Pulp cavities of teeth

PULP CAVITIES OF TEETH
KOMAL GHIYA

INDEX
 INTRODUCTION
 CANAL CONFIGURATIONS:VERTUCCI’S CLASSIFCATION
 WEINE’S CLASSIFICATION
 KARTAL AND YANIKOGLU’S CANAL
 ROOT CANAL ORIFICES:LAWS
 TYPES OF ISTHMUS
 PULP CAVITIES IN PERMANENT TEETH
 PULP CAVITIES IN PRIMARY TEETH
 CONCLUSION
 REFERENCES

INTRODUCTION
REF: Endodontics: practice and principles Mahmoud Torabinejad, Richard E. Walton- 2009

INTRODUCTION
 MAJOR APICAL DIAMETER:IT
IS THE MAIN APICAL
OPENING OF THE ROOT
CANAL.IT IS FREQUENTLY
ECCENTRICALLY LOCATED
AWAY FROM THE
ANATOMIC OR
RADIOGRAPHIC APEX
 MINOR APICAL
CONSTRICTION:IT IS THE
APICAL PORTION OF RROT
CANAL HAVING
NARROWEST DIAMETER
REF:S COHEN,K HARGREAVES,PATHWAYS OF PULP,10th edition
Grossman’s endodontic practice12 th edition

CLINICAL CONSIDERATION
 CANAL PREPARATION SHOULD EXTEND APICAALY TO THE CEMENTODENTINAL
JUNCTION.THIS JUNCTION IS LOCATD AT OR NEAR THE GREATEST
CONSTRICTION(MINOR FORAMEN)OF THE APICAL FORAMEN
 THE DISTANCE OF THE MINOR DIAMETER FORAMEN FROM THE CEMENTAL
SURFACE IS AT AN AVERAGE OF 0.5 mm IN YOUNG TEETH AND 0.75 mm IN
MATURE TEETH

VERTUCCI’S CANAL CONFIGURATION
 TYPE 1:A SINGLE CANAL EXTENDS FROM THE
PULP CHAMBER TO THE APEX
 TYPE2:TWO SEPARATE CANALS LEAVE THE
PULP CHAMBER AND JOIN SHORT OF THE
APEX TO FORM ONE CANAL
 TYPE 3:ONE CANAL LEAVES THE PULP
CAHMEBR AND DIVIDES INTO TWO IN THE
ROOT,THE TWO THEN MERGE TO EXIT AS ONE
CANAL
 TYPE4:TWO SEPARATE ,DISTINCT CANALS
EXTEND FROM THE PULP CHAMBER TO THE
APEX

 TYPE5:ONE CANAL LEAVES THE PULP
CHAMBER AND DIVIDES SHORT OF
THE APEX INTO TWO SEPARATE
DISTINCT CANALS WITH SEPARATE
FORAMINA
 TYPE 6:TWO SEPARATE CANALS LEAVE
THE PULP CHAMBER,MERGE IN THE
BODY OF THE ROOT AND REDIVIDE
SHORT OF APEX TO EXIT AS TWO
DISTINCT CANALS SHORT OF THE
APEX
 TYPE7:ONE CANAL LEAVES THE PULP
CHAMBER DIVIDES AND THEN
REJOINS IN THE BODY OF THE ROOT
AND FINALLY REDIVIDES INTO TWO
DISTINCT CANALS SHORT OF APEX
 TYPE 8:THREE SEPARATE ,DISTINCT
CANALS EXTEND FROM THE PULP
CHAMBER TO THE APEX
REF:S COHEN,K
HARGREAVES,PATHWAYS OF
PULP
,10th edition

KARTAL AND YANIKOGLU’S CANAL
CONFIGURATION
 TYPE 1:TWO SEPARATE CANALS
EXTENDED FROM THE PULP
CHAMBER TO THE MIDROOT,WHERE
THE LINGUAL CANAL DIVIDED INTO
TWO;ALL THREE CANALS JOINED IN
THE APICAL THIRD OF THE ROOT
AND EXITED AS ONE CANAL
 TYPE 2:ONE CANAL LEFT THE PULP
CHAMBER DIVIDED INTO TWO IN
THE MIDDLE THIRD OF THE
ROOT,THEN REJOINED TO FORM
ONE CANAL,WHICH AGAIN SPLIT
AND EXITED AS THREE SEPARATE
CANALS WITH SEPARATE
FORAMINA

WEINE’S CLASSIFICATION
TYPE 1:SINGLE CANALFROM PULP
CHAMBER TO THE APEX
TYPE2:TWO CANALS LEAVING
FROM THE CHAMBER AND
MERGINGTO FORM A SINGLE
CANAL SHORT OF THE APEX
TYPE 3:TWO SEPARATE AND
DISTINCT CANALS FROM
CHAMBER TO THE APEX
TYPE4;ONE CANAL LEAVING THE
CHAMBER AND DIVIDING INTO
TWO SEPARATE AND DISTINCT
CANALS
REF: Grossman’s endodontic practice12 th edition
The MB2 Canal: Following the Map of the Pulpal Floor Mitchell H. Davich,Endodontic therapy,volume 5,number2

ROOT CANALS ORIFICES:LAWS
KRASNER AND RANKOW,2004
 LAW OF SYMMETRY 1:EXCEPT FOR MAXILLARY MOLARS,THE
ORIFICES OF THE CANALS ARE EQIDISTANT FROM A LINE DRAWN
IN A MESIODISTAL DIRECTION THROUGH THE PULP CHAMBER
FLOOR
 LAW OF SYMMETRY 2:EXCEPT FOR MAXILLARY MOLARS,THE
ORIFICES OF THE CANALS LIE ON A LINE PERPENDICULAR TO A
LINE DRAWN IN A MESIODISTAL DIRECTION ACROSS THE CENTER
OF THE FLOOR OF THE PULP CHAMBER
 LAW OF ORIFICE LOCATON 1:THE ORIFICES OF THE ROOT CANALS
ARE ALWAYS LOCATED AT THE JUNCTION OF THE WALLS AND
THE FLOOR
 LAW OF ORIFICES LOCATION 2:THE ORIFICES OF THE ROOT
CANALS ARE LOCATED AT THE ANGLES IN THE FLOOR –WALL
JUNCTION
 LAW OF THE ORIFICES LOCATION 3:THE ORIFICES OF THE ROOT
CANALS ARE LOACTED AT THE TERMINUS OF THE ROOT
DEVELOMENTAL FUSION LINES

 LAW OF COLOR CHANGE:THE COLOR OF THE PULP CHAMBER FLOOR IS
ALWAYS DARKER THAN THE WALLS
 LAW OF CENTRALITY:THE FLOOR OF THE PULP CHAMBER IS ALWAYS
LOCATED IN THE CENTER OF THE TOOTH AT THE LEVEL OF THE CEJ
 LAW OF CONCENTRICITY:THE WALLS OF THE PULP CHAMBER ARE ALWAYS
CONCENTRIC TO THE EXTERNAL SURFACE OF THE TOOTH AT THE LEVEL OF
THE CEJ,THAT IS ,THE EXTERNAL ROOT SURFACE ANATOMY REFLECTS THE
INTERNAL PULP CHAMBER ANATOMY
 LAW OF CEJ:THE DISTANCE FROM THE EXTERNAL SURFACE OF THE CLINICAL
CROWN TO THE WALL OF THE PULP CHAMBER IS THE SAME THROUGHOUT
THE CIRCUMFERENCE OF THE TOOTH AT THE LEVEL OF THE CEJ,MAKING THE
CEJ IS THE MOST CONSISTENT REPETABLE LANDMARK FOR LOCATING THE
POSITION OF THE PULP CHAMBER
REF:S COHEN,K HARGREAVES,PATHWAYS OF PULP
,10th edition

