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Introduction: Understanding root canal morphology is important to achieve successful root canal treatment (RCT). Studies on mandibular premolars showed that, there is a significant variation in the root canal anatomy between different ethnicities. Therefore, this retrospective study aimed to evaluate the root canal anatomy of mandibular premolars in Egyptian population using cone-beam computed tomography (CBCT). Materials and Methods: 248 CBCT scans were evaluated and the anatomy of 392 mandibular first and 384 second premolars was classified according to Vertuci's classification. Data was statistically analyzed using SPSS software to calculate the incidences of root and canal number, each canal type, bilateral symmetry, and the association between gender and variation in root canal morphology. Results: First and second premolars with two roots were found in 1.8% and 1% of scans respectively. Most of the mandibular first (80.1 %) and second premolars (93.5%) showed (type I) root canal morphology followed by, type II (6.4 %) and type V (2.1%) in the first and second premolars respectively. While, Type VIII showed the least frequency in both premolars. Only the second premolars showed a statistically significant association between gender and both canal type and number. Bilateral symmetrical anatomy was observed more in the second premolar (94.8 %) than the first premolar (85.7%). Conclusions: Mandibular premolars in Egyptian population showed great variation in root canal configuration. Therefore, preoperative CBCT evaluation is advantageous to avoid missing of existing extra canals during RCT. New classification systems for root canal morphology is highly recommended in further studies.

Purpose of Review: Cone-beam computed tomography (CBCT) is an imaging modality with high-resolution diagnostic value that provides accurate and high-quality three-dimensional information on the elements of the maxillofacial complex. Therefore, this study aimed to present an up-to-date status of the main indications for the use of CBCT in endodontics, and to discuss its main limitations relative to diagnosis in endodontics. Recent Findings: The data captured by CBCT devices and processed by a specific software programs create a reconstruction of the scanned volume. Thus, they allow dynamic and interactive analysis of the information, by means of simultaneously scanning the object in different anatomical planes of imaging: axial, coronal, or sagittal, and their subsequent reconstruction thereby revealing structures that are not visible in periapical radiographs. Although periapical radiographs continue to be the imaging method of choice for the evaluation of endodontic treatment, a significant leap has occurred in the growth of CBCT use Endodontics in recent years. However, the importance of recognizing the different types of artifacts generated during the image acquisition and reconstruction process is emphasized, especially in the presence of high-density endodontic materials that can compromise the quality of the diagnosis. Summary: Considering the findings of this study, and based on international guidelines, it was concluded that the possibilities of using CBCT during endodontic treatment were mainly focused on diagnosis, assessment [of existent dental conditions], and preoperative treatment; establishing the morphology, diagnosis, and treatment planning of root canal systems; evaluation of root resorption; planning and evaluation of the treatment of traumatic dental injuries, perforations, fractures, and for the preparation of endodontic guides.

A comprehensive knowledge of the root canal anatomy is essential for successful endodontic treatment. However, presence of anatomic variation in the tooth can be diagnostically and technically challenging and hence may pose difficulties during endodontic therapy. The anatomical variations associated with permanent mandibular canines have been reported by several investigators. Mandibular canines are recognized as usually having one root with one root canal in majority of cases. The occurrence of two root canals in single-rooted mandibular canine is considered unusual in Indian population. This case report describes non-surgical endodontic management of right permanent mandibular canine having one root with two canals and one apical foramen (Vertucci Type II). Keywords: Anatomical variation, Endodontic management, Mandibular canine, Vertucci type II

Context: Studying in detail the root canal morphology specific to the Indian mandibular molars will help discern whether the root canal anatomy patterns resemble those reported internationally or are different from it. Aim: The aim is to study the root canal anatomy of Indian permanent mandibular first, second, and third molar teeth using a tooth clearing technique. Methods: The root canals of a total of 300 extracted Indian mandibular molars consisting of 100 first, second, and third molars each were accessed and injected with India ink, after which they were subjected to the clearing technique. Statistical Analysis: Data was analyzed using descriptive statistics for the computation of percentages using SPSS version 21. Results: Of the hundred first molars, 90% of teeth were two rooted with three canals, 79% had two apical foramina. 70% mesial roots of the three-rooted type showed Type I, whereas 100% distal roots and distolingual roots showed Type I Vertucci’s anatomy. About 70% mesial roots of two roots showed Type II and 90% distal canals showed Type I configuration. Among the second molars, five (5%) were single-rooted, ninety-one (91%) teeth were two rooted and four (4%) had three roots. Among the mandibular third molars, fifteen (15%) teeth had one root, sixty-three (63%) teeth had two roots, eighteen (18%) teeth had three roots, and four (4%) teeth had four roots. Conclusions: The root canal anatomic features of mandibular molars showed differences in the frequency of particular anatomic types as compared to mandibular molars from other racial backgrounds. Further comparative studies on inter-racial anatomic characteristics from various geographic locations would be beneficial.

Premolars have been blessed for having an aberrant root canal anatomy. The occurrence of more than 2 canals with different portal of exit is very rare. If one is facing the scenario of treating the maxillary and mandibular premolars clinically than he must be aware of the internal anatomy of these teeth. These teeth may require special shaping and obturating techniques. This case series is the reflection of the endodontic challenges clinicians face to manage such cases. Careful examination of pre-operative radiograph and careful negotiation is necessary to deal with such variable anatomies. Keywords: Premolars, Canal negotiation.

Unusual root canal anatomy always poses a diagnostic and treatment challenge.Therefore a thorough knowledge of root canal anatomical variations along with proper diagnosis, treatment planning and clinical expertise is the key to their successful management. The C-shaped root canal configuration is one such aberrant canal anatomy, common in the mandibular second molar. It often goes undetected and due to the intricate root canal configuration, it is often difficult to negotiate, debride and obturate such canalsleading to failure of root canal treatment. Case Reports: This article presents management of four different C-shape root canal configurations using the cold lateral condensation and thermoplasticized obturation techniques. Conclusion: Understanding the anatomical presentations of this variation will enable the clinician to manage these cases effectively. Advanced irrigation and obturation techniques help in managing such anomalous canal configurations. Keywords: Anatomic variation, Cshaped canal, Mandibular second molars, Endodontic treatment, Thermoplasticized obturation.

