The document discusses the anatomy of the pulp space, including its components and classifications. It begins with an introduction and objectives. The components of the pulp space are then defined, including the coronal and radicular pulp. Various terminologies used in describing pulp space anatomy are provided. The classifications of pulp space and canal configurations according to different authors are presented. Techniques for visualizing internal anatomy are also mentioned. Details on specific tooth anatomy are then provided. [END SUMMARY]

2. Good morning

3. ANATOMY OF PULP SPACE
 Dr. Sona Joseph
 READER
 Dept. Of Conservative Dentistry And Endodontics
MAHE INSTITUTE OF DENTAL SCIENCES & HOSPITAL

4.  Introduction
 Objectives
 Components of pulp space – terminology
 Classification of pulp space
 Techniques for visualization of internal
anatomy
contents

5.  Detailed study of internal anatomy of permanent tooth
 Comparative study of deciduous and permanent tooth
structure
 Variation in normal pulpal structure and its significance
 Physiological
 Pathological
 Development
 Conclusion
 References

6. INTRODUCTION

8. Why???
learning objectives
-.

9. STAGES OF TOOTH DEVELOPMENT

10. COMPOSITION OF THE PULP
Cells Fibers Ground substance
Odontoblasts
Fibroblasts
Undifferentiated
mesenchymal cells
Macrophages
Immunocompetent cells
Collagen – Type I
Type III
Oxytalan
Water
Glycosaminoglycans
Glycoproteins
Proteoglycans

11. Morphology and anatomy

12. Components of pulp system
 Coronal pulp
 Radicular pulp

14. Coronal pulp
 Located centrally with pulp horns
 Six surfaces
 Dentinal maps are present in the floor
 Pulp horns- these are the
projections/prolongations of roof of the pulp
corresponding to major cusps or lobes

15. Radicular pulp
 Radicular pulp is that pulp extending from
cervical region of the crown to root apex
 Canal configurations
 Accessory canals ,
 lateral canals ,
 apical delta
 Furcation canal
 Isthmus

16. Terminologies:
 Root canal system:
 The entire space in the dentine where the pulp
is housed is called the root canal system.
 Pulp chamber:
 It is the part of the root canal system located in
the anatomic crown of the tooth.
 Pulp canal :
 It is the part of the root canal system located in the anatomic root of the
tooth.
 Pulp horn:
 It is an accentuation of the roof of the pulp chamber directly under the
cusp or the development lobe
 Canal orifices:
 They are openings in the floor of the pulp chamber
leading into the root canals or pulp space.

17.  Accessory canals:
They are minute canals that extend in a horizontal ,
lateral ,or vertical direction from the pulp to the
periodontium.
 Furcation canals :
Accessory canals seen in the bifurcation or
trifurcation of the multirooted teeth are called
furcation canals.
 Apical foramen: ( Major apical diameter)
It is an aperture at or near the apex of the root through which the blood
vessels and nerves enter or leave the pulp cavity. (Grossman)
 It is the circumference or rounded edge, like a funnel or crater that
differentiates the termination of the cemental canal from the exterior surface
of the root. (Cohen)
 Apical constriction: (Minor apical diameter)
It is the part of the root canal with the smallest apical diameter; it also is the
reference point the clinician use most often as the apical termination for
cleaning shaping and obturation.

18.  CDJ:
It is a point in the canal where cementum meets dentine; it
is a point where the pulp tissue ends and periodontal tissue
begins. (Approximately 1mm from the apical foramen).
 Isthmus:
It is a narrow ribbon shaped communication between two
root canals that contain pulp or pulpally derived tissue.

19. Anatomy of apical root
Apical constriction
Cementodentinaljuncti
on
Apical foramen

20. Classification of canal configurations :
 According to Gross man :
 One canal existing as one canal
 Two canal exiting as one canal
 Two canals exiting as two canals
 One canal exiting as two canals
 According to Wiene :
 Type I:One canal exiting at one foramina
 Type II :Two canals exiting at one foramina
 Type III:Two canals exiting into two foramina
 Type IV:One canal exiting at two foramina.

21.  According to Vertucci (1984)
 One canal at apex
Type I : Single canal extending from pulp chamber to the apex.
Type II : Two canals leave the pulp chamber and joins short of the apex
to form one canal.
Type III: One canal leaves the pulp chamber, divides into two, within
the root and then merges to unite as one canal.