TYPES OF ISTHMUS
 TYPE 1:INCOMPLETE ISTHUMUS;A
FAINT COMMUNICATION BETWEEN
TWO CANALS
 TYPE 2:TWO CANALS WITH A
DEFINITE CONNECTION BETWEEN
THEM
 TYPE3:A VERY SHORT COMPLETE
ISTHMUS BETWEEN THEM
 TYPE 4:COMPLETE OR INCOMPLETE
ISTHMUS BETWEEN TWO CANALS
 TYPE 5:MARKED BY TWO OR THREE
CANALS WITHOUT VISIBLE
CONNECTIONS
REF:S COHEN,K HARGREAVES,PATHWAYS
OF PULP,10th edition

MAXILLARY CENTRAL INCISOR
 PULP CHAMBER
 LOCATED AT THE CENTER OF THE
CROWN EQUIDISTANT FROM THE
DENTINAL WALLS
 BROAD MESIODISTALLY ,WITH ITS
BROADEST PART INCISALLY
 USUALLY FOLLOWS THE CONTOURS OF
THE CROWN AND HAS THREE PULP
HORNS THAT CORRESPONDS TO THE
DEVELOPMENTAL MAMELONS IN A
YOUNG TOOTH
 CHAMBER IS OVOID MESIODISTALLY
 THE DIVISION BETWEEN ROOT CANAL
AND PULP CHAMBER IS INDISTINCT
REF:S COHEN,K HARGREAVES,PATHWAYS OF
PULP,10th edition
ADM WATSON ,HARTY’S CLINICAL
ENDODONTICS,11 TH EDITION

ROOT AND ROOT CANALS
ONE ROOT CANAL
ROOT CANAL IS BROAD LABIOPALATALLY ,LARGE AND
SIMPLE IN OUTLINE
CONICAL IN SHAPE
CENTRALLY LOCATED
A DEFINITE APICAL CONSTRICTION IS PRESENT AND IN
MATURE ROOT CANAL
IN CROSS SECTION,THE CANAL IS OVOID TO ALMOST
ROUND IN THE MIDDLE THIRD AND ROUND IN THE
APICAL THIRD
REF:John Ide Ingle, Leif K.
Bakland, J. Craig
Baumgartner,INGLE6

CLINICAL SIGNIFICANCE
 MAJORITY OF ROOT(75%) ARE
STRAIGHT BUT SOME MAY CURVE
LABIALLY OR PALATALLY
 LATERAL CANALS MAY BE
PRESENT(24%) USUSALLY IN THE
APICAL THIRD
 LABIAL SURFACE OF THE ROOT LIES
UNDER THE LABIAL CORTICAL
PLATE OF THE MAXILLA AND MAY
FUSE IT.BECAUSE OF THE
PROXIMITY OF THE LABIAL ROOT
SURFACE TO THE CORTICAL
PLATE,FENESTRATIONS AND
DEHISENCE MAY BE PRESENT AND
ABSCESSES MAY PERFORATE THE
LABIAL CORTICAL PLATE
 IN SOME PATIENTS THE APEX OF
THE ROOT IS CLOSE TO THE NASAL
FLOOR AND HENCE ABSCESS MAY
DRIAN INO THE INFERIOR NASAL
MEATUS

MAXILLARY LATERAL INCISOR
 PULP CHAMBER
 SHAPE:SIMILAR TO THE
MAXILLARY CENTRAL INCISOR BUT
SMALLER
 HAS ONLY TWO PULP
HORNS,CORRESPONDING TO THE
DEVELOPMENTAL MAMELONS
 BROAD MESIODISTALLY ,WITH ITS
BROADEST PART INCISALLY
 DIVISION BETWEEN ROOT CANAL
AND PULP CHAMBER IS
INDISTINCT
REF:John Ide Ingle, Leif K. Bakland, J. Craig
Baumgartner,INGLE6

 ROOT CANAL:
 CONICAL CONFIGURATION
 FINER DIAMETER THAN THE MAXILLARY
CENTRAL INCISOR
 OCCASIONALLY MAY HAVE FINE
CONSTRICTION IN ITS COURSE TOWARDS
APEX
 THE CANAL IS OVOID LABIOPALATALLY IN
THE CERVICAL THIRD BECAUSE OF
FLATNESS OF ROOT ,OVOID IN MIDDLE
THIRD AND ROUND IN THE APICAL THIRD
REF: John Ide Ingle, Leif K. Bakland, J. Craig
Baumgartner,INGLE6
REF:S COHEN,K HARGREAVES,PATHWAYS OF
PULP
,10th edition

LATERAL CANALS OCCURS MORE
FREQENTLY IN THESE TEETH(26%)
LABIAL PERFORATIONS ARE MOST
COMMON IATROGENIC ERROR
ROOT CURVE DISTALLY(53%)
REF:GROSSMAN’S ENDODONTIC
PRACTICE,12 EDITION
REF:S COHEN,K
PULP,10th edition

MAXILLARY CANINIE
 PULP CHAMBER:
 LARGEST OF ANY SINGLE ROOTED TEETH
 LABIOPALATALLY ,CHAMBER IS TRIANGULAR IN
SHAPE WITH APEX TOWARDS THE SINGLE CUSP AND A
BROAD BASE IN THE CERVICAL THIRD OF THE CROWN
 MESIODISTALLY ,IT IS NARROW,RESEMBLING A FLAME
 IN CROSS SECTON ,THE CHAMBER IS OVOID IN
SHAPE,WITH THE GREATEST DIAMETER
LABIOPALATALLY
 ONLY ONE PULP HORN IS PRESENT ,CORRESPONDING
TO ONE CUSP
 DIVISION BETWEEN THE PULP CHAMBER AND ROOT
CANAL IS INDISTINCT
REF: John Ide Ingle, Leif K. Bakland, J.
Craig Baumgartner,INGLE6

 ROOT AND ROOT CANAL
 SINGLE ROOT CANAL IS LARGER THAN THAT OF
MAXILLARY INCISOR
 WIDER LABIOPALATALLY THAN IN MESIODISTAL
DIMENSION AND ON REACHING THE MIDDLE
THIRD ,IT TAPERS GRADUALLLY TO AN APICAL
CONSTRICTION
ADM WATSON ,HARTY’S CLINICAL
ENDODONTICS,11 TH EDITION
REF: John Ide Ingle, Leif K.
Bakland, J. Craig
Baumgartner,INGLE6

 DISTAL CURVATURE OF ROOT:32%
 AN ABSCESS IN MAXILLARY
CANINE USUALLY PERFORATES
THE LABIAL CORTICAL PLATE
BELOW THE INSERTION OF
LEVATOR MUSCLES OF UPPER LIP
AND DRAINS INTO THE BUCCAL
VESTIBULE
 IF PERFORATION WILL DRAIN
INTO THE CANINE SPACE WILL
CAUSE CELLULITIS
 APICAL CURRETAGE MAY BE
DIFFICULT DURING
PERIRADICULAR PROCEDURES
BECAUSE OF THE LENGTH OF THE
TTOT
REF:S COHEN,K HARGREAVES,PATHWAYS OF PULP,10th
edition
REF:GROSSMAN’S ENDODONTIC PRACTICE,12 ed

