DOCSLIB.ORG

Root Canal Treatment of a Maxillary Second Premolar with Two Palatal

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Root Canal Treatment of a Maxillary Second Premolar with Two Palatal Case Report Root canal treatment of a maxillary second premolar with two palatal roots: A case report Gingu Koshy George, Anju Mary Varghese1, Aravindan Devadathan1 Department of Conservative Dentistry and Endodontics, 1Department of Orthodontics, Pushpagiri College of Dental Sciences, Thiruvalla, Kerala, India Abstract Anatomical variations in root canal morphology are an enigma and it is this variability, which is often a complicating factor in a successful root canal treatment. To achieve success in endodontic therapy it is imperative that all the canals are located, cleaned and shaped and obturated three dimensionally. Maxillary first premolar having three separate roots has an incidence of 0.5-6%. Even rarer are reported clinical case reports of maxillary second premolar with three separate roots and three canals. This case report describes the endodontic management of maxillary second premolar with two palatal roots and one buccal root having three root canals Keywords: Maxillary second premolar; root canal treatment; three canaled INTRODUCTION premolar adjacent to it had a proximal carious lesion associated with it. The second premolar was tender Anatomical variations in root canal morphology are to percussion. An intra oral periapical radiograph was an enigma. The outcomes endodontic procedures are advised and it showed distoproximal radiolucency of highly influenced by variable anatomic structures and, crown approximating the pulp space of the maxillary therefore, the clinicians ought to be aware of complex right second premolar (Image 1). Multiple intra oral peri- root canal structures and cross-sectional dimensions.[1] apical radiographs were taken using Clark’s tube shift Maxillary first premolar having three separate roots has technique as the premolar showed multiple roots. Pulp an incidence of 0.5-6%.[2-7] The maxillary second premolars vitality test with electric pulp tester (Digitest, Parkell show an even lesser incidence of 0.3 to 2% in laboratory Products, NY, USA) showed a delayed response for the studies.[8,9] Even rarer are reported clinical cases of maxillary second premolar. A diagnosis of irreversible maxillary second premolar with three separate roots pulpitis was made and endodontic treatment was and three canals.[10,11] Three rooted maxillary premolars initiated. look anatomically similar to the molars are sometimes called small molars or radicolous[12,13] and usually have a Access opening was done under local anesthesia mesiobuccal, a distobuccal and a palatal canal. The root (2% Lignocaine with 1:80,000 Adrenaline, Lignox, Indoco canal morphology of the maxillary second premolar in Remedies Ltd, India) after rubber dam isolation. The unusual Indians shows a higher incidence of type II configuration anatomy made it difficult to precisely discern, whether the (33.6%).[1] In this case report, we would like to describe the roots were located on the buccal or palatal aspect. The endodontic management of maxillary second premolar access cavity was modified as described by Balleri et al.,[14] with two palatal roots and one buccal root having with a tooth preparation at the bucco-proximo angle from independent root canals. the entrance of the buccal canal to the cavosurface angle resulting in a cavity with a T-shaped outline. But only one CASE REPORT buccal (B) [Image 2] and one palatal canal (P1) [Image 2] orifices could be located. A modification was again made A 32-year-old female reported to department with pain and the preparation was extended in the palato proximal in her upper right posterior region since one month. directions and the orifice of the third root canal (P2) On clinical examination an old amalgam restoration [Image 2] was located mesiopalatally in the palatal aspect. was seen on the maxillary right molar and the second Access this article online Address for correspondence: Quick Response Code: Dr. Gingu Koshy George, Department of Conservative Dentistry Website: and Endodontics, Pushpagiri College of Dental Sciences, www.jcd.org.in Thiruvalla - 686 548, Kerala, India. E-mail: [email protected] Date of submission : 04.11.2013 DOI: Review completed : 03.12.2013 10.4103/0972-0707.131807 Date of acceptance : 25.02.2014 290 Journal of Conservative Dentistry | May-Jun 2014 | Vol 17 | Issue 3 George, et al.: RCT of maxillary premolar with two palatal roots Figure 1: Composite image showing pre operative IOPA, access preparation, working length IOPA, master cone IOPA and obturation IOPA of a maxillary 3 rooted second premolar Working length was determined with apex locator and Accurate preoperative radiographs (straight and angled) are confirmed with intra oral peri-apical radiograph [Image 3]. essential to reveal the number of roots and canals that exist The three canals were initially enlarged with hand files until in a tooth.