Katherine A Divine1, Scott B McClanahan2, Alex Fok3. 1. Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota. Electronic address: divin030@umn.edu. 2. Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota. 3. Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota.
Abstract
INTRODUCTION: The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning. METHODS: Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test. RESULTS: The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation. CONCLUSIONS: The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.
INTRODUCTION: The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning. METHODS: Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test. RESULTS: The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation. CONCLUSIONS: The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.