1
|
Barbhai S, Shetty R, Joshi P, Mehta V, Mathur A, Sharma T, Chakraborty D, Porwal P, Meto A, Wahjuningrum DA, Luke AM, Pawar AM. Evaluation of Root Anatomy and Canal Configuration of Human Permanent Maxillary First Molar Using Cone-Beam Computed Tomography: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10160. [PMID: 36011794 PMCID: PMC9408299 DOI: 10.3390/ijerph191610160] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to review the literature on root canal configuration (RCC) and the frequency of occurrence of a second mesiobuccal canal (MB) in human permanent maxillary first molars where cone-beam computed tomography (CBCT) is used. Online electronic databases such as PubMed-Medline, Embase, Scopus and Cochrane Library were searched using appropriate keywords from the earliest available date until 12th June 2022, without restriction on language. In the mesiobuccal root, type I was the most frequent (33.29%), followed by types II and IV (27.18% and 26.36%, respectively). Moreover, 68.2% of maxillary first molars had a second MB canal. For both the distobuccal and palatal roots, type I was the most prevalent, with 99.08% and 97.83% occurrence, respectively. All other types were infrequent. Type I RCC is most frequent in all the roots of the maxillary first molars. Hence, care must be taken during biomechanical preparation of the MB roots.
Collapse
Affiliation(s)
- Sourabh Barbhai
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Rajesh Shetty
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Poonam Joshi
- Department of Conservative Dentistry & Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Ankita Mathur
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Tanvi Sharma
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Damini Chakraborty
- Bhowal’s Dental and Implant Clinic, Bengal GreenField Heights, Galaxy-6FS, beside Apollo Pharmacy, DJ Block (Newtown), Newtown, Kolkata 700136, West Bengal, India
| | - Priyanka Porwal
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya 60132, East Java, Indonesia
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
| |
Collapse
|
2
|
Endodontic Management of Maxillary Second Molar Tooth with a Single Root and Single Canal. Case Rep Dent 2020; 2020:2829304. [PMID: 32089899 PMCID: PMC7021452 DOI: 10.1155/2020/2829304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/17/2019] [Accepted: 11/28/2019] [Indexed: 11/24/2022] Open
Abstract
Comprehensive understanding of variations in the root canal morphology of a maxillary molar is useful for performing successful endodontic treatment in such cases. This case report describes endodontic management of a case with such aberrant root canal morphology of a maxillary second molar having a single root and single canal.
Collapse
|
3
|
Abstract
AIM The aim of this scientific work is to illustrate the technique of shaping the root canal system using the multistep technique. BACKGROUND Over time, various endodontic instrumentation techniques have been put forward, from the "step-back" technique (apical-coronal) to the "crown-down" technique (coronal-apical), the "double-flared" technique, and the most recent "single-length" technique. TECHNIQUE The multistep technique involves six steps, one of the main objectives of these being the safety of the use of mechanical instruments with a reduction in the risk that they fracture. This technique ("mixed") provides for the use of both manual instruments in stainless steel and mechanical instruments in nickel titanium (Ni-Ti). CONCLUSION The multistep technique is based on a standardized, flexible, and clinical protocol, which can provide for a reduction in the number of endodontic passages and instruments used and, therefore, a simplification of the operating procedure depending on both the difficulty of the root canals and the competence of the operator. CLINICAL SIGNIFICANCE This technique is a technique for shaping the endodontic space that allows the set objectives of endodontic therapy to be reached in a predictable way with a reduced risk of iatrogenic complications.
