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Mandibular First and Second Molars with Three Mesial Canals: A Case Series
Mohsen Aminsobhani,Behnam Bolhari,Noushin Shokouhinejad,Abdollah Ghorbanzadeh
Iranian Endodontic Journal , 2010,
Abstract: Adequate cleaning, shaping and filling of the root canal system are mandatory for successful root canal treatment. Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for the practitioner. The occurrence and location of the third mesial canal (Middle Mesial Canal) in mandibular first and second molars in relation to other two mesial canals that were treated in private practice were studied. In 27 clinical cases, the presence of a middle mesial canal was demonstrated. The third canal was located in the middle of the distance between the mesiobuccal and mesiolingual canals. This canal configuration was found in six second lower molars and twenty one first molars. Middle mesial canal in all of our cases joined to mesiobuccal or mesiolingual canals. None of the teeth consisted of three independent canals with three apical foramina. In conclusion, every attempt should be made to find and treat all root canals of a tooth.
Evaluation of the anatomical alterations of lower molars mesial root?s apical third
FR?NER, Izabel Cristina;IMPERADOR, Cristina Aparecida;SOUZA, Luiz Gustavo de;
Revista de Odontologia da Universidade de S?o Paulo , 1999, DOI: 10.1590/S0103-06631999000200008
Abstract: the anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. the knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.
Evaluation of the anatomical alterations of lower molars mesial root?s apical third
FR?NER Izabel Cristina,IMPERADOR Cristina Aparecida,SOUZA Luiz Gustavo de
Revista de Odontologia da Universidade de S?o Paulo , 1999,
Abstract: The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.
Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases  [PDF]
Mohanavelu Deepalakshmi,Chellasamy Savarimala Karumaran,Revathi Miglani,Rajamani Indira
Case Reports in Dentistry , 2012, DOI: 10.1155/2012/103125
Abstract: Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars. 1. Introduction Knowledge of both normal and abnormal anatomy of the root canal system dictates the parameters for execution of root canal therapy and can directly affect the outcome of the endodontic therapy. Missed extra roots and root canals are a major reason for failure of root canal treatment [1]. All categories of teeth may have additional roots and/or canals, with an increased likelihood of finding aberrant canal configurations in premolars and molars [2]. Lower mandibular molars are the first permanent teeth to erupt and most often require endodontic treatment [3]. The lower mandibular first molar normally has two roots, one mesial and one distal with two canals in the mesial and one or two canals in the distal root. The literature cites the anatomic variations and abnormalities associated with lower first mandibular molars; variations in canals include C-shaped canals, five canals, six canals, and seven canals. Variations in roots like three rooted mandibular molars have also been reported [2, 4–9]. Till date few clinical reports have described more than two canals in the mesial root of mandibular molars. Among these, the occurrence of middle mesial canal in the lower mandibular molar is (1–15%); this canal is also called “intermediary mesial canal” or “medial mesial canal” since it is situated centrally between the main buccal and lingual root canals [10–17]. The diameter of these middle mesial canals is smaller than other two [10] and is age related due to dentinal apposition [5]. The mesial canal is called independent when a distinct coronal orifice and apical foramen were observed or confluent when converging to one of the other two main canals and terminating at a common foramen [4]. It is of prime importance for the clinician to identify the entire topographic location of any additional canal orifices and also extremely important that clinicians use all the armamentaria at their disposal to locate and treat the entire root canal system [18]. Well-angulated periapical films should be taken with cone-directed straight-on,
Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases
Mohanavelu Deepalakshmi,Chellasamy Savarimala Karumaran,Revathi Miglani,Rajamani Indira
Case Reports in Dentistry , 2012, DOI: 10.1155/2012/103125
Abstract: Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.
