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Maxillary lateral incisor

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MAZEN DOUMANI

Published in: Health & Medicine
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Maxillary lateral incisor

  1. 1. MAXILLARY LATERAL INCISOR EXTERNAL ROOT MORPHOLOGY • 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 • The maxillary lateral incisors are single-rooted, virtually 100% of the time • Most reported cases of two-rooted maxillary lateral incisors are a result of fusion or gemination and are usually associated with a macrodont crown. MAZEN DOUMANI 2014 1
  2. 2. MAXILLARY LATERAL INCISOR • The root apex and the apical foramen were displaced distolingually • The coincidence of the apical foramen and the root apex was found in only (6.7%) of the specimens. 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. MAZEN DOUMANI 2014 2
  3. 3. MAXILLARY LATERAL INCISOR • the average diameter of the major foramen is 0.4 mm, while the accessory foramina were 0.2 mm in diameter. • The average distance of the major apical foramen from the anatomical root apex was found to be 0.3 mm. • Approximately 10% of the maxillary lateral incisors exhibited accessory foramina. Apical foramen Lateral foramen MAZEN DOUMANI 2014 3
  4. 4. MAXILLARY LATERAL INCISOR • An SEM investigation of 14 extracted maxillary lateral incisors with radicular grooves concluded that direct communication between the groove and the pulp was evident in these specimens and that accessory canals were the primary mechanism of communication between the periodontium and the pulp MAZEN DOUMANI 2014 4
  5. 5. MAXILLARY LATERAL INCISOR • An SEM investigation of 14 extracted maxillary lateral incisors with radicular grooves concluded that direct communication between the groove and the pulp was evident in these specimens and that accessory canals were the primary mechanism of communication between the periodontium and the pulp MAZEN DOUMANI 2014 5
  6. 6. OEHLERS CLASSIFIED DENS INVAGINATUS INTO THREE TYPES BASED ON THE SEVERITY OF THE DEFECT. • Type 1 dens invaginatus is an invagination confined to the crown. • Type 2 extends past the cementoenamel junction but • does not involve periapical tissues. • Type 3 defect. The invagination extends past the cementoenamel junction and may result in a second apical foramen. 1 2 3 MAZEN DOUMANI 2014 6
  7. 7. In cases of dens invagination : • Vitality of the pulp in the main canal has been shown to be maintained while treating (surgically, nonsurgically, or both) the accessory canal system, when there has been no communication between the two Vital pulp Treatment is on this accessory canal MAZEN DOUMANI 2014 7
  8. 8. MAXILLARY CANINE • A small percentage of maxillary canines have two canals(3.5%) • Of those having two canals, the majority (75%) join in the apical third and exit through a single foramen • Accessory (lateral) canals are not uncommon and become evident radiographically after the completion of RCT • The majority of lateral canals occur in the apical third of the tooth Lateral canal radicular-form of dens invaginatus type 3. canine MAZEN DOUMANI 2014 8
  9. 9. MAXILLARY CANINE • One individual with an extremely long root length was reported by Booth in 1988 with canine teeth having an overall length of 41 mm. • This patient was a 31-year-old female of Dutch origin. • The total incidence of dens evaginatus has been shown to be approximately 1% MAZEN DOUMANI 2014 9
  10. 10. MAXILLARY FIRST PREMOLAR • The root anatomy of the maxillary premolar can vary depending on whether one, two, or three roots are present . MAZEN DOUMANI 2014 10
  11. 11. MAXILLARY FIRST PREMOLAR There are some common features to the various forms of maxillary first premolars: The overall length of the maxillary first premolar is 22.5 mm . Prominent root concavities are present on both the mesial and the distal surfaces of the root. The mesial root concavity is more prominent and extends onto the cervical third of the crown. This results in a root that is broad buccolingually and narrow mesiodistally with a kidney shape when viewed in cross section at the cementoenamel junction MAZEN DOUMANI 2014 11
