Three-rooted Maxillary Premolars Research Articles

Three-rooted Maxillary Premolar: A Case Report of an Unusual Anatomic Variation

Three-rooted Maxillary Premolar: A Case Report of an Unusual Anatomic Variation

Detection of root canals in historical population from Radom (Poland).

The aim of this study was to analyse the number of root canals in maxillary first premolars, first molars and mandibular first molar teeth from an 18th to 19th century Radom (Poland) population, and then assess whether the diversity of root canals has fluctuated for about two hundred years. A total of 139 human permanent teeth were analysed by cone beam computed tomography in three projections. The types of root canal systems were classified in each tooth root separately. In one-rooted maxillary premolars, two canals occurred most often (53%).In two-rooted majority buccal (91%) and every palatal roots there is one canal. All three-rooted maxillary premolars have one root canal. In two-rooted first maxillary molars, fused roots have two canals. All mesiobuccal roots presented type 2-1 canal configurations. In three-rooted maxillary first molars in the mesiobuccal roots the most common root canal type is 2-1 (72%). A second mesiobuccal canal occurred in 86%. The distobuccal and palatal roots presented one canal in all cases. First mandibular molars occurred in two-rooted form in 98%. In mesial roots, two root canals predominated (59%). Most distal root (66%) had one canal. In three-rooted teeth one root canal was the most frequent finding. Knowledge about the variation in root canals is important in studies of past populations. This evidence may be important in relation to assessing the variability of human populations. The analysis carried out show the cohesion between the historical population of Radom and other groups from modern Poland.

Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study.

To investigate the number of roots and root canal configurations using two coding systems and the root canal diverging and merging levels in extracted maxillary premolars in an Egyptian subpopulation using cone beam computed tomography (CBCT). A total of 700 maxillary premolars were examined using CBCT in an Egyptian subpopulation. The number of roots was identified, and root canal configurations were classified according to Vertucci's classification and a new system for classifying root and canal morphology. In addition, the position where roots bifurcated and the levels where canals merged or diverged were identified. Fisher's exact test and independent t-test were used for statistical analysis, and the level of significance was set at 0.05 (P=0.05). More than half of maxillary first premolars were double-rooted, and the majority of maxillary second premolars were single-rooted (P<0.001). Most of the double-rooted samples had bifurcations in the middle of the root. According to the Vertucci classification, canal configuration type IV was the most common in both first and second maxillary premolars. According to the new system, the code 2 FP B1 P1 was the most common for maxillary first premolars, whilst 2 SP B1 P1 , 1 SP2 and 1 SP2-1 codes were the most common for maxillary second premolars. The three-canalled morphology in double- and three-rooted maxillary premolars had considerable variations. Root canal merging and diverging levels were comparable in both tooth types. Maxillary premolars in this Egyptian subpopulation had a wide range of root and canal anatomical variations. Clinicians should be aware of where canals merge and diverge to facilitate the treatment of all canals. The new system for classifying canal morphology describes the root and canal configurations in a more accurate and practical manner compared to the Vertucci classification.

Three-rooted premolar analyzed by high-resolution and cone beam CT

The aim of this study was to analyze the variations in canal and root cross-sectional area in three-rooted maxillary premolars between high-resolution computed tomography (μCT) and cone beam computed tomography (CBCT). Sixteen extracted maxillary premolars with three distinct roots and fully formed apices were scanned using μCT and CBCT. Photoshop CS software was used to measure root and canal cross-sectional areas at the most cervical and the most apical points of each root third in images obtained using the two tomographic computed (CT) techniques, and at 30 root sections equidistant from both root ends using μCT images. Canal and root areas were compared between each method using the Student t test for paired samples and 95 % confidence intervals. Images using μCT were sharper than those obtained using CBCT. There were statistically significant differences in mean area measurements of roots and canals between the μCT and CBCT techniques (P < 0.05). Root and canal areas had similar variations in cross-sectional μCT images and became proportionally smaller in a cervical to apical direction as the cementodentinal junction was approached, from where the area then increased apically. Although variation was similar in the roots and canals under study, CBCT produced poorer image details than μCT. Although CBCT is a strong diagnosis tool, it still needs improvement to provide accuracy in details of the root canal system, especially in cases with anatomical variations, such as the three-rooted maxillary premolars.

