Escolar Documentos
Profissional Documentos
Cultura Documentos
discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/235602581
CITATIONS
READS
27
188
3 authors:
Marco Versiani
University of So Paulo
SEE PROFILE
SEE PROFILE
doi:10.1111/iej.12061
Abstract
cora JD, Sousa-Neto MD. MicroVersiani MA, Pe
computed tomography analysis of the root canal morphology
of single-rooted mandibular canines. International Endodontic
Journal.
Aim To investigate the anatomy of single-rooted mandibular canine teeth using microcomputed tomography
(lCT).
Methodology One hundred straight single-rooted
human mandibular canines were selected from a pool
of extracted teeth and evaluated using lCT. The anatomy of each tooth (length of the roots, presence of
accessory canals and apical deltas, position and major
diameter of the apical foramen and distance between
anatomical landmarks) as well as the two- and threedimensional morphological aspects of the canal (area,
perimeter, form factor, roundness, major and minor
diameter, volume, surface area and structure model
index) were evaluated. The results of the morphological analysis in each canal third were compared statistically using Friedmans test (a = 0.05).
Results The length of the roots ranged from 12.53
to 18.08 mm. Thirty-one specimens had no accessory
Introduction
The main role of laboratory-based studies is to develop
well-controlled conditions that are able to reliably
compare certain factors. The main confounding factor
of ex vivo studies is the anatomy of the root canal sys-
canals. The location of the apical foramen varied considerably. The mean distance from the root apex to
the major apical foramen was 0.27 0.25 mm, and
the major diameter of the major apical foramen ranged from 0.16 to 0.72 mm. Mean major and minor
diameters of the canal 1 mm short of the foramen
were 0.43 and 0.31 mm, respectively. Overall, the
mean area, perimeter, form factor, roundness, major
and minor diameters, volume, surface area and
structure model index (SMI) were 0.85 0.31 mm2,
3.69 0.88 mm, 0.70 0.09, 0.59 0.11, 1.36
0.36 mm and 0.72 0.14 mm, 13.33 4.98
mm3, 63.5 16.4 mm2 and 3.35 0.64, respectively, with significant statistical difference between
thirds (P < 0.05).
Conclusions The anatomy and morphology of the
root canal of single-rooted canines varied widely in
different levels of the root.
Keywords: mandibular canine,
tomography, root canal anatomy.
microcomputed
Figure 1 Frontal and lateral views of three-dimensional models of the root canals of 100 single-rooted mandibular canines.
Results
Three-dimensional reconstruction of the internal
anatomy revealed that all specimens had only one
main root canal (Fig. 1). The length of the roots
measured from the apex to the cemento-enamel junction at the buccal aspect of the root ranged from
12.53 to 18.08 mm (15.57 1.20 mm). Thirty-one
specimens had no accessory canals (Fig. 2a), and
four specimens had a lateral canal in the middle
third (Fig. 2b). No accessory canals were observed in
the cervical third of the samples, and apical deltas
were observed in six specimens (Fig. 2c). In 62
canines, the number of accessory canals in the apical
third ranged from 1 to 3, in a total of 112 canals
(Fig. 2d).
(a)
(b)
(c)
(d)
Figure 2 Representative three-dimensional models of the internal anatomy of four single-rooted mandibular canines showing
(a) no accessory canals, (b) one lateral canal in the middle third of the root, (c) apical delta and (d) one accessory canal in the
apical third of the root.
(a)
(c)
(b)
Figure 3 Three-dimensional reconstruction of the apical third of a single-rooted mandibular canine. (a) Lateral view of the
apex showing the apical foramen located at the distal aspect of the root and its mean perpendicular distance from the anatomical apex; (b) detail of the apex showing the apical foramen; (c) higher magnification (outlined area in b) showing the mean
( SD) size of the apical foramen (in black), the bucco-lingual (in yellow) and the mesio-distal (in blue) mean diameters of the
root canal 1 mm short of the apical foramen.
Discussion
Knowledge of root canal anatomy and its variations is
a basic requirement for successful root canal treatment (Vertucci 2005). The significance of canal anatomy has been emphasized by studies demonstrating
that variations in canal geometry before cleaning and
shaping had a greater effect on the changes that
occurred during preparation than did the instrumentation techniques (Peters et al. 2001). The main
purpose of this study was to evaluate mandibular
canines with a single root canal that extended from
the pulp chamber to the apex (type I) (Vertucci 1974).
It has been reported that the prevalence of type I root
canal configuration in mandibular canines ranged
from 78% to 98% of the sample (Vertucci 1984,
Pecora et al. 1993), but occasionally, it may have two
roots and two canals (Versiani et al. 2011a).