[15,16,19] But radiographic analysis themselves are the 15 K file (Mani Inc. Tochigi, Japan) freely glided through inadequate in obtaining a suitable abstraction of root and the canal, following which the canals were enlarged to size pulp canal system as evident in this case necessitating the F2 ProTaper rotary files ((Dentsply Maillefer, Ballaigues, use of more advanced methods like CBCT as a diagnostic Switzerland) sequentially. During canal preparation Glyde tool to determine the canal morphology. (Dentsply Malliefer, Ballaigues, Switzerland) was used as a lubricant and the root canals were copiously irrigated with A general guideline for the identification of a three-rooted 3% sodium hypochlorite (Prime Dental Product, Mumbai, maxillary premolar on preoperative radiograph is that India) and 0.9% normal saline (Baxter India Pvt Ltd., if the mesial-distal width of the mid-root image appears Alathur, India) after the use of each instrument. The root equal to or greater than the mesial-distal width of the [18] canals were properly dried with absorbent paper points crown image, then the tooth most likely has three canals. and obturated with gutta-percha (Elements Obturation This guideline may act as a good visual clue but is not necessarily absolute. system, Sybron Endo, USA) and resin based sealer (AH plus, Dentsply De Trey, Konstanz, Germany) [Images 4 and 5]. The access cavity for maxillary second premolars is usually The access cavity was then sealed with IRM (DENTSPLY oval[20] in the bucco-palatal direction. In three rooted Caulk, Milford, USA). The patient was recalled after seven maxillary premolar, the buccal orifices are usually close to days for the permanent restoration and then referred to each other and are hard to locate. Balleri et al., suggested the Department of Prosthetic Dentistry for a full coverage a T-shaped access outline for three rooted maxillary first crown Figure 1 contains the sub images 1-5. premolars.[14] This modification allows good access to the two buccal canals. But in this case a further modification DISCUSSION had to be done as the canals were on the palatal aspect of the tooth and not buccally as expected from the Extra roots present an additional challenge, which necessitates radiographic interpretation necessitating an extension of modifications from the initial assessment stage to the the access preparation palato proximally to reveal the third design of the access preparation, cleaning and shaping and orifice mesiopalatally. obturation of the tooth. So awareness of abnormal variation in the internal anatomy of the tooth is essential for success In today’s endodontic practice aberrant anatomy has become of an endodontically treated tooth. Velmurugan et al.,[15] have more common than before and, therefore, clinicians should reported that out of 220 maxillary second premolar teeth that be constantly on the lookout for variations in anatomy as were endodontically treated from Indian population, only the successful outcome of any case that depends on the three of these had three roots and three canals. complete debridement and disinfection of all canals. Journal of Conservative Dentistry | May-Jun 2014 | Vol 17 | Issue 3 291 George, et al.: RCT of maxillary premolar with two palatal roots REFERENCES 12. Maibaum WW. Endodontic treatment of a “radiculous” maxillary premolar: A case report. Gen Dent 1989;37:340-1. 13. Goon WW. The “radiculous” maxillary premolar: Recognition diagnosis, 1. Jayasimha Raj U, Mylswamy S. Root canal morphology of maxillary and case report of surgical intervention. Northwest Dent 1993;72:31-3. second premolars in an Indian population. J Conserv Dent 14. Balleri P, Gesi A, Ferrari M. Primer premolar superior com tres raices. 2010;13:148-51. Endod Pract 1997;3:13-5. th 2. Cohen S, Burns RC. Pathways of the Pulp. 5 ed. St. Louis: Mosby; 15. Velmurugan N, Parameswaran A, Kandaswamy D, Smitha A, 2002. p. 173-228. Vijayalakshmi D, Sowmya N. Maxillary second premolar with three roots th 3. Weine FS. Initiating endodontic treatment. Endodontic Therapy. 