The maxillary molars especially the third molars have the most complicated root canal system in permanent dentition There are many variations in root canal number system and configuration in maxillary molars It is imperative and paramount for the clinician to seek out every possible aberration of root canal anatomy for all teeth undergoing treatment This paper relates a case of a maxillary right third molar with a canal configuration rarely reported in the literature The tooth had four roots with four root canals two separate palatal roots mesiopalatal and distopalatal with their own distinct canals and orifices The mesiobuccal and distobuccal roots had normal anatomy This paper escalates the complexity of maxillary molar variation and is intended to brace clinician rsquo s awareness of the rare morphology of root canal system

The most common configuration of the mandibular first molar is the presence of two roots and three root canals. The objective of this work is to present two rare anatomic configurations with six root canals on two mandibular left first molars diagnosed during endodontic therapy. Root canal therapy was performed using a dental operating microscope. Ultrasonic troughing in the grooves in between the mesial root canals and in between the distal root canals was able to show the middle root canals. Large samples population characterization researches and systematic reviews were unable to detect a single case of six root canals configuration in a mandibular first molar in their investigations. Although it is a rare configuration, a six root canal configuration is possible to be found in the mandibular first molar. Three different pulp chamber configurations are possible to be found. Two or three roots may be present and the root configuration more common in the mesial root is the Type 8 and Type 12 for the distal root. Some concepts about the required technique to approach these cases are also debated.

This study aimed to assess the effectiveness of ultrasonic vibration and thermo-hydrodynamic obturation (VibraTHO) using two types of root canal sealers, in comparison to the single-cone (SC) technique and a calcium silicate-based root canal sealer in complex root canal anatomies. Thirty single-rooted human maxillary premolars with two canals that had a complex root canal anatomy of transverse anastomoses or ramifications were prepared and assigned to the following three experimental groups, according to the filling method: SE group, SC technique with Endoseal TCS, VE group, VibraTHO with Endoseal TCS, and VG group, VibraTHO with GuttaFlow 2. Each tooth was scanned using micro-computed tomography, and the volume percentages of the filling material were calculated. The analysis of variance was used to analyze the statistical differences between the three groups (p &lt, 0.05). The mean volume of the filling material was higher in the VG and VE groups than that in the SE group (p &lt, 0.05) along the apical to middle-to-coronal thirds, and significant differences were observed between each root canal area (p &lt, 0.05), with the only exception being at the apical thirds between the VE and SE groups. The VibraTHO technique using GuttaFlow 2 can be a more effective root canal filling method for anatomically complex root canal systems than the SC technique with Endoseal TCS. On the other hand, the VibraTHO technique using Endoseal TCS has a limited effect on improving the quality of the root filling at the apical portion of anatomically complex root canal systems, compared to the SC technique with Endoseal TCS.

Current improvements in nickel-titanium (Ni-Ti) rotary file systems have created a paradigm shift in the root canal therapy of primary teeth. Therefore, it is necessary to perform a comprehensive evaluation regarding the efficiencies of newly manufactured instruments for different parameters. The current study was conducted to evaluate the abilities of RaceEvo, R-Motion, ProTaper Gold (PTG) systems in curved primary root canals with regard to the patterns of canal transportation and volumetric dentin removal by using cone-beam computed tomography (CBCT). Two experimental sets were designed following the determination of experimental groups by using pre- and post-operative CBCT data: canal transportation and volumetric dentin removal. The highest amount of canal transportation was significantly detected in the PTG group in comparison to RaceEvo and R-Motion groups. When the mean values of volumetric dentin removal data were analyzed across all groups, the PTG group again exhibited the significantly highest value of dentin removal volumetrically, compared to RaceEvo, R-Motion and manual instrumentation groups. It is possible to state that R-Motion and RaceEvo rotary systems could be used as reliable alternatives without causing adverse mechanical effects and maintaining the original root canal anatomy of curved primary root canal systems compared with PTG rotary systems and manual instrumentation, with a high diagnostic sensitivity of CBCT in pediatric endodontics when the alternative methods are not adequate.

Endodontic mishaps are very unfortunate and most of the time iatrogenic Causes include inadequate knowledge of radicular morphology and some are due to the negligence of the dental surgeon. Maxillary first molar having three roots and three distinct canals is normal anatomical finding but presence of fourth root with a patent root canal is rare phenomenon to found in routine endodontic practice. Present case report discusses successful non surgical root canal treatment of maxillary first molar with a exceptional root canal anatomy of four separated roots. Invariably maxillary first molar has most complicated root canal anatomy. Most commonly found variation in maxillary molar are presence of two canals i.e.MB1 AND MB2 in mesiobuccal root and accessory canals in the area of furcation. Extra root or fourth root is a rare finding and least documented. This case report explains the successful root canal treatment of first maxillary molar with four distinct roots and four canals. Access cavity modified according to root canal anatomy, cleaning and shaping done with rotary instruments and obturation done with the help of calcium hydroxide based sealer. Keywords: Four Roots, Endodontically, Irreversible Pulpitis, Heat Test, Periapical

Aim: This study aims to evaluate and compare the canal transportation and centering ability of two nickel–titanium file systems, ProTaper Next and WaveOne Gold, in comparison with ProTaper Universal in mesiobuccal canals of maxillary molars using micro-computed tomography. Materials and Methods: Seventy-five permanent maxillary first and second molars having mesiobuccal canals with curvatures between 20° and 30° were selected and subjected to pre-operative micro-computed tomographic scans. They were then divided into three groups (n = 25) based on the file system to be tested: Group 1-ProTaper universal (control), Group 2: ProTaper Next, and Group 3-WaveOne Gold. Access cavities were prepared, following which each specimen was instrumented using the specific file system. Post-instrumentation micro-computed tomographic scans were then carried out for each specimen. Pre- and post-instrumentation measurements of mesiobuccal canals were performed using the ImageJ 1.8.0 software. Canal transportation and centering ratio were calculated at three cross-section levels that corresponded to 3-mm, 6-mm, and 9-mm distance from the apical end of the root. The data obtained were then subjected to statistical analysis using ANOVA and Tukey's post-hoc tests. Results: It was seen that WaveOne Gold caused the least overall canal transportation and exhibited the highest centering ability, followed by ProTaper Next and ProTaper Universal, though the difference was not significant. Furthermore, there was no significant difference between the canal transportation and centering ability of ProTaper Universal, ProTaper Next, and WaveOne Gold at all three levels. Conclusion: None of the systems evaluated exhibited perfect centering ability and zero canal transportation. All file systems caused root canal transportation and minor changes in the root canal anatomy.

