title: Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery.
abstract: The purpose of this study was to investigate the relationship between the root apex of the upper incisors and neighbouring anatomical structures as well as the morphology of the root-end foramen after apicoectomy. Fifty-seven patients requiring endodontic surgical treatment for a maxillary anterior root were enrolled. A preoperative diagnostic computed tomography (CT) scan was analysed to determine: the distance between the anterior wall of the nasopalatine duct and the central (CI-ND) incisor root 4mm from the apex; and the distance between the floor of the nasal cavity and the tip of either the central (CI-NF) or the lateral (LI-NF) incisor root. After apicoectomy, root-end foramen endoscopic pictures were taken in order to characterize their morphology. Fifty-nine central and 26 lateral incisors were evaluated. The average CI-ND was 4.71 ± 1.26 (SD) mm. The average CI-NF was 10.62 ± 2.25 mm. The average LI-NF was 13.05 ± 2.43 mm. The foramen shape after apicoectomy was ovoid to circular in about 90% of cases in both central and lateral incisors. A sound knowledge of the anatomical relationships at the surgical site is essential for the clinician to perform a safe endodontic surgical procedure.
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Department of Health Technologies, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Taschieri
authors.forename: T
authors.initials: T
authors.lastname: Weinstein
authors.forename: G
authors.initials: G
authors.lastname: Rosano
authors.forename: M
authors.initials: M
authors.lastname: Del Fabbro
mesh_terms: D000537:Aluminum Oxide / Q000627:therapeutic use; D001047:Apicoectomy / Q000295:instrumentation / Q000379:methods; D003475:Curettage / Q000379:methods; D003738:Dental Cements / Q000627:therapeutic use; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007180:Incisor / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008297:Male; D008437:Maxilla / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D009296:Nasal Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D010027:Osteotomy / Q000379:methods; D021362:Palate, Hard / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D010483:Periapical Diseases / Q000628:therapy; D016300:Radiography, Bitewing; D012184:Retrograde Obturation / Q000379:methods; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods; D019227:Tooth Apex / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D019553:Tooth, Nonvital / Q000628:therapy; D015034:Zinc Oxide / Q000627:therapeutic use
chemical_list: D003738:Dental Cements; C022998:EBA alumina cement; D012387:Root Canal Filling Materials; C449162:zinc oxide-non-eugenol cement; D000537:Aluminum Oxide; D015034:Zinc Oxide