Restor Dent Endod.  2018 May;43(2):e16. 10.5395/rde.2018.43.e16.

Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment

Affiliations
  • 1Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea. yhchoi@snubh.org
  • 2Department of Conservative Dentistry, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea.

Abstract


OBJECTIVES
Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments.
MATERIALS AND METHODS
This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area.
RESULTS
Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals.
CONCLUSIONS
Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

Keyword

Molar; Tooth root; Tooth apex

MeSH Terms

Cone-Beam Computed Tomography
Dental Pulp Cavity
Dentin
Molar*
Replantation
Retreatment*
Tooth
Tooth Apex
Tooth Root
Treatment Outcome
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