Influence of the incorporation of small-group practical seminars to a traditional lecture for the understanding of root canal morphology classification systems

INTRODUCTION

This study aimed to assess if the incorporation of small-group practical seminars into a traditional lecture format improved the understanding and learning of the root canal classification systems in undergraduate students.

MATERIALS AND METHODS

A small-group practical seminar was designed for 3rd year undergraduate students. The seminar consisted of the analysis of a guided summary of root canal morphology classifications, a participative discussion of several cases and drawing exercises of several internal anatomies based on the different classifications in templates presenting the external anatomy of different dental groups. Students were inquired about their perspectives on the different classifications and the learning strategies with an anonymous questionnaire. The knowledge acquired was assessed in an exam. The scores obtained were compared using the Mann-Whitney U-test with those obtained in the cohort of the previous year in which only the traditional lecture was delivered.

RESULTS

Students' scores (mean = 7.7; SD = 2.5) were significantly higher (p = .006) than those from the previous cohort (mean = 6.9; SD = 2.3). Most students agreed that Ahmed's classification system was the most complete (98.8%) and intuitive (84%), but also the most difficult to understand (67%). All the students believed that the learning activity helped them understand the new classification system.

CONCLUSION

The incorporation of small-group practical seminars into traditional lecture improved the understanding and learning of root canal configurations in undergraduate students. Students rated the classification system suggested by Ahmed et al. as the most complete and intuitive out of the three systems, but also the most difficult to learn.

Internal and external morphological analysis of fused-rooted mandibular second molars in the Chinese population: A micro-computed tomographic study

This study investigated the root canal morphology of fused-rooted mandibular second molars based on the pulp chamber floor (PCF) and analysed the correlation between the external morphology of the radicular groove, and the internal morphology of the PCF and root canal configuration. A total of 291 fused-rooted teeth collected from the Chinese population were scanned using micro-computed tomography and a dental operating microscope was used for observing the PCFs. The classification of the PCF and root canal configuration were identified according to modified Min et al.'s and Gao et al.'s classifications, respectively. Additionally, a new radicular groove classification was proposed. The correlation among these morphological characteristics was investigated using the chi-square test and Fisher's exact test (p < 0.05). The results showed that 74.2% of teeth had C-shaped PCFs, while 21.0% had non-C-shaped PCFs. As for the root canal configurations, 37.5% of teeth were merging type, 40.9% were symmetrical type, and 14.8% were asymmetrical type. Statistical analysis revealed a significant correlation between the PCF types and the root canal configurations (p < 0.001). The dominant root canal types for teeth with C-shaped PCFs were merging and symmetrical types, while the asymmetrical type was not identified in non-C-shaped PCFs. In addition, significant morphological association between the root canals and radicular grooves was also revealed (p < 0.001). Teeth with different PCF morphologies exhibit specific patterns of root canal category distribution. Understanding the morphological nuances of the root canal based on the PCF can assist clinicians in predicting and identifying the canal configuration beneath the visible orifice.

A Case Report of a Maxillary Second Molar with Two Distinct Palatal Canals, Confirmed by CBCT

Cases of unusual and complex root canal morphology could be difficult to diagnose and treat. This report describes the diagnosis and management of a rare maxillary right second molar (tooth #17) with two distinct palatal canals. The tooth was diagnosed with irreversible pulpitis and symptomatic apical periodontitis. Non-surgical root canal treatment was performed. Accurate diagnosis and comprehensive treatment of cases with unusual root canal morphology can be achieved by evaluation of periapical radiographs at different angulations, advanced magnification techniques, and the Cone Beam Computed Tomography (CBCT) scanning. Clinicians should be aware that two separate palatal canals could exist in maxillary second molar teeth.

Prevalence and morphological analysis of isthmuses in mandibular molars of the Indian population: A micro-computed tomographic study

Objectives

This study evaluated the prevalence, configurations, and correlation of isthmuses at coronal, middle, and apical root 3rd in mandibular molars of the Indian population using micro-computed tomography μCT).

Materials and Methods

One hundred and five permanent mandibular molar teeth were scanned under μCT. The axial sections were analyzed at the coronal, middle, and apical thirds of the root for isthmus types and classified according to Hsu and Kim's classification. Descriptive statistics for each isthmus type were calculated. The correlations between the apical, middle, and coronal thirds of the root were determined using Pearson's correlation coefficient.

Results

Type IV isthmus was the most common in the coronal third of the mesial root of mandibular 1st molar (42.9%), while Type V was prevalent in the coronal third of the mesial root of 2nd molar (42.9%). Type I isthmus was found to be highly prevalent in the middle 3rd (71.4%) and apical 3rd (61.9%) of mesial roots of 1st molars, and in the middle 3rd (71.4%) and apical 3rd (42.9%) of mesial roots of 2nd molars. Type V isthmus was the most prevalent in all the thirds of the distal roots of both 1st and 2nd molars, ranging from 40% to 50%. Furthermore, a strong correlation of 0.965 (P < 0.01) was found between the isthmuses in the apical and middle thirds of roots.

Conclusion

There are variations in the prevalence and type of isthmuses across different sections of the root, including the presence of atypical isthmuses. Micro-CT with high-resolution imaging and three-dimensional reconstruction is crucial for investigating root canal morphology. Clinicians could benefit from considering demographic characteristics to better predict the presence of isthmus variations.

Clinical Relevance

The isthmus configurations and frequency differ at each section of mandibular teeth.

Rare root canal morphology of maxillary second molars: A report of three cases

Key Clinical Message

Endodontists should be aware that some maxillary second molars can have more than three roots. If any unusual anatomical features are detected during dental radiography or endodontic procedures, it is necessary to conduct cone-beam computed tomography (CBCT) scanning to prevent procedural mishaps.

Abstract

CBCT can provide three-dimensional reconstructed images of the root canal system. With the help of CBCT, variations in tooth root number and root canal morphology, such as extra canals, apical ramifications, apical deltas, and lateral canals, can be identified. Knowledge of the variations is very important for the success of endodontic treatment. This report suggests that endodontists must not assume that a MSM has only three tooth roots, which is the most prevalent number.

