Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations

Ahmad, Ibrahim Ali; Alenezi, Mohammad Ahmad

doi:10.1016/j.joen.2016.02.017

Cited by 66 publications

(63 citation statements)

References 83 publications

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“…The distribution of the number of roots in the present study was similar to that reported in a number of studies in non-Asian populations (USA, Brazil, Poland, Spain, Jordan, Australia): 35% of the first maxillary premolars were reported to have one root, 66% two roots, and 3% three roots 3 . However, the numbers are different when Asian populations (South China, Singapore, Japan) were considered 3 . In a recent CBCT study from a Chinese population, one-rooted teeth were the most common (66%), whereas two-rooted teeth were found in only 33% of cases 17 .…”

Section: Discussionmentioning

confidence: 99%

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Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study

Kfir

Mostinsky

Elyzur

et al. 2020

Sci Rep

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Anatomical features of first maxillary premolars may greatly affect endodontic and following restorative treatments. The aim of this study was to evaluate root canal configuration and root wall thickness of first maxillary premolars using a preexisting CBCT database. A CBCT database of 400 first maxillary premolar was used to study canal configuration, presence of furcation-facing groove on the buccal root and root wall thickness. Root wall thickness was measured from axial CBCT slices at three critical points of the root: The most coronal part of the furcation-facing groove in the buccal root, when present, the CEJ level of the palatal root and 5 mm apically to the CEJ level of the palatal root. Vertucci Type IV configuration was the most common among all teeth, but in single-rooted teeth, Vertucci Type II was predominant. The mean thickness of the buccal root in the area of a furcation-facing groove was 1.1 (±0.2) mm, but in 39% of the cases, it was thinner than 1 mm. The mean thickness of the palatal root at 5 mm from the CEJ was 1.1 (±0.2), but in 28% of the cases, it was thinner than 1 mm. Thickness of root dentin walls of first maxillary premolars varies and may be limited at critical points in both buccal and palatal roots. In case the patient has a previous CBCT scan it may be useful for planning treatment of first maxillary premolars, in order to recognize and avoid potential risks such as furcation-facing groove, thin dentin walls in critical areas and presence of Type II Verucci canal, all of which may dictate less invasive procedures, using smaller files.Endodontic treatment requires knowledge of and familiarity with root anatomy, root canal morphology and their commonly occurring variations. Such variations may include the number of roots, the number and configuration of the root canals and the frequency of their occurrence 1-3 .Cone-beam computed tomography is an accepted method to study and visualize the ambiguous morphology of an individual tooth 4 . Traditional radiographic methods present the anatomy of the root as a two-dimensional plenary projection. On the other hand, CBCT provides three-dimensional imaging that offers the possibility to view an individual tooth in any plane, rather than only in the predetermined "default views" of periapical radiographs 4 .Recently, the AAE and AAOMR Joint Position Committee (2015) indicate in its 3 rd recommendation that "Limited FOV CBCT should be considered the imaging modality of choice for initial treatment of teeth with the potential for extra canals and suspected complex morphology, such as mandibular anterior teeth, and maxillary and mandibular premolars and molars" 5 . However, the same committee also clearly stated in its Recommendation #1 that "Intraoral radiographs should be considered the imaging modality of choice in the evaluation of the endodontic patient" 5 . Thus, CBCT should not be used for routine dental screening.Nevertheless, large databases of CBCT images, which were previously acquired for a variety of clinical reasons, may provide va...

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Section: Discussionmentioning

confidence: 99%

“…Therefore, the diameter of the canal and the root wall thickness at the area that is expected to be prepared for the post may also be of particular interest and importance. Several studies have shown that posts must be surrounded by at least 1 mm thickness of sound dentin, if the long-term integrity of the root is to be preserved 3,10 .…”

mentioning

confidence: 99%

Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study

Kfir

Mostinsky

Elyzur

et al. 2020

Sci Rep

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“…second premolars) (Morfis et al; Arora & Tewari; Ayranci et al). These differences may be due to sample heterogeneity, because the sample in these studies contained different tooth types and also because of ethnic differences Ahmad & Alenezi, 2016;Wu et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Morphology of the Physiological Apical Foramen of Maxillary Premolars

et al. 2018

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SUMMARY:The purpose of this study was to determine the shape and diameter of the physiological foramen in maxillary premolars of a Chilean population. The sample consisted of 125 extracted maxillary premolars, in which the apical three to five millimeters were cut and observed under magnification of 40x, photographed (Motic Cam), and analyzed using Motic Images Plus 2.0 ML in order to obtain measurements of the minor and major diameter of each physiological foramen. The average minor and major diameter in maxillary premolars was 0.270 and 0.413 mm, respectively. In terms of shape, 72.19 % had oval shaped physiological foramen; 18.93 % were irregularly shaped and 8.88 % were round. Oval and irregular canals are significantly more difficult to shape and require special attention in order to obtain a thoroughly disinfected root canal system.

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“…Using dental loupes and dental operating microscope (DOM) provides the endodontist with good lighting and magnification which improves the ability to locate extra canals. (30) Ahmad et al (31) reviewed 92 studies done on the maxillary first premolars for different populations and calculated the averages for certain internal and external morphologic features. They reported that the majority of maxillary first premolars had two roots (56.6%) or one root (41.7%) and the majority had two root canals (86.6%) with type IV being the most common canal type (64.8%).…”

Section: (3)mentioning

confidence: 99%

The Number of Roots and Canals in the Maxillary First Premolars in a Group of Jordanian Population

Al-Ghananeem¹,

Al-Weshah²,

Alsakarna³

2017

JRMS

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Objectives: To investigate clinically and radiographically the number of roots and root canals in the maxillary first premolars in a group of Jordanian population using magnifying loupes while carrying out routine endodontic practice. Methods: A total of 176 patients 87 female (49.4%) and 89 male (50.6%) received root canal treatment of maxillary first premolar at King Hussein Medical Centre from January 2012 till January 2015. The age of the patients was ranging from 18 to 60 years. The teeth included in the study were both clinically and radiographically examined for the number of root canals using sharp endodontic explorer and magnifying loupes. Diagnostic preoperative radiographs were taken for evaluation. Two radiographs in two planes (parallel and 20ᵒ-40ᵒ horizontal angle cone shift) were taken during routine endodontic treatment for these teeth. The number of roots and root canals in the maxillary first premolars was recorded. Results: Out of the total of 176 maxillary first premolars 56 teeth had one root (31.8%), 118 teeth had two roots (67.0%) and two teeth had three roots (1.1%). Based on Vertucci's classification of root canal morphology: one tooth (0.6%) had type I canal configuration (one canal), 17 teeth (9.7%) had type II (two canals with shared apical foramen), 156 teeth (88.6%) had type IV (two canals with separate apical foramen) and two teeth (1.1%) had type VIII (three canals with separate apical foramina). The percentage of two canals (type II and IV) is 98.3%. Conclusion: The percentage of two canals (either with shared or separate apical foramina) is very high in the maxillary first premolars in Jordanian population. Inspection should be done for the presence of second canal whenever endodontic treatment is planned for this tooth.

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Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations

Cited by 66 publications

References 83 publications

Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study

Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study

Morphology of the Physiological Apical Foramen of Maxillary Premolars

The Number of Roots and Canals in the Maxillary First Premolars in a Group of Jordanian Population

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