Canalsof the MaxillaryFourthPremolar

Furcation andthe
MandibularFirstMolarTeethin Cats
DDS,PhD;
DVM,PhD;BeatrizM.Maresca,
VivianaB. Negro,DVM,PhD;Sab6sZ.HernAndez,
CesarE. Lorenzo.DVM
With the development of veterinary dentistry over the past
Summary: 2}-years, interest in acquiring knowledge on endodontic
morphology of teeth in cats and dogs has been encouraged.
Thefurcation region morphologt was evaluatedin 103
Studiesto verifu the existenceofa true apical delta, where the
mature feline carnassial teeth (54 maxillary fourth
main canalchangesinto a complex systemof small canals,have
premolar and 49 mandibularfirst molar teeth).Patent
been performed in dogs.'ttt The presence of lateral canals
furcation canals were present in 27.2 %' of teeth. No
connecting the pulp and surrounding periodontal tissues have
significant diference ( p : 0.SS) in distribution of this
anatomical variation was found between maxillary also been reported but furcation canals have not been
The presenceof apical deltas,with similar char-
reported.'e2z23
fourth premolar and mandibularJirst molar teeth. The
meanwidth of thesefu.rcationcanals was 104.0pm with acteristics as those described in the dog, have also been
two-thirdsof lhe canalshaving a buccal orientarion.The Lateral canalshavebeenreportedto occur
confirmed in cats.'o-26
presence offurcation canals could be a factor in the sporadicallyin feline molar and premolar teeth.'z3
Finally, some
etbpathogenesis of feline dental resorptive lesions, as authors have proposed that felines may have furcation canals
well as a iharacteristic to be considered in'the similar to those in humans."
diagnosis, prognosis, and lreatrnent of endodontic or In many of these studies on endodontic morphology, the
Iesions in car teettLJ Va Dmt dental clearing technique was used with different variations in
ry::d":,:::/o^d:."n, both human and animal specimens.r20'2'26 It has been accepted
21 (l); 10-14,2004
that this technique has considerablevalue for the study of
endodonticanatomy since it permits a three-dimensionalview
lntroduction of the pulp chamberwith respectto the exterior of the tooth.s
The study of root canal morphology in human teeth has
revealed different and anatomically complex systems.
Accessory root canals have been shown to connect the pulp
ll'i,n;*"i
cavity with the periodontium.'" Thesecanalscan connectpulp
tissuewith the periodontalligament at any level of the root but Diagrammaticrepresentationof a mandibularfirst molar
are more frequent as ramifications at the apical area.7 tooth showingthe pulp cavity (chamberand root canals)
Communications befween the pulp chamber and periodontal and a furcationcanal.
tissues in the furcation area have also been reported. Studies
have been conducted in human permanent and deciduousmolar
teeth documentingthe presenceof furcation canals,8'r3 although
direct visualization ofthese canalsis consideredexceptional.ro
These communications have received various designations
including: accessorycanals of the firrcation a"rea,accessory
foramina or orifices, periodontal fistula, or furcation canals
(Fig. 1).
The intimate anatomicalrelationshipbetweenthe pulp and
periodontal tissues through the aforementioned endodontic
system,as documentedin humans,makes interactionbetween
both tissueareaspossible.In pathologicalconditions,interaction
betweenthesetissuescan occur, leading to deteriorationofthe
pulp-periodontalsystem.10'15''6
Completeknowledgeof the topo-
graphicalanatomyof the pulp cavity (from the floor of the pulp
chamberto the root apex) is essentialfor attaining the highest
possiblesuccesswhen app$ing an endodonticor periodontic-
endodontictreatrnentplan. Further, knowledge of the possible
anatomic variations of the pulp canal system may provide a
better understanding of pathophysiologic mechanisms in
periodontic-endodonticdisease.

