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Cross-sectional root canal shape (a) and images (b) of maxillary first premolar. A, round; B, oval; C, long oval; D, flat; E and F, irregular shape; E, triangle; F, “8” figure; G, semilunar.
Source publication
Objectives:
To investigate the root morphology and root canal anatomy of maxillary first premolar using microscopic computed tomography (micro-CT).
Methods:
324 maxillary first premolars were collected and scanned. The root and canal diameter, canal wall thickness, root taper, and cross-sectional shapes were determined in the single root with 1...
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This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access w...
Citations
... Com a microscopia também pode atuar como um facilitador para encontrar as variações e orifícios adicionais dos condutos radiculares. (Estrela, et al., 2015;Hajihassani, et al., 2017;Ingle, 2008;Liu X, et al., 2019;Plotino, et al., 2016). ...
... Mas, com a tomografia computadorizada de feixe cônico, microscopia, e uma boa abertura coronária, podem auxiliar em uma análise detalhada dos aspectos anatômicos da câmara pulpar (Estrela, et al., 2015;Hajihassani, et al., 2017;Ingle, 2008;Liu X, et al., 2019;Guimarães, et al., 2020;Rodrigues, et al., 2016). Conforme podemos constatar nesse relato, que só foi possível identificar o canal extra, a partir do acesso coronário. ...
A endodontia tem como propósito, conter as alterações da polpa e periápice, através do preparo biomecânico, que com instrumentais e soluções irrigadoras, desinfecta os condutos radiculares. Esse trabalho tem como propósito descrever um caso clínico de um tratamento endodôntico em um primeiro pré-molar superior com três condutos radiculares. Paciente compareceu a clínica queixando-se de dores espontâneas na região do dente 24. No exame clínico e radiográfico, constatou-se uma restauração insatisfatória e a existência de infiltração. Após a realização do teste térmico e de percussão, levou-se ao diagnóstico de pulpite irreversível sintomática. Na primeira sessão houve a realização do acesso coronário, expondo todos os canais e podendo observar o terceiro canal. Depois da neutralização da câmara pulpar, colocou-se uma medicação intracanal e provisório. Na segunda sessão, teve a instrumentação dos canais radiculares, obtendo como instrumento de memória dos canais vestibulares a lima #35, e #40 no palatino, como também a obturação de todos os condutos. A existência de três canais radiculares no primeiro pré-molar superior tem pouca predominância, mas é importante que o profissional saiba sobre as prováveis alterações na anatomia, mesmo essas não sendo constantes, já que podem alterar o êxito da pulpectomia. A maneira eficiente de condução desse caso é designada a um conhecimento prévio da anatomia interna dos dentes e suas possíveis alterações, seguidas de um assertivo acesso coronário e forma de contorno/conveniência, permitindo a localização dos canais presentes.
... Convencionalmente el control de la cantidad de tejido dentinario eliminado es realizado mediante radiografías periapicales a través de la medición del espesor dentinario a nivel mesial y distal (Souza et al., 2008), sin embargo, el método radiográfico tiene la limitación de presentar una imagen en dos dimensiones de una estructura tridimensional, la cual podría producir la sobreestimación de la medida del espesor de la raíz residual durante la preparación para poste debido a la superposición de estructuras y con ello provocar un adelgazamiento de las paredes o la perforación radicular (Liu et al., 2021;Mangal et al., 2018). Además, esta mala interpretación en la medición podría incrementarse debido a las características anatómicas externas de los dientes, como los primeros premolares superiores, los cuales presentan depresiones y concavidades en su superficie (Ahmad & Alenezi, 2016;Liu et al., 2019Liu et al., , 2021 . Diversos estudios han evaluado el espesor dentinario empleando la tomografía volumétrica de haz cónico luego del uso de instrumentación rotatoria para la preparación de poste en las zonas de peligro (Azimi et al., 2020;Harandi et al., 2017;Mangal et al., 2018), evidenciando que este método presenta precisión diagnóstica clínicamente aceptable (Bunn et al., 2020). ...