Third canal in the mesial root of permanent mandibular first molars: Review of the literature and presentation of 3 clinical reports and 2 in vitro studies
Forner Navarro,Leopoldo; Luzi,Arlinda; Almenar García,Amelia; Hervás García,Adela;
Medicina Oral, Patología Oral y Cirugía Bucal (Internet) , 2007,
Abstract: introduction. systematic anatomical studies corroborate the anatomical complexity of the root canal system. deviations from the norm such as multiple orifices, apical deltas, accessory canals and other variations are frequent. objectives. to present clinical reports of mandibular molars with three canals in the mesial root and two in vitro studies of the morphology of these canals, together with a review of the literature. materials and methods. three clinical reports are presented of mandibular molars where three canals in the mesial roots were treated endodontically. two in vitro studies were performed, one using computerized tomography and the other with scanning electron microscopy, to describe the morphology of the mesial root canals of permanent first molars. the scientific literature on this anatomical situation was also reviewed. results. the tomographic study found that the prevalence of a third mesial canal in the 27 teeth analysed was 14.81%; the microscopic study of 25 teeth found it to be 12%. the review of the literature encountered that the authors who report cases such as these found prevalences ranging from 1% to 15%. conclusions. from the teeth analysed in vitro, it is concluded that a third mesial canal may be present in a mandibular first molar in approximately 13% of cases. clinically, the third canal is difficult to find and exhibits a very variable morphology, which may present anastomosis with the other canals.
Comparison of isthmus detection methods in the apical third of mesial roots of maxillary and mandibular first molars: macroscopic observation versus operating microscope
Kontakiotis, Evangelos G.;Palamidakis, Fotios D.;Farmakis, Eleftherios-Terry R.;Tzanetakis, Giorgos N.;
Brazilian Dental Journal , 2010, DOI: 10.1590/S0103-64402010000500009
Abstract: the aims of this study were to assess the presence and the frequency of isthmuses in the mesial roots of the maxillary and mandibular first molars (at two resection levels from the apex), and to compare the findings obtained by macroscopic observation (mo) and operating microscope (om). forty maxillary and 40 mandibular mesial roots were observed at 3 and 5 mm from the apex initially macroscopically and then with the use of an om. the presence of an isthmus and the number of root canals detected were recorded. data were analyzed statistically by fisher's exact test for isthmus evaluation and wilcoxon signed rank-test for number of root canals at a confidence interval of 95%. comparison between mo and om regarding the number of roots with isthmuses provided the following results: mandibular group: at 3 mm level: mo 19 ?s. om 27; at 5 mm level: mo 31 ?s. om 32. maxillary group: at 3 mm level: mo 9 ?s. om 14; at 5 mm level: mo 19 ?s. om 21. significant differences (p<0.05) were found concerning the accuracy of the isthmus detection methods at both resection levels (3 and 5 mm) and both types of roots, as well as for the number of the canals inspected under the om between the two resection levels of the mesial roots of the maxillary first molars. under the tested conditions, om increased the diagnostic accuracy of isthmus detection at both resection levels and root types.
The Effect of EDTA and Citric Acid on Smear Layer Removal of Mesial Canals of First Mandibular Molars, A Scanning Electron Microscopic Study  [cached]
A Khademi,M Feizianfard
Journal of Research in Medical Sciences , 2004,
Abstract: Background: The purpose of this in vitro study was to determine the effect of EDTA and citric acid on smear layer removal in different regions of root canals. Methods: In this study, mesial roots of 48 freshly extracted human mature mandibular first molar teeth with curved mesial roots of about 15-45 degrees and lengths of 20-23 mm were used. Instrumentation was done using the crown down technique by hand and rotary filing. Irrigant used during instrumentation was NaOCl. The teeth were divided in three groups. The mesial canals of teeth were irrigated by 17% EDTA in group I, 7% citric acid in group II and 5.25% NaOCl in group III as the control group. Then, the mesial roots were split in to two parts and studied under scanning electron microscopy. Results: The degree of cleanliness by 17% EDTA and 7% citric acid were 96.55% and 95% respectively. Although both solutions seem to be appropriate, their difference was statistically significant (P<0.05) and EDTA proved better than citric acid especially in middle and apical thirds of canals. The smear layer removal in apical area was less than that in other areas and was maximum in the middle third. However, the removal of smear layer in apical area was acceptable in both groups. Conclusion: It seems that use of both 17% EDTA and 7% citric acid offer desired results and they can remove smear layer from narrow and curved canals especially from apical region. Keywords: EDTA, citric acid, smear layer, irrigation