Determination of a Representative and 3D-Printable Root Canal Geometry for Endodontic Investigations and Pre-Clinical Endodontic Training-An Ex Vivo Study

Models of artificial root canals are used in several fields of endodontic investigations and pre-clinical endodontic training. They allow the physical testing of dental treatments, the operating of instruments used and the interaction between these instruments and the tissues. Currently, a large number of different artificial root canal models exist whose geometry is created either on the basis of selected natural root canal systems or to represent individual geometrical properties. Currently, only a few geometric properties such as the root canal curvature or the endodontic working width are taken into consideration when generating these models. To improve the representational capability of the artificial root canal models, the aim of the current study is therefore to generate an artificial root canal based on the statistical evaluation of selected natural root canals. Here, the approach introduced by Kucher for determining the geometry of a root canal model is used, which is based on the measurement and statistical evaluation of the root canal center line's curvatures and their cross-sectional dimensions. Using the example of unbranched distal root canals of mandibular molars (n = 29), an artificial root canal model representing the mean length, curvature, torsion and cross-sectional dimensions of these teeth could be derived.

Restorative and Endodontic Management of a Mandibular Canine With Two Roots and Two Canals: A Case Report

The existence of a permanent mandibular canine with two roots and two canals is rare. This case report presents restorative and endodontic management of a mandibular canine with two roots and two canals of a 32-year-old Saudi woman with multiple periradicular lesions of mandibular anterior teeth. Cone beam computed tomography (CBCT) was used for accurate diagnosis of the root canal morphology. CBCT helped to accomplish the restorative and endodontic treatment in a conservative approach.

Radix molaris is a hidden truth of mandibular first permanent molars: A descriptive- analytic study using cone beam computed tomography

BACKGROUND

Cone-beam computed tomography (CBCT) could be more beneficial in clinical situations that involve the determination of root canal morphology.

AIM

The aim of the study was to ascertain the prevalence of radix molaris (paramolaris-RP and entomolaris-RE) in a subpopulation of Saudi Arabia using CBCT.

METHOD

A total of 700 CBCT scans of mandibular permanent first molars were included in this study. All CBCT scans were interpreted by two trained dentists and an endodontist. Mandibular permanent first molars with fully developed roots and closed apices were only included. Computed Tomography scans were obtained from the dental college record. The anatomic characteristics which were checked included: the prevalence of radix molaris in both RE and RP and the prevalence of radix molaris according to the patient's gender and age. All CBCT images were processed and reconstructed using OnDemand3DTM imaging software.

RESULTS

Of the 700 patients included, 651 (93.0%) did not have radix molaris, 46 (6.6%) had radix entomolaris and 3 (0.4%) had radix paramolaris in the study group. There was no statistically significant difference between the genders and age in the incidence of RE and RP (P-value < 0.05).

CONCLUSION

The study showed that RE prevalence is more compared to RP in the first lower molars in the population studied. It is important to identify extra roots and associated canals to perform successful root canal treatment and avoid failure.

Prediction of accessory canals on the apical third of mandibular second molar based on micro-computed tomography

OBJECTIVE

The aim of this study was to investigate the anatomical factors influencing the incidence of accessory canals (ACs) in the apical third of the mandibular second molar in Chinese population.

METHODS

Micro-CT was performed on 86 root canals. The five possible factors influencing the incidence of ACs in the apical third were named X1 to X5. These factors were the canal length of the apical third, fused roots, location of apical foramen, curvature of the root canals, and complexity of the canals. Statistical analysis was performed by the least absolute shrinkage and selection operator, receiver operating characteristic curve, and the χ2 test (α = 0.05).

RESULTS

The selected variables in the least absolute shrinkage and selection operator regression model were fused roots and complex root canals. The area under the curve was 0.737, indicating that the model had a certain predictive ability. ACs were mainly distributed in the buccal wall and mesial wall of root canals in the apical third of molars (p < 0.05).

CONCLUSIONS

For Chinese population, fused roots and complex root canals are anatomical factors influencing ACs in the apical one-third of mandibular second molars, and the ACs mainly occur in the buccal wall and mesial wall of the root canal.

Analysis of the effects of apical backfilling depth on apical sealing of different root canal filling qualities and morphologies

PURPOSE

The aim of this study was to evaluate the effects of apical backfilling depth on the apical sealing of different root canal filling qualities and morphologies.

METHODS

3D-printed root canals (A: round, B: oval, C: long oval, D: flat) were used and divided into subgroups by root canal filling quality (a: good, b: poor, c: nonfilling) and backfilling depth (3 mm, 5 mm). A glucose microleakage device was used to measure leakage.

RESULTS

(1) 3-mm iRoot BP Plus was filled at the apex, and no obvious leakage occurred in the good root canal filling group, which was significantly smaller than that in the poor/nonfilling groups (P < 0.05). Under good root canal filling conditions in groups A, B, C, and D, no obvious leakage was observed. Under poor/nonfilling root canal filling conditions, there was significant leakage; A and B (P > 0.05) and C and D were compared (P < 0.05). (2) Apical backfilling with 5-mm iRoot BP Plus showed no significant leakage in the poor root canal filling groups with the four morphologies.

CONCLUSION

3-mm iRoot BP Plus was filled at the apex, root canal filling was poor, apical sealing was poor, and root canal morphology affected apical sealing. Apical backfilling with 5-mm iRoot BP Plus improved apical sealing under poor root canal filling conditions, and apical sealing was unaffected by root canal morphology.

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems

PURPOSE

An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans.

METHODS

Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05).

RESULTS

Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al. ¹MP¹) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created.

CONCLUSION

Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.