MAXILLARY FIRST PREMOLAR
 PULP CHAMBER
 NARROW MESIODISTALLY
 HAS A PULP HORN UNDER EACH CUSP,BUT BOTH MAY
BE MISSED IN ROUTINE RADIOGRAPHIC PROJECTONS
BECAUSE OF SUPERIMPOSITION OF ONE OVER OTHER
 WIDE BUCCOPALATALLY AND THE BUCCAL PULP HORN
IS MORE PROMINENT THAN THE PALATAL IN YOUNG
TEETH
 FLOOR OF THE PULP CHAMBER IS CONVEX , USUALLY
WITH TWO CANAL ORIFICES ,ONE BUCCAL AND THE
OTHER PALATAL AND IT LIES DEEP IN THE CORONAL
THIRD OF ROOT BELOW CERVICAL LINE
 IN CROSS SECTION ,PULP CHAMBER IS WIDE AND OVOID
IN A BUCCOPLATAL DIMENSION
Baumgartner,INGLE6

 ROOT CANAL
 ROOTS IN 54.6% OF CASES TWO
ROOTS
 21.9% OF DOUBLE ROOTED
CASES,ROOTS ARE SEPERATED WHERE
AS IN 32.7% ,ROOTS ARE PARTIALLY
FUSED
 REGARDLESS OF WHETHER MAXILLARY
FIRST PREMOLAR HAVE ONE OR TWO
ROOTS,THEY HAVE TWO ROOT
CANALS AT APEX IN 69% CASES
 WHEN FUSED ROOTS OCCURS, A
GROOVE RUNNING IN AN
OCCLUSOAPICAL DIRECTION DIVIDES
THE ROOT INTO BUCCAL AND PALATAL
PORTIONS,EACH CONTAINING A
SINGLE ROOT CANAL
REF:HARTY’S ENDODONTICS IN CLINICAL PRACTICE,6th EDITION

 BUCCAL AND PALATAL
CANALS ARE SITUATED
DIRECTLY UNDER THE
RESPECTIVE CUSP AND
ORIFICES CAN BE LOCATED BY
FOLLOWING THIS
 DISTAL CURVE:36.8%
 ANOMALIES:IN RARE
CASES:THREE CANALS
AUTHORS ONE
CANAL(%)
TWO
CANALS%
THREE
CANALS(2
BUCCAL ,ONE
PALATAL)
VERTUCCI 26 69 5
PINEDA NAD
KUTTLER
50.1 49.2 0.5
CALISKAN ET
AL
9.8 90.2 -
WALKER 36 64 -
PECORA ET AL 9.7 88.6 1.7
KARTAL ET AL 17.1 80.45 2.5
SOARES AND
LEONARDO
CASE REPORT
CARNS AND
SKIDMORE
22 72 6
REF:S COHEN,K
PULP,10th edition
PRACTICE,12 ed

MAXILLARY SECOND PREMOLAR
 PULP CHAMBER
 HAS A NARROW CHAMBER
MESIODISTALY SHOWING ONE PULP
HORN SUPERIMPOSED OVE ANOTHER
WHEN IT IS VIEWED IN THIS PROJECTION
 WIDER BUCCOPLATALLY THAN THE
MAXILLARY FIRST PREMOLAR AND
SHOWS TWO PULP HORN IN THIS
PROJECTON A BUCCAL AND PALATAL
 ROOT OF PULP CHAMBER IS SIMILAR TO
THAT OF MAXILLARY PREMOLAR BUT
PULP FLOOR IS DEEPER OF TWO CANAL
PRESENT
Baumgartner,INGLE6

 ROOT CANAL
 HAVE A SINGLE ROOT IN 90.3% OF PATIENTS
 ONLY 2% HAVE TWO WELL DEVELOPED
ROOTS,WHEREAS 7.7% HAVE TWO ROOTS
THAT ARE PARTIALLY FUSED
 WHEN TWO ROOT CANALS OCCUR,THE MAY
BE DISTINCT AND SEPERATED ALONG THE
ENTIRE LENGTH OF THE ROOT,OR THEY MAY
CONVERGE TO FORM A COMMON CANAL
AS THEY APPROACH THE APEX
 THE MAJORITY OF CANALS ARE CURVED
Baumgartner,INGLE6

AUTHORS ONE
CANAL(%)
TWO
CANALS%
THREE
CANALS(2
BUCCAL ,ONE
PALATAL)
VERTUCCI 75 24 1
PINEDA NAD
KUTTLER
81.8 18.2 -
CALISKAN ET
AL
72 28 -
FERREIRA et al - - CASE REPORT
PECORA ET AL 67.3 32.4 0.3
KARTAL ET AL 55 44.3 0.7
SOARES AND
LEONARDO
CASE REPORT
LOW CASE REPORT
ANOMALY:MAY HAVE THREE
ROOT CANALS
REF:S COHEN,K
PULP,10th edition

MAXILLARY FIRST MOLAR
 PULP CHAMBER
 LARGEST IN THE DENTAL ARCH WITH FOUR
PULP
HORNS:MESIOBUCCAL,MESIOPALATAL,DIST
OBUCCAL,DISTOPALATAL
 ARRANGEMENT:RHOMBOIDAL SHAPE IN
CROSS SECTION
 FOUR WALLS WHERE THE LINGUAL WALL
ALMOST DISAPPEARS ,THE FLOOR OF THE
PULP CHAMBER THUS HAS TRIANGULAR
FORM IN CROSS SECTION
 ORIFICES OF ROOT CANALS ARE LOCATED IN
THE THREE ANGLES OF FLOOR
 ANATOMIC DARK LINES IN THE FLOOR OF
PULP CHAMBER CONNECTS THE ORIFICES
Baumgartner,INGLE6

PALATAL ORIFICE:LARGEST,ROUND OR OVAL IN SHAPE
EASILY ACCESIBLE FOR EXPLORATION
MESIOBUCCAL ORIFICE: UNDER THE MESIOBUCCAL CUSP
LONG BUCCOPALATALLY AND MAY HAVE A DEPRESSION AT THE PALATAL END IN
WHICH THE ORIFICE OF A FOURTH CANAL MAY BE PRESENT
THIS ORIFICE IS LOCATED BY INSINERATING THE TIP OF A LONG SHANK EXPLORER
IN A MESIOBUCCOAPICAL INCLINATION INTO THE PONT ANGLE CREATED AT THE
JUNCTURE OF BUCCAL WALL,MESIAL WALL AND SUBPULPAL FLOOR OF PULP
CHAMBER
DISTOBUCCAL ORIFICE:LOCATED SLIGHTLY DISTAL AND PALATAL TO THE
MESIOBUCCAL ORIFICE AND IS ACCESIBLE FROM THE MESIAL FOR EXPLORATION
FLOOR OF PULP CHAMBER IS IN THE CERVICAL THIRD OF THE ROOT AND THE
ROOF IS IN THE CERVICAL THIRD OF CROWN

 ROOTS AND ROOT CANALS
 MAXILLARY FIRST MOLAR HAS THREE ROOTS WITH USUALLY THREE
ROOTS WITH USUALLY THREE CANALS SITUATED MESIOBUCCALY
,DISTOBUCCALY AND PALATALLY
 MESIOBUCCAL CANAL IS NOT ALWAYS PATENT ALONG ITS ENTIRE LENGTH
AND IS DIVIDED TO FORM A SECOND ROOT CANAL KNOWN AS THE MB2
CANAL
 DISTOBUCCAL ROOT IS SMALL AND IS MORE OR LESS ROUND IN SHAPE
 DISTOBUCCAL ROOT USUALLY HAS A SINGLE ROOT CANAL WHICH IS A
NARROW AND TAPERING CANAL
 PALATAL ROOT HAS THE LARGEST DIAMETER AND IS LONGEST ROOT OF
THE MAXILLARY FIRST MOLAR
 STRAIGHT IN ONLY 40% OF CASES AND MAY CURVE BUCCALY(55%)
Baumgartner,INGLE6