6 ed. and three separate root canals-case reports. Aust Endod J 2005;31:73-5. St Louis: Mosby; 2004. p. 104-63. 16. Soares JA, Leonardo RT. Root canal treatment of three-rooted maxillary 4. Bellizzi R, Hartwell G. Radiographic evaluation of root canal anatomy first and second premolars — a case report. Int Endod J 2003;36:705-10. of endodontically treated maxillary premolars. J Endod in vivo 17. Poorni S, Karumaran CS, Indira R. Mandibular first premolar with two 1985;11:37-9. roots and three canals. Aust Endod J 2010;36:32-4. 5. Carns EJ, Skidmore AE. Configurations and deviations of root canals of 18. Sieraski SM, Taylor GN, Kohn RA. Identification and endodontic management maxillary first premolars. Oral Surg Oral Med Oral Pathol 1973;36:880-6. of three-canalled maxillary premolars. J Endod 1989; 15:29-32. 6. Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic 19. Theruvil R, Ganesh C, George AC. Endodontic management of a maxillary investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol first and second premolar with three canals J Conserv Dent 2014;17:88-91.
Load more

Recommended publications
  • Maxillary Premolars
    Maxillary Premolars Dr Preeti Sharma Reader Oral & Maxillofacial Pathology SDC Dr. Preeti Sharma, Subharti Dental College, SVSU Premolars are so named because they are anterior to molars in permanent dentition. They succeed the deciduous molars. Also called bicuspid teeth. They develop from the same number of lobes as anteriors i.e., four. The primary difference is the well-formed lingual cusp developed from the lingual lobe. The lingual lobe is represented by cingulum in anterior teeth. Dr. Preeti Sharma, Subharti Dental College, SVSU The buccal cusp of maxillary first premolar is long and sharp assisting the canine as a prehensile or tearing teeth. The second premolars have cusps less sharp and function as grinding teeth like molars. The crown and root of maxillary premolar are shorter than those of maxillary canines. The crowns are little longer and roots equal to those of molars. Dr. Preeti Sharma, Subharti Dental College, SVSU As the cusps develop buccally and lingually, the marginal ridges are a little part of the occlusal surface of the crown. Dr. Preeti Sharma, Subharti Dental College, SVSU Maxillary second premolar Dr. Preeti Sharma, Subharti Dental College, SVSU Maxillary First Premolar Dr Preeti Sharma Reader Oral Pathology SDC Dr. Preeti Sharma, Subharti Dental College, SVSU The maxillary first premolar has two cusps, buccal and lingual. The buccal cusp is about 1mm longer than the lingual cusp. The crown is angular and buccal line angles are more prominent. The crown is shorter than the canine by 1.5 to 2mm on an average. The premolar resembles a canine from buccal aspect.
    [Show full text]
  • Root Canal Configuration and Root Wall Thickness of First Maxillary
    www.nature.com/scientificreports OPEN Root canal confguration and root wall thickness of frst maxillary premolars in an Israeli population. A Cone-beam computed tomography study Anda Kfr1, Olga Mostinsky1, Orly Elyzur1, Moran Hertzeanu1, Zvi Metzger 1* & Ajinkya M. Pawar2 Anatomical features of frst maxillary premolars may greatly afect endodontic and following restorative treatments. The aim of this study was to evaluate root canal confguration and root wall thickness of frst maxillary premolars using a preexisting CBCT database. A CBCT database of 400 frst maxillary premolar was used to study canal confguration, presence of furcation-facing groove on the buccal root and root wall thickness. Root wall thickness was measured from axial CBCT slices at three critical points of the root: The most coronal part of the furcation-facing groove in the buccal root, when present, the CEJ level of the palatal root and 5 mm apically to the CEJ level of the palatal root. Vertucci Type IV confguration was the most common among all teeth, but in single-rooted teeth, Vertucci Type II was predominant. The mean thickness of the buccal root in the area of a furcation-facing groove was 1.1 (±0.2) mm, but in 39% of the cases, it was thinner than 1 mm. The mean thickness of the palatal root at 5 mm from the CEJ was 1.1 (±0.2), but in 28% of the cases, it was thinner than 1 mm. Thickness of root dentin walls of frst maxillary premolars varies and may be limited at critical points in both buccal and palatal roots.
