Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Morphotypes of the apical constriction of maxillary molars: a micro-computed tomographic evaluation

  • Received : 2021.06.11
  • Accepted : 2021.08.21
  • Published : 2022.05.31
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Abstract

Objectives: The aim of this study was to evaluate and compare the apical constriction (AC) and apical canal morphology of maxillary first and second molars, using micro-computed tomography (micro-CT). Materials and Methods: The anatomical features of 313 root canals from 41 maxillary first molars and 57 maxillary second molars of patients with known age and sex were evaluated using micro-CT, with a resolution of 26.7 ㎛. The factors evaluated were the presence or absence of AC, the morphotypes, bucco-lingual dimension, mesio-distal dimension, and the profile (shape) of AC and the apical root canal. The apical root canal dimensions, location of the apical foramen (AF), AC to AF distance, and presence of accessory canals in the apical 5 mm were also assessed. Descriptive and analytical statistics were used for data evaluation. Results: AC was present in all 313 root canals. Patients' age and sex did not significantly impact either AC or the apical canal dimensions. The most common AC morphotype detected was the traditional (single) constriction (52%), followed by the parallel (29%) morphotype. The mean AC dimensions in maxillary first molars were not significantly different from those in maxillary second molars. Sixty percent of AF were located within 0.5 mm from the anatomic apex. Conclusions: The most common morphotype of AC detected was the traditional constriction. Neither patients' age nor sex had a significant impact on the dimensions of the AC or the apical root canal. The majority of AF (60%) were located within 0.5 mm from the anatomic apex.

Keywords

Acknowledgement

The authors wish to express their gratitude to Dr. N Velmurugan and Dr. S Jothilatha for their comments and helpful discussions.

References

  1. Eleazer P, Glickman G, McClanahan S. AAE glossary of endodontic terms. New York, NY: American Association of Endodontists; 2020.
  2. Kuttler Y. Microscopic investigation of root apexes. J Am Dent Assoc 1955;50:544-552. https://doi.org/10.14219/jada.archive.1955.0099
  3. Dummer PM, McGinn JH, Rees DG. The position and topography of the apical canal constriction and apical foramen. Int Endod J 1984;17:192-198. https://doi.org/10.1111/j.1365-2591.1984.tb00404.x
  4. Gani O, Visvisian C. Apical canal diameter in the first upper molar at various ages. J Endod 1999;25:689-691. https://doi.org/10.1016/S0099-2399(99)80357-4
  5. Meder-Cowherd L, Williamson AE, Johnson WT, Vasilescu D, Walton R, Qian F. Apical morphology of the palatal roots of maxillary molars by using micro-computed tomography. J Endod 2011;37:1162-1165. https://doi.org/10.1016/j.joen.2011.05.012
  6. ElAyouti A, Hulber-J M, Judenhofer MS, Connert T, Mannheim JG, Lost C, Pichler BJ, von Ohle C. Apical constriction: location and dimensions in molars-a micro-computed tomography study. J Endod 2014;40:1095-1099.
  7. Schell S, Judenhofer MS, Mannheim JG, Hulber-J M, Lost C, Pichler BJ, ElAyouti A. Validity of longitudinal sections for determining the apical constriction. Int Endod J 2017;50:706-712. https://doi.org/10.1111/iej.12670
  8. Wu MK, Wesselink PR, Walton RE. Apical terminus location of root canal treatment procedures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:99-103. https://doi.org/10.1016/S1079-2104(00)80023-2
  9. Marceliano-Alves M, Alves FR, Mendes DM, Provenzano JC. Micro-computed tomography analysis of the root canal morphology of palatal roots of maxillary first molars. J Endod 2016;42:280-283. https://doi.org/10.1016/j.joen.2015.10.016
  10. Wada M, Takase T, Nakanuma K, Arisue K, Nagahama F, Yamazaki M. Clinical study of refractory apical periodontitis treated by apicectomy. Part 1. Root canal morphology of resected apex. Int Endod J 1998;31:53-56. https://doi.org/10.1046/j.1365-2591.1998.t01-1-00123.x
  11. Divine KA, McClanahan SB, Fok A. Anatomic analysis of palatal roots of maxillary molars using micro-computed tomography. J Endod 2019;45:724-728. https://doi.org/10.1016/j.joen.2019.03.007
  12. De-Deus G, Silva EJ, Marins J, Souza E, Neves AA, Goncalves Belladonna F, Alves H, Lopes RT, Versiani MA. Lack of causal relationship between dentinal microcracks and root canal preparation with reciprocation systems. J Endod 2014;40:1447-1450. https://doi.org/10.1016/j.joen.2014.02.019
  13. Versiani MA, Pecora JD, Sousa-Neto MD. Microcomputed tomography analysis of the root canal morphology of single-rooted mandibular canines. Int Endod J 2013;46:800-807. https://doi.org/10.1111/iej.12061
  14. Verma P, Love RM. A micro CT study of the mesiobuccal root canal morphology of the maxillary first molar tooth. Int Endod J 2011;44:210-217. https://doi.org/10.1111/j.1365-2591.2010.01800.x
  15. Wolf TG, Paque F, Sven Patyna M, Willershausen B, Briseno-Marroquin B. Three-dimensional analysis of the physiological foramen geometry of maxillary and mandibular molars by means of micro-CT. Int J Oral Sci 2017;9:151-157.
  16. Versiani MA, Pecora JD, de Sousa-Neto MD. Root and root canal morphology of four-rooted maxillary second molars: a micro-computed tomography study. J Endod 2012;38:977-982. https://doi.org/10.1016/j.joen.2012.03.026
  17. De-Deus G, Souza EM, Barino B, Maia J, Zamolyi RQ, Reis C, Kfir A. The self-adjusting file optimizes debridement quality in oval-shaped root canals. J Endod 2011;37:701-705. https://doi.org/10.1016/j.joen.2011.02.001
  18. De-Deus G, Belladonna FG, de Siqueira Zuolo A, Perez R, Carvalho MS, Souza EM, Lopes RT, Silva EJ. Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals. Clin Oral Investig 2019;23:3087-3093. https://doi.org/10.1007/s00784-018-2729-y
  19. Stein TJ, Corcoran JF. Anatomy of the root apex and its histologic changes with age. Oral Surg Oral Med Oral Pathol 1990;69:238-242. https://doi.org/10.1016/0030-4220(90)90334-O
  20. Briseno-Marroquin B, Paque F, Maier K, Willershausen B, Wolf TG. Root canal morphology and configuration of 179 maxillary first molars by means of micro-computed tomography: an ex vivo study. J Endod 2015;41:2008-2013. https://doi.org/10.1016/j.joen.2015.09.007
  21. Ordinola-Zapata R, Martins JN, Bramante CM, Villas-Boas MH, Duarte MH, Versiani MA. Morphological evaluation of maxillary second molars with fused roots: a micro-CT study. Int Endod J 2017;50:1192-1200. https://doi.org/10.1111/iej.12752
  22. Harris SP, Bowles WR, Fok A, McClanahan SB. An anatomic investigation of the mandibular first molar using micro-computed tomography. J Endod 2013;39:1374-1378. https://doi.org/10.1016/j.joen.2013.06.034
  23. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006;32:813-821. https://doi.org/10.1016/j.joen.2006.04.014