It is very rare (2%–6% cases) for a mandibular canine to have two root canals and the incidence of finding two roots with two root canals in a mandibular canine that too bilaterally is almost negligible. This case report discusses the presence and multidisciplinary management of such rarest configuration in both mandibular canines of a female patient. This case shows the importance of recognition of anatomical variations in successful accomplishment of root canal treatment.

A detailed acquaintance of root canal anatomy is essential for the endodontic root canal therapy. Aberrations or unusual variations in the root canal morphology, mainly in multirooted teeth, can cause a substantial challenge to the endodontist during endodontic management. Knowledge of these variations, mostly concerning the position and treatment of all canals, is very essential for the successful outcomes of endodontic therapy; the failure to find and properly treat the root canals may cause treatment failure because it is important to assess individual case for variations. Endodontist should be suspicious while treating maxillary first molars because of its root curvatures, additional canals and variations in internal morphology. Keywords: Two palatal canals, Maxillary first molar, Endosequence BC Sealer.

The aim of this in vitro pilot study was to describe the shaping ability of a rotary nickel-titanium (NiTi) instrument in combination with different torque-controlled endodontic devices and to compare them with NiTi files in combination with a conventional preparation by hand in severely curved root canals of plastic blocks. Thirty blocks simulating a severely curved root canal were divided into three groups (n=10 for each). All canals were prepared with NiTi files to an ISO size of 40 using an apical-coronal preparation technique. Mity Roto 360° files (Loser, Leverkusen, Germany) were used for the automatic systems, while Mity K-Files (Loser, Leverkusen, Germany) were used for the preparation by hand. We evaluated the frequency of instrument failure, the preparation time, loss of working length, loss of weight, elbow-zip effects, and changes in root canal anatomy.

This study aimed at establishing a comprehensive specification of the root canal anatomy of second primary mandibular molars using micro computed tomography (CT). 10 s primary molars from Caucasian young patients were selected for this purpose. Micro CT imaging with a high resolution of 20 microns was performed to observe the roots and canals according to specific criteria. The Vertucci canal configuration, the presence of lateral canals and their location, the presence of an isthmus and its location, were first observed. Then, the length of the canals, their diameter in the mesio-distal and vestibulo-lingual direction, the dentinal thickness and the direction of the minimal dentinal thickness were measured. The mean working length was not significantly different between the canals (p = 0.710). The bucco-lingual diameter was significantly higher when the tooth had a single distal canal at the coronal (p

Mey Al-Habib, Mohammed Howait Department of Endodontics, Faculty of Dentistry King Abdul Aziz University, Jeddah, Saudi ArabiaCorrespondence: Mohammed Howait P.O. Box 80209, Jeddah, 21589, Saudi ArabiaEmail Mhowait@kau.edu.saAim: The aims of this study were to assess the prevalence and configuration of the second mesiobuccal (MB2) canal in the mesiobuccal MB root of permanent maxillary first molars at different root levels in a Saudi sub-population using cone‑beam computed tomography (CBCT) and to measure the inter-orifice distance between MB & MB2 at the pulpal floor level.Materials and Methods: This retrospective study was carried out on CBCT images of Saudi patients seen at King Abdul Aziz University. A total of 106 maxillary first molars were evaluated using a specialized software program (iCAT CBCT software). The prevalence of MB2, canal configuration and location of joining (apical-middle-coronal), if present was calculated. Also, the inter-orifice distance between both canals was measured at the level of the pulpal floor. Chi‑square and one-way analysis of variance (ANOVA) were used.Results: The MB2 canal was found in 92 (86.8%) maxillary first molar teeth. The MB and MB2 canals were joined in 61 (58%) cases, where the location of joining was 14 (23%), 17 (27%), and 31 (50%) in the coronal, middle, and apical third, respectively. The mean inter-orifice distance between both canals at the level of the pulpal floor was 2.52± 0.76 mm.Conclusion: The prevalence of MB2 canal in this Saudi sub-population was high. The prevalence decreased as the root canal approached the apical third. There was no correlation between the average distance and occurrence of canal joining. CBCT is useful in detecting and mapping the mesiobuccal root canal system, with a likelihood of enhancing the quality of root canal treatment.Keywords: CBCT, maxillary first molar, root canal anatomy, mesiobuccal root morphology

Aim: The achievement of root canal treatment is influenced by the status of the root canals. The aim of this study was to investigate the frequency of second root canals in mandibular incisors and the prevalence of root canal separation in the cervical, middle and apical thirds of cases with 2 root canals. Methodology: Retrospective cone-beam computed tomography (CBCT) datas of 500 patients seen between 2016 and 2018 were evaluated. A total of 300 patients, 134 males and 166 females, aged 13-71 years (mean age 39.34±13.44) were included in this study. A total of 587 central mandibular incisors and 582 lateral mandibular incisors were examined. The number of roots and root canal morphology based on the Vertucci’s classification were analyzed. The effect of gender on the prevalence of root canal anatomy was also evaluated. Results: The occurence of more than 1 root canal in mandibular lateral and mandibular central was 41.2% and 40.4% respectively and all teeth had a single root. Type I (59.2%) was the most common type, followed by Type III (31.4%), Type II (5.8%), Type VII (2.1 %), Type VI (0.8%) and Type V (0.7%). Type IV and Type VIII were not observed. The root canal separation in two root canaI of central and lateral mandibular incisors was found in the middle third of the root in 65.4% and 74.6%, respectively. The incidence of Type III in males (39%) was higher than that of females (25.4%), while the incidences of Type I in females (67.7%) were significantly higher than that of males (48.3%). The prevalence of second canals in mandibular incisors were detected more frequently in men than in women. Conclusion: The prevalence of second canal in total mandibular incisors is 40.8% (Type III was observed the most frequently). CBCT is an appropriate method for identifying of canal morphologies of mandibular incisors. How to cite this article: Çoban Kanyılmaz AN, Okumuş Ö, Sunay H. Assessment of root canal anatomy of mandibular incisors using cone-beam computed tomography in a Turkish subpopulation. Int Dent Res 2021;11(1):46-53. https://doi.org/10.5577/intdentres.2021.vol11.no1.8 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Objectives This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy. Materials and Methods In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01). Results In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

