Three-Dimensional Analysis of the Pulp Chamber and Coronal Tooth of Primary Molars: An In Vitro Study

Abstract

The anatomical variability of primary molars promotes research to improve clinical restorative activity, forensic identification, and industrial development. The objective was to study the morphology of the pulp chamber and its three-dimensional relationship with the external morphology of the tooth. A total of 151 deciduous molars were collected and subjected to three-dimensional imaging analysis in order to determine dental crown (CV) and pulp chamber (PV) volumes, their ratio (VR), pulp chamber roof (PCR) and pulp chamber floor (PCF) area, the furcation length (FD), and morphological peculiarities. The data were compared using the Kruskal–Wallis test in SPSS 26 software. The statistical analysis determined statistically significant differences between the four groups of molars for all variables. Great anatomical variability was observed, especially in the maxillary first molar, the volumes were higher in the maxillary second molar and the highest risk of furcal perforation was seen in the mandibular first molar. Additionally, mandibular second molars with six pulp horns, and some different density images compatible with accessory canals and pulp stones were found. Based on the findings of this investigation, we confirm the great anatomical variability that exists between the maxillary and mandibular molars.

Measuring Dental Chamber Volume with DICOM Images from Cone-Beam Computed Tomography Can Be Improved with a Simple Algorithm

“…To our knowledge, this is the first study applying an algorithm with in vivo CB-CT to calculate dental pulp chamber volume and comparing it with ex vivo micro-CT results. However, the results should be interpreted cautiously due to the small sample size and differences between maxillary and mandibular molars [19]. Further studies are needed to explore other CB-CT brands and dental groups.…”

“…We compared in vivo CB-CT images-both raw and after manipulation by two trained experts and an algorithm-with ex vivo micro-CT images. Molars were chosen due to their large pulp chamber size [19]. The anatomy and dimensions of the pulp chamber are of interest in several dental fields, including endodontics [20,21], age estimation [22,23], dental pulp tissue engineering [24], and preclinical teaching and training of endodontic postgraduates [25,26].…”

A Proposal to Develop a New Classification for Pulp Chamber Anatomy

“…These anatomical features require careful attention during caries excavation and other restorative procedures to prevent pulp exposure ( 53 ), considering the fact that the size of the pulp chamber affects the thickness of the external tooth structure, especially in first molars and the mesio-buccal cusp of maxillary second molars ( 53 ). This is in addition to access cavity preparations during root canal treatment of primary molars, which also requires special consideration, to prevent furcal perforations ( 54 , 55 ).…”

The Study and Relevance of Pulp Chamber Anatomy in Endodontics – A Comprehensive Review

“…Two micro-CT studies investigated the pulp chamber anatomy in primary molars and reported a wide range of variations in the morphological measurements, size of the chamber in relation to the crown, location and number of the pulp horns as well as the pulp chamber floor. These anatomical features require careful attention to prevent procedural errors such as furcal perforations ( 45 , 82 ).…”