  12. 12. MAXILLARY FIRST PREMOLAR The majority of anatomical studies found that the most common form of the maxillary first premolar is the two-rooted form. There was a wide variation in the incidence of the number of roots in the anatomical studies cited. (three canals in two fused buccal roots and a lingual root.) MAZEN DOUMANI 2014 12
  13. 13. MAXILLARY FIRST PREMOLAR • The incidence of three-rooted maxillary first premolars ranged from 0% to 6% • Single-rooted maxillary first premolars are the dominant form in Asian population, and three-rooted forms are rare MAZEN DOUMANI 2014 13
  14. 14. MAXILLARY FIRST PREMOLAR • The majority of maxillary premolars were found to have two canals, irrespective of whether the tooth has a single or a double root. • over 75% of the teeth studied had two canals. • The incidence of a single canal was significantly higher in Asian populations compared to the mixed non-Asian population MAZEN DOUMANI 2014 14
  15. 15. MAXILLARY FIRST PREMOLAR • The Weine type IV root canal system, with a wide buccolingual canal that branches into two apical canals and foramina in the apical third, may sometimes be confused as a taurodont-like root canal anatomy, when it occurs in single-rooted maxillary premolar teeth. MAZEN DOUMANI 2014 15
  16. 16. MAXILLARY FIRST PREMOLAR • The Weine type IV root canal system, with a wide buccolingual canal that branches into two apical canals and foramina in the apical third, may sometimes be confused as a taurodont-like root canal anatomy, when it occurs in single-rooted maxillary premolar teeth. MAZEN DOUMANI 2014 16
  17. 17. MAXILLARY SECOND PREMOLAR • The root tip usually 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. One Canal Dividing in Apical Third MAZEN DOUMANI 2014 17
  18. 18. MAXILLARY SECOND PREMOLAR • The overall average length of the maxillary second premolar 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. • The incidence of two rooted maxillary second premolars ranged from 5.5% to 20.4%while the three-rooted form was a rare finding and ranged from 0% to 1% MAZEN DOUMANI 2014 18
  19. 19. MAXILLARY SECOND PREMOLAR MAZEN DOUMANI 2014 19
  20. 20. MAXILLARY SECOND PREMOLAR NOTICE • 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. MAZEN DOUMANI 2014 20
  21. 21. MAXILLARY SECOND PREMOLAR Maxillary left second premolar with a single root and a single canal Maxillary right second premolar with a single root and single canal; the apical third exhibits a curvature to the mesial. Maxillary left second premolar with a single root and a single main canal; two lateral (accessory) canals are visible in the apical third of the root. MAZEN DOUMANI 2014 21
  22. 22. MAXILLARY FIRST MOLAR • The maxillary first molar normally has three roots . • The mesiobuccal root is broad buccolingually and has prominent depressions MAZEN DOUMANI 2014 22
  23. 23. MAXILLARY FIRST MOLAR • The internal canal morphology is highly variable, • The majority of the mesiobuccal roots contain two canals. MAZEN DOUMANI 2014 23
  24. 24. MAXILLARY FIRST MOLAR • The distobuccal root is generally rounded or ovoid in cross section and usually contains a single canal. • The palatal root is more broad mesiodistally than buccolingually and ovoidal in shape but normally contains only a single canal M D P MAZEN DOUMANI 2014 24
  25. 25. MAXILLARY FIRST MOLAR • The palatal root generally appears straight on radiographs, 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 13 mm MAZEN DOUMANI 2014 25
  26. 26. MAXILLARY FIRST MOLAR • The maxillary first molar root anatomy is predominantly a three-rooted form(95%), as shown in all anatomical studies of this tooth • The two rooted(3.8%) form is rarely reported and may be due to the fusion of the distobuccal root to the palatal root or the fusion of the distobuccal root to the mesiobuccal root. MAZEN DOUMANI 2014 26
  27. 27. MAXILLARY FIRST MOLAR • The single root or the conical form of root anatomy in the first maxillary molar is very rarely reported. • The four-rooted anatomy in its various forms is also very rare MAZEN DOUMANI 2014 27
  28. 28. MAXILLARY FIRST MOLAR MAZEN DOUMANI 2014 28
  29. 29. MAXILLARY FIRST MOLAR • The mesiobuccal root of the maxillary first molar contains a double root canal system more often than a single canal MAZEN DOUMANI 2014 29
  30. 30. MAXILLARY FIRST MOLAR • The mesiobuccal root of the maxillary first molar contains a double root canal system more often than a single canal Pathways of the pulp tenth edition MAZEN DOUMANI 2014 30
