Advertisement

Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations

Published:April 20, 2016DOI:https://doi.org/10.1016/j.joen.2016.02.017

      Highlights

      • The maxillary first premolars are predominantly 2-rooted teeth with 2 root canals.
      • The presence of a third root is the most common anatomic variation in these teeth.
      • The clinician should have sound knowledge about the internal and external morphology of maxillary first premolars and their relationship with adjacent anatomic structures to improve the treatment outcome of surgical and nonsurgical dental procedures.

      Abstract

      Introduction

      Sound knowledge of the external and internal morphology of the different teeth groups is essential to ensure a successful outcome of root canal treatment. The aims of this study were to review the available literature with respect to the root and root canal morphology of maxillary first premolars and discuss the clinical considerations of this morphology on the various dental procedures.

      Methods

      The MEDLINE/PubMed and Scopus databases were searched for relevant literature. The identified publications were classified into anatomic studies and clinical case reports. The data extracted from anatomic studies were tabulated, and weighted averages for certain internal and external morphologic features were calculated. The anatomic and developmental variations in the clinical case reports were summarized.

      Results

      A total of 92 studies (45 anatomic studies and 47 case reports) including a total of 11,299 teeth were identified. The majority of maxillary first premolars had 1 root (41.7%) or 2 roots (56.6%). Regardless of the number of roots, the vast majority (86.6%) had 2 root canals, with type IV (2-2) being the most common canal configuration (64.8%). The majority of the apical foramina (66.6%) did not coincide with the apical root tip. About 38% of the teeth had lateral canals, 12.3% had apical deltas, and 16.0% had isthmi. The clinical case reports showed that the 3-rooted variant was the most common anatomic variation, and developmental anomalies were rarely reported.

