Unusual Deviation of the Main Foramen from the Root Apex.

Marco Aurélio Versiani,Manoel Damião De Sousa-Neto,Gustavo De-Deus,Paul Michael Howell Dummer,Hany Mohamed Aly Ahmed

doi:10.1590/0103-6440201601106

Marco Aurélio Versiani, Manoel Damião De Sousa-Neto + Show 3 more

Open Access

https://doi.org/10.1590/0103-6440201601106

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Abstract

The relationship of the main foramen to the anatomic root apex has been the subject of several studies. Although they are anatomically close, they rarely coincide, and their distance can vary according to age or tooth type, ranging from 0.2 to 3.0 mm. The aim of this short communication was to evaluate the distance between the main foramen of independent middle mesial canals (MMCs) and the anatomical mesial root apex of mandibular first molars using the micro-computed tomography. Twenty-five mandibular first molars with MMCs were scanned (resolution of 9.9 µm), and the distance from its main foramen to the anatomical apex was evaluated. Overall, the distance ranged from 0.2 to 2.4 mm; however, in 3 specimens the distance was greater than 3 mm. This report demonstrates that the exit of the main foramen of the MMC varies considerably and could approach a substantial distance from the anatomical apex greater than previously reported in the literature.

Highlights

An understanding of the common and unusual morphology of the root canal system, especially in the apical third, is a fundamental prerequisite for successful root canal treatment [1,2,3]
The apical constriction is the apical part of the root canal with the narrowest diameter, and is generally located 0.5 – 1.5 mm from the apical foramen, the major apical foramen is the main exit of the root canal onto the external root surface, while the cemento-dentinal junction (CDJ) is the line of union between dentin and cementum at which pulpal tissue ends [4]
In 22 mandibular first molars, the distance from the main foramen of the middle mesial canals (MMCs) to the anatomic apex of the mesial root ranged from 0.2 to 2.4 mm; in 3 specimens this distance was greater than previously reported in the literature (Fig. 1)

Summary

Introduction

An understanding of the common and unusual morphology of the root canal system, especially in the apical third, is a fundamental prerequisite for successful root canal treatment [1,2,3]. The literature describes the terminal portion of a tooth root by distinct landmarks namely the minor apical foramen, apical constriction, major apical foramen, root apex, and cemento-dentinal junction (CDJ) [2]. The relation of the major apical foramen with the anatomic root apex has been the subject of several studies. They are anatomically close, they rarely coincide [4,5], and their distance can vary according to age or tooth type, ranging from 0.2 to 3.0 mm [2,6]

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