    [Show full text]
  • Anterior and Posterior Tooth Arrangement Manual
    Anterior & Posterior Tooth Arrangement Manual Suggested procedures for the arrangement and articulation of Dentsply Sirona Anterior and Posterior Teeth Contains guidelines for use, a glossary of key terms and suggested arrangement and articulation procedures Table of Contents Pages Anterior Teeth .........................................................................................................2-8 Lingualized Teeth ................................................................................................9-14 0° Posterior Teeth .............................................................................................15-17 10° Posterior Teeth ...........................................................................................18-20 20° Posterior Teeth ...........................................................................................21-22 22° Posterior Teeth ..........................................................................................23-24 30° Posterior Teeth .........................................................................................25-27 33° Posterior Teeth ..........................................................................................28-29 40° Posterior Teeth ..........................................................................................30-31 Appendix ..............................................................................................................32-38 1 Factors to consider in the Aesthetic Arrangement of Dentsply Sirona Anterior Teeth Natural antero-posterior
    [Show full text]
  • A Microcomputed Tomographic Evaluation of Root Canal Morphology of Maxillary Second Premolars in a Pakistani Cohort
    applied sciences Article A Microcomputed Tomographic Evaluation of Root Canal Morphology of Maxillary Second Premolars in a Pakistani Cohort Mazen F. Alkahtany 1, Saqib Ali 2,* , Abdul Khabeer 3, Shafqat A. Shah 4, Khalid H. Almadi 1, Abdulaziz Abdulwahed 5, Imran Farooq 6 , Fahim Vohra 7,8 and Tariq Abduljabbar 7,8 1 Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; [email protected] (M.F.A.); [email protected] (K.H.A.) 2 Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia 3 Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; [email protected] 4 Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar 5000, Pakistan; [email protected] 5 Department Of Endodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; [email protected] 6 Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; [email protected] 7 Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; [email protected] (F.V.); [email protected] (T.A.) 8 Research Chair for Biological Research in Oral Health, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia * Correspondence: [email protected]; Tel.: +966-13-333-1426 Citation: Alkahtany, M.F.; Ali, S.; Khabeer, A.; Shah, S.A.; Almadi, K.H.; Abstract: This study aimed to investigate variations in the root canal morphology of maxillary second Abdulwahed, A.; Farooq, I.; Vohra, F.; premolar (MSP) teeth using microcomputed tomography (micro-CT).
    [Show full text]
  • CHAPTER 5Morphology of Permanent Molars
    CHAPTER Morphology of Permanent Molars Topics5 covered within the four sections of this chapter B. Type traits of maxillary molars from the lingual include the following: view I. Overview of molars C. Type traits of maxillary molars from the A. General description of molars proximal views B. Functions of molars D. Type traits of maxillary molars from the C. Class traits for molars occlusal view D. Arch traits that differentiate maxillary from IV. Maxillary and mandibular third molar type traits mandibular molars A. Type traits of all third molars (different from II. Type traits that differentiate mandibular second first and second molars) molars from mandibular first molars B. Size and shape of third molars A. Type traits of mandibular molars from the buc- C. Similarities and differences of third molar cal view crowns compared with first and second molars B. Type traits of mandibular molars from the in the same arch lingual view D. Similarities and differences of third molar roots C. Type traits of mandibular molars from the compared with first and second molars in the proximal views same arch D. Type traits of mandibular molars from the V. Interesting variations and ethnic differences in occlusal view molars III. Type traits that differentiate maxillary second molars from maxillary first molars A. Type traits of the maxillary first and second molars from the buccal view hroughout this chapter, “Appendix” followed Also, remember that statistics obtained from by a number and letter (e.g., Appendix 7a) is Dr. Woelfel’s original research on teeth have been used used within the text to denote reference to to draw conclusions throughout this chapter and are the page (number 7) and item (letter a) being referenced with superscript letters like this (dataA) that Treferred to on that appendix page.