      Conclusions

      The maxillary first premolars are predominantly 2-rooted teeth with 2 root canals. However, the clinician should be aware about the possible anatomic variations of these teeth and their relationship with the adjacent anatomic structures while planning and performing endodontic, restorative, periodontal, and surgical procedures.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Vertucci F.J.
        Root canal morphology and its relationship to endodontic procedures.
        Endod Topics. 2005; 10: 3-29
        • Cantatore G.
        • Berutti E.
        • Castellucci A.
        Missed anatomy: frequency and clinical impact.
        Endod Topics. 2006; 15: 3-31
        • Friedman S.
        Prognosis of initial endodontic therapy.
        Endod Topics. 2002; 2: 59-88
        • Wayman B.E.
        • Patten J.A.
        • Dazey S.E.
        Relative frequency of teeth needing endodontic treatment in 3350 consecutive endodontic patients.
        J Endod. 1994; 20: 399-401
        • Zaatar E.I.
        • Al-Kandari A.M.
        • Alhomaidah S.
        • Al Yasin I.M.
        Frequency of endodontic treatment in Kuwait: radiographic evaluation of 846 endodontically treated teeth.
        J Endod. 1997; 23: 453-456
        • Pineda F.
        • Kuttler Y.
        Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals.
        Oral Surg Oral Med Oral Pathol. 1972; 33: 101-110
        • Carns E.J.
        • Skidmore A.
        Configurations and deviations of root canals of maxillary first premolars.
        Oral Surg Oral Med Oral Pathol. 1973; 36: 880-886
        • Vertucci F.J.
        Root canal anatomy of the human permanent teeth.
        Oral Surg Oral Med Oral Pathol. 1984; 58: 589-599
        • Walker R.T.
        Root form and canal anatomy of maxillary first premolars in a southern Chinese population.
        Endod Dent Traumatol. 1987; 3: 130-134
        • Pécora J.D.
        • Saquy P.
        • Sousa Neto M.
        • Woelfel J.
        Root form and canal anatomy of maxillary first premolars.
        Braz Dent J. 1991; 2: 87-94
        • Pécora J.D.
        • Sousa Neto M.
        • Saquy P.C.
        • Woelfel J.B.
        In vitro study of root canal anatomy of maxillary second premolars.
        Braz Dent J. 1992; 3: 81-85
        • Çalişkan M.K.
        • Pehlivan Y.
        • Sepetçioğlu F.
        • et al.
        Root canal morphology of human permanent teeth in a Turkish population.
        J Endod. 1995; 21: 200-204
        • Kartal N.
        • Özçelik B.
        • Cimilli H.
        Root canal morphology of maxillary premolars.
        J Endod. 1998; 24: 417-419
        • Loh H.
        Root morphology of the maxillary first premolar in Singaporeans.
        Aust Dent J. 1998; 43: 399-402
        • Chaparro A.
        • Segura J.
        • Guerrero E.
        • et al.
        Number of roots and canals in maxillary first premolars: study of an Andalusian population.
        Endod Dent Traumatol. 1999; 15: 65-67
        • Sert S.
        • Bayirli G.S.
        Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population.
        J Endod. 2004; 30: 391-398
        • Awawdeh L.
        • Abdullah H.
        • Al-Qudah A.
        Root form and canal morphology of Jordanian maxillary first premolars.
        J Endod. 2008; 34: 956-961
        • Peiris R.
        Root and canal morphology of human permanent teeth in a Sri Lankan and Japanese population.
        Anthropol Sci. 2008; 116: 123-133
        • Weng X.-L.
        • Yu S.-B.
        • Zhao S.-L.
        • et al.
        Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: a new modified root canal staining technique.
        J Endod. 2009; 35: 651-656
        • Tian Y.Y.
        • Guo B.
        • Zhang R.
        • et al.
        Root and canal morphology of maxillary first premolars in a Chinese subpopulation evaluated using cone-beam computed tomography.
        Int Endod J. 2012; 45: 996-1003
        • Bellizzi R.
        • Hartwell G.
        Evaluating the maxillary premolar with three canals for endodontic therapy.
