P. 1
Root Canal Anatomy[Lecture by Dr.Hatem Al Hadainy @AmCoFam]

Root Canal Anatomy[Lecture by Dr.Hatem Al Hadainy @AmCoFam]

5.0

|Views: 865|Likes:

More info:

Categories:Types, Research
Published by: AmericanCornerFamily on Jul 07, 2011
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PPT, PDF, TXT or read online from Scribd
See more
See less

11/05/2015

pdf

text

original

• The pulp cavity is the central

space within a tooth that enclosed by dentin except at the apical foramen. • It is divided into a coronal portion (the pulp chamber) and a radicular portion (the root canal). • Other features include pulp horns, canal orifices, accessory (lateral) canals, and apical foramen.

Pulp Horns
Although pulp horns may vary in height and location, a single pulp horn tends to be associated with each cusp in a posterior tooth, and mesial and distal horns tend to be found in incisors. Pulp horn may extends occlusally and exposure may occur as a result of caries or routine cavity preparation. Such abnormally high pulp horns may or may not be visible on radiographs.

Pulp Chamber
The pulp chamber occupies the center of the crown and trunk of the root. Its shape depends on the shape of the crown and trunk; this configuration varies with tooth age or irritation.
Roof of pulp chamber Pulp horn Pulp Chamber Floor of pulp chamber Canal Orifice opening

Root canals
o Root canals extend from orifice to
the apical foramen. o Root canals vary according to root shape, size, degree of curvature, age, and condition of the tooth. oThe shape of root canals mainly irregular, not straight and other variations in root canals may occur.

Accessory canals
Accessory (or lateral) canals are branches of the main canal. They contain connective tissue and may be located at any level from furcation to apex but tend to be more frequent in the apical third. They contribute little to pulp function and probably represent an anomaly that occurred during root formation.

Apical Region
 Root

Apex: It is the root terminus that reflects maturation and is relatively straight in the young tooth but curves distally with time due to continued apical-distal apposition of cementum. Alterations in the apical region may result from resorption and irregular cementum apposition. Thus, apical anatomy tends to be nonuniform and unpredictable.  Apical Foramen: It varies in size and configuration with maturity. It usually does not exit at the anatomic root apex but deviates an average of 0.5 mm of true apex. Apical foramen is not visible in the X-ray and the clinician must determine the extent of canal preparation and obturation (working length).

• Apical

Constriction: The cementodentinal junction formsApical Constriction the apical constriction. The intra-canal extent of cementum is variable. • Variations in Anatomy: The only consistent aspect of the apex region is its inconsistency. The canal may take twists and turns, divide into several canals to form a delta, or exhibit irregularities in the canal wall.

Types of roots
Type I
Mature straight roots (having closed apex with apical constriction)

Type II
Mature but not straight root canals, which may be:

Slightly Curved

Severely Curved

Dilacerated

Bayonet

Type III
Immature (open apex) canals )Straight or curved(

A. Tubular root apex

B. Blunderbus apex

Types of Canal System
Type I: Single canal with single orifice and single apical foramen

Type II: Two canals with two orifices and single apical foramen

Type III: Two canals with two orifices and two apical foramen

Type IV: Single canal with single orifice and two apical foramina

Type V: A canal with a single orifice that divided into two canals and exit with a single apical foramen

Type VI: Single canal with two orifices and two apical foramen

Another Classification

Anatomy of Pulp System

Tooth demineralization and cross Section of teeth showing relationship between Pulp and external surface morphology

Maxillary Central Incisor

Average Tooth Length: 23.3 ± 2.3 mm Pulp chamber: wider MD Than Labio-palatal  One root: One Root Canal (100%) C.S Straight, round, tapered, cylindrical A  Apical Distal curvature: (8%)  Lateral root canals: Occasional M Apical root canal delta: Frequent Cross section: Ovoid/Ovoid/round C

Maxillary Lateral Incisor
 Average

Tooth Length: 22.8 ± 2.3 mm Pulp chamber: wider Labio-palatal Than MD  One root: one canal  Apical distal curvature: (53 %) Lateral root canals: Occasional Apical root canal delta: Frequent  Cross section Ovoid, Ovoid round

Maxillary Canine
Average Tooth Length: 26 ± 3 mm  Pulp chamber: wide LP than MD  One Root: one canal  Apical distal curvature: 32% Lateral root canals: Infrequent Apical root canal delta: Occasional  Cross section: Ovoid/Ovoid/Round

Tooth lengths, number of roots. and canal configuration for upper anterior teeth Tooth Maxillary central incisor Maxillary lateral incisor Maxillary canine Total length A = 23.0 L = 28.0 S = 18.0 A = 22.5 L = 27.0 S = 17.0 A = 27.0 L = 32.0 S = 20.0 Crown length 10.5 12.0 8.0 9.0 10.5 8.0 9.5 12.0 8.0 Root length 12.5 16.0 8.0 16.5 16.5 8.0 16.5 20.5 11.0 Number of roots One Types of canals I

