Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study
Abstract Background The surgical complexity associated with the palatal roots of maxillary molars was considerably elevated. Previous studies on the relationships between maxillary molar roots and the maxillary sinus or cortical plates have focused on individual root observation without considering...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12903-024-05396-y |
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| author | Xiaoxiang Huang Jun Xu Benxiang Hou Ying Wang |
| author_facet | Xiaoxiang Huang Jun Xu Benxiang Hou Ying Wang |
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| description | Abstract Background The surgical complexity associated with the palatal roots of maxillary molars was considerably elevated. Previous studies on the relationships between maxillary molar roots and the maxillary sinus or cortical plates have focused on individual root observation without considering the positional relationship between buccal and palatal roots or analysing the surgical pathway of maxillary molar palatal roots. This study aimed to investigate the relationship between maxillary molar palatal roots and adjacent anatomical structures to provide a reference for performing palatal roots endodontic microsurgery. Methods Anatomical characteristics of the maxillary molar roots were determined using cone-beam computed tomography (CBCT) imaging data from 250 patients. The relationship between the root apex plane (RAP) and the maxillary sinus floor (MSF) was categorized into two types (Type I and Type II) based on whether the RAP was higher than the MSF or not. There were also two subclasses for Type I and Type II, which included Type I-a (RAP was lower than MSF), Type I-b (RAP and MSF were on the same plane), Type II-a (root apex protruded into the maxillary sinus) and Type II-b (root apex did not protrude into the maxillary sinus, but the RAP was higher than the MSF). Distances from the root apexes to the MSF and the cortical bone surface were measured. Results Of 500 teeth, 1352 roots were evaluated. Buccal roots obstruction 3 mm from the palatal root apex were present in almost all maxillary molars. The proportion of Type II-b cases in the palatal roots of three-rooted maxillary molars was significantly higher than that in the mesiobuccal (MB) and distalbuccal (DB) roots (P < 0.01). The distance from the root apex to the MSF increased with age and was significantly longer in females than in males (P < 0.05). The average distance from the apexes of palatal roots to the buccal cortical plate was 10.12 mm for first molars and 10.53 mm for the second molars. When measured through the MB roots, the distance to the buccal cortical plate was significantly shorter than that through the DB roots in the first molars (P < 0.05); however, the opposite was observed in the second molars (P < 0.05). Conclusions For determining the relationship between maxillary molar palatal roots and adjacent structures, CBCT provides reliable information, which acts as the basis for performing endodontic microsurgery of the palatal roots. Understanding the relationship between the roots of the maxillary molar and neighbouring anatomical structures helps surgeons evaluate potential difficulties, select optimal strategies, and reduce complications. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-fced013c56754823906d2ccd3279f9b0 |
| institution | Kabale University |
| issn | 1472-6831 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Oral Health |
| spelling | doaj-art-fced013c56754823906d2ccd3279f9b02025-01-05T12:48:28ZengBMCBMC Oral Health1472-68312025-01-0125111110.1186/s12903-024-05396-yProximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography studyXiaoxiang Huang0Jun Xu1Benxiang Hou2Ying Wang3Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical UniversityDepartment of General Dentistry and Emergency Dental Care, Beijing Stomatological Hospital, Capital Medical UniversityCenter for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical UniversityBeijing Yakebot Technology Co., LtdAbstract Background The surgical complexity associated with the palatal roots of maxillary molars was considerably elevated. Previous studies on the relationships between maxillary molar roots and the maxillary sinus or cortical plates have focused on individual root observation without considering the positional relationship between buccal and palatal roots or analysing the surgical pathway of maxillary molar palatal roots. This study aimed to investigate the relationship between maxillary molar palatal roots and adjacent anatomical structures to provide a reference for performing palatal roots endodontic microsurgery. Methods Anatomical characteristics of the maxillary molar roots were determined using cone-beam computed tomography (CBCT) imaging data from 250 patients. The relationship between the root apex plane (RAP) and the maxillary sinus floor (MSF) was categorized into two types (Type I and Type II) based on whether the RAP was higher than the MSF or not. There were also two subclasses for Type I and Type II, which included Type I-a (RAP was lower than MSF), Type I-b (RAP and MSF were on the same plane), Type II-a (root apex protruded into the maxillary sinus) and Type II-b (root apex did not protrude into the maxillary sinus, but the RAP was higher than the MSF). Distances from the root apexes to the MSF and the cortical bone surface were measured. Results Of 500 teeth, 1352 roots were evaluated. Buccal roots obstruction 3 mm from the palatal root apex were present in almost all maxillary molars. The proportion of Type II-b cases in the palatal roots of three-rooted maxillary molars was significantly higher than that in the mesiobuccal (MB) and distalbuccal (DB) roots (P < 0.01). The distance from the root apex to the MSF increased with age and was significantly longer in females than in males (P < 0.05). The average distance from the apexes of palatal roots to the buccal cortical plate was 10.12 mm for first molars and 10.53 mm for the second molars. When measured through the MB roots, the distance to the buccal cortical plate was significantly shorter than that through the DB roots in the first molars (P < 0.05); however, the opposite was observed in the second molars (P < 0.05). Conclusions For determining the relationship between maxillary molar palatal roots and adjacent structures, CBCT provides reliable information, which acts as the basis for performing endodontic microsurgery of the palatal roots. Understanding the relationship between the roots of the maxillary molar and neighbouring anatomical structures helps surgeons evaluate potential difficulties, select optimal strategies, and reduce complications. Clinical trial number Not applicable.https://doi.org/10.1186/s12903-024-05396-yEndodontic microsurgeryCBCTMaxillary sinusMolarsPalatal roots |
| spellingShingle | Xiaoxiang Huang Jun Xu Benxiang Hou Ying Wang Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study BMC Oral Health Endodontic microsurgery CBCT Maxillary sinus Molars Palatal roots |
| title | Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study |
| title_full | Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study |
| title_fullStr | Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study |
| title_full_unstemmed | Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study |
| title_short | Proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery: a cone-beam computed tomography study |
| title_sort | proximity of maxillary molar palatal roots to adjacent structures for endodontic microsurgery a cone beam computed tomography study |
| topic | Endodontic microsurgery CBCT Maxillary sinus Molars Palatal roots |
| url | https://doi.org/10.1186/s12903-024-05396-y |
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