J.VET.DENI Vol. 21 No. 1 March2004

 mature teeth with closed apices based on radiographic study
Figure2 were used.Basedon this parameter,it was assumedthat the cats
of this study were ) 12-months-of-age.':8
Teeth studied had no
:-3iomicrographof a mandibularleftfirstmolartooth(309)
radiographic or gross signs of pathology.Teeth were obtained
:-r!ving a normal furcatlonarea void of any furcation
-^^^t^d5.
_.1
from44 cats,with 1 tooth from 10 cats,2 teethfrom 18 cats,3
teeth from 8 cats,and 4 teeth from 8 cats.Age, sex, and breed
of the cats were not registered.Brachycephaliccats were not
included.
After extraction, each tooth was radiographed from the
mesiodistaland buccolinquallpalatalaspectsand placed in a
2.5 %osodium hypochlorite solution. Teeth were then made
transparentby using a technique describedpreviously with a
time reduction for each step based on the small size of feline
teeth." After this processwas completed,the externalstructure
of the teeth remained transoarentwith the endodontic canal

Figure4
t'
Photomicrographof a mandibularleft first molar tooth
(309)showinga furcationcanal.

Figure3
r-ciomicrograph of a maxillaryright fourth premolar
.:::h (108)showinga furcationcanal.

Figure5
Photomicrograph of a mandibllarleftfirst molartooth
(309)showing2 furcationcanals.

Feline carnassial teeth (maxillary fourlh premolar and

::-,:rdibularfirst molar teeth)are impofiant in regardto size and
-rction, and are frequently affected by resorptive lesions or
:.:r,uratic injuries. The purpose of this study was to determine
:he prevalenceand characteristicsof communicationsbetween
:he t-loor of the pulp chamber and periodontal tissues in the
:-:"'ation region of mature carnassialteeth in cats.

Materialsand Methods
For this study, 103 feline carnassialteeth (54 maxillary
--ourthpremolar and 49 mandibular first molar teeth) were
:eurovedftom catseuthanizedfor variousmedicalreasonsat the
\ eterinaryTeachingHospital, University of BuenosAires. Cats
rad not receivedprevious dental care and no cat was killed for
:re purpose of inclusion in this study. Only permanent and

J.VET.DENT.Vol. 21 No. 1 March2004

system stainedblack (Figs. 2 - s).The clcared specimens, palataldirection (Table1). Mean width of the furcation canalsof
immersed in methylsalicylate,were examined using a stereo- maxillary'fourthpremolarteethwas 93.0 prm,with a rangeof
microscope at 20 X magnification in order to establish 25.0to 200.0pm (Table1).
endodontictopographyand measurements. Measurementswere Of the 49 mandibular first molar teeth studied, 13 teeth
performed using an ocular with a micrometry scale. The (26.5 %) exhibited furcation canals (Fig. 4), with one tooth
presence,number,position, and characteristicsofthe accessory having 2 furcation canals (Fig 5). When the furcation canals
canals that connectedthe floor oI'the pulp chambcr with the were viewed in a distomesial orientation, 50.0 %oof canals
furcation area(furcation canals)were recordedit ad hoc forms. exhibited a distomesial direction, 42.9 % of canals had a
Statisticalanalysiswas performed to comparethe percentages mesiodistaldirection,and the remaining 7.l %ohada practically
obtained from data with a normal distribution usins the Chi- perpendiculardirection with respectto the furcation at the floor
squaretest with p < 0.05 consideredsignificant. of the principal cusp.When the furcation canalswere viewed in
a buccolingualorientation,16.9yo had canalswith a buccal
Results direction while the remaining 23.1 % exhibited a lingual
The presenceof furcation canalscommunicatingthe floor direction (Table l). One of the accessorycanals considereda
of the pulp chamber with the periodontium was confirmed in furcation canal did not start fiom the floor of the pulp chamber,
mature,permanentcarnassialteeth in cats (Figs. 2 - 5). Of the but emerged close to the canal of the mesial root. It was
44 catsfrom which the teethwere extracted 45.5 % had at least included in the categoryoffurcation canalsbecause,according
I furcation canal in one of their carnassialteeth. In those cats to the classification of some authors,this region is considered
that had multiple carnassialteeth extracted 58.0 % had at least parl of thc furcation area.'oMean width of the furcation canals
one furcation canal,and 25.0 % had furcation canalspresentin of mandibular flrst molar teeth was 100.0 pm, with a range of
2 or 3 teeth from the samecat. When consideringall 103 feline 50.0to 150.0pm (Table1).
camassialteethstudied28 teeth(27.2 %) had furcationcanals. Therewas no significantdifference(p:0.88) in distribution
All furcation canals were considered patent based on of furcation czrnals betwecn maxillary fourth premolar and
communication betwcen the pulp and the periodontium. The mandibularfirst molar teeth.
mean width of the furcation canalswas 104.0pm, with a range
of 25.0to 250.0pm fTable1]. Discussion
Of the 54 maxillary fourth premolarteeth studied 15 (27.8 Furcation canals have a different prevalence in human
9ir) had furcation canals(Fig 3). A11maxillary fourth premolar beings based on studies using various methodologies.When
furcation canals were found to connect the floor of the pulp using an ink penetrationtechnique similar to the one reported
chamberwith the furcation region in a practicallyperpendicular herc, patent furcation canals were found in 24.5 % of 102
orientation, emerging close to the floor of the principal cusp permanentmolars.'oA higher prevalenccof 40.0 0%was reported
when viewed in a distomesialorientation(Fig. 3). When viewed basedon direct visual examinationof 100 mandibular molars
in a buccopalatalorientation, 75.0 oh of the furcation canals using a dissection microscope.' The highest prevalence for
coursedin a buccal direction,whilc the remaining 25.0 ohhad a furcation canalshas been reportedto be 59.0 %o using a com-