CLINICAL CONSIDERATIONS
 NALAPATTI:MB2 LOCATION:
 ON THE DEVELOPMENTAL LINE THAT CONNECT MB1 AND PALATAL CANAL
 MESIAL TO THE DEVELOPMENTAL LINE THAT CONNECTS MB1 AND PALATAL
CANAL
 APPEARS AS A GROOVE ON THE PALATAL WALL OF THE MB1 CANAL
 SPLITS OFF THE MB1 CANAL IN THE MIDDLE THIRD OF THE CANAL
 SPLITS OF THE MB 1 CANAL IN THE APICAL THIRD OF THE CANAL
 COMES OF THE BUCCAL WALL OF THE PALATAL CANAL
 ANOMALIES:
 SINGLE ROOT AND A SINGLE CANAL
 TWO DISTAL CANALS
 TWO PALATAL CANALS

MAXILLARY SECOND MOLAR
 PULP CHAMBER
 IS SIMILAR TO THAT OF THE MAXILLARY FIRST MOLAR EXCEPT
IT IS NARROWER MESIODISTALLY
 BECAUSE OF THIS NARROWER DIMENSION ,THE ROOF OF THE
PULP CHAMBER IS MORE RHOMBOIDAL IN CROSS SECTION
,THE FLOOR OF THE PULP CHAMBER IS AN OBTUSE TRIANGLE
IN CROSS SECTION AND THE MESIOBUCCAL AND
DISTOBUCCAL CANALS ARE CLOSER TOGETHER AND MAY
APPEAR TO HAVE A COMMON OPENING BUT THEY ARE
READILY DISTINGUISHABLE FROM EACH OTHER
 SOMETIMES ALL THREE CANAL ORIFICES MAY BE ALMOST IN A
STRAIGTH LINE
REF:John Ide Ingle, Leif K. Bakland, J. Craig Baumgartner,INGLE6

ROOT CANALS
USUALLY HAS THREE ROOTS WHICH ARE CLOSELY GROUPED
BECAUSE OF THIS CLOSE GROUPING ,THE BUCCAL ROOTS MAY FUSE AND
OCCASIONALLY ALL THREE ROOTS FUSE TO FORM A SINGLE CONICAL ROOT
STUDIES HAVE REPORTED THIS CHARACTERISTIC IN 46% CASES
IF THE BUCCAL ROOT FUSE TO FORM ONE BUCCAL ROOT,THE TOOTH MAY HAVE
ONLY TWO CANALS ,ONE BUCCAL AND ONE PALATAL
A TOOTH WITH ONLY ONE ROOT USUALLY HAS ONLY ONE CONICAL ROOT
CANAL
REF:John Ide Ingle, Leif K. Bakland, J. Craig Baumgartner,INGLE6

 ANOMALIES:
 ONE ROOT AND ONE CANAL
 INCIDENCE OF PULP STONES IN THE PULP CHAMBER
 FIVE ROOTS AND FIVE CANALS
 THREE MESIOBUCCAL CANALS
PRACTICE,12 ed

MAXILLARY THIRD MOLAR
 PULP CHAMBER:
 ANATOMICALLY RESEMBLES THE SCOND MOLAR
 PULP CHAMBER CAN BE SIMILAR TO THAT MAXILLARY SECOND MOLAR WITH
THREE CANAL ORIFICES ,BUT IT MAY ALSO HAVE AN ODD SHAPED CHAMBER
WITH FOUR OR FIVE CANAL ORIFICES OR A CONICAL CHAMBER WITH ONLY ONE
ROOT CANAL
 ROOT CANALS
 MAY HAVE THREE WELL DEVELOPED ROOTS THAT ARE CLOSELY GROUPED
 IT MAY ALSO HAVE FUSED ROOTS ONE CONICAL OR FOUR OR MORE
INDEPENDENT ROOTS
 THE ROOTS MAY BE STRAIGTH ,CURVED OR DILACERATED AND MAY BE FULLY
OR PARTIALLY DEVELOPED
 ROOT CANALS VARY FROM ONE OR FOUR OR EVEN FIVE IN NUMBER
,DEPENDING ON THE NUMEBR OF ROOTS
 ONE MAY FIND “C SHAPED” PULP CHAMBER WITH A “C SHAPED “ROOT CANAL

MANDIBULAR CENTRAL INCISOR
 PULP CHAMBER
 SMALLEST TOOTH IN THE ARCH
 THE PULP CHAMBER IS SMALL AND FLAT
MESIODISTALLY
 THE THREE DISTICT PULP HORNS PRESENT IN A
RECENTLY ERUPTED TOOTH BECOME CALCIFIED
AND DISAPPEAR EARLY IN LIFE BECAUSE OF
CONSTANT MASTICATORY STIMULUS
 LABIOLINGUALLY THE PULP CHAMBER IS WIDE
AND OVOID IN CROSS SECTION IN THE CERVICAL
THIRD OF THE CROWN AND TAPERS INCISALLY
Baumgartner,INGLE6

 ROOT CANALS
 HAS TWO ROOT,WHICH IS FLAT AND
NARROW MESIODISTALLY BUT WIDE
LABIOLINGUALLYY
 ROOT IS STRAIGHT IN 60% CASES.THE
CANAL CONFIGURATION VARIES FROM:
 ONE CANAL EXISTING IN ONE APICAL
FORAMEN,AS IN 70% OF THESE TEETH
 ONE CANAL BIFURCATING INTO TWO
CANALS COMING TOGETHER AND EXISTING
INTO ONE APICAL FORAMEN(22%)
 FROM LABIOLINGUAL DIMENSION,THE
CANAL IS BROAD IN THE CERVICAL AND
MIDDLE THIRD OF THE ROOT ,TAPERS
GRADUALLY TOWARDS THE APEX AND
FORMS A CONSTRICTION IN THE APICAL
THIRD OF THE ROOT
Baumgartner,INGLE6

CLINICAL CONSIDERATION
 THE SECOND CANAL IS LOCATED LINGUAL TO THE PRIMARY CANAL

MANDIBULAR LATERAL INCISOR
 PULP CHAMBER
 CONFIGURATION OF PULP CHAMBER OF
MANDIBULAR LATERAL INCISOR IS
SIMILAR TO THAT OF MANDIBULAR
CENTRAL INCISOR,BUT LATERAL INCISOR
HAS LARGER DIMENSIONS
 ROOT CANALS
 ROOT OF MANDIBULAR LATERAL INCISOR
IS LARGER THAN THAT OF THE
MANDIBULAR CENTRAL INCISOR,IT HAS
BASICALLY THE SAME CONFIGURATION
 THE MAJORITY OF THE ROOTS ARE
STRAIGTH OR DISTALLY OR LABIALLY
CURVED AS THEY ARE IN THE CENTRAL
INCISOR BUT THE DISTAL CURVE OF THE
LATERAL INCISOR
 THE INCIDENCE OF DOUBLE ROOT CANALS
AT THE APEX IS ABOUT THE SAME AS IN
THE CENTRAL INCISOR AND THEIR
ANATOMY IN CROSS SECTION IS ALSO
SIMILAR
REF:John Ide Ingle, Leif K. Bakland, J.
Craig Baumgartner,INGLE6

MANDIBULAR CANINE
 RESEMBLES THE MAXILLARY CANINE
BUT SMALLER IN ALL DIMENSIONS
 THE PULP CHAMBER IS NARROW
MESIODISTALLY
 WHEN VIEWED LABIOLINGUALLY THE
CHAMBER TAPERS TO A POINT IN THE
INCISAL THIRD OF THE CROWN BUT IT IS
WIDE IN THE CERVICAL THIRD ONLY ONE
PULP HORN IS PRESENT IN THE ADLUT
TOOTH
 IN CROSS SECTION ,THE CHAMBER IS
OVOID IN THE CERVICAL THIRD
 NO DISTINCT DEMARCATION EXISTS
BETWEEN THE PULP CHAMBER AND THE
ROOT CANAL
Baumgartner,INGLE6

