Maxillary Tooth Root Anatomy

http://rootcanalanatomy.blogspot.com
Maxillary Teeth
Dr.Abdelazim Mohamed Badreldin
G.V.Black dental center- khartoum –Sudan
Feb.16- 2012

-Dental anatomy is the only fact
in dentistry that will not change
- If you have a good knowledge
in dental anatomy you can do many
procedures in dentistry
azma
azmadent@hotmail.com

Maxillary Central Incisor
 The cross-sectional root anatomy of the maxillary
central incisor is triangular or ovoid in shape and
tapers toward the lingual.

 lateral canals and apical delta usually found
at mid and apical -third of the root
 The average diameter of the major foramen
is 0.4 mm while the accessory foramina were
0.2 mm in diameter.
Green (study of root apices)
 The average distance of the major apical foramen from the
anatomical root apex was found to be 0.3 mm. Approximately
12% of the maxillary central incisors exhibited accessory foramina
Ingle ( Endodontic 6 )

 Apical ramifications were found in 12.3% . Lateral canals
were present in 49.1% .38.6% have a simple main canal
without lateral canals or apical ramifications. 90 % of the
apical foramina were located within 1.0mm of the
anatomical apex.
Kasahara et al.75
The maxillary central incisor had the highest
incidence of fusion and gemination of all
permanent teeth (fusion 2.6%, while
gemination was found in 0.94% …
Hamasha and Al-Khateeb
Study in a Jordanian population

From Vertucci FJ, Haddix JE. Tooth morphology and access cavity preparation. In: Hargreaves KW, Cohen S. Cohen’s pathways of pulp. 10th ed. Mosby Elsevier, 2011. 1026 p.

Access Cavity Preparation
Ingle …ENDODONTIC 6

 The maxillary lateral incisors are single-rooted .
 The cross-sectional root anatomy of the maxillary
lateral incisor is described as being circular, oval,
or ovoid in shape and tapers toward the lingual
 The root trunk is generally smaller than a central
incisor and has a finer root tip. often terminating
in a curve to the distal or the lingual.
 The overall average length of the maxillary
lateral incisor is 22 mm with an average crown
length of 9 mm and an average root length of 13 mm.
Maxillary Lateral Incisor

 The maxillary lateral incisor usually presents with a single canal.
 The root apex and the apical foramen usually were displaced
distolingually .
 The apical foramen and the root apex are not coincided
,therefore, the exploration of the apical foramen and the
constriction, with a fine precurved #10 size file tip and the
electronic apex locator, is essential to locate the foramen.

VARIATIONS AND ANOMALIES
 Maxillary lateral incisors often present anatomic anomalies
resulting in diagnostic and treatment challenges.
Pecora and Cruz Filho
 The incidence of radicular grooves is 3.0% .
 There are reports of maxillary lateral incisors with fusion with
a supernumerary tooth, fusion with a maxillary central incisor,
gemination two roots, dens evaginatus, or dens invaginatus .

Maxillary Canine
 The root of the maxillary canine is oval in shape and tapers
toward the lingual
 The root is wider labiolingually and is the longest root in the
dentition, approximately 17 mm in length.
 Prominent developmental depressions can be present on both its
mesial and distal surfaces, especially in the middle third of the root.
 The root tip may be blunt or it may end in a fine, often curved tip
 The overall average length of the maxillary canine is 27 mm with an
average crown length of 10 mm and an average root length of 17 mm

Maxillary Canine
 Most studies have found that the maxillary canine has a single root
100% of the time,
 The maxillary canine usually has a single canal , 3.5 % have
two canals . those having two canals, the majority join in the
apical third and exit through a single foramen.
 Accessory (lateral) canals are not uncommon and the majority
of these occur in the apical third of the tooth , and less in midroot
.
 The root apex and the apical foramen were displaced distolabially
 In the most cases the apical foramen and the root apex was not
coincided , therefore the use of the electronic apexlocator is more
reliable than the radiograph in root canal treatment.

Maxillary Canine
 The average distance of the major apical foramen from
the anatomical root apex was found to be 0.3 mm.
 Approximately 12% of the maxillary canines exhibited
accessory foramina.

Maxillary Canine
 The maxillary canine usually presents few anatomical variations.
 When variations do occur, the root is more frequently affected than the crown
 The total incidence of dens evaginatus has been shown to be approximately
1% in an extensive literature review and usually take the form of a tubercle
or a talon cusp, and is most frequently found on the lingual surface of
the crown , there are also reports of labial tubercles.
 Other variations reported in the literature include case two canals in a single
root, dens invaginatus .

Maxillary Canine

Maxillary Canine
Errors in access Cavity Preparation

Maxillary First Premolar
 Maxillary first premolar may have one, two (which is more common ),
or three roots .
 There are some common features to the various form
 overall length of the maxillary first premolar
is 22 mm with an average crown length of 8.5 mm
and an average root length of 14 mm.
 Prominent root concavities are present on both
the mesial and the distal surfaces of the root.
Buccal view Palatal mesial Distal

 The incidence of three-rooted maxillary first premolars
ranged from 0% to 6%.
 The studies identifying ethnic background have
demonstrated distinct differences between Asian and
Caucasian populations. Single-rooted maxillary first
premolars are the dominant form in Asian population,
and three-rooted forms are rare