In Vitro Macroscopic and Endoscopic Analysis of Three-Rooted Maxillary Premolars and Two-Rooted Mandibular Premolars in the Same Individual: a Case Report

La reciente incorporacion del endoscopio a la practica odontologica ha permitido al clinico, contar con una excelente visualizacion del campo operatorio, consiguiendo resultados altamente exitosos en la visualizacion de estructuras anatomicas de dificil acceso, tanto en cirugia oral como en endodoncia. El proposito de este reporte de caso es realizar una descripcion in vitro macroscopica, radiografica y endoscopica de las variables anatomicas de las raices de los primeros premolares maxilares y mandibulares en un mismo paciente. Una paciente de 22 anos es derivada por un ortodoncista para exodoncia de los primeros premolares. Una vez extraidos, los premolares fueron analizados en un principio macroscopicamente, para luego ser analizados radiograficamente una vez trepanados y obturados los sistemas de conductos radiculares. Posterior a esto, se sometieron a un proceso de diafanizacion y se les realizaron cortes a nivel del tercio apical y medio para ser observados mediante endoscopio. Se detecto que ambos primeros premolares superiores presentaban 3 raices, y los inferiores 2 raices, todos con formacion radicular completa. No se identificaron deltas apicales ni conductos accesorios en las imagenes radiograficas; sin embargo, fue posible mediante el endoscopio a nivel del tercio medio, un conducto accesorio para los primeros premolares derechos inferiores y superiores situacion que no se pudo identificar radiograficamente. Finalmente, la visualizacion a traves del endoscopio permite una mejor identificacion de conductos accesorios que las radiografias.

The anatomy of the root canal system of three‐rooted maxillary premolars analysed using high‐resolution computed tomography

To analyse the anatomy of the root canal system of maxillary premolars with three distinct roots using high-resolution computed tomography (μCT). Ten three-rooted human maxillary premolars were scanned transversally from crown to apex at 42μm intervals using a high-resolution desktop μTC system (Skyscan 1072). The images were processed and analysed for the following features: cross section of the roots and canals in the apical, middle and coronal thirds; location of the apical foramen; distance from the pulp chamber roof to the bifurcation and trifurcation of the canals and anatomic variations of the root canal system. The results were expressed descriptively. The cross-sectional shape of canals was heterogeneous along the length of the roots. The location of the apical foramen varied, tending to lie palatally or distally. The buccal pulp horn was larger than the palatal. The mean distance from the most cervical region of the pulp chamber roof to the bifurcation and trifurcation of the canals was 3.13 and 5.08mm, respectively. Features of the internal anatomy of the pulp cavity of three-rooted maxillary premolars were identified with the use of μCT. The results revealed the heterogeneity of three-rooted maxillary premolars.

Diagnosis and Treatment of Three-Rooted Maxillary Premolars

Anatomical variations must be considered in clinical and radiographical evaluations during endodontic treatment. Access cavity modifications may be required for stress free entry to complex anatomy. Higher magnification and illumination can be useful for access cavity preparation and to recognize and locate additional canals. This article describes the diagnosis and clinical management of two clinical cases of three rooted maxillary premolars.

Evaluating the maxillary premolar with three canals for endodontic therapy

A review of the morphology of three-rooted maxillary premolars has been discussed. Observations of radiographic features that will be of help in distinguishing three-rooted maxillary premolars has been presented. A brief discussion of therapy that used conventional and surgical techniques has been mentioned. It is hoped that this clinical approach to endodontics in the maxillary premolar with three canals will facilitate management of these interesting and challenging cases. A review of the morphology of three-rooted maxillary premolars has been discussed. Observations of radiographic features that will be of help in distinguishing three-rooted maxillary premolars has been presented. A brief discussion of therapy that used conventional and surgical techniques has been mentioned. It is hoped that this clinical approach to endodontics in the maxillary premolar with three canals will facilitate management of these interesting and challenging cases.