Root canals and apical foramina of the buccal root of maxillary first premolars with longitudinal sulcus

Assessment of the canal anatomy of the premolar teeth in a selected Turkish population: a cone-beam computed tomography study

BACKGROUND

Teeth may have additional roots and a different number of root canals. Overlooked root canals may cause endodontic failure. The aim of this study was to investigate the prevalence of root canals and the number of roots of premolars in a selected Turkish population.

MATERIALS AND METHODS

A total of 2,570 teeth from 1,438 patients were evaluated. The cone-beam computed tomography scans of 1,055 maxillary and 1,515 mandibular premolars were examined.

RESULTS

Type IV root canal morphology was observed most frequently in maxillary first premolars (77%), and the rates of single and double channel formations were very similar (51% and 49%, respectively). Of the second maxillary premolars, 57.4% had Type I morphology, and 89.9% of the teeth were single-rooted, while 68.6% had a single root canal. The most common formation was Type I (85%) among mandibular first premolars, and a single root was observed in 95.6% of these teeth. In addition, 87% of the mandibular first premolars had a single root canal. The second mandibular premolars mostly had Type I (95.4%) formation, and 99.3% of the teeth were single-rooted, while 96.9% had a single root canal.

CONCLUSION

According to our findings, 51% of maxillary first premolars had a single root, 79.4% had two root canals, and 77% had Type IV (77%) formation. Maxillary second premolars mostly had Type I formation. In addition, a single root and single root canal formation were most common. Mandibular first premolars generally had a single root and single root canal formation, but 13% had two root canals, and 6.4% had Type V formation. More than 95% of mandibular second premolars had Type I formation.

A retrospective pilot study of correlation of first maxillary premolar root trunk length with age and gender: a cone beam computed tomography study

BACKGROUND

Root trunk length (RTL) plays an important role in the diagnosis, prognosis and treatment of periodontitis. The aim of this retrospective pilot study was to evaluate the RTL of first maxillary premolar and to study the correlation with age and sex in this value.

METHODS

The sample included 110 cone beam computed tomography (CBCT) images comprising 220 maxillaries first premolars from systemically healthy patients aged between 18 and 70 years. The tooth length (TL), root length (RL) and RTL were measured (dependent variables). Age and sex were considered as independent variables.

RESULTS

No statistically significant correlation was found between the RTL and the TL. Longer RL and longer RTL were observed in younger patients than older subjects only in the left maxillary premolars. On the other hand, the sex of the patients had no effect on either of the dependent variables. The single rooted maxillary premolars were more frequent (relative to those with two roots) in woman and in elderly patients.

CONCLUSIONS

A correlation between the age and the RTL and RL has been found but only in left premolars. Sex seemed to have only a slight correlation on the frequency of single-rooted teeth of the right side of the mouth. Further studies should be addressed to clarify the significance of the asymmetries observed in the present study between the two sides of the mouth with the aim of deepening the knowledge and understanding of the different variables that could be correlated with the RTL.

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.

The radiculous' premolars: Case reports of a maxillary and mandibular premolar with three canals

Successful root canal therapy requires an accurate diagnosis and management of complex root canal morphology. Although the occurrence of three root canals in maxillary and mandibular premolars is very rare, the clinician must be able to identify it clinically and radiographically to make the necessary changes in his shaping and obturation techniques. We present the endodontic management of a maxillary first premolar with three separate roots and canals, which was diagnosed with the aberrant anatomy only after the access preparation. Then, a mandibular premolar with three root canals and fused roots, which were diagnosed radiographically, is presented. The necessary modifications of the routine clinical steps and the application of dental operating microscope for successful management of the complex anatomy, with emphasis on access modifications and radiographic interpretations are also explained. Teeth with extra roots and/or canals pose a challenge in clinical management. Identifying them early is necessary to facilitate appropriate modifications in treatment protocol, armamentarium to be used and plan optimal number of treatment sittings.

Anatomic study of the buccal root with furcation groove and associated root canal shape in maxillary first premolars by using micro-computed tomography

INTRODUCTION

The purpose of this study was to investigate the buccal root anatomy of bifurcated maxillary first premolars with furcation grooves and to determine the correlation between the groove depth and the buccal root canal shape by using micro-computed tomography.

METHODS

Thirty-six bifurcated maxillary first premolars with furcation grooves were obtained from native Chinese individuals aged 17-25 years and scanned by micro-computed tomography. Basic parameters including the groove length, depth, and location were recorded. The wall thickness at different portions of the buccal roots was measured by using a customized application framework in MeVisLab software. The root canal shape was quantified by the form factor, and the correlation between the mean form factor and the maximum groove depth was analyzed.

RESULTS

The minimum wall thickness was less on the palatal aspect (<1 mm) than on the buccal aspect of the coronal two thirds of the buccal roots. The mean form factor value ranged from 0.72-0.91 and correlated negatively with the maximum groove depth (ρ(2) = -0.641, P < .001).

CONCLUSIONS

The irregular wall thickness of buccal roots of bifurcated maxillary first premolars with furcation grooves and the related changes in the root canal shape should be considered during endodontic and prosthetic treatment.

Furcation groove of maxillary first premolar, thickness, and dentin structures

INTRODUCTION

Few studies mention the presence of furcation grooves in the palatal aspect of buccal roots in upper first premolars. Anatomic characteristics like external grooves or root curvatures predispose teeth to weakening during post placement. Roots with a large number of external sulci show more canal variations. Previous research found that the palatal wall is on average less than 1mm. There is a direct relation between the volume of dental structures and the capacity to resist occlusal loads. The purpose of this study was to evaluate the changes in dentin thickness and structures adjacent to the furcal groove.

METHODS

The percentage that represented furcation groove in the buccal root was specified. The sample size selected was n=20. Three horizontal slices were made to the buccal root, coronal, middle, and apical. The angles of the grooves and dentin thickness were measured with a profile projector.

RESULTS

In the coronal third, the depth of the groove was correlative with dentin thickness negatively, ie, while the depth increased, palatal dentin thickness decreased or vice versa. In the coronal and middle thirds, the palatal wall showed average dentin width smaller than the buccal. In some cases, the thickness was less than 1mm. In the apical third, palatal dentin thicknesses showed higher averages than the buccal. Structural changes were observed in dentin adjacent to the furcation groove. These results are discussed in the context of other research. Methodologic differences do not enable comparative studies.

CONCLUSIONS

Dentin thickness corresponding to the furcal groove is variable; it presents structural changes and must be taken into account in endodontic and prosthetic procedures.