Collapse
Affiliation(s)
- Livio Gallottini
- Department of Medicine and Surgery, Piazzale Filippo il Macedone, Rome Italy, Phone: +393355469409, e-mail:
| |
Collapse
|
4
|
Fujii R, Suehara M, Sekiya S, Miyayoshi N, Asai T, Morinaga K, Muramatsu T, Furusawa M. CBCT-based Diagnosis of Periapical Lesion of Maxillary First Premolar Mimicking That of Second Premolar. THE BULLETIN OF TOKYO DENTAL COLLEGE 2017; 57:291-297. [PMID: 28049977 DOI: 10.2209/tdcpublication.2016-1900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Apical periodontitis is usually diagnosed based on clinical findings and dental X-rays. Recently, however, dental cone beam computed tomography (CBCT), which provides 3-D images of the maxillofacial region, has enabled dentists to examine patients undergoing endodontic therapy more effectively, improving diagnostic accuracy. Here, we describe a positive treatment outcome achieved using CBCT to diagnose apical periodontitis of the maxillary premolars, which had proven difficult to diagnose based on clinical findings and dental radiography alone. The patient was a 42-year-old Japanese man who presented with the chief complaint of gingival swelling in the maxillary right premolar region. Our initial diagnosis, based on clinical findings and dental X-ray, was apical periodontitis of the maxillary right second premolar, and treatment was started. However, after the patient failed to respond to the treatment, CBCT was performed. Based on these new findings, the diagnosis was changed to one of apical periodontitis of the upper right first premolar, and the patient was treated accordingly. Previous studies have described the complex anatomical morphology of the upper premolars, noting multiple roots and variation in the morphology of the root canals. The 3-D images provided by dental CBCT allow better assessment of oral conditions than the traditional 2-D images provided by dental X-rays, which in turn enables the dentist to better select the most appropriate treatment. Here, the patient showed no symptoms and was progressing well at a 6-month follow-up visit. The present results indicate that when clinical findings and dental X-rays alone are insufficient to allow a secure diagnosis, CBCT offers an effective alternative which will enable the appropriate treatment to be selected more reliably.
Collapse
Affiliation(s)
- Rie Fujii
- Department of Endodontics and Clinical Cariology, Tokyo Dental College
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Hosseinpour S, Kharazifard MJ, Khayat A, Naseri M. Root Canal Morphology of Permanent Mandibular Premolars in Iranian Population: A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:150-6. [PMID: 27471522 PMCID: PMC4947835 DOI: 10.7508/iej.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/01/2016] [Accepted: 01/15/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION It is essential for clinicians to have knowledge about root canal configuration, although its morphology varies largely in different ethnicities and even in different individuals within the same ethnic group. The current study reviewed the root canal configuration of root canals in mandibular first and second premolars among Iranian population based on independent epidemiological studies. METHODS AND MATERIALS A comprehensive search was conducted on retrieved articles related to root canal configuration and prevalence of each types of root canal in mandibular premolars based on Vertucci's classification. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. RESULTS In eleven studies conducted in eight provinces, 1644 mandibular first premolars and 1268 second premolars were investigated. Within mandibular first premolars, 70.9% were Vertucci's type I, followed by 10.4% type III, 7.18% type IV, 5.23% type II and 5.16% type V. In addition, among mandibular second premolars, 82.86% were type I, 6.25 type III, 5.32% type II, 4.27% type IV, and 0.69% type V. CONCLUSION These results highlight the necessity of searching for additional possible root canals by clinicians. Moreover, these results indicated the ethnical characteristics of Iranian population regarding the morphology of mandibular premolars compared to other populations.
Collapse
Affiliation(s)
- Sepanta Hosseinpour
- Students' Research Office, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | - Akbar Khayat
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Canada;
| | - Mandana Naseri
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
6
|
Asghari V, Rahimi S, Ghasemi N, Talebzadeh B, Norlouoni A. Treatment of a Maxillary First Molar with Two Palatal Roots. IRANIAN ENDODONTIC JOURNAL 2015; 10:287-9. [PMID: 26523146 PMCID: PMC4609671 DOI: 10.7508/iej.2015.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Thorough knowledge of the morphology and internal anatomy of the root canal system is essential, because it determines the successful outcome of endodontic treatment. The main goal of endodontic treatment is to prevent apical periodontitis and/or to promote the healing of periapical lesion. Presence of two canals or roots on the palatal side of the first maxillary molar has rarely been reported. This case report presents a maxillary first molar with two separate palatal roots.