The objective of this investigation was to evaluate the root canal anatomy of permanent canines in a Saudi subpopulation utilizing CBCT. A total of 1328 CBCT images of maxillary (634) and mandibular (694) permanent canines were collected from Saudi patients who visited the College of Dentistry at King Saud University in Riyadh. The images were analyzed for root and canal numbers, canal configuration types, and symmetry between the bilateral canine teeth in each arch. Gender, age, and tooth position were recorded. The Kappa test was used for both inter- and intraexaminer reliabilities. Data were analyzed with the chi-square test at a P value ≤ 0.05 . There were no two-rooted teeth in maxillary canines, and 1.89% had two canals. Double roots and double canals in mandibular canines were found in 2.88% and 9.94% of the teeth, respectively. Type I canal configuration was more common in maxillary canines (97.94%) compared to mandibular canines (92.07%). Maxillary canines showed higher bilateral symmetries of root and canal numbers and canal configuration types (100%, 98.1%, and 97.9%, resp.) compared to mandibular canines (97.1%, 90.1%, and 92.1%, respectively). The majority of maxillary and mandibular canines had a single root with a single canal and type I canal configuration. Mandibular canines are characterized by having more than one root and canal and alterations in root canal configurations compared to maxillary canines.

INTRODUCTION: Mandibular premolars are some of the most challenging teeth to be treated endodontically, with wide variations in canal anatomy, unexpected morphology, and high incidence of rare configurations. OBJECTIVES: Investigation of root canal anatomical configurations in mandibular premolars in an Egyptian population, and evaluation of Digital Periapical Radiography efficacy in root canal anatomy identification. MATERIALS AND METHODS: The study was approved by the ethical committee at faculty of dentistry, Alexandria University (IRBNO:00010556-IORG0008839). One hundred and eighteen extracted(for periodontal reasons) human mandibular premolars were randomly selected from an Egyptian population at the outpatient clinic of the maxillofacial department in Alexandria University according to selection criteria that ensures the presence of a fully formed root canal system that was neither filled or deteriorated by decay, or restorations, or resorption or cracks. No information regarding age or gender were collected. All samples were mounted in acrylic blocks and scanned by digital periapical radiography from two horizontal angles and then dissected by grinding longitudinally buccolingually till visualizing root canal anatomy highlighted by methylene blue dye. Digital radiographs were analyzed by 5 evaluators who identified the anatomy of each sample according to Vertucci’s classification. Then anatomy displayed by each dissected sample was recorded. Data were statistically analyzed. RESULTS: (Type-I) was the most prevalent configuration (76.3%), followed by Type-V (16.9%) and Type-III (5.1%), and only (1.7%) presented 3-Canal configuration. Periapical radiography failed to correctly detect root canal anatomy in 24 teeth (20.3%). CONCLUSIONS: Presence of more than one canal in mandibular premolars is not rare in the Egyptian population, and periapical radiography is not reliable to identify root canal anatomy of mandibular premolars.

Attempting exploration at the expense of dentin tissue to reveal anatomical variation is still a common practice in root canal treatment, mainly because it relies on bi-dimensional radiographic images and clinical assessments to comprehend root morphology and root canal anatomy. The main purpose of this chapter is to understand the role of technological advances in finding the appropriate resources and maneuvers to (a) completely treat root canal anatomy avoiding residual intracanal infection, (b) balancing the size of the access cavity and the degree of root canal enlargement with the requirements of irrigation methods to achieve optimum disinfection, and (c) preserving root dentin during instrumentation to maintain the mechanical integrity of the root, minimizing the risk of fractures, all of them considered relevant causes of endodontic treatment failure.

Comprehensive knowledge of the entire root canal system is an essential prerequisite for successful routine endodontic treatments. The internal and external morphological configurations of roots and root canals are quite complex. Thus, several classifications have been put forth by researchers to appropriately understand the distinguishable features of root and root canal systems of multirooted teeth. Until now, the researchers have proposed new classification systems for a thorough understanding of the root canal systems, mainly concentrating on the root canal anatomy and anomalies. Moreover, with the advent of newer digital imaging systems, these classifications are more reproducible and relevant. They have further gained importance for the clinicians by acting as an aid in decision-making based on evidence-based dentistry. However, these classifications are primarily focused on the root canals, but none have assessed the anatomy of the pulp chamber floor. This review article delineates a novel Pawar and Singh molar pulp chamber floor classification© for the anatomy of maxillary and mandibular molars to ease the clinician's skills and further increase the prevailing literature for the benefit of researchers.

Introduction This cone-beam computed tomographic (CBCT)-based study evaluated the root canal configurations of mandibular anterior teeth in a large Brazilian population, along with the influence of sex and the frequency of symmetry between the contralateral teeth. Methods Overall, 2543 CBCT scans, including those of 4773 lower central incisors (LCIs), 4835 lower lateral incisors (LLIs), and 4805 lower canines (LCs), were analyzed. The scans were obtained from a private radiologic clinic using the PreXion 3D device (Yoshida Dental Mfg Co, Ltd, Tokyo, Japan) with a 0.14-mm voxel size; exposure parameters of 90 kV, 4 mA, and 19 seconds; and a field of view of 80 × 80 mm. Root canal anatomy was analyzed according to the Vertucci classification. Sex influence on the canal distribution and symmetry between the contralateral teeth were analyzed. The data were analyzed statistically and were considered significant when P Results All LCIs and LLIs had 1 root, whereas 2.4% of LCs had 2 roots. Two root canals were observed in approximately 20% of LCIs and LLIs and in approximately 11% of LCs. The most common configuration was type I followed by type III. Bilateral symmetry occurred in a majority of the individuals (ie, 91% in LCIs, 87% in LLIs, and 87% in LCs). No sex influence was noted with LLIs and LCs (P > .05). However, LCIs showed a higher prevalence of 2 canals in men (P Conclusions The prevalence of 2 root canals in the mandibular anterior teeth in Brazilians was approximately 20% for central and lateral incisors and 10% for canines.

