2s zs0s02406-0417800.000 Sato Bocas Toyah 1088 by The American Associaton of Sredontios unten Us. Vou 24, Nov ne 1908 Root Canal Morphology of Maxillary Premolars Nevin Kartal, PRD, Bahar Ozcelik, PhD, and Hale Cimilli ‘The objective of this study was to investigate further intemal anatomy of maxillary premolars. Six hundred recently extracted maxillary first and second premo- larteeth were used in this study. One-haif of the teeth were maxillary first premolars, the other half were maxillary second premolars. The teeth were stored in 10% formalin solution, and a standard clearing tech- nique was applied with some modifications. Finally, ink-dyed root canal systems were evaluated by a dissecting light microscope. Each tooth was exam- ined 2s to the number of roots and root canals and their types, ramifications of the main root canals, and location of apical foramina and transverse anasto- moses. Examination of the root canal systems of the teeth was based on Vertuce’’s classification. The in- cidence of type I canals (one canal) for the maxillary first premolars was 8.06%, whereas 89.64% of the {otal samples demonstrated two canals {from type Il to type Vil. Only 1.66% of maxillary first premolars were type Vill or type IX (three canals). Regarding maxillary second premolars, the incidence of type I {one canal) was 48.66%, whereas it was 50.64% for ‘ype Ito type Vl (two canals}. Type Vil (three canals) was found in 0.66% of the total sample. ‘an awareness of root canal morphology and careful interpretation ‘of preoperative radiographs is necessary for success in endodontic therapy. However radiographs are two-dimensional images of a Tvee-dimensional object. The clinician must he aware of this limitation during radiographic interperation (1, 2) Studies with various findings have been reported on the root canal types of maxilary first and second premolars (3-12). When ‘oot canal systems are evaluated by a clearing technique, it gives rnore comprehensive knowledge than other techniques for the study of variations in the sot canal system (9, 13-15). Thus, when ‘he results of clearing techniques are compared with other studies, ‘higher incidence of variation is found in root canal morphology 6-42, 15). Inhisextensive study, Vetacsi (16) classified and described the root canal systems of human permanent teth ino eight different \ypes. The purpose ofthis study was to investigae further complex a7 root canal enatomy of maxillary premolars using Vertueci's clas- sification, MATERIALS AND METHODS Six hundred previously extracted intact maxillary frst and see ‘ond premolar teeth were used in our study. One-half of the teeth ‘were maxillary frst premolars, and the other haf of the teeth were ‘maxillary second premolars. The teeth were stored in 10% forma- lin solation, anda clearing technique was applied (15). Briefly the teeth were kept in 5% sodium hypochlorite solution for 30 min to remove organic debris ftom the surfaces. Access cavities were Drepared with a high-speed handpiece, Canals were irigated with ‘5% sodium hypochlorite using a 22-gauge syringe, dried with ‘paper points, and the teeth were immersed in India ink for 4 days. The next step was decaleification in 10% hydrochloric acid that ‘was followed by dehyération twice with 70 to 95% alcobol, re- spectively. The last step was to store the teeth in methyi salicylate for 6 h, Finally, the ink-dyed root canal sysiems were inspected using a dissecting light microscope (Karl Kapps GmbH, Assar, Germany) at X0.6 to <4 magnification, RESULTS ‘The cleared samples were evaluated as to root canal numbers, canal types existence of lateral canals and their localization, and their apical ramifications (Tables 14), One more root canal type that isnot defined in Vertuces classification was identified and grouped as a new type Teas type IX, in which ovo separate canals leve the palp chamber proceeding in separate roots. One canal reaches the apex with apical ramifications. The other canal divides ito co canals inthe apical third and exits on canals at two separate foramina (Fig. 1). Lateral canals were found in the apical third of the root in the majority of samples (Tables 3 and 4). ‘The apical foramen was located laterally in 84.66% of the saxillay first premolars and in 77% of maxillary second premo lars (Tables 3 and 4), DISCUSSION Success in endodontic therapy depends on the removal of the inflamed pulp tissue or necrotic debris within root canal systems. ‘Therefore, a thorough knowledge of root canal morphology and its potential for variations related to race may be important for end ‘dont therapy (17, 18).418 Korta ot at “Taste 1, Classification of root canal forms of maxillary Journal of Endodontics Tame 4. Root canal morphology of maxillary second et pemclre remotes Sige Two Tee TOS" armies apa of Anastomosis Foraman ice tate