Collapse
Affiliation(s)
- Vahideh Asghari
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Ghasemi
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bita Talebzadeh
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Norlouoni
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
7
|
Sharma S, Mittal M, Passi D, Grover S. Management of a maxillary first molar having atypical anatomy of two roots diagnosed using cone beam computed tomography. J Conserv Dent 2015; 18:342-5. [PMID: 26180423 PMCID: PMC4502134 DOI: 10.4103/0972-0707.159756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/30/2015] [Accepted: 05/27/2015] [Indexed: 11/12/2022] Open
Abstract
Most often, a clinician working on maxillary first molar when anticipates an aberration thinks of an extra canal but rarely does he preempt fewer canals. Maxillary first molar is a tooth, which has been extensively reviewed with respect to its external and internal morphology. Abundant literature related to its anatomy is available, but reports on incidence of two roots and two root canals in maxillary first molar are very limited. Here, a case of maxillary first molar is presented that had two roots: one palatal root with Type I canal configuration and one bulbous fused buccal root with Type V canal configuration; a unique root and canal configuration not seen in any of the earlier reported cases. Diagnosis of root canal aberrancy and subsequently, accurate management of the tooth was greatly facilitated by cone beam computed tomography (CBCT) scan. The relevance of CBCT in improving treatment prognosis is greatly emphasized in this report.
Collapse
Affiliation(s)
- Sarang Sharma
- Department of Conservative Dentistry and Endodontics, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - Meenu Mittal
- Department of Pediatric Dentistry, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - Deepak Passi
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - Shibani Grover
- Department of Conservative Dentistry and Endodontics, ESIC Dental College and Hospital, Rohini, Delhi, India
| |
Collapse
|
8
|
Kato A, Ziegler A, Higuchi N, Nakata K, Nakamura H, Ohno N. Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics. Int Endod J 2014; 47:1012-33. [PMID: 24483229 PMCID: PMC4258081 DOI: 10.1111/iej.12256] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 01/27/2014] [Indexed: 01/15/2023]
Abstract
The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts.
Collapse
Affiliation(s)
- A Kato
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | | | | | | | | | | |
Collapse
|
9
|
Bhuyan AC, Kataki R, Phyllei P, Gill GS. Root canal configuration of permanent maxillary first molar in Khasi population of Meghalaya: An in vitro study. J Conserv Dent 2014; 17:359-63. [PMID: 25125850 PMCID: PMC4127696 DOI: 10.4103/0972-0707.136511] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/08/2013] [Accepted: 06/03/2014] [Indexed: 12/13/2022] Open
Abstract
AIMS AND OBJECTIVE To investigate the root canal configuration of permanent maxillary first molar in Khasi population of Meghalaya. MATERIAL AND METHODS Sixty (60) permanent maxillary first molars collected from patients of Khasi population of Meghalaya were studied using canal staining and clearing technique. Observations of the number of roots, root canal configuration, lateral canal, apical delta, and presence of the additional type of canals were made. RESULTS Based on Vertucci's classification the different types of canal identified are: Mesiobuccal root, Type I (28.3%), Type II (28.3%), Type IV (30.0%), Type V (5.0%), Type VI (6.7%), and an additional type of canal (2-1-2-1-2; 1.7%) were observed. The distobuccal root displayed Type I (95%), Type II (1.7%), Type V (3.3%). The most prevalent canal configuration in the palatal roots is Type I (98.3%), Type II (1.7%). CONCLUSION In Khasi population of Meghalaya, the most prevalent root canal configuration in the mesiobuccal root is Type IV followed by Type I and Type II. MB2 canals are present in more than 65% cases. In palatal and distobuccal roots, Type I configuration is present in most cases. Racial divergence may be responsible for such variations.