he investigation´s objective was to determine the influence of external morphology of the root of upper first premolars in the existence of radiographic overestimation during preparation for post. An in vitro cross-sectional study was carried out, where 60 single-rooted upper premolars were instrumented with burs. Gates Glidden and Pesso of caliber 1, 2 and 3, then, digital radiographic images of each dental piece were obtained by means of a positioning device at a constant distance in the buccolingual direction; volumetric tomographic images of the samples were also performed. In both imaging techniques, the mesial and distal thickness of the pieces was measured. The overestimation was calculated by the difference of the tomographic measurement minus the radiographic one. The results indicated that in both root walls there was a significant difference between the radiographic and tomographic measurements (p<0.05), with highly significant differences being found in the distal wall (p<0.001); In addition, it was evidenced that the radiographic overestimation was greater in the distal wall. The study concluded that there is radiographic overestimation in upper premolars during post preparation of 20.42% on average, with the distal wall being the structure that presents the greatest overestimation.
... Biol., Salvador, v. 22, n. 1, p. 24-29, jan./abr. 2023 in root morphology, and multiple canals, thus increasing the difficulties faced by the endodontist 7 . As for channel morphology, Vertucci et al. 6 (1984) reported in their studies that 75% of the maxillary second premolars studied had a single foramen, 24% had two foramina and 1% had three foramina 6 . ...
... This classification helped in the mastery of these canals, positively impacting endodontic treatments. Using this scientific support, this classification continues to be the most used until today for studies of anatomical variations, being able to classify this relationship into 8 types: root and canal 6,7 . ...
Introduction: Root canal cleaning is the main objective of endodontic treatment and requires knowledge of the internal anatomy. The premolars are evidenced in the literature with great anatomical variations. In view of this, studies indicate that the use of Cone Beam Computed Tomography helps in the visualization of highly complex anatomy. Objective: to describe the anatomical variations in maxillary and mandibular premolars using cone beam computed tomography in a radiologic clinic in Piaui. Methods: 54 cone beam computed tomography scans with 160 premolars were used, produced using the Orthopantomograph OP300 equipment and analyzed by multiplanar reconstructions: axial, coronal and sagittal. Data regarding sex, number of roots and canals were recorded to compare and classify according to Vertucci. Results: the maxillary first pre-molars had 63.5% two roots,83.7% with one root and the mandibular pre-molars mostly with one root. Regarding the number of channels, 92.3% of the first premolars had two channels, most of them maxillary second premolars and mandibular premolars only one channel. Vertucci variations of types I, II, III and IV were verified in single-rooted elements, observing a great variation in superior elements. As for the prevalence of sex, only the first superiors showed greater variation in males. Conclusions: the upper first premolars prevailed with a great anatomical variation in relation to the other premolars with prevalence of Vertucci Type I and in males.
... In this study, we did not nd a statistical difference between male and female patients in the number of roots in maxillary rst premolars in the east of China. However, in a similar study of Chinese, in which the samples were collected in the north of China, a signi cant difference could be seen in the number of roots in maxillary rst premolars [34]. Knowing the number of roots of the maxillary rst premolar helps the doctor avoid missing roots during root extraction and provides force during orthodontic operations. ...
The aim of this research was to study the anatomical shape of the maxillary first premolars in Chinese people using cone-beam computed tomography (CBCT). The anatomical morphology of root canals and crowns of 637 first premolars from China was observed by CBCT. In this study, 73.3% of the 637 maxillary first premolars were single roots, 26.7% were double roots, and 41.8%(n = 266) of the 637 maxillary first premolars were type IV in the light of Vertucci. The most frequent distance between two root canal orifices was 2-3mm (n = 257, 47.6%). There was a range in distance from the top of the medullary chamber to the central fossa (from 4.25mm to 4.45mm), with a mean distance of 4.35 ± 0.62mm. The incidence of mesial depression was 65.6%, and the mean angle of the mesial depression was 151.8 ± 10.5 degrees. In conclusion, the root canal system and anatomical morphology of the maxillary first premolar in the Chinese population exhibit a wide range of morphologies based on CBCT.