Radiographic assessment of root canal morphology of mandibular central incisors using new classification system: A cross-sectional study

Lack of basic knowledge about the external and internal anatomies of the root canal system and common variations in teeth may lead to various procedural errors or treatment failure. In this study, the root canal configurations of mandibular incisors and the symmetry of the contralateral incisors of Saudi Arabian subpopulations were analyzed and determined using cone beam computed tomography (CBCT). A retrospective evaluation of 700 patients was conducted, and 1260 fully developed permanent mandibular central incisors were assessed. The number of root canals was determined, and the internal root canal anatomies were categorized based on Ahmed et al.'s criteria. The CBCT images were independently evaluated by 2 trained dentists and an endodontist. The data were assessed using the chi-square and one-way analysis of variance tests. All the mandibular central incisors included in the study were single-rooted. According to Ahmed et al's classification system, the most common classification (82.6%) was 1ManA1 (Vertucci type I), followed by 1ManA1-2-1 (Vertucci type III; 13%). Second canals were more frequently recorded in the male participants than in the female participants. The root canal configuration between contralateral incisors was largely symmetrical. Most of the mandibular incisors in the examined Saudi Arabian population had a single canal. Nevertheless, a substantial number of patients had a complex root morphology. Hence, CBCT can be utilized as a potential supplementary tool during root canal treatment.

Root canal morphology of primary molars - A cone beam computed tomography (CBCT) study

Objectives

To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone-beam computed tomography (CBCT).

Methods

A retrospective cross-sectional study was performed, where CBCT scans of children less than 10 years of age taken for valid diagnostic purposes previously were considered and images were analyzed. The number of roots, root canals, and variations in morphology were recorded. Left-right symmetry was also noted.

Results

A total of 433 deciduous maxillary and mandibular primary molars were studied. It was observed that two separate roots with three separate canals were common in primary mandibular first molars, whereas two separate roots with two canals in each root were common in mandibular second primary molars. In primary maxillary molars, three separate roots with one canal each were the most common. Maxillary first molars (17.21%) and 17.35% second molars had fused distobuccal and palatal roots. It was observed that primary maxillary molars showed more left-right symmetry (86.7% in first molars and 82.7% in second molars) compared to primary mandibular molars (54.05% in first molars and 68% in second molars).

Conclusions

It was concluded that in both primary maxillary first and second molars, three separate roots, a mesiobuccal root, a distobuccal root, and a palatal root with one canal in each root, were the most common. Two separate roots with three separate canals were the most common in primary mandibular first molars, whereas two separate roots with two canals each in both roots were more common in mandibular second primary molars.

An In-Vivo cone-beam computed tomography analysis of root and canal morphology of maxillary first permanent molars in an Indian population

Background

The root and canal morphology of maxillary first permanent molars (MFPMs) is a very widely studied issue in endodontics. However, only one study has been conducted to date on this issue using cone-beam computed tomography (CBCT) in India, and the sample consisted of extracted teeth.

Aim

To investigate the root and canal morphology of MFPMs in an Indian population, by using CBCT.

Methods and Material

487 bilateral MFPMs (974 teeth) were assessed and the root and canal morphology were determined according to Vertucci's classification. In addition, the prevalence of a second mesiobuccal canal in the mesiobuccal root (MB2) was correlated with gender, age and arch side.

Results

Three roots were most commonly found in the MFPMs regardless of gender (P > 0.05), but this prevalence varied according to the side of the dental arch (P < 0.05). MB2 was present in 77.5% of 3-rooted teeth. Patients above 60 years had a higher incidence of these canals (84.7%) (P < .05). The occurrence of bilateral MB2 was 71.8% in 3-rooted MFPMs. Gender had no significant impact on the occurrence of bilateral MB2 in 3-rooted MFPMs (P > .05). The most common canal configuration was type IV (46.5%) and I (98.9%) in the mesiobuccal and distobuccal roots, respectively (P < .05). The prevalence of MB2 in 3-rooted MFPMs was higher in patients above 60 years of age.

Conclusions

The root and canal morphology of MFPMs in an Indian population may have significant variations depending on the dental arch side and patient age.

New classification for pulp chamber floor anatomy of human molars

Comprehensive knowledge of the entire root canal system is an essential prerequisite for successful routine endodontic treatments. The internal and external morphological configurations of roots and root canals are quite complex. Thus, several classifications have been put forth by researchers to appropriately understand the distinguishable features of root and root canal systems of multirooted teeth. Until now, the researchers have proposed new classification systems for a thorough understanding of the root canal systems, mainly concentrating on the root canal anatomy and anomalies. Moreover, with the advent of newer digital imaging systems, these classifications are more reproducible and relevant. They have further gained importance for the clinicians by acting as an aid in decision-making based on evidence-based dentistry. However, these classifications are primarily focused on the root canals, but none have assessed the anatomy of the pulp chamber floor. This review article delineates a novel Pawar and Singh molar pulp chamber floor classification© for the anatomy of maxillary and mandibular molars to ease the clinician's skills and further increase the prevailing literature for the benefit of researchers.

Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration

Adequate knowledge and accurate characterization of root and canal anatomy is an essential prerequisite for successful root canal treatment and endodontic surgery. Over the years, an ever-increasing body of knowledge related to root and canal anatomy of the human dentition has accumulated. To correct deficiencies in existing systems, a new coding system for classifying root and canal morphology, accessory canals and anomalies has been introduced. In recent years, micro-computed tomography (micro-CT) and cone beam computed tomography (CBCT) have been used extensively to study the details of root and canal anatomy in extracted teeth and within clinical settings. This review aims to discuss the application of the new coding system in studies using micro-CT and CBCT, provide a detailed guide for appropriate characterization of root and canal anatomy and to discuss several controversial issues that may appear as potential limitations for proper characterization of roots and canals.

A maxillary center incisor with three independent roots and three root canals: A case report

RATIONALE

Three root canals (mesiobuccal, distobuccal and palatal) are rarely found (frequency <1%) in the maxillary central incisor even though root canal morphology in maxillary premolars is highly variable. Therefore, research papers showed that dentists can easily miss the root canals in diagnosis and inflammatory diffusion; which could cause unsuccessful root canal treatment leading to various possible infections and no change in original inflammations. In this report, the diagnose and clinical management of an unusual case of a maxillary center incisor with three independent roots and three root canals is presented, along with a demonstration of using CBCT (Cone Beam Computed Tomography) and collaborate with other departments to successfully accomplish an accurate diagnosis of the morphology and quantity of the root canal system.

PATIENT CONCERNS

The patient was referred to clinic for his repeatedly abscessed in the gums of the left upper central incisor.