Introduction. Incomplete understanding of the root canal system leads to endodontic failure. Missed canal was the fourth most common endodontic failure, which needed retreatment. There were a few studies on internal morphology of posterior teeth of Myanmar population. However, there was no report on root canal anatomy of anterior teeth. So, the aim of the in vitro study was to investigate root canal anatomy of Myanmar permanent mandibular incisors in Mandalay Region by the staining and clearing method. Materials and Methods. A total of 96 teeth from the tertiary hospitals and one academic department in Mandalay Region were selected according to inclusion and exclusion criteria. Then, they were cleaned, drilled, stained with Indian ink, and decalcified with 5% nitric acid for 3 days. After that, they were dehydrated with ascending concentration of ethanol (80% overnight, 90% for 1 hour, and full strength for three hours). Finally, they were clarified with 98% methyl salicylate and investigated by calibrated observer in case of Vertucci’s classification, allocation of apical foramen, and the detailed anatomy. Result. Almost 70% of the teeth had type Ι followed by 21.8% type ΙΙΙ, 4% 1-2-1-2-1 and type ΙΙ, and 1-3-2 and 2-3-1 comprised 1% each. Nearly 70% of apical foramen at central allocation of the root and 14% of detailed anatomy were seen in the sample teeth. Conclusion. Most of the sampled Myanmar teeth comprised one canal and one foramen followed by type ΙΙΙ. However, unusual anatomies, such as 1-2-1-2-1, 1-3-2, and 2-3-1, were also seen. Contrastively, proportions of central location of apical foramen and of detailed anatomy were differed from the former reports. This study summarized that 3 in 10 mandibular incisors comprised the evidence of second or third canal configuration. Three types of intercanal calcifications, fusiform, islet, and bead, were additionally explored.

The aim of this study was to explore the root morphology and root canal configuration of first premolars among Shandong Chinese residents using cone-beam computed tomography (CBCT). Randomly selected CBCT images were collected from 648 patients (44% women, 56% men). In total, 1268 maxillary and 1296 mandibular first premolars were analyzed. The number of roots and the canal configuration were recorded and identified based on Vertucci's classification. The majority of the maxillary first premolars had 1 root (67.4%), followed by 2 roots (32%). A 2-canal configuration (89%) was the most prevalent observation. For mandibular first premolars, 98.8% had 1 root and 81% presented the type I configuration. There were no statistical differences in the number of roots or morphology in terms of the left/right side or sex (P > .05). Among Chinese residents, the majority of maxillary first premolars had 1 root and 2 canals, whereas the most common anatomical configuration for mandibular first premolars was 1 root with 1 canal.

Aim: The purpose of this article is to determine the racial predilection of C-shaped canal configuration in a mandibular second molar. Background: Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of root canal treatment outcome. C-shaped canal configuration is such an aberrant morphology of molar teeth that vary in different population and is commonly seen in a mandibular second molar. Thus, knowledge of racial predilection of C-shaped canal configuration in different population for early diagnosis is obligatory. Materials and Methods: An exhaustive search was undertaken to identify published research articles related to C-shaped canal configuration in mandibular second molars. Forty-three research articles were analyzed which included 12,481 mandibular second molars. Chi-square test using value of P < 0.05 was performed to assess the statistical significance of this anomalous anatomic variation among the different population. Results: Statistical test revealed a significant variation between the Asian and nonAsian population. The highest incidence of racial predilection was observed in China (Asia) with 93.1%, and the minimum was observed in America with 2.7%. Conclusion: This research reported that racial predilection of C-shaped canal configuration in mandibular second molar varies significantly.

A maxillary central incisor presenting with more than one root or root canal is an exceptionally rare scenario considering the fact that most of the anatomic studies describe maxillary central incisor as a single rooted tooth with single canal. However, several case reports have shown the presence of up to four canals in maxillary central incisors. The aim of this article is to present a case report of maxillary central incisor with a rare anatomic variation, i.e. Vertucci’s type V root canal anatomy. Failure to locate and clean additional root canal system may lead to post treatment disease. Hence, an astute clinician should be aware of possible anatomic variations this tooth might present with.

Mandibular kanin dişlerin kök kanal sayıları ve konfigürasyonlarındaki varyasyonlar morfolojilerini araştıran çalışmalarda gösterilmiştir. Bu olgu raporunun amacı, iki köke sahip iki mandibular kanin dişin endodontik tedavisini sunmaktır. Bu olgu raporu ile başarılı bir endodontik tedavi için detaylı klinik ve radyografik incelemeyle beraber kök kanal morfolojisi ve varyasyonları hakkında yeterli bilgiye sahip olmanın önemi vurgulanmaktadır, The variations in the numbers of root canal and root canal configurations of mandibular canine teeth have shown in studies investigating morphology of these teeth. The objective of this case report is to present the endodontic treatments of two mandibular canine teeth having two roots. The importance of complete knowledge about root canal morphology and possible variations with detailed clinical and radiographic examination for successful endodontic treatment is emphasized with this case report

To report a case of endodontic treatment of a maxillary canine in which an extra canal was located and successfully treated. Endodontic therapy is essentially a micro neurologic surgical procedure involving complete debridement and three dimensional obturation of the root canal system to obtain a fluid impervious seal. The foundation of the procedure is based on the intimate knowledge and thorough understanding of the anatomy of both the pulp chamber and the root-canal system. A tooth exhibit variations in their root canal anatomy and poses a challenge in diagnosis and treatment. In the teeth particularly with additional root canals or anatomical variations, root canals are often left untreated and that would be the main reason for unfavourable outcome of the treatment. Maxillary canine are statistically more commonly single rooted, single canal but rarely may have single root with two root canals.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 53-56

The radix entomolaris/paramolaris is the major anatomical variant in mandibular first molars. If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. Hence, it is essential to anticipate and find all roots and root canals during root canal treatment with the help of proper angulations and interpretation of intraoral periapical radiographs. This case series discusses the detection and clinical management of five mandibular molars with extra root and root canal anatomy.

Successful endodontic treatment requires knowledge of the root canal anatomy, cleaning, and shaping followed by three-dimensional filling of the root canals. With the advent of newer diagnostic aids such as cone-beam computed tomography (CBCT) and magnifying tools such as dental operating microscope and loupes, it has become easier for an operator to identify the root canal anatomy of teeth and reduce the risk of procedural accidents and failures. Variations in root canal configuration require modification in access cavity preparation, disinfection, and obturation of the canals. Mandibular premolars are identified to have unusual root and canal anatomy which increases the risk of endodontic failure when additional canals remain undiagnosed. The present case report elaborates successful endodontic management of a mandibular second premolar with Type IX root canal configuration using CBCT as a diagnostic tool.