Collapse
Affiliation(s)
- Atool Chandra Bhuyan
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Rubi Kataki
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Pynshngain Phyllei
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Gurdeep Singh Gill
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| |
Collapse
|
10
|
Nayak G, Dahiya S, Singh I, Mohammad FH. Endodontic management of an unusual maxillary first molar with a single buccal root. J Contemp Dent Pract 2014; 15:367-71. [PMID: 25307823 DOI: 10.5005/jp-journals-10024-1545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this clinical article is to describe the unusual anatomy that was detected in a maxillary first molar during routine endodontic treatment. BACKGROUND Variation in Root and Root canal morphology especially in multirooted teeth presents a constant challenge for a clinician in their detection and management. The literature is replete with cases that have extra canal or Root but cases with fused Root and fewer numbers of canals are sparse. CASE DESCRIPTION This case report describes the endodontic management of one such unusual case of maxillary first molar presenting with a single fused buccal and a palatal Root. The confirmatory diagnosis of this morphologic aberration was done with the help of spiral computerized tomography, which revealed that the contralateral tooth also had a similar morphology. CONCLUSION Dental practitioners should always be aware of the fact that abnormalities need not be in form of extra Roots or Root canals; anomalies can also be in form of fewer number of Roots or Root canals. CLINICAL SIGNIFICANCE A thorough knowledge of the complexities and variations of the Root canal system would help in avoiding some of the common iatrogenic access opening errors like perforations and excessive tooth removal caused during the search for the missing or extracanal.
Collapse
Affiliation(s)
- Gurudutt Nayak
- Reader, Department of Conservative Dentistry and Endodontics Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India, e-mail: gurudutt_
| | - Surya Dahiya
- Senior Resident, Dental Wing, BPS Government Medical College for Women Sonepat, Haryana, India
| | - Inderpreet Singh
- Postgraduate student, Department of Conservative Dentistry and Endodontics Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
| | - Faiz Hasan Mohammad
- Postgraduate student, Department of Conservative Dentistry and Endodontics Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
| |
Collapse
|
11
|
Maxillary first molars with six canals diagnosed with the aid of cone beam computed tomography: a report of two cases. Case Rep Dent 2013; 2013:406923. [PMID: 23984111 PMCID: PMC3745875 DOI: 10.1155/2013/406923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 06/17/2013] [Indexed: 11/17/2022] Open
Abstract
The case reports present the endodontic management of two maxillary first molars with six canals. The diagnosis of morphology of multiple canal systems was identified under magnification of the dental operating microscope and was confirmed with the help of cone beam computed tomography. This paper discusses the variations in the canal morphology and the use of the latest adjuncts in successfully diagnosing and treating unusual canal anatomy.
Collapse
|
12
|
Rahimi S, Ghasemi N. Maxillary first molar with two root canals. Sultan Qaboos Univ Med J 2013; 13:E346-9. [PMID: 23862051 DOI: 10.12816/0003251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 11/18/2012] [Accepted: 12/12/2012] [Indexed: 01/01/2023] Open
Abstract
Knowledge regarding the anatomic morphology of maxillary molars is absolutely essential for the success of endodontic treatment. The morphology of the permanent maxillary first molar has been reviewed extensively; however, the presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. This case report presents a patient with a maxillary first molar with two roots and two root canals, who was referred to the Department of Endodontics, Tabriz University of Medical Sciences, Iran.
Collapse
Affiliation(s)
- Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Tabriz Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
13
|
Shakouie S, Mokhtari H, Ghasemi N, Gholizadeh S. Two-rooted maxillary first molars with two canals: a case series. IRANIAN ENDODONTIC JOURNAL 2013; 8:29-32. [PMID: 23412400 PMCID: PMC3570973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 04/29/2012] [Accepted: 05/15/2012] [Indexed: 11/16/2022]
Abstract
Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.
Collapse
Affiliation(s)
- Sahar Shakouie
- Department of Endodontics, Dental School, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Mokhtari
- Department of Endodontics, Dental School, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Hadi Mokhtari, Department of Endodontics, Faculty of Dentistry, Golgasht Street, 5166614713, Tabriz, Iran. Tel: +98-914 3131992, Fax: +98-411 3346977, E-mail:
| | - Negin Ghasemi
- Department of Endodontics, Dental School, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seddigheh Gholizadeh
- Department of Endodontics, Dental School, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
14
|
Eskandarinezhad M, Ghasemi N. Nonsurgical endodontic retreatment of maxillary second molar with two palatal root canals: a case report. J Dent Res Dent Clin Dent Prospects 2012; 6:75-8. [PMID: 22991641 PMCID: PMC3445319 DOI: 10.5681/joddd.2012.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 01/25/2012] [Indexed: 11/17/2022] Open
Abstract
Successful endodontic treatment requires thorough knowledge regarding each root canal system of any tooth and probability of extra canals should be considered. Second maxillary molar with two palatal root canals is not frequent and its incidence reported in literatures is about 0.4–2%. The present case report describes non-surgical retreatment of maxillary second mo-lar with two palatal root canals. Radiographic interpretation is difficult in this region; so, very careful examination of pulpal space and using supportive devices such as loupe and operating microscope is recommended to discover any unusual anat-omic features like extra canals.