        J Endod. 1981; 7: 521-527
        • Sieraski S.M.
        • Taylor G.N.
        • Kohn R.A.
        Identification and endodontic management of three-canalled maxillary premolars.
        J Endod. 1989; 15: 29-32
        • Cleghorn B.M.
        • Christie W.H.
        • Dong C.C.
        Root and root canal morphology of the human permanent maxillary first molar: a literature review.
        J Endod. 2006; 32: 813-821
        • Barrett M.
        The internal anatomy of the teeth with special reference to the pulp with its branches.
        Dent Cosmos. 1925; 67: 581-588
        • Hess W.
        The Anatomy of the Root-Canals of the Teeth of the Permanent Dentition, Part 1.
        William Wood and Co, New York1925
        • Okumura T.
        Anatomy of the root canals.
        J Am Dent Assoc. 1927; 14: 632-636
        • Mueller A.H.
        Anatomy of the root canals of the incisors, cuspids and bicuspids of the permanent teeth.
        J Am Dent Assoc. 1933; 20: 1361-1386
        • Green D.
        Morphology of the pulp cavity of the permanent teeth.
        Oral Surg Oral Med Oral Pathol. 1955; 8: 743-759
        • Green D.
        Stereomicroscopic study of 700 root apices of maxillary and mandibular posterior teeth.
        Oral Surg Oral Med Oral Pathol. 1960; 13: 728-733
        • Green D.
        Double canals in single roots.
        Oral Surg Oral Med Oral Pathol. 1973; 35: 689-696
        • Hession R.W.
        Endodontic morphology: II—a radiographic analysis.
        Oral Surg Oral Med Oral Pathol. 1977; 44: 610-620
        • Bellizzi R.
        • Hartwell G.
        Radiographic evaluation of root canal anatomy of in vivo endodontically treated maxillary premolars.
        J Endod. 1985; 11: 37-39
        • De Deus Q.D.
        Endodontia.
        4th ed. Medsi, Rio de Janeiro1986
        • Wu Y.
        • Yue B.
        • Shi J.
        A morphology study on root canal system of 1769 permanent teeth.
        J Pract Stomatol. 1995; 11: 98-101
        • Deng D.
        • Zhang M.
        • Wu W.
        The morphology study of root canal system of permanent teeth.
        Sichuan J Anat. 2004; 12: 22-26
        • Oginni A.
        Clinical radiographic estimation of the number of root canals in maxillary first and second premolars among Nigerians.
        Internet J Dent Sci. 2004; 2 (Available at:) (Accessed July 7, 2015)
        • Lipski M.
        • Wozniak K.
        • Lagocka R.
        • Tomasik M.
        Root and canal morphology of the first human maxillary premolar.
        Durham Anthropol J. 2005; 12: 2-3
        • Mattuella L.G.
        • Mazzoccato G.
        • Vier F.V.
        • Só M.V.R.
        Root canals and apical foramina of the buccal root of maxillary first premolars with longitudinal sulcus.
        Braz Dent J. 2005; 16: 23-29
        • Atieh M.A.
        Root and canal morphology of maxillary first premolars in a Saudi population.
        J Contemp Dent Pract. 2008; 9: 46-53
        • Cheng X.
        • Weng Y.
        Observation of the roots and root canals of 442 maxillary first premolars.
        Shanghai Kou Qiang Yi Xue. 2008; 17: 525-528
        • Różyło T.
        • Miazek M.
        • Różyło-Kalinowska I.
        • Burdan F.
        Morphology of root canals in adult premolar teeth.
        Folia Morphol (Warsz). 2008; 67: 280-285
        • Ng’ang’a R.
        • Masiga M.
        • Maina S.
        Internal root morphology of the maxillary first premolars in Kenyans of African descent.
        East Afr Med J. 2010; 87: 20-24
        • Neelakantan P.
        • Subbarao C.
        • Ahuja R.
        • Subbarao C.V.
        Root and canal morphology of Indian maxillary premolars by a modified root canal staining technique.
        Odontology. 2011; 99: 18-21
        • Rwenyonyi C.M.
        • Kutesa A.
        • Muwazi L.
        • Buwembo W.
        Root and canal morphology of maxillary first premolar teeth in a Ugandan population.
        Open Journal of Stomatology. 2011; 1: 7-11
        • Sharma D.
        • Mathur M.
        A computed tomographic study of canal variations in maxillary & mandibular first premolar teeth in Jaipur population: an in vitro study.