Area (mm )
Perimeter (mm)
Form factor
Roundness
Major diameter (mm)
Minor diameter (mm)
Cervical
Range
0.392.90
3.139.37
0.280.86
0.170.85
1.163.81
0.451.51
1.62
5.79
0.62
0.47
2.23
1.01
0.56
1.28
0.15
0.16
0.59
0.24
Middle
Range
0.121.54
1.337.50
0.330.88
0.210.88
0.442.80
0.381.06
0.71
3.55
0.71
0.62
1.26
0.74
0.30
1.09
0.13
0.15
0.45
0.14
Apical
Range
0.040.47
0.763.07
0.460.89
0.390.87
0.261.12
0.190.62
0.20
1.70
0.78
0.68
0.59
0.40
0.10
0.46
0.08
0.09
0.17
0.09
Total
Range
0.221.92
1.786.39
0.440.86
0.290.84
0.672.52
0.400.99
0.85
3.69
0.70
0.59
1.36
0.72
0.31
0.88
0.09
0.11
0.36
0.14
Volume (mm )
Surface area (mm2)
SMI
Cervical
Range
Middle
Range
Apical
Range
Total
Range
8.54 3.23
35.7 8.8
2.20 0.52
2.0117.07
16.657.1
0.523.13
3.64 1.61
20.9 7.1
2.33 0.51
0.547.82
6.547.5
0.823.76
1.03 0.52
9.9 3.1
2.54 0.34
0.192.56
3.818.7
1.213.11
13.33 4.98
63.5 16.4
3.35 0.64
3.1624.64
26.4111.9
0.763.61
Figure 4 Three-dimensional reconstruction of the pulp cavity of four single-rooted mandibular canines showing the
variations in the two-dimensional configuration of the root
canal in different levels of the root.
Conclusions
The anatomy and morphology of the root canal of
single-rooted canine varied widely in different levels
of the root. In summary:
1. The mean length of mandibular canine roots was
15.57 1.20 mm;
2. No accessory canals were observed in the cervical
third, and apical deltas were observed only in 6%
of the sample;
3. The location of the major apical foramen varied
considerably, tending to the buccal aspect of the
root;
4. The mean distance from the root apex to the
major apical foramen was 0.27 0.25 mm;
5. The mean size of the major apical foramen was
0.42 0.13 mm;
6. In the apical third, area, perimeter, major diameter, minor diameter, volume and surface area were
significantly lower, whilst form factor, roundness
and SMI were significantly higher than in the middle and cervical thirds.
References
American Association of Endodontists (2012) Glossary of
Endodontics Terms, 8th edn. Chicago: American Association of Endodontists.
Blaskovic-Subat V, Maricic B, Sutalo J (1992) Asymmetry of
the root canal foramen. International Endodontic Journal
25, 15864.
Burch JG, Hulen S (1972) The relationship of the apical foramen to the anatomic apex of the tooth root. Oral Surgery,
Oral Medicine, and Oral Pathology 34, 2628.
Chapman CE (1969) A microscopic study of the apical region
of human anterior teeth. Journal of the British Endodontic
Society 3, 528.
De-Deus QD (1975) Frequency, location, and direction of the
lateral, secondary, and accessory canals. Journal of Endodontics
1, 3616.
De-Deus G (2012) Research that matters root canal filling
and leakage studies. International Endodontic Journal 45,
10634.
Dummer PM, McGinn JH, Rees DG (1984) The position and
topography of the apical canal constriction and apical
foramen. International Endodontic Journal 17, 1928.
Green D (1956) A stereomicroscopic study of the root apices of
400 maxillary and mandibular anterior teeth. Oral Surgery,
Oral Medicine, and Oral Pathology 9, 122432.
Hildebrand T, R
uegsegger P (1997) Quantification of bone
micro architecture with the structure model index. Computer Methods in Biomechanics and Biomedical Engineering
1, 1523.
H
ulsmann M, Peters OA, Dummer PMH (2005) Mechanical
preparation of root canals: shaping goals, techniques and
means. Endodontic Topics 10, 3076.
Kuttler Y (1955) Microscopic investigation of root apexes.
Journal of American Dental Association 50, 54452.
Martos J, Ferrer-Luque CM, Gonzalez-Rodriguez MP, Castro
LA (2009) Topographical evaluation of the major apical
foramen in permanent human teeth. International Endodontic Journal 42, 32934.
Martos J, Lubian C, Silveira LF, Suita de Castro LA, Ferrer
Luque CM (2010) Morphologic analysis of the root apex
in human teeth. Journal of Endodontics 36, 6647.
Meder-Cowherd L, Williamson AE, Johnson WT, Vasilescu D,
Walton R, Qian F (2011) Apical morphology of the palatal
roots of maxillary molars by using micro-computed tomography. Journal of Endodontics 37, 11625.
Nekoofar MH, Ghandi MM, Hayes SJ, Dummer PMH (2006)
The fundamental operating principles of electronic root
canal length measurement devices. International Endodontic
Journal 39, 595609.
Pascon EA, Marrelli M, Congi O, Ciancio R, Miceli F, Versiani
MA (2009) An in vivo comparison of working length
determination of two frequency-based electronic apex locators. International Endodontic Journal 42, 102631.
Pecora JD, Sousa Neto MD, Saquy PC (1993) Internal anatomy, direction and number of roots and size of human
mandibular canines. Brazilian Dental Journal 4, 537.
Peters OA, Laib A, Ruegsegger P, Barbakow F (2000) Threedimensional analysis of root canal geometry by high-resolution computed tomography. Journal of Dental Research 79,
14059.
Peters OA, Laib A, Gohring TN, Barbakow F (2001) Changes in
root canal geometry after preparation assessed by high-resolution computed tomography. Journal of Endodontics 27, 16.
Ponce EH, Vilar Fernandez JA (2003) The cemento-dentinocanal junction, the apical foramen, and the apical