doi.org/10.26650/eor.20210124

Abstract

Purpose
This study aimed to evaluate the validity of 2-dimensional (2D) and 3-dimensional (3D) cone-beam computed tomographic (CBCT) root canal length measurements of molar teeth compared with actual root canal lengths and the influence of canal curvature on the accuracy of CBCT measurements.
Materials and Methods
Seventy root canals of 24 molar teeth were scanned using CBCT, and the root canals were categorized as; ‘straight/curved,’ ‘highly curved,’ and ‘multiple curved.’ The 2D measurements were performed within a suitable slice between the major foramen and the corresponding cusp. The 3D measurements were performed within the slices in regular intervals of axial planes in between the same reference points. The reproducibility and reliability of the methods were analyzed by intraclass correlation coefficient. Differences between the actual and CBCT root canal lengths were evaluated by chi-square and McNemar tests if the measurements were within acceptable limits of ±0.5 mm.
Results
Both methods were found to be reproducible and presented excellent reliability. However, the 3D method was significantly more accurate, with an 85.7% frequency of measurements within acceptable limits (p<0.05). In ‘multiple curved’ root canals, the 3D method presented more reliable measurements than the 2D method. For ‘straight/curved’ root canals, the 2D method gave results significantly closer to the actual root canal length in comparison with ‘highly curved’ root canals (p<0.05).
Conclusion
The 3D measurements are more accurate than 2D measurements. If an already existing CBCT is present, it could be an alternative method for predetermination of root canal lengths in molar teeth.

References

  • 1. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009;38:609-25. [CrossRef] google scholar
  • 2. Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl HG. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg OralMed Oral Pathol Oral Radiol Endod 2007;103:114-9. [CrossRef] google scholar
  • 3. Patel S, Dawood A, Pitt Ford T, Whaites E. New dimensions in endodontic imaging: part 2. Cone beam computed tomography. Int Endod J 2009;42:463-75. [CrossRef] google scholar
  • 4. de Paula-Silva FW, Wu MK, Leonardo MR, da Silva LA, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod. 2009;35:1009-12. [CrossRef] google scholar
  • 5. Metska ME, Aartman IH, Wesselink PR, Özok AR. Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans. J Endod 2012;38:1344-7. [CrossRef] google scholar
  • 6. Shemesh H, Cristescu R, Wesselink PR, Wu MK. The use of cone-beam computed tomography and digital periapical radiographs to diagnose root perforations. J Endod 2011;37:513-6.[CrossRef] google scholar
  • 7. Kamburoglu K, Kursun S, Yuksel S, Oztas B. Observer ability to detect ex vivo simulated internal or external cervical root resorption. J Endod 2011;37:168-75. [CrossRef] google scholar
  • 8. Ziegler CM, Woertche R, Brief J, Hassfeld S. Clinical indications for digital volume tomography in oral and maxillofacial surgery. Dentomaxillofac Radiol 2002;31:126-30. [CrossRef] google scholar
  • 9. Bornstein MM, Wölner-Hanssen AB, Sendi P, von Arx T. Comparison of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol 2009;25:571-7. [CrossRef] google scholar
  • 10. Demirbuga S, Sekerci AE, Dincer AN, Cayabatmaz M, Zorba YO. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular first and second molars in Turkish individuals. Med Oral Patol Oral Cir Bucal 2013;18:737-44. [CrossRef] google scholar
  • 11. Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod 2010;36:1187-90. [CrossRef] google scholar
  • 12. Patel S, Durack C, Abella F, Shemesh H, Roig M, Lemberg K. Cone beam computed tomography in endodontics—a review. Int Endod J 2015;48:3-15. [CrossRef] google scholar