'l:', ,':::, ::t: "l' 'i. ..: t, 'r'', ..rr' :..::

Tablei'1
",
width,and directionof furcationcanalsln 103permanentmaturefelinecarnassial
Prevalence, teeth.

O,r"",,onrzr{o/o) O,r"",,oner(o/o)
i l l l .l . :a:.
r 'i , ::r '
' Lingual/
Tooth Prevalence Widtho)(pm) Buccal palatal Distal Mesial Perpendicular

Fourth
tc l nn n (5)
Premelar gl.ePk) 93.O
,ril: r 64.0
.lla:, 250
":1n=541

First .:
I Q {4 )
:ll'

Molar (tA c; 6L\

1 0 0 .0t 3 5 .0 76.9 ZJ. I 50.0 4t.Y 7.1
1n-a9) ':.tl

Totiil .':r,.r,
.1':11,,19 1 0 4 ,0t 5 8 .0 71.4 28.6 24.1 20.7 55;2
(n=103) (2 7 2 % )

i = Mean + SD; 2 = Bucqolinguallpalatalj

3 = Distomesial;4 = One of ihem double;5 = 53-3 % with slightorientationtolvard
mesial

.=-l=\T. Vo l.2 1 No .' 1 M a r ch2 0 0 4

bined method of radiopaque staining and radiography in 46
permanentmolars.r'However, some researchershave not found
q. frrcation canals using both radiographic and staining
rn€thods.rt t ze
ln the few investigations conducted on endodontic
rcgraphy in the cat, the only study with a relatively important
mumberof teeth was performed using canine teeth.'z6 Another
*4.. on teeth of 6 cats (3 yotrng and 3 adults), revealed the
asi$ence of an apical delta in matwe teeth, but makes no
r'sference to the presence of fircation canals." Small sample
sze and a different methodology (modeling pulp vessels with
rmins) and emphasis may have led to under reporting of
furcation canals.
The presence of communications between the pulp and
greriodontium implies that an infectious or inflammatory
process can extend between the pulp and periodontal tissues.
Thesepotential communications would allow for an interchange
q,f toxic and/or inflammatory products between both areas. In
periodontal diseases,the developmentofa periodontalpocket
oould expose a firrcation canal, thus allowing accessof micro-
wganisms or their metabolic products to the pulp.'030Under
mrmal conditions, some canals may not be patent because of
tre "seal" of connective tissue, but would representa potential
problem because they could "open" during pathological
cbmges in the pulp." Another accessmechanism could occur
dring periodontal therapy when furcation canals covered by
crementumcould becomepatentduring excessiveplaning.3'The
pdency of furcation canals may be enhanced by periodontal
freray at the fircation area,reaching a prevalenceof 59.0 % in
me snrdy of human molars." The prevalenceof furcation canals
reported in this study was not influenced by previous
periodontal treatment, documenting the presence of naturally
acurring, patent firrcation canals of considerablediameter.
The presenceof furcation canalsdoes not necessarilymean
6at they will serve as a conduit for diseasebetween endodontic
md periodontal locations.lo However, endodontic disease or
puiodontal diseaseofthe furcal region of feline carnassialteeth
Sould alert the clinician of the potential for a more complex
periodontic-endodonticlesion.
Furcation canals that were observed in a relatively high