    [Show full text]
  • Endodontic Treatment of a Maxillary First Premolar with an Unusual Working Length: a Clinical Case Report
    dical C Me as d e n R a e l p Sulaiman and Adebayo, Clin Med Case Rep 2018, 2:2 a o c r i t n s i l C Clinical and Medical Case Reports Case Report Open Access Endodontic Treatment of a Maxillary First Premolar with an Unusual Working Length: A Clinical Case Report Omotayo Sulaiman and Gbenga Adebayo* Department of restorative dentistry, University College Hospital, Ibadan, Nigeria Abstract Purpose: To report a clinical case of unusually long maxillary first premolar submitted to non- surgical endodontic treatment. Case presentation: A 32 year old male patient that presented on account of severe toothache in upper right quadrant of 3 weeks duration. His medical history was not contributory. Clinical examination revealed no soft tissue abnormality in relation to the tooth, however there was distooclusal carious lesion which affected less than one third of the crown of the maxillary right first premolar. There was severe tenderness to digital percussion. Periapical radiograph showed unusually long tooth 14 with coronal radiolucency communicating with the pulp, there was minimal periapical radiolucency and widening of periodontal ligament space. Diagnosis of apical periodontitis secondary to class II dental caries was made and patient planned for root canal treatment with subsequent Porcelain Fused to metal crown. Anaesthesia was achieved by infiltration technique using (2% lidocaine 1:100,000 adrenalin) and access cavity made on tooth 14 after appropriate isolation. Palatal and buccal canals were located and working length determined by tactile method confirmed radiographically to be 29 mm and 28 mm respectively which required using the longest files 31 mm available for the biomechanical preparation.
    [Show full text]
  • Maxillary Bilateral Canine-Premolar Transposition: a Rare Condition
    Open Access Journal of Dentistry & Oral Disorders Case Report Maxillary Bilateral Canine-Premolar Transposition: A Rare Condition Agarwala P1, Agarwal V1, Rekhade R1 and Kulshrestha R2* Abstract 1Department of Orthodontics and Dentofacial Tooth transposition is very rare developmental phenomena in which Orthopaedics, Haldia Institute of Dental Sciences & the adjacent teeth are switched or have their positions changed with one Research, India another and due to this aesthetical and functional problem may be present. 2Consulting Orthodontist, Private Practice, Mumbai, The maxillary permanent canine is the tooth most frequently transposed, and India it is often transposed with the first premolar followed by the lateral incisor and *Corresponding author: Rohit Kulshrestha, lastly the central incisor in very rare cases. Several etiologic factors may lead Consulting Orthodontist, Private Practice, Mumbai, to transposition like genetics, developing tooth buds displacement, mechanical India interferences, trauma and early loss of incisors. This paper reports a case of bilateral transposition in the maxillary arch involving the first premolar and Received: March 28, 2017; Accepted: May 11, 2017; canine. Published: May 18, 2017 Keywords: Ectopic eruption; Maxillary canine; Tooth transposition Introduction interchanged positions between maxillary first premolar and canine on both right and the left sides (Figure 2). Upper left deciduous canine Tooth transposition is defined as the positional interchange in was still present and it showed decalcification on its labial aspect. spatial area of two adjacent teeth including their roots, or eruption Remaining teeth in all the other quadrants were at normal location and development of a tooth in a position normally occupied by a with normal morphology, overjet and overbite.