Collapse
Affiliation(s)
- Mahsa Eskandarinezhad
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
15
|
A rare root canal configuration of maxillary second molar: a case report. Case Rep Dent 2012; 2012:767582. [PMID: 22830061 PMCID: PMC3399371 DOI: 10.1155/2012/767582] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/21/2012] [Indexed: 11/17/2022] Open
Abstract
A thorough knowledge of root canal morphology is a prerequisite for the endodontic therapy. The maxillary molars, especially the second molars, have the most complicated root canal system in permanent dentition. There are many variations in canal number and configuration in maxillary molars. Treatment may be unsuccessful because the dentist may fail to recognize the unusual canal configuration. The present paper describes a case of a right maxillary second molar with a canal configuration rarely reported in the literature. The tooth had four roots with four root canals, two individual palatal roots (mesiopalatal and distopalatal) with their own separate canals. The mesiobuccal and distobuccal root had normal anatomy. This paper may intensify the complexity of maxillary molar variation and is intended to reinforce clinician's awareness of the rare morphology of root canals.
Collapse
|
16
|
Gerrits PO, Veening JG. Leonardo da Vinci's "A skull sectioned": skull and dental formula revisited. Clin Anat 2012; 26:430-5. [PMID: 22431331 DOI: 10.1002/ca.22060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Revised: 12/23/2011] [Accepted: 02/08/2012] [Indexed: 11/06/2022]
Abstract
What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing "A skull sectioned" (RL 19058v) by Leonardo da Vinci (1452-1519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned paranasal sinuses and ductus nasolacrimalis. A dissected lateral wall of the maxilla is also present. Furthermore, at the level of the foramen mentale, the drawing displays compact and spongious bony components, together with a cross-section through the foramen mentale and its connection with the canalis mandibulae. Leonardo was the first to describe a correct dental formula (6424) and made efforts to place this formula above the related dental elements. However, taking into account, the morphological features of the individual elements of the maxilla, it can be suggested that Leonardo sketched a "peculiar dental element" on the position of the right maxillary premolar in the dental sketch. The fact that the author did not make any comment on that special element is remarkable. Leonardo could have had sufficient knowledge of the precise morphology of maxillary and mandibular premolars, since the author depicted these elements in the dissected skull. The fact that the author also had access to premolars in situ corroborates our suggestion that "something went wrong" in this part of the drawing. The present study shows that historical anatomical drawings are very useful for interactive learning of detailed anatomy for students in medicine and dentistry.
Collapse
Affiliation(s)
- Peter O Gerrits
- Section Anatomy, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands.
| | | |
Collapse
|
17
|
Shetty PP, Astekar MS, Jain A, Pandya M. Maxillary first molar with two palatal roots located under dental operating microscope. Clin Pract 2012; 2:e26. [PMID: 24765425 PMCID: PMC3981339 DOI: 10.4081/cp.2012.e26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 12/13/2011] [Accepted: 12/17/2011] [Indexed: 11/22/2022] Open
Abstract
An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. A thorough knowledge of basic root canal anatomy and its variation is necessary for successful completion of endodontic treatment. This report points to the importance of looking for additional roots and canals with the help of operating microscope. Finding additional roots and canals would enable clinician to successfully treat a case that would otherwise not be successful.
Collapse
Affiliation(s)
| | - Madhusudan S Astekar
- Department of Oral Pathology, Paher University, Pacific Dental College and Hospital, Udaipur, India
| | - Ankit Jain
- Department of Conservative and Endodontics
| | | |
Collapse
|
18
|
A new anatomically based nomenclature for the roots and root canals-part 1: maxillary molars. Int J Dent 2011; 2012:120565. [PMID: 22216031 PMCID: PMC3246733 DOI: 10.1155/2012/120565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 09/19/2011] [Indexed: 11/23/2022] Open
Abstract
Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequently named based on definite sets of criteria. A new method for identification and naming of roots and root canal anatomy in maxillary molars, based on their root and canal relationship, was formulated and is presented in this paper. The nomenclature makes certain essential modifications to the traditional approach to accommodate naming of the various aberrations presented in the maxillary molars. A simple, yet extensive, nomenclature system has been proposed that appropriately names the internal and external morphology of maxillary molars.