22.  Two Canals at apex
Type IV : Two separate canals from chamber to apex.
Type V : Leaves pulp chamber as one and divides short of the apex into 2
separate apical foramina.
Type VI: Two separate canals leave the pulp chamber and merge in the
middle body of the root then re-divides short of the apex.
Type VII: One canal leaves the pulp chamber divides and then rejoins
within the canal and finally re-divides into 2 distinct canals short of the
apex.
 Three canal at apex.
Type VIII: Three separate and distinct canals extend
from pulp chamber to the apex.

23. Maxillary central incisor
 Average tooth length-22.8 mm
 Pulp chamber
 centre of the tooth
 wider mesiodistally than
labiolingually widest part
incisaly
 3 pulp horns
 Chamber continuous with the
root canal

24.  Root canal
 Cross section
 Clinical significance
 The labial surface of the root lies under the
labial cortical plate of maxilla
 Relationship to nasal floor
 75% straight, 17% curve labially or palatally

25. Access opening
 Internal anatomy dictates the Access
cavity – refer diagnostic radiograph
 Slightly triangular with base towards
incisal aspect
 Outline of access cavity changes to
more oval shape as tooth matures
and pulp horns recede

26. Maxillary lateral incisor
 Average tooth length-
22.5mm
 Pulp chamber
 The outline chamber is
similar to central except
it is smaller.
 Two or no pulp horns

27.  Root
 Cross section
 Anatomic relationship in situ
 The labial surface of root of the
maxillary lateral under the cortical plate
of maxilla
 Palatal inclination

28. Clinical significance
 Distal and palatal curvature
 In cases of Dens invaginatus, peg lateral,
Talons cusp require modification in access
opening.
 Two or three canals have been reported

29. Maxillary canine
 Average tooth length-26 mm
 Pulp chamber
 are largest of any single
rooted teeth
 wider labiolingually than
mesiodistally
 One or No pulp horns

30.  Root –wider labiopalatally
 Straight 39%, distal curvature 32%
 Cross sections
 Anatomic relationship in situ
 An abscess usually perforates labial
cortical plate.
 If below the insertion of levatormuscle –
Buccal vestibule.
 It above the insertion – canine space 
cellulitis.

31. Clinical significance
 Longest tooth, canine eminence
 Apical curettage may be difficult.
 Buccal bone over canine eminence
disintegrates leading to fenestration.

32. Mandibular central incisor
 Average tooth length-20.8mm
 Pulp chamber:
 Smallest tooth in the arch.
 flat mesiodistally.
 Pulp horns-The three distinct
pulp horns present in recently
erupted tooth, disappear later

33.  Roots
 The mandibular central incisor has 1 root
flat and narrow mesiodistaly but wide
labiolingually.
 1 canal :70%,2 canals : 41%, 1*2*1 :22%
 Straight 60%
 Cross sections
 Anatomic relationship in situ
 The roots of the anterior teeth are broad
labiolingually occupy most of the alveolar
process

34. Clinical significance
 Because of small size and internal anatomy
may be most difficult tooth for access
opening.( smaller)
 Avoid overpreparation
 Complete removal of lingual shoulder critical,
often the second canal is present. For this
one should extend preparation lingually

35. Mandibular lateral incisor
 Average tooth length-22.6 mm
 Pulp chamber-
 configuration similar to mandibular central
except larger dimensions
 Roots also show similarity but with increased
dimensions

36.  Root curvature – Straight (Majority)
Distal (sharper)
 Clinical significance :
 2nd canal
 Gemination and fusion are common in
mandibular anterior teeth.

37. Mandibular canine
 Average tooth length -25.mm
 Pulp chamber-
 resembles maxillary canine but
it is smaller in dimensions
 labiolingually chamber narrows
to a point in the incisal third of
crown but it is wide in the
cervical third

38.  Roots
usually has a single root and canal (78%)
it may have two roots (2.3%) and two canals
(14%). These canals are narrow
mesiodistally wider labiolingually
Straight 68%, distal curvature 20%
 Cross sections

39. Clinical significance
 Lingual shoulder must be removed to gain
access to second canal / lingual wall.
 Incisal extension can approach incisal edge
for straighten access

40. Maxillary first premolar
 Average tooth length-
21.5 mm
 Pulp chamber
 wider bucco lingually
and narrow
mesiodistally.
 two pulp horns
 buccal>palatal

41.  Roots 2 roots in 54.6% cases.
separated (21.9%)
partially fused(32.7%)

 Irrespective or whether it has one root / two root it has 2
canals at the apex in 69% cases.
 The palatal canal is larger of the two and is directly
under palatal cusp and its orifice can be penetrated by
following the palatal wall of pulp chamber.
 buccal canal is under the buccal cusp

42.  Cross sections
 Anatomic relations in situ
 Relationship of the socket with alveolar
process varies with the number of roots.
 If one root then the socket is in close
relationship to buccal cortical plate.
 If two roots buccal is close to buccal
cortical plate and palatal is centrally located
 sinus.
 concavity

43. Clinical significance
 The outline form of cavity preparation
varies with the number of canals.
(2/3)
 straight or distally curved (38%:36% )
 Radiograph with angle (SLOB )
 Prone to mesio distal fracture so full
coverage restoration is required after root
canal treatment.