        People J Sci Res. 2011; 4: 1-5
        • Al-Nazhan S.
        • Al-Daafas A.
        • Al-Maflehi N.
        Radiographic investigation of in vivo endodontically treated maxillary premolars in a Saudi Arabian sub-population.
        Saudi Endod J. 2012; 2: 1-5
        • Özcan E.
        • Çolak H.
        • Hamidi M.M.
        Root and canal morphology of maxillary first premolars in a Turkish population.
        J Dent Sci. 2012; 7: 390-394
        • Elkady A.M.
        • Allouba K.
        Cone beam computed tomographic analysis of root and canal morphology of maxillary premolars in Saudi subpopulation.
        Egypt Dent J. 2013; 59: 3419-3429
        • Koçani F.
        • Kamberi B.
        • Dragusha E.
        • et al.
        Correlation between anatomy and root canal topography of first maxillary premolar on Kosovar population.
        Open Journal of Stomatology. 2014; 4: 332-339
        • Ok E.
        • Altunsoy M.
        • Nur B.G.
        • et al.
        A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population.
        Acta Odontol Scand. 2014; 72: 701-706
        • Abella F.
        • Teixidó L.M.
        • Patel S.
        • et al.
        Cone-beam computed tomography analysis of the root canal morphology of maxillary first and second premolars in a Spanish population.
        J Endod. 2015; 41: 1241-1247
        • Dashrath K.
        • Nisha A.
        • Subodh S.
        Root morphology and tooth length of maxillary first premolar in Nepalese population.
        Dentistry. 2015; 5: 324
        • Gupta S.
        • Sinha D.J.
        • Gowhar O.
        • et al.
        Root and canal morphology of maxillary first premolar teeth in north Indian population using clearing technique: an in vitro study.
        J Conserv Dent. 2015; 18: 232-236
        • Barry G.N.
        • Heyman R.
        • Fried I.
        Endodontic treatment of a three-rooted maxillary first premolar: case report.
        N Y State Dent J. 1975; 41: 75-77
        • Gazit E.
        • Lieberman M.A.
        Upper first premolar with congenitally missing buccal root: a case report.
        J Endod. 1983; 9: 145-146
        • Maibaum W.
        Endodontic treatment of a “ridiculous” maxillary premolar: a case report.
        Gen Dent. 1989; 37: 340-341
        • Zaatar E.I.
        • Al-Busairi M.A.
        • Behbahani M.
        Maxillary first premolars with three root canals: case report.
        Quintessence Int. 1990; 21: 1007-1011
        • Augsburger R.A.
        • Wong M.T.
        Pulp management in dens evaginatus.
        J Endod. 1996; 22: 323-326
        • Nahmias Y.
        • Rampado M.
        Root-canal treatment of a trifid crown premolar.
        Int Endod J. 2002; 35: 390-394
        • Stecker S.
        • DiAngelis A.J.
        Dens evaginatus: a diagnostic and treatment challenge.
        J Am Dent Assoc. 2002; 133: 190-193
        • Soares J.
        • Leonardo R.
        Root canal treatment of three-rooted maxillary first and second premolars: a case report.
        Int Endod J. 2003; 36: 705-710
        • Evans M.
        Combined endodontic and surgical treatment of a three-rooted maxillary first premolar.
        Aust Endod J. 2004; 30: 53-55
        • Šegović S.
        • Pavelić B.
        • Jukić S.
        • Anić I.
        Three-rooted maxillary first premolars: five clinical cases.
        Acta Stomat Croat. 2004; 38: 379-380
        • Oruçoğlu H.
        • Çobankara F.K.
        Maxillary first premolar with three roots: a case report.
        Hacettepe Dişhekimliği Fakültesi Dergisi. 2005; 29: 26-29
        • Rekha S.
        • Nadig P.
        • Nadig G.
        Endodontic treatment of a maxillary first premolar with three roots: a case report.
        J Conserv Dent. 2005; 8: 26-29
        • Woodmansey K.
        Endodontic treatment of a three-rooted maxillary first premolar: a case report.
        Gen Dent. 2006; 5: 420-424
        • Jafarzadeh H.
        Endodontic treatment of bilaterally occurring three-rooted maxillary premolars: a case report.