 Ethnicity was a factor in canal number. The incidence of a single
canal was significantly higher in Asian populations compared
to the mixed non-Asian population.
 All of the three-rooted first premolars in the anatomical
studies were found to have a single canal in each root.
 Regardless of the number of roots, the majority of maxillary first
Premolars had two separate canals and foramina at the apex
Ingle 6

Errors in Access Cavity Preparation

Maxillary Second Premolar
 Oval- or kidney-shaped root cross-section.
 Developmental depressions are often present on the mesial and
the distal aspects of the root.
 The single root trunk is broad buccolingually and is narrower mesiodistally.
 The root tip ends as a single blunt apex, but it may be fine and divide
into two or more, rarely three, apices.
 The curvature in the apical third is also not uncommon.
 The overall average length is 22.5 mm with an average crown length
of 8.5 mm and an average root length of 14 mm.
 The most Common form of the maxillary second premolar is a single root ,
5.5% to 20.4% the incidence of two roots ,while the three-rooted form
was a rare finding and ranged from 0% to 1% .
many patients as this anomaly is quite e. Ingle ( Endodontic 6 )

 The maxillary second premolar has a single canal in approximately
50% of the 2743 teeth examined in 10 anatomical studies,
 Even though over 90% of these teeth have a single root, a high proportion
will have two canals present.
 Canal exploration of maxillary second premolar teeth should be done
with fine curved files, keeping in mind the Vertucci or Weine classification
of two canals in one root that may not be apparent on the radiograph.
 The incidence of three canals in the maxillary second premolar
was low in each of the anatomical studies.

 Three-rooted maxillary second premolar teeth do not seem to be as
common as in first premolars.
 This anomaly is often bilateral and should be considered by exposing
radiographs taken at different angles.

Errors in Access Cavity Preparation

Maxillary First Molar
 The maxillary first molar normally
has three roots
 The mesiobuccal root is broad
buccolingually and has prominent
depressions or flutings on its mesial
and distal surfaces.
 The distobuccal root is generally
rounded or ovoid in cross section
 The palatal root is more broad
mesiodistally than buccolingually
and ovoidal in shape .
 The palatal root generally appears
straight on radiographs,but there
is usually a buccal curvature in
the apical third.
 The overall average length of the
maxillary first molar is 20.5 mm
with an average crown length
of 7.5 mm and an average root
length of 13mm.

 The internal canal morphology is highly variable, but the majority
of the mesiobuccal roots contain two Canals.
 The distobuccal root is usually contains
a single canal.
 The palatal root is normally contains
 only a single canal.

 The internal root canal system morphology reflects the external
root anatomy.
 The mesiobuccal root contains a double root canal system more often
than a single canal according to most of the anatomical studies .
 The incidence of two canals in the mesiobuccal root was 57.1 and of one
canal was 42.9% in a weighted average of all reported studies.
 The incidence of two canals in the mesiobuccal root was higher
in laboratory studies (61.1%) compared to clinical studies
 The distobuccal root had only one canal in 98.3% of teeth studied,
while the palatal root had only one canal in over 99% of the teeth studied.

 The incidence of location of a two-canal system in clinical studies
appears to be increasing with the routine use of the SOM and other
aids during the modified endodontic access opening procedure.
 The two-canal system of the mesiobuccal has a single apical foramen
roughly twice as often (66.0%) in proportion to the two-canal and
two-foramen morphology, in weighted laboratory studies .
 The single-canal system and single apical foramen in the palatal and the
distobuccal root is the most predominant form, as reported in all studies,
but multiple canals and more than one apical foramen variation do exist
in 1–3% of these roots in the weighted studies reported.

From Vertucci FJ, Haddix JE. Tooth morphology and access cavity preparation. In: Hargreaves
KW, Cohen S. Cohen’s pathways of pulp. 10th ed. Mosby Elsevier, 2011. 1026 p.

Errors in Access Cavity
Preparation

Maxillary Second Molar
 The maxillary second molar normally has three roots.
 The relative shape of each of the roots is similar to the
maxillary first molar, but the roots tend to be closer together
and there is a higher tendency toward fusion of two or three roots.
 There is also usually more of a distal inclination to the root or roots
of this tooth compared to the maxillary first molar.
 The mesiobuccal root is broad buccolingually and has prominent
depressions or flutings on its mesial and distal surfaces.
 The distobuccal root is generally rounded or ovoid in cross section
 The palatal root is more broad mesiodistally than buccolingually
and ovoidal in shape
 The overall average length is 19 mm with
an average crown length of 7 mm and an
average root length of 12 mm.

 The internal canal morphology is variable and the closer proximity
of the roots results in a higher incidence of root fusion
and C-shaped canals.
 Anatomical studies indicate that the mesiobuccal root has almost
an equal incidence of one or two canals .
 The distobuccal and the palatal roots are usually contains
a single canal.

 The shape of the root provides an indication of the shape of the
internal canal morphology.
 The mesiobuccal root is broad buccolingually and narrow
mesiodistally and may have contain may have one or two canals.
 The anatomical studies found a wide range of canal incidence in
the mesiobuccal root.
 The single canal is usually described as being kidney- or ribbon-shaped.
 Eskoz and Weine suggest that age and continued deposition of secondary
dentin in the isthmus can cause narrowing and possible occlusion
resulting in two canals.
 There was a single apical foramen found in the mesiobuccal root over
68% of the time.
 The distobuccal and palatal roots exhibited a single canal over 99%
of the time in the 10 anatomical studies reported

Access cavity Preparation

Errors of Access cavity Preparation

Maxillary Tooth Root Anatomy

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