DIAGNOSES

Based on clinical and radiographic evidences, the patient was tentatively diagnosed with a chronic periapical periodontitis for #21 tooth.

INTERVENTIONS

The patient was performed with the conventional root canal treatment and then clinical observed.

OUTCOMES

At the second visit after 7 days, the patient was not sensitive to percussion. After operation for 3 months, and found that the sinus opening had not healed. Then, the patient was undergone with the periodontal flap surgery to remove root infection for 2 weeks.

LESSONS

From this clinical case, the lesson learned is that the previous clinical experiences cannot be used to make judgments or decisions; it requires specific analysis from the information gathered through CBCT(Cone Beam Computed Tomography)and the cooperation between different departments to come up with a responsible decision. In any stomatological hospitals, due to the large number of departments and the strong specialized focuses for each department; it is very important to encourage and support the cooperation between the departments, to limit any judgment bias due to lack of knowledge and maximize each department's strengths.

Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia

AIM

To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice.

METHODS

One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05).

RESULTS

A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P < 0.001). Overall, 97% of students reported the new system helped their understanding of root and canal morphology compared with the Vertucci classification (P < 0.001). Over 97% of students recommended the use of the new system in teaching, pre-clinical courses and clinical practice (P < 0.001). Except for two schools, no significant difference was detected between the responses of students for all questions at the different schools (P > 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05).

CONCLUSIONS

The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.

Anatomical analysis of permanent mandibular incisors in a Saudi Arabian population: An in Vivo cone-beam computed tomography study

Aims

To investigate the root canal's anatomy, gender differences, and bilateral symmetry of permanent mandibular incisors using cone-beam computed tomography (CBCT).

Materials and Methods

A total of 208 patients with 822 well-developed mandibular incisors were evaluated. CBCT images were retrieved from the database of patients who received treatment in the College of Dentistry and Dental Clinics. The following parameters were evaluated using CBCT: (1) the number of roots; (2) the number of canals; (3) canal configuration according to Vertucci's classification; (4) differences between genders; and (5) bilateral symmetry.

Results

Two canals appeared in 26.3% of mandibular central incisors, 30.8% of lateral incisors, and 28.6% of all the 822 mandibular incisors. In the teeth with two canals, Type III configuration was dominant. There were no statistically significant differences found between the central and lateral incisors (P = 0.449). There were gender differences in central incisors, while lateral incisors showed none. Slight bilateral asymmetries appeared in central and lateral incisors in relation to some canals and canals configurations.

Conclusion

CBCT can be of great use in locating the second canal and determining canal configuration in mandibular incisors. Knowledge of bilateral asymmetry can be of clinical significance when the clinician is treating contralateral teeth in the same patient.

Evaluation of Root and Root Canal Morphology of Mandibular First and Second Molars in a Greek Population: A CBCT Study

Objective:

Τo study the number of roots, canal configurations, and frequency of morphological variations in mandibular first and second molars in a Greek population.

Methods:

This study examined 478 mandibular first molars and 524 mandibular second molars using a high-resolution cone-beam computed tomography (CBCT). The number of roots was recorded and the root canal configuration was categorized based on the classification by Vertucci. The presence and configuration of C-shaped root canals were recorded and they were classified according to the Fan classification. The symmetry between the right and the left side was also evaluated.

Results:

Among the mandibular first molars, 0.2% teeth were single-rooted, 96.4% were two-rooted, and 3.3% were three-rooted. In the mandibular second molars, 12.2%, 82.8%, and 4.9% were single-rooted, two-rooted, and three-rooted, respectively. In two-rooted mandibular first and second molars, the most frequent root canal pattern observed was Vertucci’s type II in the mesial root (69.8% and 64.1%, respectively) and Vertucci’s type I in the distal root (81.7% and 97.7%, respectively). Three-rooted molars showed one oval-shaped mesial root and two distal roots (56.2% in first molars, 65.4% in second molars), where each distal root contained a single root canal (type I), and the mesial root presented either type II (53.3%), IV (26.6%), I (13.3%), or V (6.6%) canal configurations. C-shaped canals were only detected in mandibular second molars (5.3% of teeth, 10.8% of individuals), and bilateral occurrence was observed in 24.5% patients. The most frequent root canal pattern was Fan’s C1 type at the orifice, followed by C3a and C3b in the coronal and middle third, which joined into a single canal (C4) apically.

Conclusion:

The characteristics of the root and root canal anatomy of the mandibular first and second molars of Greek individuals were similar to those observed in Caucasians. However, the higher incidence of third roots in mandibular molars in Greek individuals compared to Caucasians requires absolute clinical awareness.

Evaluation of root canal morphology of maxillary premolars: a cone-beam computed tomography study

The aim of this study was to evaluate the root canal configuration of maxillary premolars using cone-beam computed tomography (CBCT). CBCT images of 999 maxillary premolars from a database were analysed to determine the frequency of the number of roots, root canals and Vertucci's classification. The associations among these variables were evaluated by Chi-square test (P < 0.05). In the first premolars, 42.2% of single-rooted teeth had a type II configuration, whereas 98.7% of 2-rooted teeth showed type IV. In the second premolars, type I was the most prevalent (49.9%). The presence of two roots was more prevalent in first premolars, and the presence of one root was more prevalent in second premolars (P < 0.05). Male patients had a higher percentage of two roots compared with female patients (P < 0.05). Type IV and I was more prevalent in first and second premolars respectively (P < 0.05). There was a high frequency of 2-rooted and single-rooted teeth among maxillary first and second premolars respectively.

Root canal morphology of primary molars by clearing technique: An in vitro study

OBJECTIVE

The objective of the study was to study root canal morphology of primary molars by clearing technique and to observe for any variations.

MATERIALS AND METHODS

One hundred and twenty extracted primary molars were divided into four groups (n = 30); Group I = maxillary first, Group II = maxillary second, Group III = mandibular first, and Group IV = mandibular second. The samples were subjected to decalcification, clearing, and dye penetration. The data regarding the root canal morphology of each sample were tabulated based on the number of root canals, curvature of the root canal, and root canal configuration. Descriptive statistics were applied.

