title: Cone-beam computed tomography analysis of the vestibular surgical pathway to the palatine root of the maxillary first molar.
abstract: OBJECTIVE
  The aim of this study was to evaluate the anatomical distance between apices of the palatine root of the maxillary first molars to the buccal bone plate to identify the vestibular surgical pathway in a Turkish adult population using cone-beam computed tomography (CBCT) images.
  
  
  METHODS
  CBCT scans of 107 (48 male and 59 female) patients were retrospectively analyzed. The overall mean age was 38.6 years. The distance between the vestibular cortex and vestibular side of the palatine root was measured for 192 maxillary first molars both on axial images parallel to the palatal plane and on reformatted cross-sectional images. A Pearson's chi square test and Mann-Whitney U-test were performed to evaluate differences among age, localization, and measurements. Differences were considered statistically significant at P<.05.
  
  
  RESULTS
  The mean distance between the buccal cortex and the buccal side of the palatine root of the superior first molar in both male and female patients was 10.13 and 9.70 mm, respectively. The incidence of interposition of the lateral recess of the maxillary sinus between the roots was 42.2% and 49% in men and women, respectively. Statistically significant sex-related differences were found in the vestibular surgical pathway (P<.05).
  
  
  CONCLUSIONS
  For precise planning of endodontic surgery, it is crucial to determine the exact dimensions and location of the periapical lesion, as well as its relationship with the roots and other neighboring anatomical structures. CBCT can be a powerful tool for the evaluation of surgical cases in three dimensions with less ionizing radiation and better avoidance of complications during surgery.
authors: Department of Endodontics, Near East University, Faculty of Dentistry, Mersin 10, TURKIYE.
authors: Atakan
authors: A
authors: Kalender
authors: Umut
authors: U
authors: Aksoy
authors: Fatma
authors: F
authors: Basmaci
authors: Kaan
authors: K
authors: Orhan
authors: Ayse Isil
authors: AI
authors: Orhan
keywords: CBCT; endodontic surgery; palatine root; vestibular surgical pathway