Study of root canal accessibility in human primary molars

Abstract

The aim of the present study was to provide a general scheme for pulpectomy of primary molars that may be useful for decision-making about negotiation of root canals and selection of appropriate instruments. A total of 160 vital primary molars in 85 patients (40 males, 45 females) aged 4-6 years were selected. After taking primary radiographs, local anesthesia was induced, and the teeth were isolated using a rubber dam. Canal accessibility index (CAI) and tooth accessibility index (TAI) were calculated according to initial file size. Mandibular first molars had either three canals (79.2%) or four canals (20.8%), and all second molars had four canals. Maxillary first molars had three canals and second molars had either three canals (70.9%) or four canals (29.1%). Lower accessibility of the mandibular first molar distobuccal root accounted for the lower accessibility of these teeth in comparison with mandibular second molars. While three-canal maxillary second molars were more accessible due to the lower accessibility of the distobuccal canal of the maxillary first molar, poor accessibility of the distal canal in four-canal second molars was responsible for the difficult accessibility of these teeth. In conclusion, it seems that the accessibility of a single canal in each tooth determines the difficulty of accessibility for any given tooth. Moreover, while primary second molars are more accessible than first molars, all of them are negotiable.

Study of Pulp Chamber Morphology of Primary Mandibular Molars using Spiral Computed Tomography

“…In comparison with permanent teeth, the relatively thin layer of hard mineralized tissue between the external and internal surface leads to rapid involvement of the dental pulp by advancing caries. 2 One of the complications of pulpectomy is perforating the furcation while gaining access to the pulp chamber of primary molars. The outcome of perforation repair is not a highly predictable procedure.…”

Root Canal Morphology of Mandibular Primary Molars: A Micro-CT Study

“…This result takes part in the range 24-100%, which was reported in previous studies. [8][9][10]13,20,23,24,33 Vertucci Type 4 was the most common also in distal roots of mandibular primary first molars (41.2%). The only study that we can compare the findings of the canal morphology we have obtained from the present study within the systematic classification is a study using clearing technique, carried out by Sarı and Aras, 20 in which Vertucci Type 1 was the most common root canal morphology reported for distal roots of first molars (70%), while only 9.3% of them had Type 4 morphology.…”

“…20 In other studies where only canal numbers were reported without systematic classification, the frequency of the occurrence for two canals in mesial roots of second molars was given between 32% and 100%. [8][9][10]13,23,24,33 In the literature variations like apical ramifications, interconnecting branches and lateral fibrils in the mesial roots of mandibular molars were frequently reported. 9,13 According to findings reported by a study 13 , canal morphology characterized with these variations was the most frequent (36%) in mesial roots of mandibular primary second molars.…”

Endodontic Treatment of Primary Mandibular First Molars with Single Root and Single Canal

“…Süt dentisyonda görülmesi çok nadir bir durumdur. 8 Tek köklü ve tek kanallı süt molarlara ait ilk vaka raporu 1973 yılında Ackerman ve ark.na aittir. 5 Daha sonra 1991 yılında Holan ve ark.na ait iki olgu raporunda sekiz ve dokuz yaşlarındaki kardeş iki hastanın hem süt hem de daimi dentisyonda tek kök ve tek kanallı molar dişleri olduğu bildirilmiş-tir.…”