    [Show full text]
  • Age and Sequence of Permanent Canine and Premolar Teeth Eruption in 102-174 Months Old Children in Kerman Province
    Current Research in Dentistry 1 (1): 6-10, 2010 ISSN 1949-0119 © 2010 Science Publications Age and Sequence of Permanent Canine and Premolar Teeth Eruption in 102-174 Months Old Children in Kerman Province Farokhgissor Elham and Shahrzad Adhamy Department of Peadiatric Dentistry, Kerman University of Medical Science, Iran Abstract: Problem statement: The aim of this study was to investigate the eruption time of permanent canine and premolar teeth in 8.5-14.5 years (102-174 months) old boys and girls of Kerman province. Approach: The sample for this cross-sectional study consisted of 2602, 102-174 months old (8.5-14.5 years old) children form 56 primary and guidance schools in Kerman which were scattered over in 2 districts of the city. There were 1556 of girls and 1046 of boys were chosen by simple randomization and the emergence stage of each tooth was recorded. Results: The analysis indicated significantly earlier emergence ages in girls than in boys. The eruption pattern turned out to be symmetric in both sexes and no statically significant difference was detected between the right and left side. The most common observed emergence pattern in girls was mandibular canine and maxillary first premolar followed by mandibular first premolar, maxillary second premolar, then mandibular second premolar and canine and in boys it was maxillary and mandibular first premolar, mandibular canine, maxillary second premolar, mandibular second premolar and maxillary canine Conclusion: Significantly earlier emergence ages in girls seen than in boys. The sequence of eruption differs between girls and boys for mandibular canine and first premolar.
    [Show full text]
  • Bilateral Maxillary Canine-First Premolar Transposition in Permanent Dentition Sarwat Memon and Mubassar Fida
    CASE REPORT Bilateral Maxillary Canine-First Premolar Transposition in Permanent Dentition Sarwat Memon and Mubassar Fida ABSTRACT Transposition is a dental anomaly characterized by the exchange of position between two adjacent teeth, especially in relation to their roots, or development and eruption of a tooth in a position normally occupied by a nonadjacent tooth. Transposition of the maxillary canine and first premolar has a low prevalence in the population and it primarily affects maxillary canines and premolars. The aetiology of the transposition remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. If uncorrected, the results are often both functionally and esthetically unsatisfactory. This case report presents treatment of a female patient with complete bilateral transposition of maxillary canine and premolar. The patient was treated orthodontically with non-extraction fixed mechanotherapy by simulation of maxillary first premolar as canine bilaterally. Key Words: Bilateral maxillary canine-first premolar. Transposition. Permanent dentition. INTRODUCTION and lower labial segment crowding, crossbite of upper Transposition is defined as an interchange in the right lateral incisor with right lower canine, overjet of position of two teeth within the same quadrant of the 3 mm and overbite of 4 mm (Figure 1 and 2). dental arch. Maxillary canine-premolar transposition Cephalometric analysis showed a mild skeletal Class-III (MxC.P1) is the most frequent transposition and relationship (ANB angle = -1°) with low vertical the incidence is reported to be 0.135 - 0.510%.1 proportions (FMA = 17°).