 ROOT CANALS
 ALTHOUGH TOOTH USUALLY HAS ASINGLE ROOT ,IT
MAY HAVE TWO (2.3%)
 MOST OF THESE TEETH HAVE A STRIGHT ROOT(68%)
,BUT HAVE DISTAL CURVATURE(20%)
 MANDIBULAR CANINE USUALLY HAS ONE CANAL
EXISTING IN ONE APICAL FORAMEN(78%)
 WHEN ONE ROOT CANAL PRESENT ,A LABIOLINGUAL
VIEW OF THE ROOT SHOWS A CANAL THAT IS BROAD
IN THE MIDDLE THIRD AND TAPERS TO A CONSTRCTION
IN THE APICAL THIRD
 IT IS OVOID IN CROSS SECTION IN THE CERVICAL AND
MIDDLE THIRD OF ROOT AND ROUND IN THE APICAL
THIRD
Baumgartner,INGLE6

MANDIBULAR FIRST PREMOLAR
 PULP CHAMBER
 TRANSITIONAL TOOTH BETWEEN ANTERIOR AND
POSTERIOR TEETH AND IN ANATOMIC STRUCTURE ,IT
RESEMBELS BOTH TYPES OF TEETH
 MESIODISTAL WIDTH OF PULP CHAMBER IS NARROW
 BUCCOLINGUALLY,THE WIDTH OF PULP CHAMBER IS
WIDE,WITH A PROMINENT BUCCAL PULP HORN THAT
EXTENDS UNDER A WELL DEVELOPED BUCCAL CUSP
 IN YOUNG TOOTH , A SMALL LINGUAL PULP HORN THAT
MAY DISAPPEAR WITH AGE AND MAY GIVE THE PULP
CHAMBER AN APPEARANCE SIMILAR TO THAT OF
MANDIBULAR CANINE
 PROMINENT BUCCAL CUSP AND THE SMALLER LINGUAL
CUSP GIVE THE CROWN OF MANDIBUALR FIRST PREMOLAR
ABOUT A 30 DEGREE LINGUAL TILT
Baumgartner,INGLE6

 IN CROSS SECTION,THE CHAMBER IS OVOID,WITH THE
GREATEST DIAMETER BUCCOLINGUALLY
 IF ONLY ONE CANAL IS PRESENT,NO DISTINCT DIVISON
WILL BE BETWEEN THE PULP CHAMBER AND THE ROOT
CANAL
 ROOT CANAL
 USUALLY HAS A SHORT CONICAL ROOT
 THIS ROOT MAY DIVIDE IN THE APICAL THIRD INTO
TWO OR THREE ROOTS
 THE ROOT IS USUALLY STRAIGTH(48%) BUT SOME
ROOTS CURVE DISTALLY(35%)
 ONE CANAL AND ONE FORAMEN ARE PRESENT IN 70%
OF CASES
 IF ONE CANAL IS PRESENT ,IT WILL BE CONE SHAPED
AND SIMPLE IN OUTLINE
 MESIODISTALLY ,SUCH A ROOT CANAL IS
NARROW,BUCCOLINGUALLY ,IT IS BROAD AND TAPERS
TOWARDS THE APICAL THIRD
 IN CROSS SECTION ,THE CERVICAL AND MIDDLE THIRD
ARE OVOID AND THE APICAL THIRD IS NARROW
Baumgartner,INGLE6

CLINICAL CONSIDERATIONS
 TWO CANAL EXIT IN TWO FORAMINA IN 15%CASES
 ONE CANAL BIFURCATES INTO TWO CANALS UNITING INTO ONE CANAL IN
THE APICAL THIRD AND THEN EXITING INTO ONE FORAMEN IN 4% OF
CASES
 THREE CANALS EXIT IN THREE FORAMINA IN 0.5%OF CASES
 ONE CANAL BIFURCATES INTO TWO CANALS AND EXIST IN TWO FORAMINA
IN 24% CASES
 MENTAL CANAL AND FORAMEN ARE SOMETIMES CLOSE TO THE ROOT APEX
OF MANDIBULAR FIST PREMOLAR,THE RADIOGRAPHIC APPEARNCE MAY
MIMIC PERIRADICULAR PATHOLOGY

MANDIBULAR SECOND PREMOLAR
 PULP CHAMBER
 IS SIMILAR TO THAT OF MANDIBULAR
FIRST PREMOLAR,EXCEPT THAT THE
LINGUAL HORN IS MORE PROMINENT
UNDER A WELL DEVELOPED LINGUAL
CUSP
 ROOT CANALS
 USUALLY HAS A SINGLE ROOT BUT ON
RARE OCCASIONS TWO OR THREE ROOTS
ARE PRESENT
 ROOT HAS A GREATER GIRTH AND WIDER
BUCCOLINGUALLY THAN THAT OF
MANDIBULAR FIRST PREMOLAR
 ROOT OF MANDIBULAR SECOND
PREMOLAR MAY CURVE DISTALLY (40%)
ALTHOUGH 39% OF CAESE IT IS STRAIGTH
Baumgartner,INGLE6

 USUALLY ONE CANAL EXISTS IN ONE
APICAL FORAMEN (97.5%) ,BUT IN SOME
ROOTS (2.5%) , ASINGLE CANAL MAY
BIFURCATE EXISTING IN TWO
FORAMINA
 WHEN ONE CANAL IS PRESENT ,ITS
CONFIGURATION IS SIMILAR TO THAT
OF MANDIBUALR FIRST PREMOLAR
Baumgartner,INGLE6

AUTHORS ONE
CANAL(%)
TWO
CANALS%
THREE
CANALS(2
BUCCAL ,ONE
PALATAL)
VERTUCCI 74 25.5 0.5
PINEDA NAD
KUTTLER
74.5 24.9 0.9
CALISKAN ET
AL
75.5 18.8 5.7
YOSHIOKA et
al
76 - -
ZILLICH AND
DOWSON
80.7 18.9 0.4
AUTHORS ONE
CANAL(%)
TWO
CANALS%
THREE
CANALS(2
BUCCAL ,ONE
PALATAL)
VERTUCCI 97.5 2.5 -
PINEDA NAD
KUTTLER
98.8 1.2 -
CALISKAN ET
AL
93.6 6.4 -
EL DEEB - - Case report
BRAM AND
FLEISHER
- CASE REPORT -
MANDIBULAR FIRST PREMOLAR MANDIBULAR SECOND PREMOLAR

MANDIBULAR FIRST MOLAR
 PULP CHAMBER
 ROOF IS OFTEN RECTANGULAR IN SHAPE
 MESIAL WALL IS STRAIGHT ,THE DISTAL WALL ROUND AND BUCCAL AND
LINGUAL WALLS CONVERGE TO MEET THE MESIAL AND DISTAL WALLS AND
FORM A TRAPEZOIDAL FLOOR
 ROOF OF PULP CHAMBER HAS FOUR PULP
HORNS:MESIOBUCCALLY,MESIOLINGUALLY ,DISTOBUCCAL AND DISTOLINGUAL
 ROOF OF PULP CHAMBER IS LOCATED IN THE CERVICAL THIRD OF THE CROWN
JUST ABOVE THE CERVIX OF THE TOOTH AND THE FLOOR IS LOCATED IN THE
CERVICAL THIRD OF THE ROOT
 THREE DISTINCT ORIFICES ARE PRESENT IN THE PULPAL
FLOOR:MESIOBUCCAL,MESIOLINGUAL AND DISTALL
Baumgartner,INGLE6