... The root canal treatment of maxillary first premolars could present a challenge even for the most experienced endodontists due to the variations in their anatomy, including: the number of roots; the number of canals; the differences in canal and pulp chamber configurations; the various longitudinal and directional depressions on the roots; and the difficulty in visualization of the apical anatomy on radiographs [16][17][18][19]. A maxillary first premolar is the only tooth that can exhibit all eight types of Vertucci's classification (20). ...
Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned , bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems .
... Wolf et al., 2020 [15] Micro CT 115 (maxillary first premolars) Swiss German Two roots most predominant (70) Liu et al., 2019 [16] Microscopic CT 324 (maxillary first premolars) Chinese adolescents ...
Background:
There have been numerous cone-beam computed tomography (CBCT) studies done over the years to analyze the canal configurations among various racial and ethnic population groups. Several of these studies have highlighted a certain consistency in the incidence of particular features within these population subsets.
Aim:
The study aimed to analyze the root morphology and canal configurations of the maxillary first premolar (Mx1PM) in the Indian Dravidian subpopulation using CBCT.
Setting and design:
This study involved a retrospective analysis of 200 CBCT scans, which included 400 Mx1PM.
Methods:
The CBCT images were evaluated, and the number of roots and canal configurations was recorded as per the Vertucci's classification.
Statistical analysis:
Variations in the number of roots and canal anatomies were statistically interpreted using the Chi-square test of association with the significance level set at P < 0.05.
Results:
Among the 400 Mx1PM studied, 116 (29%) teeth displayed single roots and 284 (71%) showed the presence of two roots. The single-rooted premolars revealed a varied canal configuration with a predominance of Vertucci's Type II configuration in around 53.4% of the Mx1PM. The two-rooted premolars revealed 100% Type I canal configuration.
Conclusion:
The Mx1PM studied predominantly showed the two-rooted morphology with independent canals in each root. There was no significant difference between the teeth on either side of the same arch. The CBCT is an excellent nondestructive modality that can help us study the internal anatomy of pulp space accurately.
... Micro-CT is a nondestructive approach that reconstructs samples on a micrometric and real scale. [11] It is considered the gold standard research device in endodontics for studying the root canal anatomy, [12] the quality of shaping and cleaning processes, [13] the performance of different obturation techniques, [14] and the removal of root canal filling materials, [6] because it allows accurate qualitative and quantitative analyses to be performed in multiple planes and at different time frames, when needed. Herein, micro-CT was initially used to limit the impacts of anatomical complexity, because it allowed selecting 36 specimens with very similar flattened distal roots and root canals, based on the following features: complete root apex, with a curvature of up to 20° in the BL and MD directions, and without previous endodontic treatment or root resorption, in addition to specific numerical parameters, such as volume (mm 3 ) -7.23-7.73; ...
Background:
The effectiveness of endodontic retreatment essentially depends on the cleaning and/or disinfection processes. In this context, the removal of root canal filling materials plays a crucial role.
Aims:
To assess the efficacy of passive ultrasonic irrigation (PUI), EndoActivator system (EAS), and XP-endo Finisher R (XPEFR) as additional cleaning techniques to remove the remaining root canal filling materials from flattened root canals.
Subjects and methods:
Thirty-six similar flattened distal root canals of extracted human first lower molars were selected by micro-computed tomography (micro-CT) and then instrumented and filled. After the initial retreatment procedures, the residual volume of root canal filling materials was assessed by micro-CT (V1). Then, the specimens were divided into three groups (n. 12), according to the additional cleaning technique and submitted to another micro-CT scan (V2).
Statistical analysis used:
Analysis of variance and Games-Howell tests (P < 0.05).
