• Imaging Science in Dentistry
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• v.44 no.3
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• pp.221-227
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• 2014

Purpose: This study aimed to investigate the clinical anatomy of lower premolar roots in a Spanish population by using cone-beam computed tomography (CBCT), correlating findings with patient gender and tooth type. Materials and Methods: Using 70 CBCT images, we evaluated 126 healthy, untreated, well-developed lower premolars. The number and morphology of roots and root canals, and the foramina number were assessed. Results for gender and tooth type were compared using the chi-squared and ANOVA tests. Results: The average length of teeth and roots was significantly higher in men (p=0.00). All 126 premolars had a single root. One canal was found in 83.3% of the premolars, with no gender or tooth type differences; Vertucci configuration types I and V were the most prevalent. The first premolars showed significantly greater variability than the second premolars (p=0.03). A single apical foramen was found in 89.7% of the premolars, with no differences by tooth type. Women had a significantly higher prevalence of two apical foramina than men (p=0.04). Some degree of curvature was observed in 65% of the premolars, with no differences by gender or tooth type. A root angle of more than $20^{\circ}$ was found in 12.98% of the premolars, without any differences by gender or tooth. Conclusion: All premolars were single-rooted. One canal had the most prevalent morphology. More variability in canal anatomy was found in the first premolars. Curvatures greater than $20^{\circ}$ were found at less than 5 mm from the apex.

• Restorative Dentistry and Endodontics
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• v.4 no.1
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• pp.23-27
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• 1978

Fifty two mandibular permanent canines were chosen to study the anatomy of the root canal. The experimental teeth were injected with China ink, decalcified, cleared and observed to investigate the number of root canals, frequency and location of lateral canals, the location of apical foramens, the frequency of apical deltas, and the curvature of root canals. The results were as follows: 1) all of the experimental teeth demonstrated single canal. 2) of the 52 canals, 9.6% of the canals were found to have lateral canals and the locations of the lateral canals were in the apical third of the roots 3) Thirty three apical foramens were located laterally on the root apices and nineteen foramens were located on the centers of the root apices. 4) 37 canals showed straight curvature, 12 canals distal curvature. 3 canals labial curvature.

• Restorative Dentistry and Endodontics
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• v.43 no.2
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• pp.16.1-16.9
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• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.563.2-563
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.554-554
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.95-101
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• 2015

Purpose: This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods: We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results: The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion: In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.574.1-574
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• 2001

Maxillary first molar, the "6-year molar", is the tooth largest in volume and most complex in root and root canal anatomy. Therefore, maxillary first molar is possibly the most treated, least understood. It is the posterior tooth with the highest endodontic failure rate and unquestionably one of the most important teeth. The earliest permanent posterior tooth to erupt, the mandibular first molar seems to be the most frequently in need of endodontic treatment.(omitted)

• Restorative Dentistry and Endodontics
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• v.5 no.1
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• pp.47-51
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• 1979

Fifty two human mandibular second molars were chosen to study the anatomy of the root canal. The experimental teeth were injected with china ink, decalcified, cleared and used in study, in vitro, to determine the number of root, the number of root canals, canals per root, frequency and location of transverse anastomoses, frequency and location of lateral canals and frequency of the apical deltas. The results were as follows; 1. Most of the teeth showed three canals, but 19.2% of the teeth were found to have two canals and 9.6% of them four canals. 2. In so far as observing two canals per root, 80.8% of the teeth were found to have two canals in mesial root and 9.6% of them in distal canal. 3. In roots with, two canals, the seperated apical foramen appeared in 59.5% in mesial side and 40.0% in distal side, and the common apical foramen appeared in 40.5% in mesial side and 60.0% in distal side. 4. Of the two root canals in one root, 36.2% of the canals were found to have transverse anastomoses and were usually located in the apical third of the root. 5. 23.1% of 52 teeth were found to have lateral canals, and ramifications were mainly located in the apical third of the root.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.383-388
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• 2021

Purpose: The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. Materials and Methods: Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. Results: The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant(P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. Conclusion: Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

• Restorative Dentistry and Endodontics
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• v.48 no.2
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• pp.17.1-17.8
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• 2023

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.