RESULTS

According to Vertucci's root canal configuration in Group I, mesiobuccal root exhibited 93.10% Type I, 6.90% Type II, and 6.90% Type IV; distobuccal root had 95.65% Type I and 4.35% Type IV; and palatal roots had 100% Type I canal configuration. In Group II, mesiobuccal root showed 90% Type I and 10% Type IV; distobuccal root had 100% Type I; palatal root exhibited 96.30% Type I and 3.70% Type III. In Group III, mesial root showed 20% Type I, 6.67% Type III, and 73.33% Type IV and distal root had 76.67% Type I and 23.33% Type IV. In Group IV, mesial root exhibited 100% Type IV and distal root had 43.33% Type I and 65.67% Type IV canal anatomy.

CONCLUSION

Vertucci's Type I root canal configurations were most frequently observed.

A Cone-beam Computed Tomographic Study of Root and Canal Morphology of Maxillary First and Second Permanent Molars in a Thai Population

INTRODUCTION

Understanding tooth anatomy is crucial for effective endodontic treatment. This study investigated the roots and root canal morphology of maxillary first and second permanent molars in a Thai population using cone-beam computed tomographic (CBCT) imaging.

METHODS

This study evaluated 476 maxillary first molars and 457 maxillary second molars receiving CBCT examination and determined the number of roots and canal morphology according to Vertucci's classification, and the prevalence of a second mesiobuccal (MB2) canal in the mesiobuccal (MB) root was correlated with sex, age, and tooth side.

RESULTS

Three roots were most commonly found in maxillary first and second molars. MB2 canals in the MB root were found in 63.6% and 29.4% of first and second molars, respectively. The most common canal morphology in the first molar MB roots was type I (36.4%) followed by type II (28.8%), and type IV (25.3%). The most common canal morphology in the second molar MB roots was type I (70.6%) followed by type II (14.6%) and type IV (7.5%). Bilateral MB2 canals in the MB roots were present in 80.93% and 82.59% of the first and second molars, respectively. There was a significant correlation between males and the prevalence of MB2 canals in first molars (P < .05).

CONCLUSIONS

CBCT imaging is useful to determine root canal morphology. The prevalence of MB2 canals is approximately 60% and 30% in first and second molars, respectively. Furthermore, bilateral MB2 canals were commonly found. Our results can help endodontists to improve endodontic treatment outcomes.

Maxillary First Molars with 2 Distobuccal Canals: A Case Series

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar.

Root and canal morphology of maxillary second molars by cone-beam computed tomography in a native Chinese population

Objective

To evaluate the root and root canal morphology of the maxillary second molars (MSMs) in a native Chinese population by cone-beam computed tomography.

Methods

Cone-beam computed tomography images of 2412 MSMs from 1294 Chinese patients were analyzed to determine the number and morphology of the roots, the root canal morphology, the bilateral symmetry, and the correlations of these parameters with sex and age.

Results

The percentage of fused roots increased with age, while the percentage of fused roots in women was higher than that in men. The percentage of second mesiobuccal (MB2) canals in MSMs with three separate roots was higher in men than women. Patients aged 31 to 40 years showed a higher prevalence of MB2 canals, while those aged ≥51 years showed the lowest prevalence of MB2 canals among both men and women. There was a significant difference in bilateral symmetry of MSMs between men and women.

Conclusion

Root fusion of MSMs increased with age, while the root canal morphology was more complex in patients of intermediate ages.

Root canal treatment of a three-rooted maxillary second premolar

Successful root canal treatment relies on correct access cavity preparation, sufficient cleaning, adequate shaping, and complete obturation. Prior to these, location of all existing canals in the tooth plays an important part in the initial treatment procedures. While most teeth have a normal morphology, we should recognize that variations do exist. Normal maxillary second premolars have one or two root canals. Maxillary second premolars are less likely to have three canals. To date, only a few cases of maxillary second premolars with three roots (and three canals) have been reported in the literature. This case presentation reports a 20-year-old female who had three root canals in a maxillary second premolar, which underwent endodontic treatment at a teaching hospital in Taiwan.

The best radiographic method for determining root canal morphology in mandibular first premolars: A study of Chinese descendants in Taiwan

Background/purpose

There is large variation in root canal morphology and undetected canals and incomplete instrumentation are reasons for root canal treatment failure. The purpose of this study was to determine the best radiographic method for determining root canal morphology in mandibular first premolars in Chinese descendants in Taiwan.

Materials and methods

Mandibular first premolars extracted due to caries, periodontal diseases, trauma, or for orthodontic reasons were used. Four indices were examined: (1) root canal bifurcation observed in the buccolingual view; (2) root canal continuity in the buccolingual view; (3) double root outline in the buccolingual view; and (4) Vertucci canal classification in the mesiodistal view.

Results

A total of 82 left and right mandibular first premolars were included, a complicated root canal was confirmed in 38 (46.3%) by cross-sectional imaging and a single root canal was found in 44 (53.7%). Bifurcation identified on the mesiodistal view exhibited the highest sensitivity (94.7%) and second highest specificity (88.6%) for identifying a complicated root canal; however, this view is not possible to obtain clinically. Canal bifurcation on the buccolingual view was the most specific (93.2%), but had the lowest sensitivity (73.7%). Canal continuity on the buccolingual view had a sensitivity of 94.7%, and specificity of 70.5%.

Conclusion

Combined X-ray analyses, such as performing the buccolingual view for identification of canal bifurcation and canal continuity, may increase the accuracy of identifying complex root canal morphology.

Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations

INTRODUCTION

Sound knowledge of the external and internal morphology of the different teeth groups is essential to ensure a successful outcome of root canal treatment. The aims of this study were to review the available literature with respect to the root and root canal morphology of maxillary first premolars and discuss the clinical considerations of this morphology on the various dental procedures.

METHODS

The MEDLINE/PubMed and Scopus databases were searched for relevant literature. The identified publications were classified into anatomic studies and clinical case reports. The data extracted from anatomic studies were tabulated, and weighted averages for certain internal and external morphologic features were calculated. The anatomic and developmental variations in the clinical case reports were summarized.