Collapse
|
19
|
Kottoor J, Sudha R, Velmurugan N. Middle distal canal of the mandibular first molar: a case report and literature review. Int Endod J 2010; 43:714-22. [PMID: 20491988 DOI: 10.1111/j.1365-2591.2010.01737.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To present a clinical case report in a mandibular first molar with a middle distal canal, along with a review of the literature. SUMMARY With the use of magnification, either by microscopes or by loupes, there is an increasing possibility of detecting additional canals. The present case describes root canal treatment in a mandibular first molar with two roots and a Sert and Bayirli Type XVIII canal configuration in the distal root. The presence of a three canals in the distal root of mandibular first molars has been reported to have an incidence of 0.2-3%. KEY LEARNING POINTS * Clinicians should be aware of the variable root canal anatomy in the distal root of mandibular first molars. * Use of magnification helps to identify and locate additional root canals. * Three root canals in the distal root of mandibular first molar teeth might occur.
Collapse
Affiliation(s)
- J Kottoor
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.
| | | | | |
Collapse
|
20
|
Maxillary first molar with seven root canals diagnosed with cone-beam computed tomography scanning: a case report. J Endod 2010; 36:915-21. [PMID: 20416446 DOI: 10.1016/j.joen.2009.12.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 11/30/2009] [Accepted: 12/08/2009] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The purpose of this article was to emphasize the importance of having a thorough knowledge about the root canal anatomy. METHODS This case report presents the endodontic management of a maxillary first molar with three roots and seven canals. The clinical detection of the seven canals was made using a surgical operating microscope and confirmed using cone-beam computed tomography (CBCT) scanning. RESULTS CBCT axial images showed that both the palatal and distobuccal root have a Vertucci type II canal pattern, whereas the mesiobuccal root showed a Sert and Bayirli type XV canal configuration. CONCLUSION This report describes and discusses the variation in canal morphology of maxillary first molar and the use of latest adjuncts in successfully diagnosing and negotiating them.
Collapse
|
21
|
He W, Wei K, Chen J, Yu Q. Endodontic treatment of maxillary first molars presenting with unusual asymmetric palatal root morphology using spiral computerized tomography: A case report. ACTA ACUST UNITED AC 2010; 109:e55-9. [DOI: 10.1016/j.tripleo.2009.08.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 08/18/2009] [Indexed: 11/24/2022]
|
22
|
Chakradhar Raju RVS, Chandrasekhar V, Singh CV, Pasari S. Maxillary molar with two palatal roots: Two case reports. J Conserv Dent 2010; 13:58-61. [PMID: 20582222 PMCID: PMC2883810 DOI: 10.4103/0972-0707.62627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 01/12/2010] [Accepted: 02/03/2010] [Indexed: 11/04/2022] Open
Abstract
An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. Aberrations in root canal anatomy are commonly occurring phenomena. A thorough knowledge of basic root canal anatomy and its variation is necessary for successful completion of endodontic treatment. This report points to the importance of looking for additional roots and canals because knowledge of their existence would enable clinician to treat a case successfully that otherwise might end in failure.
Collapse
Affiliation(s)
- R V S Chakradhar Raju
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, AP, India
| | - V Chandrasekhar
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, AP, India
| | - Chandra Vijay Singh
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, AP, India
| | - Srikanth Pasari
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, AP, India
| |
Collapse
|
23
|
de Almeida-Gomes F, Maniglia-Ferreira C, Carvalho de Sousa B, Alves dos Santos R. Six root canals in maxillary first molar. ACTA ACUST UNITED AC 2009; 108:e157-9. [PMID: 19716486 DOI: 10.1016/j.tripleo.2009.04.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 04/29/2009] [Indexed: 12/16/2022]
Abstract
In this clinical article we report an unusual anatomy that was detected in a maxillary first molar with 6 root canals. The possibility of 6 root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times their presence is noticed only after canal treatment, owing to continuing postoperative discomfort.