    [Show full text]
  • Geometric Analysis of Maxillary First Premolar Prepared by Two Nickel
    JCDP Dina Al-Sudani et al 10.5005/jp-journals-10024-1510 ORIGINAL ARTICLE Geometric Analysis of Maxillary First Premolar Prepared by Two Nickel-Titanium Rotary Instruments 1Dina Al-Sudani, 2Majed Almalki, 3Saad Al-Shahrani, 4Michael Ahlquist ABSTRACT Prepared by Two Nickel-Titanium Rotary Instruments. J Contemp Dent Pract 2014;15(2):174-180. Aim: The present study was conducted with the aim of evalua- ting and comparing the shaping ability of two Nickel-titanium Source of support: Nil rotary instruments, with two disparate design features, on root Conflict of interest: None canal geometry of extracted human maxillary first premolars using microcomputed tomography. INTRODUCTION Study design: Twenty four bifurcated maxillary first premolars were divided into two groups and embedded in a rubber-based Intra-radicular microbial infection has been shown to be the impression material. Both groups were submitted to micro- main cause of apical periodontitis.1-3 Therefore, the goal of computed tomography before and after canal preparation root canal treatment is to eliminate or reduce the number (buccal and palatal) with either ProFile Vortex or Revo-S rotary instruments. Images were reconstructed and cross-sections of microorganisms to a level that will allow healing of the 4 corresponding to a distance 1, 2, 3, 4, 5, 6, and 7 mm from periapical tissues and to prevent microbial reinfection. This the anatomical apex were selected for canal transportation process involves chemomechanical cleaning and shaping as analysis. Volume changes were also measured. well as obturation of the root canal system. Results: The degree and direction of canal transportation were Root canal preparation is essential for removing necrotic non-significant for both instruments.
    [Show full text]
  • Access Cavity Pictures.Pdf
    PLATE 1 Outline Form A. A standard radiograph (left) in buccolingual pro- triangular preparation in a youngster reflects pul- jection provides only a two-dimensional view of pal horn extension and size of the pulp chamber, what is actually a three-dimensional problem. If a whereas ovoid preparation in an adult relates to a mesiodistal x-ray projection could be made grossly receded pulp. Extension toward the incisal (right), one would find the pulp of the maxillary allows central-axis access for instruments. second premolar to be flat tapering “ribbon” rather E. Large size and shape of coronal preparation in a than round “thread” visualized on the initial radi- recently calcified incisor relate to huge pulp hous- ograph. The final ovoid occlusal cavity preparation ing. To remove all pulp remnants and to accom- (F) will mirror the internal anatomy rather than modate large endodontic instruments and filling the buccolingual x-ray image. materials, coronal preparation must be an exten- B. Coronal preparation of a maxillary first molar sive, triangular, funnel-shaped opening. Actually, illustrating the major principle of endodontic cav- no more than the lingual wall of pulp chamber has ity outline form: the internal anatomy of the tooth been removed. In lower incisors, the outline form (pulp) dictates the external outline form. This is may well be extended into the incisal edge. This accomplished by extending preparation from preparation allows absolutely direct access to apex. inside of the tooth to the outside surface, that is, F. The outline form of the endodontic coronal cavity working from inside to outside.
    [Show full text]
  • 1 – Introduction to Dental Anatomy
    1 Introduction to Dental Anatomy LEARNING OBJECTIVES 5. Which of the following terms represents the surface of a tooth that is facing toward an adjoining tooth in the same dental arch? 1. Correctly define and pronounce the nomenclature (terms) A. Occlusal as emphasized in the bold type in this and each following B. Incisal chapter. C. Facial 2. Be able to identify each tooth of the primary and permanent D. Proximal dentitions using the Universal, Palmer, and Fédération Den- For additional study resources, please visit Expert Consult. taire Internationale (FDI) systems. 3. Correctly name and identify the surfaces, ridges, and ana- Dental anatomy is defined here as, but is not limited to, the study tomic landmarks of each tooth. of the development, morphology, function, and identity of each of 4. Understand and describe the methods used to measure ante- the teeth in the human dentitions, as well as the way in which the rior and posterior teeth. teeth relate in shape, form, structure, color, and function to the 5. Learn the tables of measurements and be able to discuss size other teeth in the same dental arch and to the teeth in the oppos- comparisons between the teeth from any viewing angle. A ing arch. Thus the study of dental anatomy, physiology, and occlu- useful skill at this point is to start illustrating the individual sion provides one of the basic components of the skills needed to teeth with line drawings. practice all phases of dentistry. The application of dental anatomy to clinical practice can be envisioned in Fig. 1.1A, where a faulty crown form has resulted in esthetic and periodontal problems that may be corrected by an appropriate restorative dental treatment, such as that illustrated in Fig.
    [Show full text]