Your SlideShare is downloading. ×
Tooth anatomy
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Tooth anatomy

1,854
views

Published on


0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
1,854
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
63
Comments
0
Likes
2
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. ENDO ACADEMYMay,  2013;Vol  5  -­‐  Tooth  Anatomy Root and Root Canal Morphology of the Human Permanent Maxillary First Molar: A Literature Review Blaine M. Cleghorn, DMD, MS, William H. Christie, DMD, MS, FRCD(C), and Cecilia C.S. Dong, DMD, BSc (Dent), MS, FRCD(C) Abstract The  objec�ve  of  this  study  was  to  review  the  literature  with  respect  to  the  root  and   canal  systems  in  the  maxillary  first  molar.  Root  anatomy  studies  were  divided  into   laboratory  studies  (in  vitro),  clinical  root  canal  system  anatomy  studies  (in  vivo)  and   clinical  case  reports  of  anomalies.  Over  95%  (95.9%)  of  maxillary  first  molars  had  three   roots  and  3.9%  had  two  roots.  The  incidence  of  fusion  of  any  two  or  three  roots  was   approximately  5.2%.  Conical  and  C-­‐shaped  roots  and  canals  were  rarely  found  (0.12%).   This  review  contained  the  most  data  on  the  canal  morphology  of  the  mesiobuccal  root   with  a  total  of  8399  teeth  from  34  studies.  The  incidence  of  two  canals  in  the   mesiobuccal  root  was  56.8%  and  of  one  canal  was  43.1%  in  a  weighted  average  of  all   reported  studies.  The  incidence  of  two  canals  in  the  mesiobuccal  root  was  higher  in   Key Words laboratory  studies  (60.5%)  compared  to  clinical  studies  (54.7%).  Less  varia�on  was   found  in  the  distobuccal  and  palatal  roots  and  the  results  were  reported  from  fourteen   studies  consis�ng  of  2576  teeth.  One  canal  was  found  in  the  distobuccal  root  in  98.3%   of  teeth  whereas  the  palatal  root  had  one  canal  in  over  99%  of  the  teeth  studied.  (J   Endod  2006;32:813–821)
  • 2. The Influence of Cavity Design and Glass Fiber PostsMay,  2013;Vol  5  -­‐  Tooth  Anatomy on Biomechanical Behavior of Endodontically Treated Premolars Carlos Jose Soares, DDS, MS, PhD, Paulo Vinicius Soares, DDS, MS, et al Abstract The  aim  of  this  study  was  to  evaluate  the  effect  of  cavity  design  and  glass  fiber  posts  on  stress   distribu�ons  and  fracture  resistance  of  endodon�cally  treated  premolars.  Fi�y  extracted   intact  mandibular  premolars  were  divided  into  5  groups  (n=10):  ST,  sound  teeth  (control);   MOD,  mesio-­‐occlusal-­‐distal  prepara�on    +  endodon�c  treatment  (ET)    composite  resin   restora�on  (CR);  MODP,  mesio-­‐occlusal-­‐distal  +  ET  +  glass  fiber  post    CR;  MOD2/3,  mesio-­‐ occlusal-­‐distal    two  thirds  occlusal-­‐cervical  cusp  loss  +  ET    CR;  and  MODP2/3,  mesio-­‐occlusal-­‐ distal    two  thirds  cusp  loss  +  ET  +  glass  fiber  post    CR.  The  specimens  were  loaded  on  a  cusp   slope  un�l  fracture.  Fracture  pa�erns  were  classified  according  to  four  failure  types.  Stress   distribu�ons  were  evaluated  for  each  group  in  a  twodimensional  finite  element  analysis.  The   fracture  resistance  of  the  MODP,  MOD2/3,  and  MODP2/3  groups  was  significantly  lower  than   the  ST  and  MOD  groups  (p<0.05).  The  loss  of  dental  structure  and  the  presence  of  fiber  post   restora�on  reduced  fracture  resistance  and  created  higher  stress  concentra�ons  in  the  tooth-­‐ restora�on  complex.  However,  when  there  was  a  large  loss  of  dental  structure  (MODP2/3),   the  post  reduced  the  incidence  of  catastrophic  fracture  types.  (J  Endod  2008;34:1015–1019) 2