One

I

One

I

A: average

L: largest

S: smallest

Mandibular Central Incisor
• Average Tooth Length: 21.5 ± 2 mm • Pulp Chamber: wide LL than MD • One Root One RC 70 % Two RCs with one Ap. For. 25% Two RCs with two Ap. For. 5% • Apical Distal Curvature: 23 % • Lateral root canals: Occasional • Apical root canal delta: Infrequent • Cross section: Ovoid/Round/Round

Mandibular Lateral Incisor
 Average Tooth Length: 22.5 ± 2 mm  Pulp Chamber wide LL than MD  One Root One RC > 55 % Two RCs with one ApF 30% Two RCs with two ApF 15%  Lateral root canals: Occasional  Apical root canal delta: Infrequent  Apical Distal Curvature: 23 %  Cross section Ovoid/Round/Round

Mandibular Canine
Average Tooth Length: 25.5 ± 2.5 mm. Pulp Chamber Wide LL than MD (One Pulp Horn) One Root One canal (94 %), Two canal (6 %) Lateral root canals: Occasional Apical root canal delta: Infrequent Apical Distal Curvature: 20 % Cross section Ovoid/Ovoid/Round

Tooth lengths, number of roots. and canal configuration for lower anterior teeth

Tooth Mandibular incisors

Total length A = 21.0 L = 25.0 S = 16.0

Crown length 9.0 10.5 7.0

Root length 12.0 14.5 9.0

Number of roots One

Types of canals I most frequent II less frequent III least frequent

Mandibular cuspid

A = 24.0 L = 30.5 S = 20.0

10.0 12.0 8.5

15.0 20.5 11.5

Two; one buccal and one lingual (rare)

I most frequent II less frequent III least frequent

A: average

L: largest

S: smallest

Maxillary First Premolar
Average Tooth Length: 22 ± 2.5 mm Pulp Chamber: Wide LP than MD Two Roots 72 %: 2 RCs (B&P) One Root (22%): 2 RC (13 %),1 RC (9 %) Three Roots: 3 RCs 6 % (2 B & 1 P) Apical Distal Curvature: 37% Lateral root canals: Infrequent Apical root canal delta: Infrequent Cross section: Ribbon/Ribbon/Oval

Maxillary Second Premolar
Average Tooth Length: 21 ± 2 mm Pulp Chamber: Wide LP than MD Av One Root: (90%) 1 RC 75 % 2 RCs 15 % III Two Roots: 2 RCs 10% Apical Distal Curvature: 27% Bayonet Curv: 20%
Lateral root canals: Infrequent Apical root canal delta: Infrequent

Cross section: Ribbon/Ribbon/ Round

Typicallengths. number of roots, and canal Tooth tooth lengths. number of roots, and configuration for upper bicuspids canal configuration for premolars
Tooth Maxillary first premolar Total length A = 21.0 L = 24.0 S = 17.5 Crown length 8.5 10.0 7.0 Root length 12.5 14.5 10.0 Number of roots Two, most frequent (60%), buccal and palatal One (40%) Types of canals Each, 1

III most frequent II less frequent I rare

Three rare Maxillary second A = 21.0 premolar L = 25.0 S= 17.0 8.5 10.5 7.0 12.5 15.0 9.5 one (85%)

Each, I I most frequent 11 less frequent III least frequent may have Type IV

Two (15%), buccal and palatal

Each, I

Mandibular First Premolar
 Average Tooth Length: 22 ± 2 mm  Pulp Chamber Wide LL than MD  1 Canal with 1 Foramen 73.5 %  2 Canals with 2 Foramina 19.5% with 1 Foram … 6.5 %  3 Canals 0.5 %  Apical Distal Curvature: 35%  Lateral root canals: Occasional  Apical root canal delta: Occasional  RC Cross Section: Ribbon/Ribbon/ Round

Crown has Lingual inclination Crown has Lingual inclination

Mandibular Second Premolar
• • • • • • • • • Average Tooth Length: 21 ± 2 mm Pulp Chamber: Wide LL than MD One Canal 85 % Two Canals with 2 F 14.5% Three Canals 0.5 % Apical Distal Curvature 4o % Lateral root canals: Occasional Apical root canal delta: Occasional CrossSection:Ribbon/Ribbon/Round

Tooth lengths. number of roots, and canal configuration for lower premolars
Tooth Mandibular first bicuspid Total length Crown length A = 21.5 L = 25.0 S = 17.0 A= 22.0 L = 25.0 S = 17.0 7.5 9.0 6.5 8.0 10.0 6.0 Root length 14.0 17.0 11.5 14.0 17.0 11.5 Number of roots One Two, buccal and lingual One Types of canals See previous Each, I 1 most frequent 11 or III rare IV very rare Two, buccal and lingual. very rare Three, two buccals and one lingual Each, I

Mandibular second bicuspid

Maxillary First Molar
 Average Tooth Length:
Buc roots : 20 ± 2 m Palat. root : 22 ± 3m  Three Rooted Tooth (MB, DB, PAL) • 3 canals in 3 roots: 43 % • 4 Canals in 3 roots: 57 % 4th canal (MB2)