  • 13. Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008;34:273-9. [CrossRef] google scholar
  • 14. American Association of Endodontists, American Academy of Oral and Maxillofacial Radiology. AAE and AAOMR joint position statement use of cone beam computed tomography in endodontics 2015 update. J Endod 2015;41:1393-6. [CrossRef] google scholar
  • 15. Caglayan F, Tozoglu U. Incidental findings in the maxillofacial region detected by cone beam CT. Diagn Interv Radiol 2012;18:159-63. [CrossRef] google scholar
  • 16. Oser DG, Henson BR, Shiang EY, Finkelman MD, Amato RB. Incidental Findings in Small Field of View Cone-beam Computed Tomography Scans. J Endod 2017;43:901-4. [CrossRef] google scholar
  • 17. Sherrard JF, Rossouw PE, Benson BW, Carillo R, Buschang PH. Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs. Am J Orthod Dentofacial Orthop 2010;137:100-8. [CrossRef] google scholar
  • 18. Connert T, Hulber JM, Godt A, Löst C, ElAyouti A. Accuracy of endodontic working length determination using cone beam computed tomography. Int Endod J 2014;47:698-703. [CrossRef] google scholar
  • 19. Tchorz JP, Poxleitner PJ, Stampf S, Patzelt SBM, Rottke D, Hellwig E, et al. The use of cone beam computed tomography to predetermine root canal lengths in molar teeth: a comparison between two-dimensional and three-dimensional measurements. Clin Oral Investig 2014;18:1129-33. [CrossRef] google scholar
  • 20. Yılmaz F, Kamburoglu K, Senel B. Endodontic Working Length Measurement Using Cone-beam Computed Tomographic Images Obtained at Different Voxel Sizes and Field of Views, Periapical Radiography, and Apex Locator: A Comparative Ex Vivo Study. J Endod 2017;43:152-6. [CrossRef] google scholar
  • 21. Segato AVK, Piasecki L, Felipe Iparraguirre Nunovero M, da Silva Neto UX, Westphalen VPD, Gambarini G, Carneiro E. The Accuracy of a New Cone-beam Computed Tomographic Software in the Preoperative Working Length Determination Ex Vivo. J Endod 2018;44:1024-9. [CrossRef] google scholar
  • 22. Metska ME, Liem VM, Parsa A, Koolstra JH, Wesselink PR, Ozok AR. Cone-beam Computed Tomographic Scans in Comparison with Periapical Radiographs for Root Canal Length Measurement: An In Situ Study. J Endod 2014;40:1206-9. [CrossRef] google scholar
  • 23. Janner SF, Jeger FB, Lussi A, Bornstein MM. Precision of endodontic working length measurements: a pilot investigation comparing cone-beam computed tomography scanning with standard measurement techniques. J Endod 2011;37:1046-51. [CrossRef] google scholar
  • 24. Jeger FB, Janner SF, Bornstein MM, Lussi A. Endodontic working length measurement with preexisting cone-beam computed tomography scanning: a prospective, controlled clinical study. J Endod 2012;38:884-8. [CrossRef] google scholar
  • 25. Ustun Y, Aslan T, Sekerci AE, Sagsen B. Evaluation of the Reliability of Cone-beam Computed Tomography Scanning and Electronic Apex Locator Measurements in Working Length Determination of Teeth with Large Periapical Lesions. J Endod 2016;42:1334-7. [CrossRef] google scholar
  • 26. Lucena C, Lopez JM, Martin JA, Robles V, Gonzalez-Rodriguez MP. Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography. Int Endod J 2014;47:246-56. [CrossRef] google scholar
  • 27. Tchorz JP, Wolgin M, Karygianni L, Vach K, Altenburger MJ. Accuracy of CBCT-based root canal length predetermination using new endodontic planning software compared to measurements performed with an electronic apex locator ex vivo. Int J Comput Dent 2018;21:323-8. google scholar
  • 28. Tchorz JP, Wrbas KT, Von See C, Vach K, Patzelt SBM. Accuracy of Software Based Three-Dimensional Root Canal Length Measurements Using Cone-Beam Computed Tomography. Eur Endod J 2019;4:28-32. [CrossRef] google scholar
Year 2021, Volume: 55 Issue: 2, 94 - 98, 28.06.2021
https://doi.org/10.26650/eor.20210124

