Summary Root Canal Morphology (Cohen's Pathways of the Pulp)

ENDODONTICS: TOOTH MORPHOLOGY AND ACCESS
CAVITY PREPARATION
COMPONENTS OF ROOT CANAL SYSTEM
THE ROOT CANAL
ROOT CANAL SYSTEM
 Knowledge of tooth morphology
 Careful interpretation of angled radiographs  The entire space in the dentin where the pulp is
housed
and adequate access
 Exploration of a tooth’s interior anatomy  Outline corresponds to the external contour of
the tooth
GOAL...  Factors that alters or modifies its dimensions:
 Physiologic aging
 Anatomy  Pathosis
 Radiographs  Occlusion
 Interpretation  Funnel shaped
 Angulations  Canal orifice – opening
 Techniques  Located apical to the cervical line
 Multiple radiographic view and thorough  Ends at the apical foramen
clinical exploration  Opens onto the root surface at or within
Fast Break Guideline 3mm from the center of the root apex
 Nearly all canals are curved (faciolingial
- A sudden disappearance or narrowing of a canal direction)
as a sign of canal division  Canal curvatures
 Pose problems during shaping and cleaning
MAIN OBJECTIVES OF RCT
procedures
 Thorough shaping and cleaning of all pulp  Not evident on standard facial radiographs
spaces and complete obturation with an inert  Angles views is best advised
filling material  Double S-shaped
 Untreated canals may become a reason for  The number of root canals corresponds to
failure the number of roots
 Failure to detect by the clinician  Oval roots may have more than one canal

DIAGNOSTICS MEASURES : AIDS ON LOCATION OF RC ACCESSORY CANALS
ORIFICES
 minute canals that extend in a horizontal,
 Multiple pre-treatment X-rays vertical or lateral direction from the pulp to the
 CBCT periodontium
 Examining the pulp chamber floor with a sharp  Location:
explorer  75% found in the apical third of the root
 Roughing grooves with ultrasonic tips  11% middle third
 Staying the chamber floor with 1% methylene  15% cervical third
blue dye  Contains connective and vessels but do not
 Sodium hypochlorite “champagne bubble” test supply the pulp with sufficient circulation to
 Visualizing Pulp Chamber anatomy and RC form a collateral source of blood flow
bleeding points  Formed by the entrapment of periodontal
 Application of EDTA 17% and drying with 95% vessels in HERS during calcification
ethanol for inspection  Pathologic significance:
 Dental Operating Microscopes

,  Avenues for passage of irritants from the  Diagnosis
pulp to the periodontium  Treatment planning
 Knowledge of common root canal morphology
FURCATION CANALS  Frequent variations
 Accessory canals that occur in the bifurcation or ROOT CANAL ANATOMY
trifurcation of multi-rooted teeth
 Forms as a result of the entrapment of  Complex anatomy occurs often enough to be
periodontal vessels during the fusion of the considered normal
diaphragm (floor of the pulp chamber) - Multiple foramina
 Opening size (mand. Molars) 4-720 um - Additional canals
 Number ranges from none to more than 20 per - Fins
specimen - Deltas
 Patterns of furcation canals in mandibular - Intercanal connections
molars - Loops
 13% single furcation canal from chamber to - C-shaped canals (Asians – mand 2nd molars)
intraradicular region - Furcation and lateral canals
 23% a lateral canal extends from the
coronal third to the furcation VERTUCCI’S CANAL CONFIGURATIONS
 10% have both lateral anf furcation canals  Type I : A single canal extends from the pulp
 Presence of foramina (PC floor and furcations chamber to theapex.
surface)  Type II : Two separate canals leave the pulp
 36% Max 1st Molars chamber and join short of the apex to form one
 12% Max 2nd molars canal
 32% Mand 1st molars  Type III : One canal leaves the pulp chamber
 24% Mand 2nd molars and divides into two in the root; the two then
 Mand teeth have higher incidence of foramina merge to exit as one canal.
PC and fircation (56%)  Type IV : Two separate distinct canals extend
 Maxillary teeth (48%) from the pulp chamber to the apex.
 Patent fircation canals:  Type V : One canal leaves the pulp chamber and
 24% max and mand 1st molars  divides short of the apex into two separate,
 20% mand 2nd molars distinct canals with separate foramina
 16% max 2nd molars  Type VI : two separate canals leave the pulp
 Cause of primary endodontic lesions in the chamber, merge in the body of the root, and
furcations of multicoated teeth redivide short of the apex to exit as two distinct
 Use of adhesive restorations on the floor of the canals
PC to prevent frugal breakdown  Type VII : one canal leaves thepulp chamber,
divides and then rejoins in the body of the root
APICAL DELTA
and finally redivides into two distinct canals
 A complex form of lateral canal where one main short of the apex.
canal branches in many apical exits  Type VIII : Three separate distinct canals extend
 A reminiscent of river delta from the pulp chamber to th apex.



KARTAL AND YANIKOGLU’S CANAL CONFIGURATIONS

ENDODONTIC SUCCESS