Maton acon Rarsfeaton = Cmamd a 3 7 Wdetns 118 Temge ppttws 18 Taocamayat apex eas “ye 6% mK Conta sa ra% Trevor "em ses Cae eat) Tevet 2a = 6 Tpemea 253 = Tewige-a a ee ee) Tiree canal apex 108 "pe vi -~ = is ‘Type KE-3) = 088 ' siving a three-dimensional view of the root canal system, and all a ee eee Iorpolgica deus can be observe (1,19) “Rainboots tan Fw oon ae ‘tn ccsin he apn ‘TnsLe 2, Classification of root canal forms of maxilary ‘second premolars Single Two. Three. Type" Root Rooted Rooted Total Be Sere Cre cee eee tee ‘One canal at apex Si9e Type) ao ‘Type 2-1) erga Type il 1-2-1) eae = “Two canals at apex 4431 Type V2) 933 2868 ‘ype V (1-27 300-1000 = Type V (1-2)8 ia = = Tope Vi 1-2) oe Type vi (t21-) a “Theae canals at apex. 0.88 “Type vl (3) - = a8s Total 6964 2085 0.66 “Naan paratican tans oa Gna aber an Bs own DSH “Ton cus ne mee $ueunooart nh ape ‘Taste 9, Root canal morphology of maxilay first premolars esation Treneveree of ‘Apical Foramen Apical Lateral Mnastoness Vocation Ramifcation Canal Cenvical thie 11 2 a Middie bird 16 7 Apical third St 2 contrat 46 (15.8396) Lateral 254 (84.88%) aa Total mat 200 Tn the Titeratre, various techniques have been presented 10 investigate root canal morphology G6, 16), In this study, the clearing technique was used. Ths technique has the advantage of Tn the sudies about root canal morphology, the percentage of single-canaled maxillary fist premolars has been reported at 1.50 28.1% (3-9, 11, 12), Although our results (8.668) are similar ‘0 recent studies, the percentage is considerably lower when com- pared with those of earlier studies (Table 5). In the Mteratare, the ‘dence of two-canaled maxillary first premolars ranged between 733 t0 98.5% (3-9, 11,12], Our findings support previous stules, ‘but the percentage of three-canaled maxillary frst premolats in out Fic 1. Tho rooted and three-canaled manilay first premolar.Vol. 24, No. 6, June 1998 Morphology of Maxiliary Premolars 419 Teste 5. Studies on maxillary frst promolars ‘One Canal Two Canals —_‘Tivee Ganals Year hor Modt —Noottety on 1925 Hess @) Invitro 260 195 793 12 1925 Barat (a) In vitro 2 281 638 an 1933 eter) In vito 130 15 985 ° 1972 Pinecia& Kutter (6) Invive 259 262 733 os 19873 Green (7) In vito 50 8 ca a 1973 Carne & Skidmore (@) invivo 100 3 85, 6 1879 Vertucc!& Gegaurt 2) Invitro 400 a sr 5 1985 Balizi & Hartwal (17) In vivo sia 62. 205, aa 1005 Galghan etal. (12) In vivo +100 392 967 ° 1997 Kartalotal (his stusy) Invitro 300 868 e964 1.66 Taste 6. Studies on maxillary second premolars Ne. ‘One Canal Two Canals “Three Canals Year Author Mode! of eee Tooth oo 06) an.) 1972 Pina & Kutter) in vivo 282 65 4 ° 1973 Green @) In vito 50 2 8 ° 1974 Vertucl etal (10) In vito 200 48 5 1 1985, Bota! & Harve (13) nwo 630 403 586 1 1995 ‘Gabskan otal. (12) In vito 00 4“ 56 ° 1997 Kartal etal this study) In iro 300 48,65 50.64 066 study was lower than those of previous studies, except Calskan et al, (12) (Table 5). Similar to our study, Vertuci and Gegauf? (9) studied transparent specimens for determining root canal config vratons, They reporied that 8° of the maxillary fist premotars had one canal, 87% of teeth had two canals, and 5% had three canals atthe apex. Our findings partially support those findings. In ‘our study, manillay first premolars had thuce canals in 1.66% of the teeth at the apex (Table 5). Regarding maxillary second pre= molars, our results are similar to those reported by other research es (6, 7, 10-12) (Table 6) [Examination ofthe floor ofthe pulp chamber gives some clues shout existing, raot canal types. When there is only one canal exposed, itis usually located inthe eenter of the pulp chamber and canbe found essily. If only one orifice is found thet is not i the center of the pulp chamber, another canal probably is present and Should be searched for on the opposite side (10). Vertuee} and (Gey (9) stated that the relationship ofthe two orifices to each ‘her i important IF they sre >3 mm epar,the two canals remain Separate throughout their length. Ith distance is <3 mm, the two canals usually join. The closer the orifices are to each othe, the more coronal the union, Dr Karas azote pester ana H. Cn asatan rolesor, Dap rato Endocenes, Faculty of Dest, Marmara Univ, torbul, Tate {Coat rooscor, Depart: of Endod Fart Ooi, Hae topo Unie, Asars, arey, Adcaae renuests fr rps fo De Nevn ata, crim Atel Soy, 2 BOGDD everest Ty References, 1, Fae D, Taree A. Dante’ makes n making coraet radegraphic dagen Ourt nt 1978850 2. Ingo I, Woton AE, Lambert GL, Lambert ©, Taster JF, Ziel 0, everdge €€, Preperation for edodonte tha. ne oo Ensodon: ‘ioe Se od Pncnpner tea 8 Fengae 1954-901, tess W. Antony ote root canal of to tasth ofthe erranent ention. Part. New Yar: Witar Wood and Co, 1825:2-49 “4. Gael M. 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