44. Maxillary second premolar
 Average tooth length-21.6mm
 Pulp chamber
 more wider buccopalatally
than the first premolar.
 if one root canal present
then the canal orifice may be
indistinct but if two canals are
present the two orifices will
be visible.

45.  Root canals
 Single root – 90.3% (1/2 canals)
 2 well developed roots – 2%
 Partially fused 2 roots – 7.7%.
 CROSS SECTION :
 Cervical – Ovoid and narrow
 Middle 1/3 – Ovoid (1 canal); round (2 canal)
 Apical 1/3 – Round.
 Anatomical relations in situ
close relationship with maxillary sinus

46. Clinical significance
 Depending on the number of canals the
external outline form varies.
 One canal : Buccolingual width corresponds to width
between buccal and palatal pulp horns.
 Two canals : Access preparation is nearly identical to
first premolar.
 Three canals : The access outline form is same
triangular shape.
 Presence of isthmus

47. Mandibular first premolar
 Average tooth
length-21.9mm
 It is a transitional
tooth between
anterior and
posterior
 Buccal pulp horn

48. Enigma to endodontist
 Root canals :
 The mandibular first
premolar has a short
conical root.
 A single root canal may
divide in apical third
into 2 or 3 root canals.
 Straight (48%)

49. 1*1 : 70%
1*2 : 24%
2*2 : 1.5%
1*2*1 : 4%
3*3 : 0.5%
 Cross sections
 Anatomic relationship insitu
 mental canal and foramen close to root
apex . radiographic appearance may
suggest periapical pathoses.

50. Mandibular second premolar
 Average tooth length-
22.3mm
 Pulp chamber
 similar to 1st premolar
except the lingual horn
is more prominent
under a well developed
lingual cusp

51.  Root
 usually 1 canal exists in 1apical foramen
in 97.5%
 In 2.5% cases a single canal may
bifurcate exiting in 2 foramina.
 Straight or distally curved (39%;40%)
 Cross section
 Anatomic relationship in situ
 Mandibular second premolar is in closer
relationship to mental foramen.

52. Clinical significance
 crown has less lingual inclination---- less
extension up the buccal cusp
 lingual half well developed---- access
extension is halfway up the lingual cusp
incline.

53. Maxillary first molar
 Average tooth length-
21.3mm
 Pulp chamber 4 pulp
horn
 Largest in the arch
 Roof– rhomboidal
 floor triangular in cross
section

54.  Orifices
 Palatal-largest round
 Mesiobuccal-under the
mesiobuccal cusp
long buccopalatally
 Distobuccal- distal and
to palatal mesiobucal
orifice

55. Dilema of mb2 (84%)
 generally present
mesial to or directly on
a line joining MB – 1
and palates orifice
.
 20 distal eccentric
angulation be used

56.  Roots
 Palatal-largest, flat ribbon like wider
mesiodistaly, 40%straight
 Distobuccal-small, narrow,flattenned
mesiodistally
 Mesiobuccal –narrowest ,flattened in
mesiodistal direction at orifice ,but round in
apical 3rd

57.  Anatomical relationship in situ
Close proximity to maxillary sinus
Clinical significance
 Pulp stones may be present
 concavity exists on the distal aspect or
mesiobuccal root

58. Maxillary second molar
 Average tooth length-
21.7 mm
 Pulp chamber
 Similar to maxillary first
molar except it is
narrower mesiodistally

59.  Root
 maxillary second molar has 3 roots which are
closely grouped.
 fourth canal is less frequent
 If the buccal roots fuse -2 canals (1 buccal, 1
palatal).
 A tooth with only 1 root -1 conical root canal
 Anatomic relationship in situ

60. Clinical significance
 Access cavity varies number of canals
 Four – Rhomboidal
 Three – Triangular
 Two – Ovoid widest in buccopalatal direction
 Mesial marginal ridge should not be involved.
 To enhance radiographic visibility especially
when interferences arises from malar process

61. Maxillary third molar
 Tooth length – 17.1 mm
 Pulp chamber : anatomically resembles the
second molar.
 The pulp chamber may vary greatly. This may
have odd shaped chamber with four or five
root canal orifices or a conical chamber with
only on root canal.

