Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

Anatomy research international 12/2013; 2013:254250. DOI: 10.1155/2013/254250
Source: PubMed

ABSTRACT Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24%) while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

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Available from: Jojo Kottoor, Jan 28, 2014
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    • "However, this very literature also lacks direct and categorical inferences to any geographic or ethnic patterns. In a recently published systematic literature review on root anatomy and canal configuration of permanent mandibular premolars, direct evidence to correlate certain anatomic variations in mandibular premolars to specific ethnic and geographic populations was reported [2]. Clinically, how does the endodontist utilize this information regarding tooth anatomy to enhance efficacy in root canal treatment? "
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    ABSTRACT: Mandibular premolars are known to have numerous anatomic variations of their roots and root canals, which are a challenge to treat endodontically. The paper reviews literature to detail the various clinically relevant anatomic considerations with detailed techniques and methods to successfully manage these anomalies. An emphasis and detailed description of every step of treatment including preoperative diagnosis, intraoperative identification and management, and surgical endodontic considerations for the successful management of these complex cases have been included.
    BioMed Research International 05/2014; 2014:512574. DOI:10.1155/2014/512574 · 3.17 Impact Factor
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    ABSTRACT: Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.
    11/2014; 2014:973410. DOI:10.1155/2014/973410
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    ABSTRACT: It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals.
    11/2014; 2014:320196. DOI:10.1155/2014/320196
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