Results:
The percentage reduction in the residual volume of root canal filling materials reached by PUI, EAS, and XPEFR was 28.38%, 28.12%, and 43.52%, respectively, considering the total space of the root canal (P > 0.05). In the apical third, these values were 20.05%, 21.54%, and 48.82% (P < 0.05).
Conclusions:
Additional cleaning techniques enabled removing a greater amount of root canal filling material from flattened distal root canals of extracted human first lower molars. Considering the total space of the root canal, there were no statistically relevant differences among the groups. In the apical third, XPEFR performed better.
... This technology (l-CT) is more accurate diagnostic tool compared with other radiographic techniques without the need of preparation, sectioning or destruction of the specimens (Rhodes et al., 1999, Peters et al., 2000, Versiani et al., 2012. Few studies investigated the morphology of maxillary first premolars by means of l-CT (Liu et al., 2019, Wolf et al., 2020 in Chinese and Swiss-German population. ...
... In the current study, it was found that 57 % of maxillary first premolars had a single root. This finding was higher than other studies (Vertucci, 1984, Zaatar et al., 1997, Awawdeh et al., 2008, Abella et al., 2015, Wolf et al., 2020 and lower than the study of Liu et al. (2019). On other hand, the percentage of tworooted maxillary first premolars in this study was 41 %, which showed a slightly lower percentage than studies conducted in Middle East, Europe and China (Zaatar et al., 1997, Kartal et al., 1998, Awawdeh et al., 2008, Abella et al., 2015, Wolf et al., 2020. ...
Aim
The aim of this in vitro study was to investigate the root and root canal morphology of maxillary first premolar teeth in a Kuwaiti population using micro–computed tomography (μ- CT).
Materials and methods
A total of 100 maxillary first premolars were scanned in a micro– computed tomographic device. The external anatomy (number of roots, distance from cementoenamel junction to apex, and presence of a palatal groove) and internal anatomy (number of canals and presence of apical deltas, lateral canals, and isthmi) of teeth were analyzed using descriptive analysis.
Results
The number of roots was one root (57%), two roots (41%), and three roots (2%). The longest and shortest roots measured 17.7 and 11.2 mm, respectively. The palatal groove was present in 63.4% of the teeth. According to Vertucci’s classification, type IV configuration was the most prevalent (53%), followed by type II. A new root canal configuration type (1-2-1-2-1) was detected. Apical deltas, lateral canals, and isthmi were present in 33%, 48%, and 21% of teeth, respectively.
Conclusion
Type IV canal configuration was the most common root canal configuration. A new root canal configuration type IX for (1-2-1-2-1) was proposed for Kuwaiti population. The μ-CT device could to be a better diagnostic tool for understanding the anatomy of the root canal system.
... Hence, a profound and correct experience about the regular and variable root canal system anatomy is crucial for successful endodontic therapy [2]. Several studies were performed to explore maxillary first premolar teeth' root and canal morphology; those studies showed significant alterations according to ancestry and geographic origins [3][4][5][6]. Unfortunately, root canals are left untreated when the dentist fails to locate them, particularly in teeth with additional root canals [7]. ...
... Similar results were found in previous studies conducted in Saudi Arabian subpopulations, Jordanian population, and Turkish populations, which also observed a higher prevalence of two roots followed by one root than three roots [19,28,[37][38][39][40]. Some studies showed results that were near to our findings regarding the prevalence of the number of roots with a slight variation in the percentage of the number of roots, like the studies that have been conducted in Saudi, North America, Andalusia, Singapore, Turkey, Poland, Ugandan, San Sebastian, southern India, and Australia population [5,17,21,[41][42][43][44][45][46][47][48]..On the contrary, studies in the Shandong Chinese population showed a higher prevalence of one-rooted than two-rooted maxillary first premolar [6,49]. Other studies also contradict our study, which has been done in north India, Yemen, Seri Lankan, Japan, China, Brazil, and the Iranian population [27,35,36]. ...