  • 3. Residual Dentin Thickness in Bifurcated MaxillaryMay,  2013;Vol  5  -­‐  Tooth  Anatomy Premolars After Root Canal and Dowel Space Preparation Alexander Katz, DMD, Silvia Wasenstein-Kohn, DMD, Aviad Tamse, DMD, and Ofer Zuckerman, DMD Abstract   Residual  den�n  thickness  in  25  extracted  bifurcated  maxillary  premolars  a�er  canal  and  Parapost   prepara�on  was  assessed  using  acrylic  muffle,  a�er  embedding  in  polyester  resin  and  sec�oned   horizontally.  A�er  each  procedure,  the  residual  den�n  thickness  was  compared  to  the  original  den�n   thickness  at  eight  aspects  in  three  root  levels.  Residual  den�n  thickness  measurements  were   calculated  using  photographs  and  a  Digi�zer.  In  the  lingual  aspect,  the  original  den�n  thickness   averaged  0.99  mm  (coronal  slice)  and  0.78  mm  (middle  slice).  Den�n  removal  a�er  dowel  prepara�on   was  31%.  Three-­‐way  ANOVA  with  repeated  measures  was  used.  The  difference  in  residual  den�n   thickness  was  highly  significant  regarding  procedure  (canal  and  dowel  prepara�on,  p  <0.0001),  slice   (middle,  coronal,  p  <0.0001),  and  the  eight  aspects  (p  <0.0001).  This  in  vitro  study  emphasizes  the   minimal  den�n  width  of  the  buccal  root,  especially  towards  the  bifurca�on.  Thus,  dowels  should  be   avoided  in  this  root.  (J  Endod  2006;  32:202–205) in Response to Pathologic Conditions and Treatment Procedures Domenico Ricucci, MD, DDS, and Jose´ F. Siqueira Jr, DDS, MSc, PhD Abstract Introduc�on:  This  ar�cle  reviews  and  reports  on  the  histopathologic  and   histobacteriologic  status  of  the  �ssue  in  lateral  canals  and  apical  ramifica�ons  (LC/AR)   in  diverse  clinical  condi�ons  as  well  as  in  response  to  endodon�c  treatment.  Methods:   In  total,  serial  sec�ons  from  493  human  tooth  specimens  obtained  by  extrac�on  or   apical  surgery  were  screened  for  the  presence  of  LC/  AR.  Results:  LC/AR  were   observed  in  about  75%  of  the  teeth.  In  clinically  vital  teeth,  vital  �ssue  was   consistently  found  in  LC/AR.  In  teeth  with  periodontal  disease,  the  whole  pulp  became   necro�c  only  when  the  subgingival  biofilm  reached  the  main  apical  foramen.  In  teeth   with  pulp  exposure  by  caries,  the  �ssue  in  LC/AR  remained  vital  as  far  as  the  pulp   �ssue  in  the  main  canal  did  so.  When  pulp  necrosis  reached  the  level  of  the  LC/  AR,   the  �ssue  therein  was  either  par�ally  or  completely  necro�c.  Chemo-­‐mechanical   prepara�on  par�ally  removed  necro�c  �ssue  from  the  entrance  of  LC/AR,  whereas   the  adjacent  �ssue  remained  inflamed,  some�mes  infected,  and  associated  with   periradicular  disease.  Vital  �ssue  in  LC/AR  was  not  removed  by  prepara�on.  In  cases  in   which  lateral  canals  appeared  radiographically  ‘‘filled,’’  they  were  actually  not   obturated,  and  the  remaining  �ssue  in  the  ramifica�on  was  inflamed  and  enmeshed  with  the  filling  material.  Conclusions:  Overall,   the  belief  that  lateral  canals  must  be  injected  with  filling  material  to  enhance  treatment  outcome  was  not  supported  by  literature   review  or  by  our  histopathologic  observa�ons.  It  appears  that  strategies  other  than  finding  a  technique  that  be�er  squeezes  sealer   or  gu�a-­‐percha  within  LC/AR  should  be  pursued  to  effec�vely  disinfect  these  regions.  (J  Endod  2010;36:1–15) A 5 Yr Clinical Investigation of Second Mesiobuccal Canals in Endodontically Treated and Retreated Maxillary Molars James Wolcott, DDS, Dave Ishley, DDS, MS, et al Abstract An  examina�on  of  5616  endodon�cally  treated  and  retreated  maxillary  first  and  second  molars   was  made  in  an  a�empt  to  determine  the  percentage  of  MB2  canals  that  could  be  located   rou�nely,  and  evaluate  if  there  were  any  significant  differences  between  ini�al  treatments  and   retreatments.  The  teeth  examined  were  3578  first  molars  and  2038  second  molars  treated   consecu�vely  over  a  5-­‐yr  period  by  six  endodon�sts.  Overall  the  MB2  canal  was  found  in  2133   (60%)  first  molars,  and  712  (35%)  second  molars.  The  incidence  of  a  MB2  canal  in  first  molar   retreatments  was  66%  compared  to  a  58%  incidence  in  ini�al  treatments.  Whereas  in  second   molars  the  retreatment  incidence  was  40%  compared  to  34%  in  ini�al  treatments.  The  significant   difference  in  the  incidence  of  a  MB2  canal  between  ini�al  treatments  and  retreatments  suggests   that  failure  to  find  and  treat  exis�ng  MB2  canals  will  decrease  the  long-­‐term  prognosis. 3
  • 4. Morphology of the Physiological Foramen:May,  2013;Vol  5  -­‐  Tooth  Anatomy I. Maxillary and Mandibular Molars Brita Willershausen-Zo¨ nnchen, Prof. Dr. med.dent. Abstract   Informa�on  concerning  the  anatomy  of  the  physiological  foramen  is  limited.   The  aim  of  this  study  was  to  inves�gate  the  distance  between  the  physiological   and  anatomical  apex,  accessory  foramina  frequency,  and  the  shape  and   diameter  of  the  physiological  foramen  in  maxillary  and  mandibular  molars.  The   apical  anatomy  of  523  maxillary  and  574  mandibular  molars  from  an  Egyp�an   popula�on  was  inves�gated  by  means  of  a  computeraided  stereomicroscope   (40  magnifica�on).  The  following  results  were  obtained:  (a)  There  was  a  high   percentage  of  two  physiological  foramina  in  mesial  (87.06%)  and  mesiobuccal   (71.15%)  roots  of  mandibular  and  maxillary  first  molars,  respec�vely.  (b)  There   was  a  high  frequency  of  accessory  foramina  in  maxillary   mesiobuccal  (33%)  and  mandibular  mesial  (26%)  roots.  (c)  The   most  common  physiological  foramen  shape  was  oval  (70%).         (d)  The  mean  of  the  narrow  and  wide  physiological  foramen   diameters  was  as  follows:  •  0.20  to  0.26  mm  in  mandibular   molars  •  0.18  to  0.25  mm  in  the  maxillary  mesiobuccal  and   distobuccal  root  •  0.22  to  0.29  mm  in  the  maxillary  palatal  root. The Radix Entomolaris and Paramolaris: Clinical Approach in Endodontics Filip L. Calberson, DDS, MMS, Roeland J. De Moor, DDS, MMS, PhD, and Christophe A. Deroose, DDS, MMS Abstract Mandibular  molars  can  have  an  addi�onal  root  located   lingually  (the  radix  entomolaris)  or  buccally  (the  radix paramolaris).  If  present,  an  awareness  and   understanding  of  this  unusual  root  and  its  root  canal   morphology  can  contribute  to  the  successful  outcome   of  root  canal  treatment.  This  report  discusses   endodon�c  treatment  of  three  mandibular  molars  with   a  radix  entomolaris  or  paramolaris,  both  of  which  are   rare  macrostructures  in  the  Caucasian  popula�on.  The   prevalence,  the  external  morphological  varia�ons  and   internal  anatomy  of  the  radix  entomolaris  and   paramolaris  are  described.  Avoiding  procedural  errors   during  endodon�c  therapy  demand  an  adapted  clinical   approach  to  diagnosis  and  root  canal  treatment.                     (J  Endod  2007;33:58  –63) 4