Thomas Gerhard Wolf1, Paul Kim2, Guglielmo Campus3, Michael Stiebritz3, Mark Siegrist4, Benjamín Briseño-Marroquín5. 1. Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. Electronic address: thomas.wolf@zmk.unibe.ch. 2. Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 3. Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 4. Department of BioMedical Research, University of Bern, Bern, Switzerland. 5. Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Abstract
INTRODUCTION: The aim of this study was to systematically revise the root canal configuration (RCC) literature and to investigate the root canal morphology of mandibular first premolars (Ma1Ps) of 2 populations by means of micro-computed tomographic imaging. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including RCC randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies. Furthermore, the RCC, physiological foramina, the frequency of accessory and connecting canals, and the physiological foramina morphology of 109 Ma1Ps were investigated by means of micro-computed tomographic imaging. The RCC results are described using a 4-digit system code. RESULTS: The most frequent RCCs observed were 1-1-1/1 (70.6%), 1-1-2/2 (7.3%), 1-2-2/2 (7.3%), and 1-2-1/1 (5.5%). Accessory canals were observed in 31.2%. Connecting canals were observed in 1-1-2/2 (4.6%), 1-2-2/2 (4.6%), 1-1-2/1 (1.8%), and 1-2-1/1 (1.8%) RCCs. Accessory foramina were observed in 52.3%; 30.3% of the Ma1Ps had 1 accessory foramen, 12.8% had 2, 2.8% had 3, 2.8% had 4, 2.8% had 5, and 0.92% had 6. The narrow and wide diameter mean of 136 physiological foramina was 0.28 mm (±0.9) and 0.37 mm (±0.11) when only 1 physiological foramen was present. CONCLUSIONS: This study provides detailed root canal morphology of Ma1Ps in a Swiss-German population. Within the limitations of the study, the authors recommend a final physiological foramen preparation size of instrument tip sizes 30-40; yet, such a decision should be carefully considered on an individual basis.
INTRODUCTION: The aim of this study was to systematically revise the root canal configuration (RCC) literature and to investigate the root canal morphology of mandibular first premolars (Ma1Ps) of 2 populations by means of micro-computed tomographic imaging. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including RCC randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies. Furthermore, the RCC, physiological foramina, the frequency of accessory and connecting canals, and the physiological foramina morphology of 109 Ma1Ps were investigated by means of micro-computed tomographic imaging. The RCC results are described using a 4-digit system code. RESULTS: The most frequent RCCs observed were 1-1-1/1 (70.6%), 1-1-2/2 (7.3%), 1-2-2/2 (7.3%), and 1-2-1/1 (5.5%). Accessory canals were observed in 31.2%. Connecting canals were observed in 1-1-2/2 (4.6%), 1-2-2/2 (4.6%), 1-1-2/1 (1.8%), and 1-2-1/1 (1.8%) RCCs. Accessory foramina were observed in 52.3%; 30.3% of the Ma1Ps had 1 accessory foramen, 12.8% had 2, 2.8% had 3, 2.8% had 4, 2.8% had 5, and 0.92% had 6. The narrow and wide diameter mean of 136 physiological foramina was 0.28 mm (±0.9) and 0.37 mm (±0.11) when only 1 physiological foramen was present. CONCLUSIONS: This study provides detailed root canal morphology of Ma1Ps in a Swiss-German population. Within the limitations of the study, the authors recommend a final physiological foramen preparation size of instrument tip sizes 30-40; yet, such a decision should be carefully considered on an individual basis.