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Micro-CT evaluation of apical delta morphologies in human teeth
Xianhua Gao1, Franklin R Tay2, James L Gutmann3
1The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
The intricate apical delta in root canals presents challenges for effective cleaning during root canal therapy. Its complex morphology, including non-straight, non-circular branches, complicates thorough debridement, potentially impacting treatment success.
Area of Science:
- Endodontics
- Dental Anatomy
- Radiology
Background:
- Incomplete root canal debridement can compromise the long-term success of endodontic treatment.
- The apical delta, a complex network of small canals at the root apex, is a critical area for thorough cleaning.
- Understanding the morphology of the apical delta is essential for improving root canal therapy outcomes.
Purpose of the Study:
- To investigate the detailed morphological features of apical deltas in human teeth.
- To utilize micro-computed tomography (micro-CT) and a centreline-fitting algorithm for precise analysis.
- To correlate apical delta morphology with potential challenges in root canal debridement.
Main Methods:
- Analysis of 136 apical deltas across 1400 human teeth using micro-computed tomography (micro-CT).
- Application of a centreline-fitting algorithm to characterize delta structures.
- Quantitative assessment of delta prevalence, vertical distance, branch diameter, and length.
Main Results:
- Apical deltas were found in 15.8% of molars and 6.3% of anterior teeth.
- The mesiobuccal root of maxillary molars showed a higher prevalence of apical deltas.
- Apical delta branches were characterized by non-straight paths and non-circular cross-sections, with a median diameter of 132.3 μm and length of 934.5 μm.
Conclusions:
- The complex and variable morphology of apical deltas, including their intricate branch structures, poses significant challenges for complete debridement during root canal therapy.
- These findings highlight the need for advanced techniques and careful consideration of apical delta anatomy to enhance the efficacy of endodontic procedures.
- The study provides crucial anatomical data that may inform the development of improved endodontic instrumentation and cleaning protocols.