Collapse
|
24
|
Holderrieth S, Gernhardt CR. Maxillary molars with morphologic variations of the palatal root canals: a report of four cases. J Endod 2009; 35:1060-5. [PMID: 19567335 DOI: 10.1016/j.joen.2009.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 04/21/2009] [Accepted: 04/25/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. METHODS In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. RESULTS During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. CONCLUSIONS This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.
Collapse
Affiliation(s)
- Silke Holderrieth
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | | |
Collapse
|
25
|
Gorduysus O, Nagas E, Cehreli ZC, Gorduysus M, Yilmaz Z. Localization of root canal orifices in mandibular second molars in relation to occlusal dimension. Int Endod J 2009; 42:973-7. [PMID: 19619227 DOI: 10.1111/j.1365-2591.2009.01596.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the localization and distribution of canal orifices of mandibular second molar teeth in relation to the mesio-distal and bucco-lingual dimensions of coronal tissue. METHODOLOGY Fifty extracted mandibular second molar teeth were embedded into plaster blocks with their vertical axes aligned perpendicular to the horizontal plane. The teeth were photographed digitally from the occlusal aspect under 12 x magnification. Thereafter, the occlusal halves of crowns were sectioned off to expose the root canal orifices. The teeth were than photographed under the same magnification, after which the pre- and post-sectioning images of each specimen were stacked into a single file. To plot the coordinate of each canal orifice, a 0.5-mm grid analytical plane was mounted digitally on the stack so that the x- and y-axes of the plane were superimposed on the mesiodistal and buccolingual axes (bisectors) of the tooth crowns. Localization and distribution of the coordinates of the canal orifices were evaluated using the chi-square test (P = 0.05). RESULTS Only one tooth displayed a single root canal orifice, located in the mesiobuccal-distolingual 'centre' of the occlusal surface. The majority of mandibular second molars had three orifices (72%), followed by those with two (16%) and four (10%). The distal canal was located lingual to the centre of the occlusal plane. CONCLUSION The distal canal was located lingual to the centre of the occlusal plane of mandibular second molars. The possibility of observing more divergent localizations and orifice numbers should not be overlooked in clinical practice.
Collapse
Affiliation(s)
- O Gorduysus
- Department of Endodontics Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | | | | | | | | |
Collapse
|
26
|
Maxillary first molar with an unusual morphology: report of a rare case. ACTA ACUST UNITED AC 2008; 106:e62-5. [DOI: 10.1016/j.tripleo.2008.07.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Accepted: 07/27/2008] [Indexed: 12/12/2022]
|
27
|
de la Torre F, Cisneros-Cabello R, Aranguren JL, Estévez R, Velasco-Ortega E, Segura-Egea JJ. Single-rooted maxillary first molar with a single canal: endodontic retreatment. ACTA ACUST UNITED AC 2008; 106:e66-8. [PMID: 18926738 DOI: 10.1016/j.tripleo.2008.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 07/27/2008] [Indexed: 12/11/2022]
Affiliation(s)
- Francisco de la Torre
- Department of Endodontics, School of Dentistry, European University of Madrid, Madrid, Spain
| | | | | | | | | | | |
Collapse
|
28
|
Gopikrishna V, Reuben J, Kandaswamy D. Endodontic management of a maxillary first molar with two palatal roots and a single fused buccal root diagnosed with spiral computed tomography - a case report. ACTA ACUST UNITED AC 2008; 105:e74-8. [PMID: 18329571 DOI: 10.1016/j.tripleo.2007.11.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 11/20/2007] [Indexed: 10/22/2022]
|
29
|
Shin SJ, Park JW, Lee JK, Hwang SW. Unusual root canal anatomy in maxillary second molars: two case reports. ACTA ACUST UNITED AC 2007; 104:e61-5. [PMID: 17942346 DOI: 10.1016/j.tripleo.2007.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 07/10/2007] [Indexed: 10/22/2022]
Abstract
The aim of this clinical report is to describe the unusual root canal anatomy of 2 maxillary second molars with 2 separated palatal roots and the endodontic treatment procedures for those teeth. In these presented cases, microscopy was useful to identify distopalatal orifice. Radiographic interpretation was difficult owing to the overlap of the buccal and secondary palatal roots.
