In Vitro Macroscopic and Endoscopic Analysis of Three-Rooted Maxillary Premolars and Two-Rooted Mandibular Premolars in the Same Individual: a Case Report

Abstract

ARACENA, D.; BELTRÁN, V.; FUENTES, R. & BORIE, E.In vitro macroscopic and endoscopic analysis of three-rooted maxillary premolars and two-rooted mandibular premolars in the same individual: a case report. Int. J. Morphol., 30(1):19-24, 2012. SUMMARY:The recent addition of endoscopy in dental practice has enabled clinicians to have an excellent view of the operative field, yielding highly successful visualization of anatomical structures that are difficult to access, both in oral surgery and endodontics. The purpose of this report is to provide an in vitro macroscopic, radiographic, and endoscopic description of the anatomic variation of the roots of maxillary and mandibular first premolars in the same patient. A 22-year-old patient was referred by an orthodontist for the extraction of all the first premolars. Once extracted, the premolars were examined macroscopically and then analyzed radiographically after trepanation and filled root canal systems. Subsequently, a diaphanization process was carried out and the samples were sectioned at the middle and apical third for observation by endoscope. It was found that both the maxillary first premolars had three roots, and mandibular first premolars had two roots, all with complete root formation. Apical deltas or accessory canals were not identified in the radiographic images; however, through endoscope at the middle third, it was possible to observe an accessory canal to the first maxillary and mandibular right premolars. Thus, it can be concluded that the view through the endoscope allows better identification of accessory canals than X-rays.

A computational modeling method for root canal endoscopy using a specific CBCT filter: A new era in the metaverse of endodontics begins

“…Apical deltas or accessory canals were frequently not identified on radiographs, but the endoscope used in the middle third showed an accessory canal in the maxillary and mandibular first premolars. Endoscopic views show accessory canals better than periapical radiographs (18).…”

“…Several studies have investigated the internal morphology of root canals (7)(8)(9)(10)18,20,35) and the potential for new advances including the application of CBCT (6)(7)(8)(9)(10)35,36). There have also been attempts to find alternatives to a tool that would act as an endoscope inside the root canal.…”

Endodontic management of small molars

“…2,3 The formation of an accessory root could be related to hyperactivity of Hertzwig epithelial root sheath or an invagination of dental papilla at a pathological degeneration site in the root sheath resulting in an extra root. 4 Moreover, Midtbø et al 5 evaluated root length, crown height and root morphology of patient's with Turner's syndrome and reported incidences of three roots in maxillary first premolar as one of the macromorphological radicular variant.…”

Bilateral Two-rooted Mandibular Canines in the Same Individual: a Case Report

“…The root and canal morphology may be evaluated by many techniques such as cone-beam computerized tomography (Tian et al, 2012), clinically (Marcaccini et al, 2012), radiographically (Oporto et al), endoscopically (Aracena et al, 2012), among others. Thus, in this case the bilateral two-rooted mandibular canines were found radiographically.…”