62. Mandibular first molar
 Average tooth length-
21.9mm
 Pulp chamber -
 Pulp horns - four
 Roof –rectangular
 Floor- trapezoidal
/rhomboidal

63.  Roots
 Usually 2 well differentiated roots with 3
canals
 wide and flat buccolingually
 a depression in the middle of the root
buccolingually

64.  Distal -is oval in shape with the
widest diameter buccolingually. The
opening is generally located distal to
the buccal groove.
 Mesiobuccal -under the
mesiobuccal cusp.
 long shank starlite D-11 explorer
is inserted in mesiobucco apical
inclination
 mesiolingual- a depression
formed by mesial and lingual wall

65. Clinical significance
 Mesial root-
2* 2 (41%), 2*1 (28%),
2*1*2 (13%), 1*1 (12%),
3*3 - midmesial - rare
 Distal root-
1*1(70%), 2*1(15%), 1*2 (8%)
2*2 (5%), 2*1*2 (2%)
 slob
 Avoid overpreparation

66. Mandibular second molar
 Average tooth length-
20.4mm
 Pulp chamber
 The pulp chamber is
smaller than that or
mandibular first molar
and the root canal
orifices are smaller and
closer together.

67.  Roots
 Majority of mandibular second
molars have
 2 roots (71%)
 1 root (27%)
 3 roots (2%)
 Three root canals are usually
present in mandibular second
molars.
 Cross section
 Anatomic relationship in situ

68. Clinical significance
 This tooth very close to mandibular canal
 The clinician must take care not to allow
instruments or filling material to invade this
space because paresthesia may result.
 C shaped canal

69. C shaped canals
 The C-shaped canal
was first reported in
1979
 mandibular second
molar.
 cross sectional
morphology of their
roots and root canals is
a single ribbon orifice
with an arc of 180 or
more.

70. classification
Meltons classification
Fans classification

71. Mandibular third molar
 Average tooth length-
18.5mm
 Pulp chamber-
 resembles the pulp
chamber of mandibular
first and second molar
. possess many
anomalous
configuration

72. Comparison of permanent and
deciduous teeth

73. Variations to normal pulpal structure
Factors
Physiological
Development
al
Pathological
Others

75. Variation of pulp space
1. Variation in development.
 Dentinogenesis imperfecta
 Dens Invaginatus
 Dens Evaginatus
 Fusion
 Gemination
 Concrescence
 Taurodontism
 Talons cusp
 Dentine dysplasia (rootless teeth)
 Regional odontodysplasia (ghost teeth)
 Palatogingival groove
 Extra root
 Missing root

76. 2. Variation in size of length
 Microdontia
 Macrodontia
 Idiopathic
3. Variation in shape of the pulp space
 Apical curve
 Gradual curve
 Sickle shape
 ‘C’ shaped
 Bayonet shaped
 Dilaceration

77. 4. Variation caused by pulp pathology
 Internal resorption
 External resorption
 Pulp stones
 Calcified canals
5. Variation in Apical third
 Open apex
 Variation in location of apex
 Apical ramification
 Lateral canal

78. Internal resorption

79. External resorption

80. GEMINATION (Twinning)
 Attempt at division of a single tooth germ
by invagination resulting in incomplete
formation of two teeth.
 Two completely or incompletely formed
crown with single root canal.
 Differentiate gemination with fusion

81. FUSION
 By levitas
 Fusion of two separate tooth germs
 It may be complete or incomplete
depending on stage of development
 Caused due to physical force or
pressure
 Separate or fused root canal
 It may fuse with supernumerary tooth

82. Taurodontism

83. DILACERATION
 Angulation, sharp bend, or
curve in the root
 It depends on the stage of
root formation
 Common with maxillary
lateral incisor and maxillary
first molar

84. Open apex (Incomplete Rhizogenesis)
Refers to the absence of sufficient root development to provide a
conical taper to the canal and is referred to as a blunderbuss canal (This
means that the canal is wider toward the apex than near the cervical area)

85.  Introduction
 Objectives
 Development, histology of pulp
 Components of pulp space – terminology
 Classification of pulp space
 Techniques for visualization of internal
anatomy
summary

86.  Detailed study of internal anatomy of permanent tooth
 Comparative study of deciduous and permanent tooth
structure
 Variation in normal pulpal structure and its significance
 Physiological
 Pathological
 Development
 Conclusion
 References

87. Conclusion
The eyes do not see what
The mind doesn’t know

88. references