Abstract

References

  • 1. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009;38:609-25. [CrossRef] google scholar
  • 2. Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl HG. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg OralMed Oral Pathol Oral Radiol Endod 2007;103:114-9. [CrossRef] google scholar
  • 3. Patel S, Dawood A, Pitt Ford T, Whaites E. New dimensions in endodontic imaging: part 2. Cone beam computed tomography. Int Endod J 2009;42:463-75. [CrossRef] google scholar
  • 4. de Paula-Silva FW, Wu MK, Leonardo MR, da Silva LA, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod. 2009;35:1009-12. [CrossRef] google scholar
  • 5. Metska ME, Aartman IH, Wesselink PR, Özok AR. Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans. J Endod 2012;38:1344-7. [CrossRef] google scholar
  • 6. Shemesh H, Cristescu R, Wesselink PR, Wu MK. The use of cone-beam computed tomography and digital periapical radiographs to diagnose root perforations. J Endod 2011;37:513-6.[CrossRef] google scholar
  • 7. Kamburoglu K, Kursun S, Yuksel S, Oztas B. Observer ability to detect ex vivo simulated internal or external cervical root resorption. J Endod 2011;37:168-75. [CrossRef] google scholar
  • 8. Ziegler CM, Woertche R, Brief J, Hassfeld S. Clinical indications for digital volume tomography in oral and maxillofacial surgery. Dentomaxillofac Radiol 2002;31:126-30. [CrossRef] google scholar
  • 9. Bornstein MM, Wölner-Hanssen AB, Sendi P, von Arx T. Comparison of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol 2009;25:571-7. [CrossRef] google scholar
  • 10. Demirbuga S, Sekerci AE, Dincer AN, Cayabatmaz M, Zorba YO. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular first and second molars in Turkish individuals. Med Oral Patol Oral Cir Bucal 2013;18:737-44. [CrossRef] google scholar
  • 11. Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod 2010;36:1187-90. [CrossRef] google scholar
  • 12. Patel S, Durack C, Abella F, Shemesh H, Roig M, Lemberg K. Cone beam computed tomography in endodontics—a review. Int Endod J 2015;48:3-15. [CrossRef] google scholar
  • 13. Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008;34:273-9. [CrossRef] google scholar
  • 14. American Association of Endodontists, American Academy of Oral and Maxillofacial Radiology. AAE and AAOMR joint position statement use of cone beam computed tomography in endodontics 2015 update. J Endod 2015;41:1393-6. [CrossRef] google scholar
  • 15. Caglayan F, Tozoglu U. Incidental findings in the maxillofacial region detected by cone beam CT. Diagn Interv Radiol 2012;18:159-63. [CrossRef] google scholar
  • 16. Oser DG, Henson BR, Shiang EY, Finkelman MD, Amato RB. Incidental Findings in Small Field of View Cone-beam Computed Tomography Scans. J Endod 2017;43:901-4. [CrossRef] google scholar
  • 17. Sherrard JF, Rossouw PE, Benson BW, Carillo R, Buschang PH. Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs. Am J Orthod Dentofacial Orthop 2010;137:100-8. [CrossRef] google scholar
  • 18. Connert T, Hulber JM, Godt A, Löst C, ElAyouti A. Accuracy of endodontic working length determination using cone beam computed tomography. Int Endod J 2014;47:698-703. [CrossRef] google scholar
  • 19. Tchorz JP, Poxleitner PJ, Stampf S, Patzelt SBM, Rottke D, Hellwig E, et al. The use of cone beam computed tomography to predetermine root canal lengths in molar teeth: a comparison between two-dimensional and three-dimensional measurements. Clin Oral Investig 2014;18:1129-33. [CrossRef] google scholar
  • 20. Yılmaz F, Kamburoglu K, Senel B. Endodontic Working Length Measurement Using Cone-beam Computed Tomographic Images Obtained at Different Voxel Sizes and Field of Views, Periapical Radiography, and Apex Locator: A Comparative Ex Vivo Study. J Endod 2017;43:152-6. [CrossRef] google scholar
  • 21. Segato AVK, Piasecki L, Felipe Iparraguirre Nunovero M, da Silva Neto UX, Westphalen VPD, Gambarini G, Carneiro E. The Accuracy of a New Cone-beam Computed Tomographic Software in the Preoperative Working Length Determination Ex Vivo. J Endod 2018;44:1024-9. [CrossRef] google scholar
  • 22. Metska ME, Liem VM, Parsa A, Koolstra JH, Wesselink PR, Ozok AR. Cone-beam Computed Tomographic Scans in Comparison with Periapical Radiographs for Root Canal Length Measurement: An In Situ Study. J Endod 2014;40:1206-9. [CrossRef] google scholar
  • 23. Janner SF, Jeger FB, Lussi A, Bornstein MM. Precision of endodontic working length measurements: a pilot investigation comparing cone-beam computed tomography scanning with standard measurement techniques. J Endod 2011;37:1046-51. [CrossRef] google scholar
  • 24. Jeger FB, Janner SF, Bornstein MM, Lussi A. Endodontic working length measurement with preexisting cone-beam computed tomography scanning: a prospective, controlled clinical study. J Endod 2012;38:884-8. [CrossRef] google scholar
  • 25. Ustun Y, Aslan T, Sekerci AE, Sagsen B. Evaluation of the Reliability of Cone-beam Computed Tomography Scanning and Electronic Apex Locator Measurements in Working Length Determination of Teeth with Large Periapical Lesions. J Endod 2016;42:1334-7. [CrossRef] google scholar
  • 26. Lucena C, Lopez JM, Martin JA, Robles V, Gonzalez-Rodriguez MP. Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography. Int Endod J 2014;47:246-56. [CrossRef] google scholar
  • 27. Tchorz JP, Wolgin M, Karygianni L, Vach K, Altenburger MJ. Accuracy of CBCT-based root canal length predetermination using new endodontic planning software compared to measurements performed with an electronic apex locator ex vivo. Int J Comput Dent 2018;21:323-8. google scholar
  • 28. Tchorz JP, Wrbas KT, Von See C, Vach K, Patzelt SBM. Accuracy of Software Based Three-Dimensional Root Canal Length Measurements Using Cone-Beam Computed Tomography. Eur Endod J 2019;4:28-32. [CrossRef] google scholar
There are 28 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Original Research Articles
Authors

Selen Nihal Sisli 0000-0002-6718-3425

Orhan Gülen This is me 0000-0003-0722-6494

Publication Date June 28, 2021
Submission Date November 2, 2019
Published in Issue Year 2021 Volume: 55 Issue: 2

Cite

EndNote Sisli SN, Gülen O (June 1, 2021) Root canal length measurement of molar teeth using cone-beam computed tomography (CBCT): comparison of two-dimensional versus three-dimensional methods. European Oral Research 55 2 94–98.