        N Z Dent J. 2007; 103: 37-38
        • Parolia A.
        • Kundabala M.
        • Acharya S.
        • Ballal V.
        Root canal treatment for three-rooted-three canalled maxillary first premolar.
        Endodontology. 2007; 19: 52-54
        • Javidi M.
        • Zarei M.
        • Vatanpour M.
        Endodontic treatment of a radiculous maxillary premolar: a case report.
        J Oral Sci. 2008; 50: 99-102
        • Arisu H.
        • Alacam T.
        Diagnosis and treatment of three-rooted maxillary premolars.
        Eur J Dent. 2009; 3: 62-66
        • Cardinali F.
        • Cerutti F.
        • Tosco E.
        • Cerutti A.
        Preoperative diagnosis of a third root canal in first and second maxillary premolars: a challenge for the clinician.
        ENDO (Lond Engl). 2009; 3: 51-57
        • Dadresanfar B.
        • Khalilak Z.
        • Shahmirzadi S.
        Endodontic treatment of a maxillary first premolar with type IV buccal root canal: a case report.
        Iran Endod J. 2009; 4: 35-36
        • Al-Abdulwahhab B.
        • Al-Harthi M.
        • Al-Fayez S.
        • et al.
        Maxillary first premolar with three canals: case report.
        Smile Dent J. 2010; 5: 34-36
        • Farooq R.
        • Mushtaq M.
        • Ibrahim M.
        • Purra A.R.
        Endodontic management of maxillary first premolars with three roots: a report of two cases.
        Rom J Stomatol. 2010; 56: 297-300
        • Abraham D.
        • Kumar P.
        Radiculous premolar.
        Endodontology. 2011; 23: 95-97
        • Idris M.
        • Sakkir N.
        • Prasad L.
        Endodontic treatment of a radiculous maxillary premolar: a case report.
        Journal of Health Sciences and Research. 2011; 2: 17-18
        • Karumaran C.
        • Gunaseelan R.
        • Krithikadatta J.
        Microscope-aided endodontic treatment of maxillary first premolars with three roots: a case series.
        Indian J Dent Res. 2011; 22: 706-708
        • Nica L.
        • Ianes C.
        • Florita Z.
        Root canal treatment of a three-rooted maxillary first premolar: a case report.
        ENDO (Lond Engl). 2011; 5: 63-66
        • Aracena D.
        • Beltrán V.
        • Fuentes R.
        • Borie E.
        In vitro macroscopic and endoscopic analysis of three-rooted maxillary premolars and two-rooted mandibular premolars in the same individual: a case report.
        Int J Morphol. 2012; 30: 19-24
        • Chauhan R.
        • Chandra A.
        Endodontic management of three-rooted maxillary first and second premolars: a case report.
        Gen Dent. 2012; 59: 288-290
        • Çolak H.
        • Aylıkçi B.U.
        • Keklik H.
        Dens evaginatus on maxillary first premolar: report of a rare clinical case.
        J Nat Sci Biol Med. 2012; 3: 192-194
        • Gandhi B.
        • Majety K.K.
        • Gowdra R.H.
        Root canal treatment of bilateral three-rooted maxillary first premolars.
        J Orofac Sci. 2012; 4: 56-59
        • Garapati S.
        • Raturi P.
        • Chakravarthy K.
        Maxillary first premolar with three roots: a case report.
        Heal Talk. 2012; 5: 35
        • Gupta S.
        • Saxena P.
        • Chandra A.
        The “radiculous” maxillary first premolar: a rare anatomic variation.
        Gen Dent. 2012; 60: 178-181
        • Kamath U.
        • Kamath M.
        • Kusuma S.
        The identification and endodontic management of two “radiculous” maxillary premolars: a challenge for the clinicians.
        Endodontology. 2012; 24: 120-124
        • Nimigean V.
        • Nimigean V.R.
        • Sălăvăstru D.
        • Buţincu L.
        A rare morphological variant of the first maxillary premolar: a case report.
        Rom J Morphol Embryol. 2013; 54: 1173-1175
        • Ocak M.S.
        • Ahmetoğlu F.
        Endodontic treatment of three-rooted maxillary first premolar: a case report.
        İnönü Üniversitesi Sağlık Bilimleri Dergisi. 2013; 1: 46-48
        • Oporto V.
        • Saavedra R.
        • Soto P.
        • Fuentes R.