Aim: This study aimed to compare the canal-centering ability, apical transportation, and remaining dentin thickness (RDT) of OneShape and WaveOne (WO) systems using cone-beam computed tomography. Objective: The objective of this study was to evaluate the efficiency of two rotary systems in maintaining original root canal anatomy. Materials and Methods: Forty extracted human single-rooted mandibular premolars were used in the present study. Preinstrumentation scans of all teeth were taken, canal curvatures were calculated, and the samples were randomly divided into two groups with twenty samples in each group: Group 1 – OneShape (OS) rotary system and Group 2 – WO reciprocation system. Postinstrumentation scans were performed using DICOM software and the two scans were compared to determine the canal-centering ability, canal transportation, and RDT at 1, 3, and 5 mm from the root apex. Results: Using Student's unpaired t-test, results were as follows: for canal-centering ability and RDT, Group 1 showed nonstatistically significant difference at 1 and 5 mm, while statistically significant difference (P < 0.05) at 3 mm was obtained. For canal transportation, Group 1 showed statistically significant difference (P < 0.05) at 1 and 3 mm and nonsignificant difference was obtained at 5 mm, but for Group 2, nonstatistically significant difference (P > 0.05) was obtained at 1, 3, and 5 mm. When comparing the RDT between both the groups, the difference was not statistically significant (P > 0.05). Conclusion: WO single reciprocation file has better canal-centering ability, maintains original canal curvature, causes lesser canal transportation, and preserves more dentine as compared to OS.

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar.

Ali/0000-0003-2835-767X WOS: 000419353900010 PubMed: 28846136 Aim To conduct a quantitative and qualitative analysis of the band-shaped isthmus area, the floor of which was in the apical third in the mesial roots of mandibular first molars using micro-computed tomography (micro-CT). Methodology Micro-CT images of 269 mesial roots of mandibular first molars were evaluated, and 40 specimens with a band-shaped isthmus, with a floor in the apical third, were selected. The major diameter, minor diameter, roundness, area and perimeter values for the most coronal and apical slices where the isthmus was visible were measured. The distances between these slices were measured as the isthmus length, and the total volume, structure model index and surface area of the isthmus were measured. The distances between the isthmus floor and two apical foramina and the number of root canal orifices were calculated. The dimensions of the isthmus roof and the floor were compared, and the data were analysed using descriptive statistics and Student's t-tests with a significance threshold set at 5%. Results A total of 15% of the specimens had band-shaped isthmuses with a floor in the apical third. The isthmus roof exhibited significantly greater major and minor diameter values compared to the isthmus floor (P < 0.05). No significant difference was detected between the isthmus roof and the floor with regard to roundness (P > 0.05). Conclusion Three- and two-dimensional analyses of the mesial roots of mandibular molars revealed that band-shaped isthmuses had complex shapes. Scientific and Technological Research Council of Turkey-TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [114S002] This study was supported by the Scientific and Technological Research Council of Turkey-TUBITAK (grant no. 114S002). Authors deny any conflicts of interest.

Cilj: Usporediti reznu površinu, očuvanje anatomije korijenskog kanala i neinstrumentiranu površinu nakon instrumentacije sustavima F360®, F6SkyTaper®, HyflexEDM®, iRace®, Neoniti®, O.Shape®, P.Next®, Reciproc®, Revo-S® i WaveOneGold® s veličinom instrumenta 25. Materijali i metode: Tristo zubi s jednim ravnim korijenom i okruglim ili eliptičnim presjekom korijenskog kanala podijeljeno je u 10 skupina (1-F360®, 2-F6SkyTaper®, 3-HyflexEDM®, 4-iRace®, 5-Neoniti®, 6-O Shape®, 7-P.Next®, 8-Reciproc®, 9-Revo-S® i 10-WaveOneGold®) i poprečno prerezano na trećine ultrafinim reznim diskovima. Uzorci su fotografirani pod stereomikroskopom i provedena je predinstrumentacijska analiza prije ponovnog spajanja zuba K-instrumentom #10 i epoksi smolom. Ručno je uspostavljena prohodnost K-instrumentima #10 i #15 te je svaka skupina instrumentirana jednim od rotacijskih ili recipročnih sustava. Rezna površina, očuvanje anatomije korijenskog kanala i neinstrumenirana površina analizirani su s pomoću AutoCAD-a 2015. Za statističku analizu korišteni su Leveneov test, Welchov test, Games-Howellsov test i Pearsonov hi-kvadrat test. Rezultati: Leveneov test nije pokazao jednakost varijacije (P < 0,05), pa su primijenjeni Welchov i Games-Howellov test u analizi rezne površine, pokazujući statistički značajne razlike za sve trećine i ukupno (P < 0,05). Nisu zabilježene razlike u očuvanju anatomije korijenskog kanala (P > 0,05). Što se tiče neinstrumentirane površine, pronađene su statistički značajne razlike (P < 0,05), pri čemu su u srednjoj trećini bili bolji Reciproc®, Neoniti® i WaveOneGold®, a u apikalnoj trećini P.Next®, Reciproc®, HyflexEDM®, Neoniti® i WaveOneGold®. Zaključci: Što se tiče rezne površine, P.Next® i Reciproc® bili su bolji u koronarnoj trećini, Neoniti® i HyflexEDM® u sredini i apikalno, a sveukupno Neoniti® i Reciproc®. Što se tiče očuvanja anatomije korijenskog kanala, svi su sustavi bili slični. S obzirom na neinstrumentiranu površinu, svi su sustavi postigli slične rezultate koronarno, ali Reciproc®, Neoniti® i WaveOneGold® bili su bolji u srednjoj trećini te P.Next®, Reciproc®, HyflexEDM®, Neoniti® i WaveOneGold® apikalno., Objective: The aim of this study was to compare the cutting are, root canal anatomy preservation and non-instrumented areas of F360®, F6-SkyTaper®, Hyflex-EDM®, iRACE®, Neoniti®, O.Shape®, P.Next®, Reciproc®, Revo-S® and Wave-One-Gold® size 25 files. Materials and Methods: 300 teeth with a single straight root and a circular or elliptical root canal were divided into 10 groups (1-F360®, 2- F6-SkyTaper®, 3-Hyflex-EDM®, 4-iRACE®, 5-Neoniti®, 6-O.Shape®, 7-P.Next®, 8-Reciproc®, 9-Revo-S® and 10-Wave-One-Gold®) cut into 3 cross sections using an ultrafine cutting disc. They were photographed under a stereo microscope and preinstrumentation analyses were made before rebuilding the teeth with# 10 K- File and epoxy glue. A glide path was created with #10 and #15 K files and each group was instrumented using rotary or reciprocating systems. Cutting areas, root canal anatomy preservation and non-instrumented areas were analyzed using the AutoCAD 2015 Levene’s test, the Welch´s test, and the Games-Howell´s test. The Pearson’s chi-squared test was used for statistical analysis. Results: Levene’s test showed no equality of variances (P0.05). In non-instrumented areas, significant differences were found (P