MESIOBUCCAL ORIFICE:UNDER THE MESIOBUCCAL CUSP AND USUALLY IS DIFFICULT TO
FIND AND TO ENTER IS NOT ENOUGH TOOTH STRUCTURE IS REMOVED
TO PENETRATE THIS ORIFICE,INSERT A LONG SHANK EXPLORER IN A MESIOBUCCOAPICAL
INCLINATION INTO THE POINT ANGLE CREATED AT THE JUNCTURE OF THE MESIAL
WALL,BUCCAL WALL AND THE SUBPULPAL FLOOR OF THE PULP CHAMBER
MESIOLINGUAL ORIFICE:IS LOCATED IN A DEPRESSION FORMED BY THE MESIAL AND
LINGUAL WALLS.THIS ORIFICE CAN BE EXPLORED FROM A DISTOBUCCAL DIRECTION.A
GROOVE USUALLY CONNECTS THE ORIFICES OF THE MESIOBUCCAL AND MESIOLINGUAL
CANAL.THE MESIOBUCCAL AND MESIOLINGUAL ORIFICES MAY BE CLOSE TOGETHER
UNDER THE MESIOBUCCAL CUSP
DISTAL ORIFICES:OVAL IN SHAPE,WITH THE WIDEST DIAMETER BUCCOLINGUALLY,CAN BE
EXPLORED BY STARTING FROM A MESIAL DIRECTION
IF THE DISTAL ORIFICE IS PENETRATED IN A MARKED DISTOBUCCAL OR DISTOLINGUAL
DIRECTION ,ONE SHOULD SEEEK AN ADDITIONAL ORIFICE AND CANAL IN DISTAL ROOT
THE MULTIPLE ORIFICE IN THE DISTAL ROOT ARE USUALLY FOUND IN BUCCAL AND
LINGUAL PORTIONS OF OVOID CORORNAL ROOT CANAL

 ROOT CANAL
 TWO WELL DIFFERENTAITED ROOTS ARE PRESENT IN
THE MANDIBULAR FIRST MOLAR ,ONE MESIAL AND
ONE DISTAL
 BOTH ROOTS ARE WIDE AND FLAT BUCCOLINGUALLY
WITH A DEPRESSION IN THE MIDDLE OF THE ROOT
BUCCOLINGUALLY
 THIS ANATOMIC CHARACTERISTIC MAY BE
ACCENTUATED IN THE MESIAL ROOT
 A THIRD ROOT IS FOUND IN SOME CASE,EITHER
DISTALLY AND MESIALLY (5.3%) AND IS OFTEN
REFERRED TO AS RADIX ENTOMOLARIS
 THE MESIAL ROOT CURVES DISTALLY IN 84%CASES AND
IS STRAIGTH IN 16%
 THE DISTAL ROOT IN STRAIGTH IN 74% OF
CASES,CURVES TO THE DISTAL IN 21% AND CURVES TO
THE MESIAL IN 5%
Baumgartner,INGLE6

 ALTHOUGH THE MANDIBULAR FIRST MOLAR HAS TWO ROOTS,THREE CANALS
ARE USUALLY PRESENT
MESIAL ROOT:HAS TWO CANALS THAT EXIT IN TWO FORAMINA IN 4% CASES
TWO CANALS THAT COALESCE TO EXIT IN ONE FORAMEN IN 28%CASES
TWO CANALS THAT COALESCE TO FORM ONE CANAL AND BIFURCATE AND EXIT IN TWO FORAMINA IN 13%
ONE CANAL THAT EXITS IN ONE FORAMINA IN 12%
ONE CANAL THAT BIFURCATES AND EXITS IN TWO FORAMINA IN 8%
IN RARE CASES,THREE CANALS EXITS IN THREE FORAMINA AND THIS THIRD CANAL WHICH IS PRESENT
BETWEEN THE MESIOBUCCAL AND MESIOLINGUAL CANAL ORIFICE IS REFERRED TO AS MIDDLE MESIAL
DISTAL ROOT:THE DISTAL ROOT HAS ONE CANAL EXISTING IN ONE FORAMEN IN 70%CASES
TWO CANAL COALESCING AND EXITING IN ONE FORAMENIN 15%
ONE CANAL BIFURCATING AND EXITING IN TWO FORAMNA IN 8%
TWO CANALS COALESCING TO FORM ONE CANAL AND LATER BIFURCATNG TO EXIT IN TWO FORAMINA IN 2%
CASES
TWO CANALS ARE PRESENT IN EITHER ROOT ,THEY MAY CONVERGE TOWARDS AND EXIT IN ONE FORAMEN,OR
THEY MAY HAVE INTERCONNECTING LATERAL CANALS BWTEEN THEM THAT FORM A SINGLE RIBBON CANAL
ENDING IN ONE FORAMEN
IN CROSS SECTION ,ALL THREE CANALS ARE OVOID IN THE CERVICAL AND MIDDLE THIRDS AND ROUND IN THE
APICAL THIRDS.TWO CANALS PRESENT IN THE DISTAL ROOT ARE USUALLY ROUND IN CROSS SECTION FROM THE
CERVICAL THIRD TO THE APICAL THIRD

MANDIBULAR SECOND MOLAR
 PULP CHAMBER
 THE PULP CHAMBER OF THE MANDIBULAR SECOND
MOLAR IS SMALLER THAN THAT OF THE MANDIBULAR
FIRST MOLAR AND ROOT ORIFICES ARE SMALLER AND
CLOSES TOGETHER
 ROOT CANALS
 THE MAJORITY OF THE MANDIBULAR SECOND MOLARS
HAVE TWO ROOTS (71%) ,BUT TEETH WITH ONE
ROOT(27%) AND TEETH WITH THREE ROOTS (2%) ARE
ALSOO SEEN
 THREE ROOT CANALS ARE USUALLY PRESENT IN THE
MANDIBUALR SECOND MOLAR
 THE MOST FREQUENT VARIATION IS THE PRESENCE OF
ONLY TWO CANALS
Baumgartner,INGLE6

MANDIBULAR THIRD MOLAR
 PULP CHAMBER:
 ANATOMICALLY RESEMBLES THE PULP CHAMBER OF MANDIBULAR FIRST
AND SECOND MOLAR
 IT IS LARGE AND POSSESSES MANY ANAMALOUS CONFIGURATIONS SEEN
AS C SHAPED ROOT CANAL ORIFICE
 ROOT CANALS
 HAS TWO ROOTS AND TWO CANALS,BUT OCCASIONALLY ONE ROOT AND
ONE CANAL OR THREE ROOTS AND THREE CANALS
 THE ROOT CANALS ARE GENERALLY LARGE AND SHORT
REF: John Ide Ingle, Leif K. Bakland, J. Craig
Baumgartner,INGLE6

REF:GROSS
MAN’S
ENDODONT
IC
PRACTICE,1
3 ed

MAXILLARY CENTRAL INCISOR
 THE INTERNAL ANATOMY IS CONSISTENT WITH
THE EXTERNAL MORPHOLOGY OF TOOTH
 THE PULP CHAMBER IS COMPARITIVELY LARGER
THAN THE COUNTERPART AND HAS THREE
INCISAL PROJECTIONS ,SIMILAR TO THE INCISAL
MAMELONS
 PULP CHAMBER AND SINGLE PULP CANAL TAPERS
TO THE ROUNDED APICAL FORAMEN
 SINGLE,CONICAL OR TRIANGULAR SHAPED ROOT
AND A LARGE SINGLE CANAL
 MESIAL PULP HORN IS MORE PROMINENT
HORNON THE MESIAL ASPECT AND 2.4mm FROM
THE DISTAL PULP HORN ON DISTAL ASPECT
 ON THE MESIAL AND DISTAL ASPECTS THE PULP
HORNS ARE APPROX 1.2mm FROM
DENTINOENAMEL JUNCTION(DEJ)
REF:P. Sema Aka , Murat Yagan , Nergis Canturk in Primary tooth development in infancy,A text and
atlas,2016