... The type IV root-canal morphology was the most common type seen in the present study and the similar studies reviewed in the literature but with variations in the percentage and frequency-specific for different kinds of canal configurations [36][37][38][39][40], except in the teeth with the three roots which showed only type VIII. This result agrees with Wu et al. [49], Liu et al. [6], Senan et al. [35], and Asheghi et al. [36], who found type VIII in all three rooted maxillary first premolar. ...
Background
A thorough understanding of the original root and canal anatomy is a critical technical prerequisite for performing cleaning and shaping treatments. Therefore, this research aimed to characterize maxillary first premolar teeth' root morphology and canal architecture.
Methods
One hundred forty-two extracted human adult maxillary first premolar teeth have been retrieved. The extracted teeth were thoroughly cleaned and irrigated to eliminate any remaining debris or blood. They were then preserved in formalin solution until they were eligible for screening. To begin, a visual examination was employed to ascertain the number of roots and their geometry in each sample. Then, utilizing digital radiography in two plains, mesiodistal and distomesial, to further determine those parameters. Finally, a sectioning technique had been used to have the samples cut mesiodistally into slices to validate the internal root canal architecture and identify the number of root canals and their varieties in accordance with Vertucci's categorization system. The canal layout, the pulp chamber, and the root canals were all highlighted (marked) using a fine tip marker in a permanent orange hue to make the canal features more accessible and accurate to visualize. All of the processes were conducted by two highly qualified dentists. The sample size was estimated statistically using the Sealed Envelope program, and the percentage of each configuration was derived in proportion to the overall sample size in order to establish the percentage of each type in each configuration.
Results
From the 142 teeth examined, 42 (29.57%) had one root, 97 (68.31%) had two roots, and only three premolars (2.12%) had three roots. Concerning canal configurations, 100 teeth (70.43%) had type (IV) canal configuration, followed by 37 teeth (26.05%) had types (V), three teeth (2.12%) had type (VIII), and one tooth (0.70%) for each of type (I) and type (II).
Conclusions
The anatomical pattern of inspected maxillary first premolars are mainly two rooted and predominantly have a type (IV) canal morphology.
... Saber et al., (2019) avaliaram 700 pré-molares superiores extraídos e encontraram uma prevalência de 1,4% de dentes com 3 canais radiculares. Uma prevalência semelhante também foi encontrada por Liu et al., (2019) com 1,23% dos dentes com configuração do tipo VIII. Nesse estudo apresentamos um caso de primeiro pré-molar superior com duas raízes e três canais separados. ...
Resumo O presente estudo tem como objetivo relatar uma série de casos clínicos do tratamento endodôntico de dentes pré-molares superiores e inferiores apresentando três canais radiculares, com auxílio da magnificação e modernas técnicas operatórias da terapia endodôntica. O tratamento endodôntico desses dentes foi baseado na avaliação radiográfica criteriosa e o acesso realizado com uso da magnificação, o que permitiu a localização dos orifícios dos canais radiculares e a condução do tratamento endodôntico. O preparo químico-mecânico foi realizado com instrumentos de níquel-titânio mecanizados (X1-Blue) associados à solução irrigadora hipoclorito de sódio a 2,5%. Como protocolo auxiliar na limpeza final foi realizada uma irrigação ultrassônica passiva (PUI). Ao final empregou-se a técnica de obturação com cone único associado ao cimento endodôntico. A presença de três canais radiculares nos pré-molares tem uma prevalência baixa, no entanto é de suma importância o conhecimento do profissional acerca das possíveis variações anatômicas, visto que isso pode influenciar no sucesso do tratamento endodôntico. Dada as limitações, o correto manejo desses casos pode ser atribuído a uma boa avaliação radiográfica, ao uso da magnificação e de critérios clínicos que, juntos, ajudaram a obter o melhor resultado possível. Palavras-chave: Pré-molar; Canal radicular; Variação anatômica.