RESULTS

A total of 92 studies (45 anatomic studies and 47 case reports) including a total of 11,299 teeth were identified. The majority of maxillary first premolars had 1 root (41.7%) or 2 roots (56.6%). Regardless of the number of roots, the vast majority (86.6%) had 2 root canals, with type IV (2-2) being the most common canal configuration (64.8%). The majority of the apical foramina (66.6%) did not coincide with the apical root tip. About 38% of the teeth had lateral canals, 12.3% had apical deltas, and 16.0% had isthmi. The clinical case reports showed that the 3-rooted variant was the most common anatomic variation, and developmental anomalies were rarely reported.

CONCLUSIONS

The maxillary first premolars are predominantly 2-rooted teeth with 2 root canals. However, the clinician should be aware about the possible anatomic variations of these teeth and their relationship with the adjacent anatomic structures while planning and performing endodontic, restorative, periodontal, and surgical procedures.

[Confusion and solution for root canal working length determination]

Pulpitis and periapical periodontitis is a type of bacterial infectious disease, and bacteria frequently plant in the entire root canal system during the terminal stage. Main clinical treatment strategy of the disease requires root canal therapy, a key and core procedure for the successful treatment by thoroughly removing the root canal infection. The premise and guarantee of thoroughly removing root canal infection is by determining the accurate root canal working length. However, introduction of the complexity of the apical root anatomical structure, the confusion in determining the position of apical stop, and the method to determine the root canal working length. methods of accurately determining root canal working length, especially determining the position of apical stop, has been a hot topic among endodontic specialists, frequently causing confusion among many clinicians. This review provides a brief

Retrospective study of root canal configurations of maxillary third molars in Central India population using cone beam computed tomography Part- I

Objective:

The aim of this study was to investigate the root and canal morphology of maxillary third molars in Central India population using cone-beam computed tomography (CBCT) analysis.

Materials and Methods:

CBCT images of 116 maxillary third molars were observed, and data regarding the number of roots, the number of canals, and Vertucci's Classification in each root was statistically evaluated.

Results:

Majority of Maxillary third molars had three roots (55.2%) and three canals (37.9%). Most MB root (43.8%), DB root (87.5%), and palatal root (100%) of maxillary third molars had Vertucci Type I. Mesiobuccal root of three-rooted maxillary third molars had Vertucci Type I (43.8%) and Type IV (40.6%) configuration. Overall prevalence of C-shaped canals in maxillary third molars was 3.4%.

Conclusion:

There was a high prevalence of three-rooted maxillary molars with three canals.

Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography

OBJECTIVE

The aim of the present study is to assess the root and root canal morphology of maxillary and mandibular premolars in a Turkish population by using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

In this study, CBCT images of 2134 premolars (987 maxillary, 1147 mandibular) were obtained from 404 patients. Details of gender, age, number of roots and canals, and canal configuration in each root were recorded. The canal configuration was classified and evaluated according to Vertucci's criteria.

RESULTS

The majority of maxillary premolars had two separate roots; although, three roots were identified in 1% of maxillary first premolars. However, most of the mandibular premolars had a single root. The two canals (69.9%) and type I (62.6%) and type II (34.1%) configuration for upper first premolar, one canal (82.1%) and type I (77.6%) canal configuration for second premolar was the most prevalent root canal frequency. The most prevalent root canal frequency was the one canal (96.2%) and type I (94.2%) and type V (3.2%) configuration for mandibular first premolar, one canal (98.9%) and type I (98.9%) canal configuration for second premolar. There was no difference in the root canal configurations and the numbers of canals between the left and the right side of both females and males (P > 0.05).

CONCLUSIONS

Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment. Preoperative CBCT examination allows determination of root canal configuration of premolar teeth and helps clinicians in root canal treatment.

Anatomic symmetry of root and root canal morphology of posterior teeth in Indian subpopulation using cone beam computed tomography: A retrospective study

OBJECTIVE

To investigate the anatomic symmetry of maxillary and mandibular posteriors in Indian subpopulation using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

CBCT images of 246 patients that had at least one noncarious, posterior tooth free of restorations in each quadrant were enrolled for retrospective analysis. A total of 3015 teeth (811 maxillary premolars, 845 mandibular premolars, 738 maxillary molars, and 621 mandibular molars) were analyzed for number of roots and root canals, canal morphology and anatomic symmetry, and concurrent types between the maxilla and mandible.

RESULTS

There was no difference in the percentage of symmetry for maxillary first (81.5%) and second (81.5%) premolars. Mandibular second premolars (98.3%) exhibited greater symmetry than mandibular first premolars (96.1%). First molars (77.5% and 82.1%) showed greater symmetry than second molars (70.8% and 78.6%), in both maxillary and mandibular arches, respectively. The most common anatomy observed were: maxillary first premolars - 2 roots with 2 canals, maxillary second premolars - 1 root with 2 canals, mandibular first and second premolars - 1 root with 1 canal, maxillary first and second molars - 3 roots with 4 canals, and mandibular first and second molars - 2 roots with 3 canals. When compared with any other teeth, maximum asymmetry was observed in maxillary second molar (29.2%).

CONCLUSION

The percentage of symmetry observed in the present study varied from 70% to 98% with least percentage of symmetry in maxillary second molars. These data should alert the clinicians while treating homonymous teeth of the same patient.

Cone-beam computed tomography study of the root and canal morphology of mandibular permanent anterior teeth in a Chongqing population

OBJECTIVE

To investigate the root and canal morphology of permanent mandibular anterior teeth in a Chongqing population using cone-beam computed tomography (CBCT).

METHODS

CBCT images of 1,725 patients in a Chongqing population were selected, and a total of 9,646 mandibular anterior teeth were analyzed. The number of root canals and the canal configurations were investigated.

RESULTS

In total, 0.3% (11/3,257) of lateral incisors and 0.8% (26/3,014) of canines had double roots, and 3.8% (127/3,375) of central incisors, 10.6% (345/3,257) of lateral incisors, and 4.2% (127/3,014) of canines had multi-root canals. The difference in the incidence of multi-canals in lateral incisors between female and male was statistically significant. The frequency of multi-canals in the different age groups was 5.0% for central incisors for ages 21-30 years, 14.7% for lateral incisors for ages 41-50 years, and 8.1% for canines for ages 41-50 years.

