Taurodontism: a review of the condition and endodontic treatment challenges.

Taurodontism can be defined as a change in tooth shape caused by the failure of Hertwig's epithelial sheath diaphragm to invaginate at the proper horizontal level. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cementoenamel junction are the characteristic features. Although permanent molar teeth are most commonly affected, this change can also be seen in both the permanent and deciduous dentition, unilaterally or bilaterally, and in any combination of teeth or quadrants. Whilst it appears most frequently as an isolated anomaly, its association with several syndromes and abnormalities has also been reported. The literature on taurodontism in the context of endodontics up to March 2007 was reviewed using PubMed, MEDLINE and Cumulative Index to Nursing & Allied Health Literature. Despite the clinical challenges in endodontic therapy, taurodontism has received little attention from clinicians. In performing root canal treatment on such teeth, one should appreciate the complexity of the root canal system, canal obliteration and configuration, and the potential for additional root canal systems. Careful exploration of the grooves between all orifices particularly with magnification, use of ultrasonic irrigation; and a modified filling technique are of particular use.