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Summary Root Canal Morphology (Cohen's Pathways of the Pulp)
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A summary of a chapter from the 10th edition of Cohen's Pathways of the Pulp discussing the morphology of root canals
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ENDODONTICS: TOOTH MORPHOLOGY AND ACCESSCAVITY 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
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