 STUDY:AN EX VIVO STUDY BY SALMA et al EXAMINED 10 PRIMARY MAXILLAY
CENTRAL AND 10 PRIMARY MAXILLARY LATERAL INCISORS ARE SUBJECTED
HALF TO CLEARING TECHNIQUE AND HALF TO SECTIONING
 IN ADDITION TO CONFIRMING THE RESULTS OF THE PREVIOUSLY MENTIONED
STUDIES,THEY FOUND THAT APEX IN EACH OF THESE CONSISTENTLY CURVED
LABIALLY IN THE APICAL THIRD ,HAD NO BIFURCATIONS OR ACCESSORY
CANALS AND THE CANALS WERE ROUND IN SHAPE
REF: Blaine m. Cleghorn, noriko b. Boorberg &William h. Christie, primary human teeth and their
Root canal systems, endodontic topics 2012, 23, 6–33

MAXILLARY LATERAL INCISOR
 MAXILLARY LATERAL INCISOR IS SMALLER THAN THE MAXILLARY CENTRAL
INCISOR
 PULP CHAMBER IS ALSO SMALLER(2.6 mm FROM THE INCISAL EDGE TO THE
PULP)
 THE PULP IS APPROXIMATELY 0.9mm FROM THE DENTINOENAMEL
JUNCTION ON THE MESIAL AND DISTAL ASPECT
REF: Richard J. Mathewson and Robert E. Primosch, Fundamentals of Pediatric Dentistry,3rd ed

MAXILLARY CANINE
 PULP CHAMBER ,LIKE THE OTHER INCISOR
FOLLOWS THE GENERAL CONTOUR OF THE
TOOTH ,WITH THE PULP HORN 3.2 mm
FROM THE DEJ AT THE INCISAL EDGE
 ON THE MESIAL AND DISTAL SURFACES
THE PULP IS APPROXIMATELY 2.1 mm
FROM THE DENTINOENAMEL JUNCTION
 THE CENTRAL PULP HORN OF THE PULP
CHAMBER IS PROMINENT AND HAS A
CONSIDERABLE INCISAL EXTENSION
 ROOT CANAL
 HAVE A SINGLE TRIANGULAR SHAPED
ROOT AND A LARGE SINGLE CANAL

MAXILLARY FIRST MOLAR
 PULP CAVITY INCLUDES A PULP CHAMBER AND THREE DIVERGENT PULP
CANALS
 PULP CHAMBER IS LARGE WHEN COMPARED TO THE PERMANENT
COUNTERPARTS AND HAS THREE PROMINENT PULP HORNS(POSSIBLY 4)
LOCATED UNDER RESPECIVE CUSPS
 MOST PROMINENT PULP HORN IS MESIOBUCCAL FOLLOWED BY
MESIOLINGUAL AND THEN DISTOBUCCAL
 MESIOBUCCAL PULP HORN IS 1.8 mm ,DISTOBUCCAL PULP HORN IS 2.3 mm
,LINGUAL PULP HORN IS 2.0mm FROM CUSP TIP

ROOT AND ROOT CANAL
 MAXILLARY FIRST MOLAR NORMALLY THREE
ROOTS(MB,DB,PALATAL),BUT SOME STUDIES HAVE SHOWN
RELATIVELY HIGH INCIDENCE OF FUSION OF DISTOBUCCAL AND
PALATAL ROOTS
 PALATAL ROOT IS LONGEST AND IS CURVED ,FOLLOWED BY THE
MESIOBUCCAL ROOT.THE DISTOBUCCAL ROOT IS THE SHORTEST AND
SMALLEST IN DIAMETER OF THREE ROOTS
 THE ROOT CANAL SYSTEM OF MAXILLARY FIRST MOLAR IS COMPLEX
AND VARIABLE.
 THE MESIOBUCCAL ,DISTOBUCCAL AND PALATAL ROOT MOST
COMMONLY HAVE ONE CANAL PRESENT IN EACH ROOT,ALTHOUGH
TWO CANALS CAN BE FOUND IN THE MESIOBUCCAL AND
DISTOBUCCAL ROOTS
 EVEN WHEN THERE IS FUSION OF THE DISTOBUCCAL AND PALATAL
ROOTS,THREE CANALS IS MOST COMMON CONFIGURATION

MAXILLARY SECOND MOLAR
 THERE MAY BE 4 OR 5 PULP HORNS,USUALLY ARE MOST PROMINENT
BENEATH EACH CUSP TIP.
 THE MESIOBUCCAL PULP HORN AS USUAL,IS LARGEST AND CLOSEST TO DEJ
 MESIOBUCCAL PULP HORN IS USUALLY 2.8 mm FROM DENTINOENAMEL
JUNCTION,WHILE DISTOBUCCAL HORN IS 3.1mm FROM DENTINOENAMEL
JUNCTION
 ROOT AND ROOT CANAL
 HAS THREE ROOTS THAT ARE WIDELY SEPERATED BUT SOME SPECIMENS
EXHIBIT FUSION BETWEEN DISTOBUCCAL AND PALATAL ROOTS
 PALATAL ROOT IS LONGEST FOLLOWED BY THE MESIOBUCCAL ROOT

 ROOT CANAL SYSTEM OF MAXILLARY
SECOND MOLAR IS ALSO COMPLEX AND
VARIABLE
 MESIOBUCCAL,DISTOBUCCAL AND PALATAL
ROOTS MOST COMMONLY HAVE ONE
CANAL PRESENT IN EACH ROOT,ALTHOUGH
ONE CANAL HAS BEEN FOUND IN THE
MESIOBUCCAL AND DISTOBUCCAL ROOTS IN
SOME STUDIES
REF: Blaine m. Cleghorn, noriko b. Boorberg &william h. CHRISTIE, primary human teeth and their

MANDIBULAR CENTRAL INCISOR
 PULP CANAL FOLLOWS THE OUTLINE FORM OF THE
SURFACE TOPOGRAAPHY OF PRIMARY
MANDIBULAR INCISOR
 PULP IS APPROXIMATELY 2.6 mm FROM THR
INCISAL EDGE IN PRIMARY CENTRAL INCISOR
 THE DISTANCE TO THE PULP IS 1.7 mm FROM THE
DISTAL ENAMEL SURFACE AND 1.0 mm FROM THE
MESIAL SURFACE
 FINN INDICATES THAT THE PRIMARY MANDBULAR
INCISOR HAS A CLEAR DEMARCATION BETWEEN
THE PULP CHAMBER AND PULP CANAL AND THAT
THIS IS NOT EVIDENT IN PRIMARY MANDIBULAR
LATERAL INCISOR
 HAVE A SINGLE CONICAL ROOT AND A SINGLE
CANAL

MANDIBULAR LATERAL INCISOR
 PULP OF MANDIBULAR LATERAL
INCISOR HAS SIMILAR DIMENSIONS BUT
IS SOMEWHAT SMALLER THAN
MANDIBULAR CANINE
 PULP CHAMBER AND SINGLE PULP
CANALS TAPERS TO THE ROUNDED
APEX
 ROOT CANAL
 SINGLE,CONICAL ROOT AND A LARGE A
SINGLE CANAL
REF:P. Sema Aka , Murat Yagan , Nergis Canturk in Primary tooth
development in infancy,A text and atlas,2016