CONCLUSION

With the limitations of the current study, we found that a high percentage of mandibular anterior teeth had multiple canals in the studied Chinese Chongqing population. The current data may provide clinicians practicing in Chongqing with a more thorough understanding of root canal morphology.

Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature

OBJECTIVE

Knowledge of primary tooth morphology is essential for clinical dentistry, especially for root canal treatment and dental traumatology. However, this has not been well documented to date with a large sample. This study was carried out to investigate the variation in number and morphology of the root canals of the primary molars, to study the applicability of cone beam computerized tomography (CBCT) in assessing the same and to provide a comprehensive review of the literature.

MATERIALS AND METHODS

A total of 343 primary molars, without any root resorption, were divided into four main groups including the maxillary first molars, maxillary second molars, mandibular first molars and mandibular second molars. All of them were analysed in CBCT images in the axial, sagittal and coronal planes. Various parameters such as the number of roots, number of canals, the root canal type, diameter of root and root canal and root canal curvature were studied.

RESULTS

Primary molars in all four groups showed variability in the number of roots and root canals. As far as length of the roots was concerned, the palatal root of the maxillary molar was found to be longest, while the distobuccal root was shortest. In mandibular molars, the mesial root was longer than the distal root. The length of distobuccal root canal of the maxillary molars and the distolingual canal of the mandibular molars was found to be shortest. The number of roots and root canals varied from two to four and three to four, respectively. The maxillary molars exhibited more one-canal than two-canal roots.

CONCLUSION

The present study provides comprehensive information to the existing literature concerning the variation in root canal morphology of the maxillary and mandibular primary molar teeth. These data may help clinicians in the root canal treatment of these teeth.

Evaluation and endodontic management of a patient with 6 single-rooted molars: a case report

This case report describes a patient with unusual tooth morphology involving the bilateral presence of 6 maxillary and mandibular first and second molars with a single root and a single canal. The article also discusses the endodontic management of a single-rooted maxillary molar and the use of cone beam computed tomography for evaluation and diagnosis of these anatomical variations.

Gender difference and root canal morphology in mandibular premolars: A cone-beam computed tomography study in an Iranian population

BACKGROUND

Mandibular premolars are of the most difficult teeth to treat endodontically.

AIMS

To compare the root canal morphology of mandibular premolars between two genders in an Iranian population.

SETTINGS AND DESIGN

Totally, 230 cone-beam computed tomography images of the mandibles belonged to 115 males and 115 females were evaluated in the three spatial planes.

MATERIALS AND METHODS

The total number of roots and canals in the mandibular premolars was counted, and the difference between males and females were analyzed.

STATISTICAL ANALYSIS

Data were analyzed using Chi-square test. The significance level was set as P < 0.05.

RESULTS

The majority of mandibular first and second premolars had one root (85.7% and 94.8%, respectively) and one canal (63.9% and 78.3%, respectively). The number of roots in the mandibular first premolars had statistically significant difference between two genders (P = 0.001). There was no significant difference between two genders in the number of roots (P = 0.208) and canals (P = 0.498) in the mandibular second premolars.

CONCLUSION

According to the results of this study, the root canal morphology in the mandibular first premolars had statistically significant difference between two genders.

Mandibular first molar with single root and single root canal

Mandibular molars demonstrate considerable anatomic complexities and abnormalities with respect to number of roots and root canals. Clinicians should be aware that there is a possibility of the existence of a fewer number of roots and root canals than the normal root canal anatomy. Mandibular first molar with a single root and single canal was diagnosed with the aid of dental operating microscope and multiple angled radiographs. This case report presents a rare case of successful endodontic management of mandibular first molar with a single root and root canal.

A retrospective comparative study of cone-beam computed tomography versus rendered panoramic images in identifying the presence, types, and characteristics of dens invaginatus in a Turkish population

INTRODUCTION

This study assessed the presence, characteristics, and type of dens invaginatus (DI) by using cone-beam computed tomography (CBCT) and panoramic images rendered from CBCT images. In addition, the findings of the imaging techniques were compared.

METHODS

We evaluated 300 CBCT images to determine the type of DI, the presence of an impacted tooth near the DI, and the presence of apical pathosis. The McNemar test was used to compare the prevalence of DI according to CBCT and panoramic images rendered from CBCT images.

RESULTS

The presence of DI was lower on panoramic images rendered from CBCT images (3% of the patients) compared with on CBCT images (10.7% of the patients) (P < .001). According to the CBCT images, the distribution of teeth with DI was as follows: maxillary lateral incisors (75%), maxillary central incisors (6.8%), mandibular premolars (4.6%), mesiodens (9%), maxillary canines (2.3%), and mandibular canines (2.3%). Type I DI was the most commonly observed type of invaginatus (65.9%), followed by type II (29.5%) and type III (4.6%). All patients with type III DI and 25% of the patients with type II DI had apical pathosis at the time of referral, but periapical lesions were not observed in teeth with type I DI. In total, 13.6% of DI cases had impacted teeth.

CONCLUSIONS

CBCT can be recommended as an effective diagnostic device for identifying DI because it provides an accurate representation of the external and internal dental anatomy.

[The technology of apical infection control]

Root canal therapy is the most efficient way to treat pulptitis and periapical inflammation, which can clear infections of root canal systems, fill the root canal firmly, and avoid reinfection. However, the variations in root canal morphology and complexity of infection confer difficulty in thoroughly eliminating microorganisms and their by-products in the root canal system, especially in the root apex area (including the top one-third of the root canal and periapical tissue), which is described as the hardest area to clean during endodontic treatment. Infection is difficult to remove entirely because the apex area is hard to approach using dental instruments and because of the existence of special morphological structures, such as apical ramification, intercanal anastomoses, and lateral branch of root canal. This review gives a brief introduction of the characteristics and difficulties of apical infection and knowledge on how to control such infections, including root apex preparation, irrigation and disinfection, and root canal filling.

A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population

Objective:

The aim of this study was to determine the root and canal morphology of the maxillary and mandibular anterior teeth in a Turkish population by analyzing cone-beam computed tomography (CBCT) images.

