Assessment of Ramifications in the Apical Region of Root Canals: A Micro-CT Study in a Brazilian Population

Author(s)

Natalia Siqueira Lobo ^[1] ; Victor Aquino Wanderley ^[2] ; Yuri Nejaim ^[3] ; Amanda Farias Gomes ^[4] ; Alexandre Augusto Zaia ^[5]

Affiliation

^[1] State University of Campinas. Piracicaba Dental School. Department of Restorative Dentistry, Endodontic Division - Brasil

^[2] State University of Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Division of Oral Radiology - Brasil

^[3] State University of Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Division of Oral Radiology - Brasil

^[4] State University of Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Division of Oral Radiology - Brasil

^[5] State University of Campinas. Piracicaba Dental School. Department of Restorative Dentistry, Endodontic Division - Brasil

• Document type: Journal article
• Source: Brazilian Dental Journal; v. 31, n. 5, p. 505-510, 2020-11-02.

Abstract

Abstract The present study used microcomputed tomography (micro-CT) images to assess the prevalence, number, and location of apical ramifications (ARs) in the root canals of different dental groups in a Brazilian population. Three hundred and sixty-seven extracted human teeth, totaling 475 roots, were scanned by micro-CT at 19.6 µm spatial resolution. The obtained images were evaluated by two observers in consensus, and a descriptive analysis was performed to verify the prevalence, number, and location of ARs in each dental group. Chi-square test was used to compare the prevalence of ARs in different types of roots, and one-way analysis of variance compared the number of ARs in the apical 1 mm, 2 mm, and 3 mm of the root. Significance level was established at 5% (α=0.05). ARs were present in 253 (53.3%) of the 475 roots evaluated. A total of 607 ARs were detected, with the vast majority (530) located at one and two millimeters from the main foramen. The highest prevalence of ARs was observed in maxillary canines (65%); maxillary premolars - single-rooted (83.3%), buccal root (80%), and palatine root (73.3%); mandibular premolars (64.2%); mesiobuccal root of maxillary molars (76.6%); and mesial root of mandibular molars (66.6%). For the Brazilian population, most of the ARs are located in the apical 1 and 2 mm of the root, with greater prevalence in the posterior teeth and maxillary canines. These findings suggest the need for additional attention while planning endodontic treatments, including strategies to effectively clean and fill the apical region. (AU)

• FAPESP's process: 17/05391-9 - Incidence of ramifications located in the apical 3 mm of the root with the use of digital periapical radiography, CBCT and computerized microtomography
• Grantee: Natália Siqueira Lobo
• Support Opportunities: Scholarships in Brazil - Master