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A new system for classifying root and root canal morphology

Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH

Int Endod J, 2017 Aug;50(8):761-770.
PMID: 27578418 DOI: 10.1111/iej.12685

Knowledge of root and root canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in nondestructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.

Matched MeSH terms: Tooth Root/anatomy & histology*
Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study

Saber SEDM, Ahmed MHM, Obeid M, Ahmed HMA

Int Endod J, 2019 Mar;52(3):267-278.
PMID: 30225932 DOI: 10.1111/iej.13016

AIM: To investigate the number of roots and root canal configurations using two coding systems and the root canal diverging and merging levels in extracted maxillary premolars in an Egyptian subpopulation using cone beam computed tomography (CBCT).
METHODOLOGY: A total of 700 maxillary premolars were examined using CBCT in an Egyptian subpopulation. The number of roots was identified, and root canal configurations were classified according to Vertucci's classification and a new system for classifying root and canal morphology. In addition, the position where roots bifurcated and the levels where canals merged or diverged were identified. Fisher's exact test and independent t-test were used for statistical analysis, and the level of significance was set at 0.05 (P = 0.05).
RESULTS: More than half of maxillary first premolars were double-rooted, and the majority of maxillary second premolars were single-rooted (P rooted samples had bifurcations in the middle of the root. According to the Vertucci classification, canal configuration type IV was the most common in both first and second maxillary premolars. According to the new system, the code 2 FP B1 P1 was the most common for maxillary first premolars, whilst 2 SP B1 P1 , 1 SP2 and 1 SP2-1 codes were the most common for maxillary second premolars. The three-canalled morphology in double- and three-rooted maxillary premolars had considerable variations. Root canal merging and diverging levels were comparable in both tooth types.
CONCLUSION: Maxillary premolars in this Egyptian subpopulation had a wide range of root and canal anatomical variations. Clinicians should be aware of where canals merge and diverge to facilitate the treatment of all canals. The new system for classifying canal morphology describes the root and canal configurations in a more accurate and practical manner compared to the Vertucci classification.

Matched MeSH terms: Tooth Root/anatomy & histology*
Evaluation of interfacial adaptation and penetration of bioceramic-based sealers in oval root canals: A confocal laser scanning microscope study

Chew ST, Eshak Z, Al-Haddad A

Microsc Res Tech, 2023 Jul;86(7):754-761.
PMID: 37078493 DOI: 10.1002/jemt.24323

To assess the interfacial adaptation and penetration depth of three different bioceramic-based sealers (CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG) compared to an epoxy resin-based sealer (AH Plus) in oval root canals. Fourty extracted single-rooted mandibular premolar with oval canal were prepared and randomly allocated according to the obturation into; CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG and AH Plus. The roots were sectioned at 3, 6 and 9 mm from the apex. The sealer adaptation and the penetration depth were evaluated under confocal laser scanning microscope. One-way ANOVA and Repeated measure ANOVA were used to statistically analyze the data. Nishika Canal Sealer BG showed significantly higher sealer adaptation than EndoSeal MTA (P root canal sealers have some percentage of gaps and vary in their penetration capability into dentinal tubules. Nishika Canal Sealer BG has significantly better sealer adaptation to root dentinal walls than that of EndoSeal MTA at the apical and middle third but not significantly different from other type of sealers used. Nishika Canal Sealer BG has significantly better penetration depth than AH Plus and EndoSeal MTA at the coronal third of radicular dentin.

Matched MeSH terms: Tooth Root/anatomy & histology
Fulltext Accessory roots in maxillary molar teeth: a review and endodontic considerations

Ahmed HM, Abbott PV

Aust Dent J, 2012 Jun;57(2):123-31; quiz 248.
PMID: 22624750 DOI: 10.1111/j.1834-7819.2012.01678.x

Maxillary molar teeth may have accessory roots. The aim of this paper is to review and discuss the endodontic implications of this anatomical variation. A review of the literature was undertaken to identify studies and reported cases where accessory roots have been recorded in maxillary molar teeth. The results show that although the prevalence of accessory roots in maxillary molar teeth is low, they can exist in all three types of maxillary molar teeth, and they may be located palatally, buccally, mesially or distally. Hence, it is essential that dentists undertaking root canal treatment thoroughly assess all teeth to determine how many roots are present in order to provide the best possible outcome of treatment for the patient.

Matched MeSH terms: Tooth Root/anatomy & histology*
Comparison between two ultrasonic units in shaping curved canals in teeth using macroradiography

Ahmad M

Endod Dent Traumatol, 1991 Apr;7(2):55-8.
PMID: 1782894

The efficacy of two ultrasonic units in shaping curved canals in teeth were compared. Twenty teeth were instrumented using the Cavi-Endo unit at a power setting 1 using the technique recommended by the manufacturer. Another group of 20 teeth received similar treatment but were instrumented with the Enac unit. The time taken to instrument each canal was recorded. The pre- and post-instrumented radiographs of the teeth of x 10 magnification were taken using a microfocal technique. The radiographs were subjected to a subtraction technique to result in composite images of the pre- and post-instrumented shapes. The canal shape and the incidence of elbows were evaluated using various measurements taken from the radiographs. The manner the dentine was removed was similar in both groups. All canals exhibited unequal removal along the canal with more dentine being removed at the coronal end. The Enac group exhibited a higher incidence of elbows which occurred further apically than those in the Cavi-Endo group. There was no significant difference between groups in the following: time of instrumentation, amount of apical and coronal canal enlargement, apical deviation and change in width at the elbow. These findings were no different from those of another study using simulated canals.

Matched MeSH terms: Tooth Root/anatomy & histology
Fulltext Root canal morphology of permanent teeth in a Malaysian subpopulation using cone-beam computed tomography

Pan JYY, Parolia A, Chuah SR, Bhatia S, Mutalik S, Pau A

BMC Oral Health, 2019 01 14;19(1):14.
PMID: 30642318 DOI: 10.1186/s12903-019-0710-z

BACKGROUND: To determine the root canal morphology of human permanent maxillary and mandibular teeth in a Malaysian subpopulation using cone-beam computed tomography (CBCT).
METHODS: A total of 208 CBCT images were examined retrospectively. Prevalence of an extra root/canal and internal morphology based on Vertucci's classification were observed in human maxillary and mandibular permanent teeth. Variations in the external and internal morphology were compared in relation to gender and tooth side (left vs right) using Pearson Chi-square and Fisher's exact tests with significance level set at p root (radix entomolaris) were detected in 1.9, 19.5 and 21.4% of mandibular first molars, respectively. The prevalence of a C-shaped canal was observed in 48.7% of mandibular second molars. Females displayed significantly higher prevalence of a C-shaped canal in the right mandibular second molars than males (p root anatomy and root canal morphology were observed in relation to gender and tooth side.
CONCLUSIONS: Wide variations in the root canal morphology exist among Malaysians. CBCT is a clinically useful tool in the identification of external and internal morphological variations in the human teeth.

Matched MeSH terms: Tooth Root/anatomy & histology*
Reply to the editor

Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH

Int Endod J, 2018 Oct;51(10):1182-1183.
PMID: 30191599 DOI: 10.1111/iej.12928
Matched MeSH terms: Tooth Root/anatomy & histology*