MANDIBULAR CANINE
 CENTRAL PULP HORN OF THE PULP
CHAMBER HAS AN INCISAL
EXTENSION AS DOES PRIMARY
MAXILLARY CANINE
 THE PULP HORN IS 3.0 mm FROM DEJ
AT THE INCISAL EDGE
 THERE IS 1.8mm DISTANCE FROM THE
PULP TO THE MESIAL AND DISTAL DEJ
 ROOT CANAL
 NORMALLY HAVE A SINGLE ,CONICAL
ROOT THAT TAPERS TOWARDS THE
LINGUAL AND A LARGER SINGLE
CANAL
REF:P. Sema Aka , Murat Yagan , Nergis Canturk in Primary
tooth development in infancy,A text and atlas,2016

MANDIBULAR FIRST MOLAR
 FOUR PROMINENT PULP HORN PRESENT
 MOST PROMINENT IS THE MESIOBUCCAL PULP HORN
WHICH IS VERY LARGE AND NEEDS TO BE CAREFULLY
CONSIERED WHEN PREPARING OCCLUSAL AND
MESIOOCCLUSAL CAVITY PREPARATIONS
 DISTOBUCCAL PULP HORN IS LESS PROMINENT
 MESIOLINGUAL PULP HORN IS LOCATED JUST MESIAL TO
THE MESIOLINGUAL CUSP.THIS PULP HORN IS SECOND IN
HEIGHT BUT THIRD IN SIZE(MB>DB>ML>DL)
 THREE PULP CANAL SYSTEM ARE USUALLY PRESENT WITH
ONE OR TWO FOUND IN THE SINGLE MESIAL ROOT AND
ONE IN THE DISTAL ROOT

 A DOUBLE MESIAL CANAL SYSTEM IS PRESENT IN THE MESIAL ROOT WHICH IS
RIBBON SHAPED AND SUBSEQUENTLY SEPERATES INTO TWO CANALS BELOW
THE PULP CHAMBER
 THE DISTAL ROOT CONTAINS A SINGLE RIBBON SHAPED CANAL BUT
SOMETIMES NARROWS WITH AGE INTO TWO CANAL(WIDE,BUCCOLINGUALLY
AND NARRROW MESIODISTALLY)
 THERE IS CONSIDERABLE VARIATION IN NUMBER AND SHAPE OF CANAL
SYSTEMS IN THE PRIMARY TEETH.
 BOTH BUCCAL AND LINGUAL MESIAL PULP HORNS ARE 2.1 mm FROM DEJ
WHILE THE DISTAL PULP HORN ARE 2.4mm AWAY FROM THE DEJ

ROOT NUMBER AND FORM
 TWO ROOTS ARE NORMALLY PRESENT.BOTH ROOTS ARE WIDER IN THE
BUCCAL –LINGUAL DIMENSION,NARROWER MESIODISTALLY AND OFTEN
FLUTED
 THE MESIAL AND DISTAL ROOTS FLARE TO ACCOMODATES THE
DEVELOPING PERMANENT FIRST PREMOLAR
 FROM THE PROXIMAL VIEW,EACH ROOT TAPERS A LITTLE TOWARDS THE
ROUNDED APEX OF EACH OF THE ROOTS
 ROOT CANAL SYSTEM
 MOST STUDIES FOUND EITHER ONE OR TWO CANALS IN EACH OF MESIAL
AND DISTAL ROOTS OF MANDIBULAR FIRST MOLARS
 HOWEVER THERE IS GENERALLY A HIGHER INCIDENCE OF TWO CANALS IN
THE MESIAL ROOT AND ONE CANAL IN DISTAL ROOT

MANDIBULAR SECOND MOLAR
 FIVE PROMINENT PULP HORNS PRESENT
 MESIOBUCCAL AND MESIOLINGUAL PULP HORN
ARE MOST PROMINENT
 DISTOBUCCAL IS NEXT IN SIZE FOLLOWED BY
SMALLER DISTOLINGUAL PULP HORN
 THREE OR FOUR PULP CANALS ARE USUALLY
PRESENT
 TWO CANALS ARE USUALLY PRESENT IN THE
MESIAL ROOT.INITIALLY IT IS RIBBON SHAPED
CANAL THAT SEPERATES INTO TWO CANAL FROM
PULP CHAMBER
 THE DISTAL ROOT CONTAINS A SINGLE RIBBON
SHAPED CANAL(WIDE BUCCOLINGUALLY AND
NARROW MESIODISTALLY WHICH IS
COMPARABLETO THE PRIMARY MANDIBULAR
FIRST MOLAR
 WITH AGE AND CALCIFICATION ,THE DISTAL ROOT
MAY ALSO PRESENT A DOUBLE CANAL SYSTEM
REF:P. Sema Aka , Murat Yagan , Nergis Canturk in Primary
tooth development in infancy,A text and atlas,2016

 ROOT AND ROOT CANALS
 IN CAUCASIAN AND BLACK POPULATION ,THERE IS NORMALLY TWO WELL
SPREAD ROOTS,MESIAL AND DISTAL BUT MANY STUDIES HAVE IDENTIFIES
THREE ROOTED SPECIMENS IN ASIAN POPULATIONS
 LIU et al FOUND THREE ROOTED PRIMARY MANDIBULAR SECOND MOLARS IN
APPROXIMATELY 10% PATIENTS AND 6% OF TEETH IN A RADIOGRAPHIC STUDY
OF 227 CHINESE PATIENTS.
 SONG et al NOTED THAT IN A STUDY OF 4050 KOREAN CHILDREN,THERE WAS
27.8% INCIDENCE OF A THIRD DISTOLINGUAL ROOT ON PRIMARY
MANDIBULAR SECOND MOLAR.THIS WAS ALMOST A THREE TIMES MORE
LIKELY INCIDENCE THAN THE PRIMARY MANDIBULAR FIRST MOLAR

 THEY SUGGEST THAT THE THIRD DISTOLINGUAL ROOT IN MANDIBULAR
MOLARS.PRIMARY OR PERMANENT SHOULD BE CONSIDERED A NORMAL
RACIAL AND MORPHOLOGICAL VARIANT OF POPULATIONS OF MONGLOID
ORIGIN
 MOST STUDIES FOUND EITHER ONE OR TWO CANALS EACH OF MESIAL AND
DISTAL ROOTS OF THE MANDIBULAR SECOND MOLARS
 THE MAJORITY REPORTED A HIGHER INCIDENCE OF TWO CANALS IN THE
MESIAL ROOTS
 DEPENDING ON THE STYUDY,EITHER ONE OR TWO CANALS WERE
PREDOMINANT IN THE DISTAL ROOTS

CONCLUSION
 THUS KNOWING THE PULP CHAMBERS IS VERY IMPORTANT FOR DENTIST TO
SUCCESSFULLY DO THE ENDODONTIC TREATMENTS

REFERENCES
Endodontics:practice and principles Mahmoud Torabinejad, Richard E. Walton- 2009
P. Sema Aka , Murat Yagan , Nergis Canturk in Primary tooth development in infancy,A
text and atlas,2016
The MB2 Canal: Following the Map of the Pulpal Floor Mitchell H. Davich,Endodontic
therapy,volume 5,number2
S cohen, k hargreaves, pathways of pulp,9th edition
Adm watson harty’s clinical endodontics,11 th edition

 Richard J. Mathewson and Robert E. Primosch, Fundamentals of Pediatric
Dentistry,3rd ed
 Blaine m. Cleghorn, noriko b. Boorberg &William h. Christie, primary human teeth
and their Root canal systems, endodontic topics 2012, 23, 6–33
 Grossman’s endodontic practice,13 ed
 John Ide Ingle, Leif K. Bakland, J. Craig Baumgartner,INGLE6

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