        Double root anatomical variations in a single patient: endodontic treatment and rehabilitation of a three-rooted first premolar—case report.
        Int J Morphol. 2013; 31: 45-49
        • Relvas J.B.F.
        • de Carvalho F.M.A.
        • Marques A.A.F.
        • et al.
        Endodontic treatment of maxillary premolar with three root canals using optical microscope and NiTi rotary files system.
        Case Rep Dent. 2013; 2013: 710408
        • Sulaiman A.
        • Dosumu O.
        • Amedari M.
        Maxillary first premolar with three root canals: a case report.
        Ann Ib Postgrad Med. 2013; 11: 105-108
        • Victorino F.
        • Men-Martins M.
        Maxillary first premolar with three roots: case report.
        Dent Press Endod. 2013; 3: 73-77
        • Chandra S.
        • Mathew S.
        Endodontic treatment of maxillary ‘radiculous’: a case report.
        Endodontology. 2014; 26: 314-316
        • Gopal S.
        • John G.
        • Pavan Kumar K.
        • et al.
        Endodontic treatment of bilateral maxillary first premolars with three roots using CBCT: a case report.
        Case Rep Dent. 2014; 2014: 505676
        • Jayesh R.
        • Masthan K.M.K.
        • Nalini A.
        • Aravindha B.N.
        Three rooted maxillary first premolar: an unusual occurrence.
        Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2014; 5: 1276-1279
        • Kirilova J.
        • Topalova-Pirinska S.
        • Kirov D.
        Variation of maxillary first premolar with three root canals.
        Journal of International Medical Association Bulgaria. 2014; 20: 584-588
        • Mantri V.
        • Palekar A.
        • Kala S.
        Endodontic treatment of three-rooted maxillary first premolar: a case report.
        J Pierre Fauchard Acad. 2014; 28: 18-22
        • Theruvil R.
        • Ganesh C.
        • George A.C.
        Endodontic management of a maxillary first and second premolar with three canals.
        J Conserv Dent. 2014; 17: 88-91
        • Davoudi A.
        • Akhavan A.
        Endodontic treatment of maxillary first premolar with three root canals: a case report.
        TMU J Dent. 2015; 2: 31-33
        • Mathew J.
        • Devadathan A.
        • Syriac G.
        • Shamini S.
        Root canal treatment of a maxillary first premolar with three roots.
        J Pharm Bioallied Sci. 2015; 7: 746-748
        • Praveen R.
        • Thakur S.
        • Kirthiga M.
        • et al.
        The radiculous’ premolars: case reports of a maxillary and mandibular premolar with three canals.
        J Nat Sci Biol Med. 2015; 6: 442-445
        • Hamasha A.
        • Alomari Q.
        Prevalence of dens invaginatus in Jordanian adults.
        Int Endod J. 2004; 37: 307-310
        • Darwazeh A.
        • Hamasha A.
        • Pillai K.
        Prevalence of taurodontism in Jordanian dental patients.
        Dentomaxillofac Radiol. 1998; 27: 163-165
        • Pillai K.
        • Scipio J.
        • Nayar K.
        • Louis N.
        Prevalence of taurodontism in premolars among patients at a tertiary care institution in Trinidad.
        West Indian Med J. 2007; 56: 368-371
        • Gordon M.P.J.
        • Chandler N.P.
        Electronic apex locators.
        Int Endod J. 2004; 37: 425-437
        • Weine F.S.
        The enigma of the lateral canal.
        Dent Clin North Am. 1984; 28: 833-852
        • van der Sluis L.W.M.
        • Versluis M.
        • Wu M.K.
        • Wesselink P.R.
        Passive ultrasonic irrigation of the root canal: a review of the literature.
        Int Endod J. 2007; 40: 415-426
        • Kim S.
        • Kratchman S.
        Modern endodontic surgery concepts and practice: a review.
        J Endod. 2006; 32: 601-623
        • Joseph I.
        • Varma B.
        • Bhat K.M.
        Clinical significance of furcation anatomy of the maxillary first premolar: a biometric study on extracted teeth.
        J Periodontol. 1996; 67: 386-389
        • Tamse A.
        • Katz A.
        • Pilo R.
        Furcation groove of buccal root of maxillary first premolars: a morphometric study.
