Abstract
The aim of this study was to investigate the physiological foramen diameter, shape and distance between physiological and anatomical apex of maxillary and mandibular first and second molars. Accurate knowledge of the physiological foramina morphology; thus, inherent mechanical shaping technical hindrances, is decisive when taking the corresponding root canal final preparation decision. The morphological dimensions of a total of 1727 physiological foramina were investigated by means of micro-computed tomography. Mean narrow and wide (to a high number, oval) diameters of the physiological foramen were 0.24, 0.22 and 0.33 mm and 0.33, 0.31 and 0.42 mm in mesiobuccal (MB), distobuccal (DB) and palatal (P) roots in maxillary first molars; 0.24, 0.22 and 0.33 mm and 0.41, 0.33 and 0.44 in MB, DB, and P roots in maxillary second molars. Mandibular first molars showed mean narrow and wide diameters of 0.24 and 0.30 mm and of 0.39 and 0.46 mm in mesial (M) and distal (D) roots; second mandibular molars showed 0.25 and 0.31 mm and 0.47 mm in M and D roots. The mean distance between the physiological foramina and anatomical apex was 0.82, 0.81 and 1.02 mm and 0.54, 0.43 and 0.63 mm in MB, DB and P roots of the maxillary first and second molars, respectively. A mean distance of 0.95 mm (M) and 1.05 mm (D) in the first and 0.78 mm (M) and 0.81 mm (D) in the second mandibular molars was observed. Based on the results obtained, assumable recommendations for final preparation size of the physiological foramen were calculated. However, when taking into consideration, the resulting standard deviations of marginal errors must be cautiously considered when taking a final decision in clinical endodontic treatment.
Highlights
Successful endodontic non-surgical and surgical endodontic treatment requires detailed knowledge of tooth anatomy and morphology.1–2Morphological knowledge of the apical region should be accurate, as instrumentation and filling of root canals is based, to a great extent, on that information
Micro-computed tomography with software rendering is known as a high-resolution imaging technique that provides a three-dimensional and detailed imaging of the tooth structures
The present study provides morphological data of the physiological foramen by means of high-resolution micro-computed tomography
Summary
Successful endodontic non-surgical and surgical endodontic treatment requires detailed knowledge of tooth anatomy and morphology.1–2Morphological knowledge of the apical region should be accurate, as instrumentation and filling of root canals is based, to a great extent, on that information. Different authors have investigated the physiological foramen and have shown the anatomic variations of the root canal systems. These investigators have employed different research techniques such as clearing technique, scanning electron microscopy, optical microscopy or micro-computed tomography. The present study provides morphological data of the physiological foramen by means of high-resolution micro-computed tomography. The aim of this investigation was to determine the distance between the physiological and anatomical apex, the diameter and the shape of the physiological foramen, as well as to outline a clinically oriented physiological foramen size recommendation for the roots of maxillary and
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