Collapse
Affiliation(s)
- Su-Jung Shin
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.
| | | | | | | |
Collapse
|
30
|
Abstract
AIM This case report presents an unusual C-shaped root canal system in a maxillary first molar tooth. SUMMARY Although C-shaped root canals are most frequently seen in the mandibular second molar, they may also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. The present case describes a C-shaped canal in the buccal root of a maxillary first molar. The endodontic access cavity displayed two canal orifices, one leading to the canal system in the buccal root, the other into the palatal root canal system. In the buccal root, what appeared to be the mesial and distal canals joined to form a single C-shaped canal. KEY LEARNING POINTS --Careful examination of radiographs and the internal anatomy of teeth is essential.-- The location and morphology of root canals should be identified at high magnification under the microscope.
Collapse
Affiliation(s)
- Z Yilmaz
- Department of Endodontics, Faculty of Dentisty, Hacettepe University, Ankara, Turkey.
| | | | | | | |
Collapse
|
31
|
Gopikrishna V, Bhargavi N, Kandaswamy D. Endodontic management of a maxillary first molar with a single root and a single canal diagnosed with the aid of spiral CT: a case report. J Endod 2006; 32:687-91. [PMID: 16793482 DOI: 10.1016/j.joen.2005.10.057] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Revised: 10/24/2005] [Accepted: 10/26/2005] [Indexed: 02/08/2023]
Abstract
The aim of this article is to present an endodontically managed maxillary first molar with an unusual morphology of a single root and a single canal, which has not been reported in the literature so far. An accurate assessment of this unusual morphology was made with the help of a Spiral computed tomography. This report extends the range of known possible anatomical variations to include teeth with lesser number of roots and canals. This report also highlights the role of Spiral computed tomography as an objective method to confirm the three-dimensional anatomy of teeth.
Collapse
Affiliation(s)
- Velayutham Gopikrishna
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College, Alapakkam Main Road, Maduravoyal, Chennai, India.
| | | | | |
Collapse
|
32
|
Abstract
The purpose of this study was to show anatomical variations in permanent maxillary molars. Two clinical cases of four-rooted maxillary molars and a macroscopic study of an extracted tooth, showing a five-rooted maxillary molar, are presented.
Collapse
|
33
|
Abstract
AIM The aim of this clinical article is to describe the unusual anatomy that was detected in a maxillary first molar during routine endodontic treatment. SUMMARY Success in root canal treatment is achieved after thorough cleaning and shaping followed by the complete obturation of the root canal system. Such treatment may be performed in root canal systems that do not comply with the normal anatomical features described in standard textbooks. The present case describes root canal treatment in a maxillary first molar with two roots and a type IV canal configuration in the buccal root. KEY LEARNING POINTS Careful examination of radiographs and the internal anatomy of teeth is essential. Root canal treatment is likely to fail if the entire system is not debrided and filled. Anatomic variations can occur in any tooth.
Collapse
|
34
|
Fava LR, Weinfeld I, Fabri FP, Pais CR. Four second molars with single roots and single canals in the same patient. Int Endod J 2000; 33:138-42. [PMID: 11307455 DOI: 10.1046/j.1365-2591.2000.00272.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE REPORT Studies on canal configuration have demonstrated a substantial variation in the number of roots and root canals in different teeth. Maxillary and mandibular molars may have three and two roots, respectively, and generally present with three of four root canals. This case describes the presence of one single root and one root canal in all second molars of the same patient.
Collapse
Affiliation(s)
- L R Fava
- Methodist University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | | | | | | |
Collapse
|
35
|
Abstract
A case report is presented describing the endodontic treatment of a maxillary second molar with two palatal roots.
Collapse
Affiliation(s)
- E Deveaux
- Département de Dentisterie Restauratrice et d'Endodontie, Faculté d'Odontologie de Lille, Université de Lille 2, France
| |
Collapse
|