        J Endod. 2000; 26: 359-363
        • Katz A.
        • Wasenstein-Kohn S.
        • Tamse A.
        • Zuckerman O.
        Residual dentin thickness in bifurcated maxillary premolars after root canal and dowel space preparation.
        J Endod. 2006; 32: 202-205
        • Lammertyn P.A.
        • Rodrigo S.B.
        • Brunotto M.
        • Crosa M.
        Furcation groove of maxillary first premolar, thickness, and dentin structures.
        J Endod. 2009; 35: 814-817
        • Al-Shahrani S.M.
        • Al-Sudani D.
        • Almalik M.
        • et al.
        Microcomputed tomographic analysis of the furcation grooves of maxillary first premolars.
        Ann Stomatol (Roma). 2013; 4: 142-148
        • Li J.
        • Li L.
        • Pan Y.
        Anatomic study of the buccal root with furcation groove and associated root canal shape in maxillary first premolars by using micro–computed tomography.
        J Endod. 2013; 39: 265-268
        • Bellucci С.
        • Perrini N.
        A study on the thickness of radicular dentine and cementum in anterior and premolar teeth.
        Int Endod J. 2002; 35: 594-606
        • Pilo R.
        • Shapenco E.
        • Lewinstein I.
        Residual dentin thickness in bifurcated maxillary first premolars after root canal and post space preparation with parallel-sided drills.
        J Prosthet Dent. 2008; 99: 267-273
        • Schäfer E.
        • Diez C.
        • Hoppe W.
        • Tepel J.
        Roentgenographic investigation of frequency and degree of canal curvatures in human permanent teeth.
        J Endod. 2002; 28: 211-216
        • Willershausen B.
        • Tekyatan H.
        • Kasaj A.
        • Marroquín B.B.
        Roentgenographic in vitro investigation of frequency and location of curvatures in human maxillary premolars.
        J Endod. 2006; 32: 307-311
        • Watzek G.
        • Bernhart T.
        • Ulm C.
        Complications of sinus perforations and their management in endodontics.
        Dent Clin North Am. 1997; 41: 563-583
        • Hauman C.
        • Chandler N.
        • Tong D.
        Endodontic implications of the maxillary sinus: a review.
        Int Endod J. 2002; 35: 127-141
        • Nedbalski T.R.
        • Laskin D.M.
        Use of panoramic radiography to predict possible maxillary sinus membrane perforation during dental extraction.
        Quintessence Int. 2008; 39: 661-664
        • Selden H.S.
        Endo-antral syndrome and various endodontic complications.
        J Endod. 1999; 25: 389-393
        • Lu Y.
        • Liu Z.
        • Zhang L.
        • et al.
        Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study.
        J Endod. 2012; 38: 1069-1074
        • Phothikhun S.
        • Suphanantachat S.
        • Chuenchompoonut V.
        • Nisapakultorn K.
        Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus.
        J Periodontol. 2012; 83: 557-564
        • Eberhardt J.A.
        • Torabinejad M.
        • Christiansen E.L.
        A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth.
        Oral Surg Oral Med Oral Pathol. 1992; 73: 345-347
        • Von Arx T.
        • Fodich I.
        • Bornstein M.M.
        Proximity of premolar roots to maxillary sinus: a radiographic survey using cone-beam computed tomography.
        J Endod. 2014; 40: 1541-1548
        • Freedman A.
        • Horowitz I.
        Complications after apicoectomy in maxillary premolar and molar teeth.
        Int J Oral Maxillofac Surg. 1999; 28: 192-194
        • Ju Y.-R.
        • Tsai A.
        • Wu Y.-J.
        • Pan W.-L.
        Surgical intervention of mucosal fenestration in a maxillary premolar: a case report.
        Quintessence Int. 2004; 35: 125-128
        • Chen G.
        • Fang C.
        • Tong C.
        The management of mucosal fenestration: a report of two cases.
        Int Endod J. 2009; 42: 156-164
        • Vertucci F.
        • Haddix J.
        Tooth morphology and access cavity preparation.
        in: Hargreaves K.M. Cohen S.F. Pathways of the Pulp. Mosby, St Louis2010: 182-184