Materials and Methods:

CBCT images of 417 females and 410 males with a mean age of ranging from 14 to 70 years were examined in this study. A total of 1453 maxillary central incisors, 1504 maxillary lateral incisors, 1523 maxillary canines, 1582 mandibular central incisors, 1603 mandibular lateral incisors, and 1604 mandibular canines were analyzed. The number of root canals and the canal configurations were investigated and then were classified according to Vertucci's classification. The data were analyzed with the Pearson Chi-square test.

Results:

The Type 1 canal configuration was most prevalent in the maxillary anterior teeth (96.8-99.7%). The Types 2, 3, 4, and 5 canal configurations were observed within the range of 0-1.3%, 0-0.8%, 0-0.7%, and 0-1.8%, respectively. In the mandibular anterior teeth, the Type 1 canal configuration was most prevalent (77-95%). The Types 2, 3, 4, and 5 canal configurations were observed within a range of 0.2-2.7%, 0.2-1.6%, 0.9-5.9%, and 1.8-14.4%, respectively. The prevalence of two canals was higher in males than in females both in the maxillary and mandibular anterior teeth (P < 0.05).

Conclusions:

Type 1 was the most prevalent canal configuration of maxillary and mandibular anterior teeth in the Turkish population. Type 5 was the most frequently observed canal configuration of the two canalled teeth. The incidence of root canal numbers and configurations differed with sex.

Endodontic management of a four rooted retained primary maxillary second molar

The presence of accessory roots is rare in the primary dentition. Complete knowledge and understanding of tooth anatomy is essential to carry out high quality dental treatment with excellent outcome. In addition, the persistent primary tooth and its missing permanent successor in the dental arch pose several hurdles in front of the clinician due to doubtful survival of primary tooth. In this paper, highlights the root canal treatment of a rarest four rooted retained primary maxillary second molar.

Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo

INTRODUCTION

The aim of the present study was to use cone-beam computed tomography (CBCT) to analyze root canal anatomy and symmetry of maxillary and mandibular first and second molar teeth of a white population.

METHODS

A total of 201 patients who required CBCT examinations as part of their dental diagnosis and treatment were enrolled in the present study. Overall, 596 healthy, untreated, well-developed maxillary and mandibular molar teeth (161 maxillary first molars, 157 maxillary second molars, 117 mandibular first molars, and 161 mandibular second molars) were examined by CBCT to establish the symmetry in root and canal anatomy between right and left sides in the same patient by evaluating the number of roots and root canals and the root canal configuration.

RESULTS

Three separate roots with 3 separate canals was the normal anatomy of maxillary first and second molars. Most mandibular first and second molars had 2 separate roots, and the majority had 3 canals. In the present study, first molars, both maxillary and mandibular, exhibited greater asymmetry than the second molars. Maxillary first molars were found to be symmetrical in 71.1% of patients, whereas maxillary second molars were symmetrical in 79.6%. The remaining 28.9% and 20.4% of patients, respectively, showed asymmetry. Around 30% of the mandibular first molars and 20% of the mandibular second molars showed asymmetry.

CONCLUSIONS

The results of the present study reported a percentage of symmetry that varied from 70%-81%. These variations in symmetry should be taken in high consideration when treating 2 opposite molars in the same patient, because their anatomy may be different in up to 30% of the cases.

Endodontic management of four rooted mandibular first premolar

Mandibular premolars have earned the reputation for having aberrant anatomy. The literature is replete with reports of extra canals in mandibular first premolars, but reports about the incidence of extra roots in these teeth are quite rare. This paper attempts at explaining a rare case of successful endodontic management of a four-rooted mandibular first premolar with diagnostic, interoperative and postoperative radiographic records along with a substantial data on the incidence of extra roots in these teeth. The standard method of radiographic appraisal was maintained as the criteria for determining the presence of extra roots.

Root canal treatment of a mandibular second premolar with atypical canal pattern

To present a unique case of mandibular second premolar with an atypical canal pattern. Thorough knowledge of root canal morphology, appropriate assessment of the pulp chamber floor, and critical interpretation of radiographs are a prerequisite for successful root canal treatment. Mandibular premolars frequently exhibit variable and complex root canal morphology and are one of the most difficult cases to treat endodontically. These teeth may require skillful and special root canal preparation and obturation techniques. This article reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically.

Mandibular left first premolar with two roots: A morphological oddity

Thorough knowledge of the root canal morphology, appropriate assessment of the pulp chamber floor, and critical interpretation of radiographs are a prerequisite for successful root canal therapy. The possibility of additional root/canal should be considered even in teeth with a low frequency of abnormal root canal anatomy. This article reports on a case of mandibular first premolar with two roots, which was successfully treated with root canal therapy.

Maxillary right second molar with two palatal root canals

We report a clinical case of maxillary right second molar with two palatal root canals. The morphology is atypical because it is characterized by two palatal roots with two canals with widely separated orifices and canals. Modifications to the normal access opening and examination of the pulpal floor for additional canals are stressed.

Root canal morphology of maxillary second premolars in an Indian population

INTRODUCTION

The purpose of this study was to investigate root canal morphology of maxillary second premolars in an Indian population.

MATERIALS AND METHODS

Two hundred maxillary second premolars were collected, stained, decalcified, and cleared. Cleared teeth were examined in a steromicroscope under 7.5× magnification and the following observations were made: (1) length of the teeth, (2) number of root canals, (3) root canal configuration by Vertucci's classification, (4)number of isthmi between the canals, (5) frequency of apical deltas.

RESULTS

Of the two hundred maxillary second premolars, 64.1% had one root canal at the apex and 35.4 % had two root canals at the apex. The average length of the teeth was 21.5 mm. Concerning the canal morphology, 33.6% of the teeth exhibited Vertucci type II configuration followed by type IV pattern (31.1%); 29.2% of the teeth possessed type I pattern. An additional canal configuration type XIX was found in one tooth. Isthmi and apical deltas was found in 19% and 14% of the cases, respectively.

CONCLUSION

The root canal morphology of Maxillary second premolars can be complex and requires careful evaluation prior to endodontic therapy.