psrcentageof feline carnassial teeth, yet not detected in canine
canassial teeth,'e22could be a contributing factor in the etio-
pathogenesisof feline dental resorptive lesions (RL). Dental RL
rexrain an enigma and understandingthe causeof this relatively
recent but common diseaseis elusive. Studies carried out on cat
slrrlls before the 1960's demonstrated a low prevalence of
dental RL.'3 Various etiologic factors have been proposed
concerning the origin of these dental lesions including
infectious, chronic inflammatory nutritional, malocclusion, and
matomical particularities.3o
The prevalenceof RL in furcation areasof feline carnassial
te,eft could reflect tooth anatomy that includes the presence of
cznals and relatively thin dentin in the furcation area.t'"
Furcation canals, apical and nonapical ramifications, and the
cementoenamel junction could be areas that favor the
developmentof RL ifthe protective cementallayer fails to cover
the dentin.36 Exposed mineralized dentin could attract
odontoclasts.36The potential involvement of firrcation canals in
RL is further supported by the predominant buccal direction
Q5.0 yA of furcation canals coinciding with the prevalence of
RL on the buccal aspectof affectedteeth."
Further studies concerning endodontic anatomy in small
animals is recommended to provide greater information
concerning other teeth, and to confirm the results ofprevious
studies. ln order to avoid the controversy that exists in the
human literature concerning the prevalence and location of
accessory canals including those of the fircation area, it is
important to use methodology that is consistent across study
groups. Data concerning the prwalence and characteristics of
fircation canals in other types of multirooted teeth frequently
affectedby RL wouldbe ofvalue. The authorshavebegun some
of these studies,although the dental clearing technique must be
adapted due to the great fragility of non-carnassial, feline
premolars.
The authorsconsider the results reported here useful for the
diagnosis, prognosis, and treatrnent of endodontic and perio-
dontal lesions in the cat. Further, the presence of furcation
canals should be considered when performing dental
investigations using felines as the researchmodel.
Acknowledgements
The authors wish to thank Dr. Roberto Botti, Professor of
Anatomy, Faculty of Dentistry, University of Buenos Aires, for
his contribution to the clearing technique and to Vet. Juan
Ivanic, for his collaboration in specimen preparation. The
authors also wish to thank the University of Buenos Aires for
sponsoring this project.
Author Information
From the Faculty of Veterinary Sciences Qllegro,
Hernandez)University of BuenosAires Chorroarin 280 -
(C|427CW0)BuenosAires, Argentina;Facultyof Dentistry
(Maresca),University of BuenosAires, Marcelo T.deAlvear
2142 - (1022) BuenosAires, Argentina;and PrivatePractice
(Lorenzo),Galo ll82 - (1470)BuenosAires,Argentina.E-
mail: vinegro@fvet.uba.ar
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J.VET.DENT.