Abstract
The success of endodontic treatment depends on the identification of all root canals
so that they can be cleaned, shaped, and obturated. This study investigated internal
morphology of maxillary first molars by 3 different methods: ex vivo, clinical, and cone beam computed tomography (CBCT) analysis. In all these different
methods, the number of additional root canals and their locations, the number of foramina,
and the frequency of canals that could or could not be negotiated were recorded. In
the ex vivo study, 140 extracted maxillary first molars were evaluated. After canals were accessed
and detected by using an operating microscope, the teeth with significant anatomic
variances were cleared. In the clinical analysis, the records of 291 patients who
had undergone endodontic treatment in a dental school during a 2-year period were
used. In the CBCT analysis, 54 maxillary first molars were evaluated. The ex vivo assessment results showed a fourth canal frequency in 67.14% of the teeth, besides
a tooth with 7 root canals (0.72%). Additional root canals were located in the mesiobuccal
root in 92.85% of the teeth (17.35% could not be negotiated), and when they were present,
65.30% exhibited 1 foramen. Clinical assessment showed that 53.26%, 0.35%, and 0.35%
of the teeth exhibited 4, 5, and 6 root canals, respectively. Additional root canals
were located in this assessment in mesiobuccal root in 95.63% (27.50% could not be
negotiated), and when they were present, 59.38% exhibited 1 foramen. CBCT results
showed 2, 4, and 5 root canals in 1.85%, 37.05%, and 1.85% of the teeth, respectively.
When present, additional canals showed 1 foramen in 90.90% of the teeth studied. This
study demonstrated that operating microscope and CBCT have been important for locating
and identifying root canals, and CBCT can be used as a good method for initial identification
of maxillary first molar internal morphology.
Key Words
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© 2009 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