 Buccal Apical Curvature
( PL root ) > 55 %  Distal Apical Curvature ( MB root ) > 78%  Pulp Chamber: Triangular  Lateral root canals: Occasional  Apical root canal delta: Infrequent

Maxillary Second Molar
 Average Tooth Length: Buccal roots : 20 ± 2 m Palatal root : 21 ± 2m  Three Rooted Tooth: 44 % 63 % 3 Canals ( MB ,DB , PAL) 37 % 4 Canals 4th canal (MB2) Two roots or ( fused ): 46 % (BC & PL (3 or 2 Canals)

 Buccal Apical Curvature
( PL root ) > 35 %  Distal Apical Curvature ( MB root ) > 55%  Pulp Chamber: Triangular Lateral root canals: Occasional Apical root canal delta: Infrequent

Tooth Lengths, number of roots. and canal configuration for upper molars
Tooth Total length Crown length Root length Number of roots Types of canals

Maxillary first molar

A= 20.5 L=24.0 S = 17.0

7.5 9.0 7.0

13.0 16.0 10.0

Three. two buccal and one palatal

Distobuccal and palatal: each I

Maxillary second molar

A = 20.0 L=21.0 S = 17.0

7.0 8.5 7.0

13.0 15.5 10.0

Three. two buccal Distobuccal and palatal: and each I. one palatal (90%)

Two. one buccal and

Each I most frequent; buccal root

Mandibular First Molar
• Average Tooth Length: 21 ± 2 mm • Roots are FLAT wider B-L • 2 rooted tooth: (M & D). 3 root canals: 70 % M. Root 2 canals. D. Root 1 canal. 4 root canals: (30 %) (2 canals in Distal root)

•Apical Distal Curvature: (M root ) 85 % • Pulp chamber: Triangular (Base Mesial, Apex distal) • Lateral root canals: Occasional (furcation) • Apical root canal delta: Frequent (Mesial root)

Mandibular Second Molar
 Average Tooth Length: 20 ± 2 mm Roots are FLAT wider BL M. root wider BL than D. root  2 rooted tooth: (M&D). 3 root canals:70 % 4 root canals: 10 %. 2 root canals: 20 %

• Apical Distal Curvature
M root: 60 % • Pulp chamber Triangular (Base Mesial, Apex distal) Lateral root canals: Occasional (furcation) Apical root canal delta: Frequent (Mesial root)

Tooth Lengths, number of roots. and canal configuration for lower molars
Tooth Total length A = 21.0 L = 24.5 S = 18.0 Crown length 7.5 10.0 6.0 Root Number of roots length 13.5 15.0 11.5 Two, most common. mesial and distal Types of canals

Mandibular first molar

Mesial: 1II most frequent II less frequent Distal: I most frequent II less frequent III least frequent Mesial: same as above Distal: distolingual very curved

Three. one mesial and two distal

Mandibular second A = 20.0 molar L = 24.0 S= 17.0

7.0 8.5 6.0

13.0 15.5 12.0

Two, most common. mesial and distal One

Mesial: same as above
Distal: I most frequent

II or ill rare II most frequent I less frequent III least frequent

Third Molars
 The root canals of third molars are
completely unpredictable because they are frequently short, tortuous, multiple & branching. There is no patterns or rules to follow when treating this unpredictable tooth.
 

May have only one single canal.

Premolars Mandible Maxilla

Molars

Third molars can present problems, which are related to accessibility and anatomy. Reaching the most posterior teeth with hand piece and hand instruments can be difficult because of poor visibility and restricted jaw opening.

Often these molars are tipped or malpositioned.

Age Changes
• Dentin formation tends to occur in the roof and floor of the chamber pulp chamber are reduced in size, eventually making the chamber almost disc-like in configuration. • The orifices of the canals become smaller in diameter. • A pronounced curve in the canal might result from the newly formed secondary dentin. • A sharp curvature in the coronal area of the root canal might result from the secondary dentin formation.

Irritants
• Anything that exposes dentin to the oral cavity can potentially stimulate increased dentin formation at the base of tubules in the underlying pulp. • Vital pulp therapy such as pulpotomy, pulp capping, or placement of irritating materials in a deep cavity may cause occlusion, calcific metamorphosis, resorption, or other unusual configurations in the chamber or canals.
Secondary dentin

Reparative dentin

Pulp Stones
• Although pulp stones are usually found in the chamber and diffuse calcifications within the radicular pulp, the reverse may also occur. • Stones in the chamber may reach considerable size and can alter the internal chamber anatomy. • Chamber stones may be attached or free and are usually removed during access preparation. • Pulp stones are NOT common in canals, they are usually attached or embedded in the canal wall in the apical region. Rarely do they form a barrier to instrument passage.

Resorption
• Resorptions are less frequent than dentin formation or calcifications and when present are usually not extensive. • Resorptions are a response to irritation that is sufficient to cause inflammation. • When visible radiographically, they are usually extensive and may create operative difficulties

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->