Lateral and apical ramifications of the main root canal create potential pathways through which bacteria can spread and remain unaffected by treatment procedures. It is a challenge for the specialty to find techniques that can predictably reach, disinfect, and obturate these ramifications. Here, we report the use of a novel instrumentation approach to aid in the negotiation and management of a lateral canal discernible on cone-beam computed tomography (CBCT) in an unusual maxillary central incisor. A 23-year-old female patient was referred for evaluation and possible treatment of tooth 9. The periapical radiographic examination revealed pulp chamber obliteration, existence of a lateral lesion, and a possible complex internal root canal anatomy. The CBCT evaluation revealed the existence of a lateral lesion, a periapical lesion, an additional distopalatal canal, and a lateral canal exiting at the lateral lesion. The diagnosis of asymptomatic apical and lateral periodontitis of tooth 9 was reached. CBCT-aided access cavity preparation and scouting resulted in the successful negotiation of all canals, main and lateral. A novel instrumentation technique with precurved controlled memory files was used for the mechanical preparation of the lateral canal to a 25/04 enlargement. Obturaton of the lateral canal was achieved with a single gutta-percha cone and AH Plus Root Canal Sealer. At the 2-year follow-up, the patient was asymptomatic, and the 2-dimensional radiographic examinations revealed resolution of both the periapical and the lateral lesions. This case report describes the application of a novel instrumentation technique for the mechanical debridement of an infected lateral canal discernible on CBCT and reinforces the importance of treating the root canals as systems that possesses anatomic intricacies that need to be addressed.

It is mandatory for every clinician to have a thorough knowledge about the normal internal anatomy of teeth; equally important is the awareness about variations in internal anatomy that could be seen with different teeth. The outcome of a root canal therapy depends significantly on the clinician's awareness about root canal anatomy, followed by their clinical skills. Literature states that the permanent maxillary first molar shows a wide variation in the number of canals particularly with respect to the mesiobuccal root. This case report describes the endodontic management of a permanent maxillary first molar with three distinct mesiobuccal canals.

An in-depth knowledge of the root canal anatomy is important for any successful root canal treatment; however, complexities exist within the root canal morphology. The maxillary first molar has variations in its root morphology and canal configurations. In literature, this variation is only observed in an estimated 1.12%-1.17%. One such case is described in this case report which provides the endodontic management of a left maxillary first molar with two palatal canals using loupes magnification.

Knowledge of root canal anatomy and morphology is one of the significant elements for the successful result of endodontic therapy. Absence of knowledge relating to internal anatomy will lead to mistakes like access, localization of canals, cleaning and shaping and obturation of the root canal. Slowey expressed that root canal morphology has boundless variations and clinicians ought to consistently know that anatomic variations contribute a great challenge to the successful finishing of endodontic treatment.

OBJECTIVE: This study aimed to investigate the root canal system morphology of maxillary first molar mesiobuccal (MB) roots in a Brazilian sub-population using micro-computed tomography. METHODS: Ninety-six MB roots were scanned with a micro-CT (Skyscan 1173, Bruker). Three-dimensional images were analyzed regarding the number of pulp chamber orifices, the number and classification of the canals, the presence of accessory canals in different thirds of the root as well as the number and type of apical foramina. RESULTS: A single entrance orifice was found in 53.0% of the samples, two in 43.9% and only 3.1% had three orifices. The second mesiobuccal root canal (MB2) was present at some portion of the root in 87.5% of the specimens. A single apical foramen was present in 16.7%, two in 22.9%, and three or more foramina in 60.4% of the roots. Only 55.3% and 76.1% of the root canals could be arranged by Weine's and Vertucci's classifications, respectively. CONCLUSION: The number of orifices at the pulp chamber level could not work as a predictor of the MB2 presence. The most prevalent canal configuration was Weine type IV / Vertucci type V. The anatomical complexity of the MB root could not be entirely classified by the current most accepted classifications. ispartof: EUROPEAN ENDODONTIC JOURNAL vol:5 issue:2 pages:105-111 ispartof: location:Turkey status: published

WOS: 000518755000001 PubMed: 32141355 Objective: The aim of this study was to investigate the accuracy of endoscopic visualization to detect root canal anastomoses at the coronal half of the mesial root canals of mandibular molars using micro-computed tomographic (micro-CT) images as reference. Material and methods: Seventy-four mesial roots of mandibular first molars with (n = 47) or without (n = 27) intercanal anastomosis were selected based on the micro-CT scans of 269 mandibular first molars at a pixel size of 10 mu m. The specimens were mounted on the mannequins and their root canals were evaluated using dental operating microscope (DOM) and endoscope. The endoscopic probe was inserted into the main mesial root canals and 2 blinded observers evaluated the presence of a divergence point of anastomosis (where the branching occurs) as 'present' or 'absent'. The scorings were compared with the three-dimensional reconstructed images of the specimens and recorded as 'correct' or 'incorrect' evaluation. Degree of agreement between evaluators was assessed with Kappa test and the accuracy of endoscopic visualization according to the presence and location of anastomosis was compared using Fisher exact tests with a significance threshold at 5%. Results: High inter-examiner reliability was reported (0.91). None of the divergence points were identified using DOM whereas 11 divergence points were detected using endoscope, corresponding the 23.4% of the intercanal anastomoses. The endoscope also showed the absence of an intercanal anastomosis correctly in all of the specimens without an anastomosis. Detectability of a divergence point using endoscope was not affected by its location within the coronal half of root canal (p > .05). Conclusions: The endoscopes were able to visualize the divergence points of 23.4% of the intercanal anastomoses located at the coronal halves of root canals. Scientific and Technological Research Council of Turkey-TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [117S139] This study was supported by the Scientific and Technological Research Council of Turkey-TUBITAK (grant no. 117S139).