  31. 31. MAXILLARY FIRST MOLAR The single-canal system and single apical foramen in the palatal and the distobuccal root of the maxillary first molar 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 Two canals in both buccal roots with a common foramen in each root. Two separate canals in palatal root MAZEN DOUMANI 2014 31
  32. 32. MAXILLARY FIRST MOLAR Age was found to have an effect on the incidence of MB2.  Fewer canals were found in the mesiobuccal root due to increasing age and calcification. The MB2 canal was found in (71.1%) when using SOM and in(62.5%) when using loupes MAZEN DOUMANI 2014 32
  33. 33. MAXILLARY FIRST MOLAR There are reports of : 1) two palatal canals in three-rooted teeth 2) three palatal canals in a reticular palatal root 3) five roots (two palatal, two mesiobuccal, and one distobuccal) 4) C-shaped canals . 5) Of all the canals in the maxillary first molar, the MB2 can be the most difficult to find and negotiate in a clinical situation MB 1 2 3 First molar: 6 canals MAZEN DOUMANI 2014 33
  34. 34. 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. MAZEN DOUMANI 2014 34
  35. 35. MAXILLARY SECOND MOLAR • 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 mesiobuccal root has almost an equal incidence of one or two canals MAZEN DOUMANI 2014 35
  36. 36. MAXILLARY SECOND MOLAR • The distobuccal root is generally rounded or ovoid in cross section and usually contains a single canal. • The palatal root is more broad mesiodistally than buccolingually and ovoidal in shape but normally contains only a single canal. • The overall average length of the maxillary second molar is 19 mm with an average crown length of 7 mm and an average root length of 12 mm MAZEN DOUMANI 2014 36
  37. 37. MAXILLARY SECOND MOLAR • The majority of maxillary second molars (88.6%) in the anatomical studies were found to be three rooted. • The closer proximity of the roots results in a higher incidence of root fusion (25.8%). • C-shaped canals(4.9%). MAZEN DOUMANI 2014 37
  38. 38. MAXILLARY SECOND MOLAR MAZEN DOUMANI 2014 38
  39. 39. MAXILLARY SECOND MOLAR MAZEN DOUMANI 2014 39
  40. 40. MANDIBULAR CENTRAL INCISOR • single-rooted. • The external form of the root is broad labiolingually and narrow mesiodistally. • Longitudinal depressions are present on both the mesial and the distal surfaces of the root • A cross section of the root is ovoid to hourglass in shape • The overall average length 21.5 mm with an average crown length of 9 mm and an average root length of 12.5 mm. MAZEN DOUMANI 2014 40
  41. 41. MANDIBULAR CENTRAL INCISOR • All of the anatomical studies reviewed reported that 100% of the mandibular central incisors studied were single-rooted teeth. • The canal system is either ovoid or ribbon shaped. MAZEN DOUMANI 2014 41
  42. 42. MANDIBULAR CENTRAL INCISOR • Approximately 12% of the mandibular exhibited accessory foramina. • average distance of the apical foramen from the anatomical root apex was found to be 0.2 mm Mandibular left central with two canals and one apex. MAZEN DOUMANI 2014 42
  43. 43. MANDIBULAR CENTRAL INCISOR A few anomalies are reported for this tooth in the literature: A. two canals and two separate foramina B. dens invaginatus C. fusion D. Gemination E. dens evaginatus that includes a lingual talon cusp and a labial talon cusp MAZEN DOUMANI 2014 43
  44. 44. MANDIBULAR LATERAL INCISOR  The mandibular lateral incisor is single-rooted . and is comparable in form to the mandibular central incisor.  The external form of the root is broad labiolingually and narrow mesiodistally.  Longitudinal depressions are present on both the mesial and the distal midroot surfaces of the root  A cross section of the root is ovoid or hourglass in shape due to the developmental depressions on each side  The overall length is 23.5 mm with an average crown length of 9.5 mm and an average root length of 14 mm MAZEN DOUMANI 2014 44
  45. 45. MANDIBULAR LATERAL INCISOR • All of the anatomical studies reviewed reported that 100% of the mandibular lateral incisors studied were single-rooted teeth, • The shape of the canal system is comparable to the mandibular central incisor and is either round or ribbon-shaped two canals and one apical foramen MAZEN DOUMANI 2014 45

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