No abstract

No abstract

Purpose: An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans. Methods: Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05). Results: Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al.1 MP 1 ) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created. Conclusion: Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.

Purpose: This study investigated the root and canal morphology of the permanent anterior dentition in a Black South African population. Methods: In total 2,343 permanent anterior teeth were evaluated using cone-beam computed tomography images and described according to the Vertucci and Ahmed et al. classifications. Demographic information, root number and internal canal morphology were recorded. Age and sex associations were made using Fisher's exact test (P < 0.05). Results: All anterior teeth were single-rooted (100%). The most frequent configuration in maxillary anteriors was a single canal (Vertucci Type I/ 1 MXA 1 ). In mandibular anteriors, single canal configurations (Type I/ 1 MDA 1 ) predominated, however 36.6% of mandibular central and 33.9% of lateral incisors displayed two canals. Older subjects (>40 years) demonstrated single canals more than younger subjects (P = 0.0004). Females displayed variations more compared to males (P = 0.002). The two classifications were found to be comparable for evaluation of permanent anterior teeth. Complex configurations were better described using the newer system. Conclusion:The permanent anterior teeth of this population exhibited exclusively single roots and diverse internal characteristics. Clinicians should be aware of anatomical variations, particularly in mandibular incisors, as these may result in adverse endodontic outcomes if not taken into consideration by the treating practitioner.

Dentin dysplasia (DD) Type I is a developmental condition affecting dentin, inherited in an autosomal‐dominant pattern or occurring due to a new mutation. Whilst the crowns of DD Type I affected teeth appear clinically normal, the roots are blunt and shortened. Pulp necrosis and periapical pathoses may be seen in the absence of obvious causes. Pulp stones and calcifications are frequently encountered. Endodontic management of DD may be challenging. A case of DD Type I, sub‐classification d, in which spontaneous irreversible pulpitis developed on three mandibular incisors is documented. The case was managed by conventional endodontic treatment. Knowledge of this uncommon dental condition may assist dentists to adequately diagnose and manage these cases. Extraction should not be considered the first‐line treatment option when sufficient root length is available to attempt endodontic treatment. Referral for medical evaluation is recommended to rule out systemic diseases which may mimic this condition.