The objective of dentists is to preserve teeth affected by either caries, trauma, or any other pathological condition. Teeth with deep carious lesions often require endodontic treatment to preserve their form and function. Sound knowledge of root canal anatomy, endodontic pathology, and proper treatment protocol are vital in endodontic treatment success. Currently, there has been an ongoing trend of case reports that highlight the presence of extra canals, which in turn, cautions the clinician to be more prudent. Any missed canal during root canal therapy is the common cause of treatment failure. This case report emphasizes the fact that proper understanding of pulp anatomy combined with the use of modern diagnostic aids and proper treatment protocol is essential for treatment success. This case report describes successful management of three rooted mandibular first molar with extra canals.

Objectives. To investigate the root morphology and root canal anatomy of maxillary first premolar using microscopic computed tomography (micro-CT). Methods. 324 maxillary first premolars were collected and scanned. The root and canal diameter, canal wall thickness, root taper, and cross-sectional shapes were determined in the single root with 1 canal (SR1C), single root with 2 canals (SR2C), and 2 roots with 2 canals (2R2C) by micro-CT. Results. The results showed that single-rooted maxillary premolars were more common than other types. The incidence of SR1C, SR2C, and 2R2C reached 25%, 26.39%, and 26.39%, respectively. Root and canal diameters and canal wall thickness were decreased from coronal third to apical foramen. The three parameters and canal taper showed increases from buccal and palatal (BP) to mesiodistal (MD) aspects. The root canal tapers were smallest of the middle third level. The findings showed the different variations in 2R2C teeth. The root canal cross-sectional morphology in maxillary first premolars is complicated, including round, oval, long oval, flat canal, and irregular canal shapes. The distribution varied in different aspects. Conclusion. Root canal morphology showed a wide variation and complicated structure. The single-rooted teeth were more common in the Chinese adolescent population, and the majority of maxillary first premolars have two canals.

AIM To determine whether a relationship exists between the apical shape of roots and root canal system complexity by performing a micro-computed tomography analysis. METHODOLOGY One hundred extracted permanent maxillary first molars were scanned using a micro-computed tomography device at 19.6 μm voxel size. Two groups of mesiobuccal roots were formed according to the root aspect ratio value in the apical 3-mm cross-sectional level ('

The persistence of microorganisms in the root canal system is one of the leading causes of root canal treatment failure. Root canal anatomy is complex, and it is often a challenge to obtain optimal disinfection. Biofilms of putative pathogens hidden inside dentin tubules and other root canal ramifications may limit current disinfection protocols. The search for additional disinfection of the root canal has been intensely carried out over the last twenty years. Antimicrobial photodynamic therapy (aPDT) is an adjunctive, conservative, non-selective bacterial kill approach. aPDT has been used to improve root canals disinfection without inducing bacterial resistance. This review focuses on the up-to-date aPDT performance and upcoming promising strategies for disinfection of the root canal system. First, we summarized the barriers encountered by photosensitizer (PS) and light delivery applied to root canal disinfection. Second, we compile the most updated clinical literature. A systematic search for scientific articles was conducted in PubMed, MEDLINE, SCOPUS, and EMBASE to screen the related in vivo studies about this theme. Third, we summarized and critically analyzed the current developments to overcome the aPDT limitations, and we revealed upcoming perspectives in this scoping literature review. We present a timely and opportune review article focusing on the significant potential of aPDT in endodontic disinfection. aPDT offers multiple capabilities that may be considered toward the root canal system’s disinfection with future outlooks in nanosized-platforms’ design and performance.

A rare case of birooted primary maxillary central incisor is reported. A 5-year-old male patient reported with carious maxillary primary anterior teeth. Radiographic examination incidentally revealed root bifurcation in primary maxillary central incisors bilaterally. This represents a rare finding. There are few cases that have reported birooted permanent incisors, but there is no case reported till date with birooted primary incisors. This report discusses the findings in the context of the available literature. The possible etiology and the need for careful assessment prior to root canal therapy are highlighted. How to cite this article Jajoo SS. Primary Maxillary Bilateral Central Incisors with Two Roots. Int J Clin Pediatr Dent 2017;10(3):309-312.

Mandibular premolars that have rare and complex anatomies may have the highest failure rate in nonsurgical endodontic treatment. Awareness of rare and complex anatomies of mandibular second premolars would aid in better outcomes of the treatment. This study aimed to evaluate the success of nonsurgical root canal treatment of mandibular second premolar teeth with complex apical branching.Twenty-six mandibular second premolar teeth with complex apical branching treated with multiple-visit nonsurgical root canal treatment or nonsurgical retreatment were retrospectively evaluated.For the clinical outcomes, 9 subjects had complete healing, 1 subject had functional healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had functional healing, and 2 subjects had no healing scores out of 16 retreatment subjects. For the radiographic outcomes, 7 subjects had complete healing, 3 subjects had incomplete healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had incomplete healing, and 2 subjects had no healing scores out of 16 retreatment subjects. The clinical outcome of root canal treatment subjects was significantly different than retreatment subjects (P .05). Similarly, the radiographic outcome of root canal treatment subjects was also significantly different than retreatment cases (P .05).The outcome of endodontic treatment of mandibular second premolars may be influenced by treatment type.

Background: The present study was conducted to evaluate the bond strength in the different root thirds (premolars and maxillary central incisors) of composite relined glass fiber posts compared to untreated glass fiber posts cemented with dual- or chemical-cure cements. Materials and Methods: Sixty human single-rooted premolars (flat canal) ( n = 15) and 12 maxillary central incisors were used (round canal) ( n = 3). The teeth were sectioned, and the roots received endodontic treatment. The standardized preparation of the canals was carried out, and the roots were randomly divided into four groups according to the cementation systems: G1: cemented posts (dual: Ambar/Allcem); G2: relined posts (dual: Ambar/Allcem); G3: cemented posts (chemical: Fusion Duralink/Cement Post); and G4: relined posts (chemical: Fusion Duralink/Cement Post). The roots were cut to give two slices of each third of the root canal per specimen. Push-out test was conducted at a speed of 0.5 mm/min. Data were analyzed by analysis of variance and Tukey's post hoc test (α = 0.05). Results: There was no statistically significant difference between groups for the premolars (flat canal) ( P = 0.959). There was a significant difference in the central incisors between the middle and apical thirds in the cemented group when using the dual system ( P = 0.04) and between the middle and apical thirds ( P = 0.003) and cervical and apical thirds ( P = 0.033) when using the chemical system. Conclusion: Due to the anatomy of the root canal, flat canal of the premolars does not require relining, but round canal of the maxillary central incisors demands it for more secure in the bond strength.

Knowledge of root and root canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in nondestructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.