DIAPHYSIAL NUTRIENT FORAMINA OF RADIUS
IRFAN AHMAD MUGHAL
The Professional Medical Journal , 2003,
Abstract: The topography and direction of nutrient foramina on the long bones are assumed to be constant. In humanbeings this is not invariably so. OBJECTIVES: Present study was conducted to observe the nutrientforamina in radii of Pakistani (Punjabi) people and comparing with that of the Indians. MATERIAL &METHODS: Two hundred well preserved radii bones from each sides were examined for the number, theposition, the direction and the incidence of asymmetry of the nutrient foramina. All the surfaces of bonewere examined in a regular order. To observe the position of foramen, the bone was divided into upper 1/3,junction of upper and middle 1/3, middle 1/3 and lower 1/3. RESULTS & OBSERVATIONS: Rightradius: Of the 192 foramina, 64 (33.33%) were in the upper third, 32 (16.67%) in the middle third and 96(50%) at the junction of upper third and middle third of the bone. Of the 192 foramina, 58 (30.21%) wereon the anterior surface and 13 (6.77%) on the posterior surface. 85 (44.27%) were present on the anteriorborder and 36 (18.75%) on the inter-osseous border. Left radius: Of the 177 foramina, 50 (28.25%) werein the upper third, 37 (20.90%) in the middle third and 90 (50.85%) at the junction of upper third and middlethird of the bone. Of the 177 foramina, 84 (47.46%) were on the anterior surface and 23 (12.99%) on theposterior surface. 30 (16.95%) were present on the anterior border and 40 (22.60%) on the inter-osseousborder. CONCLUSION: The arrangement of the diaphysial foramina in the radius usually follows a definitepattern. The foramina are invariably above or at the junction of the upper third with the middle third andmost frequently occur on the anterior surface nearer either the anterior or the inter-osseous border. Thepresence of the nutrient foramina at different levels could be due to differential growth and the length of thebones in different ethnic groups in Pakistani people as compared to the Indians.
Evaluación in vitro de la preparación de conductos mesiales de molares con instrumentos manuales Ni-Ti y Protaper Universal rotatorio In vitro evaluation of mesial molars canals preparation with manual Ni-Ti instruments and rotatory Protaper Universal  [cached]
D. Aracena Rojas,E. Borie,R. Fuentes,F. Boldt
Avances en Odontoestomatología , 2013,
Abstract: Con la finalidad de disminuir los errores durante la preparación de los conductos radiculares, se han introducido diversas modificaciones en los sistemas de instrumentación mecanizados de níquel-titanio. Se realizó un estudio in vitro para comparar el grado de transporte que se presenta a nivel de la unión del tercio apical con el tercio medio de conductos radiculares con el sistema rotatorio Protaper Universal y el sistema manual de níquel-titanio, con la técnica de fuerzas balanceadas. Se trabajó con 52 conductos mesiales de 26 molares maxilares y mandibulares, las cuales fueron divididas en dos grupos. El primer grupo de conductos (n = 28) fueron instrumentados con Protaper Universal rotatorio y el segundo grupo de conductos (n = 24) fueron instrumentados con técnica manual de fuerzas balanceadas. Las raíces mesiales de los molares fueron sumergidas en una matriz de acrílico, la cual permitió manipular las preparaciones, realizar cortes transversales y comparar los conductos radiculares antes y después de la instrumentación, para establecer las diferencias que se apreciaron en cuanto al transporte apical. Las imágenes obtenidas fueron fotografiadas con un microscopio estereoscópico y analizadas mediante el programa Autodesk AutoCAD 2007. Finalmente, los datos obtenidos fueron tabulados y analizados con el programa Stata 9.0 v. En el presente trabajo Protaper provocó menos transporte apical comparado con la técnica manual de fuerzas balanceadas. In order to reduce errors during root canal preparation, there have been several changes in instrumentation with rotatory systems of nickel-titanium. This is an in vitro study and the aim was to compare the degree of transportation that occurs at the union between the apical third and half third of root canals with the rotaroty Protaper Universal and nickel titanium manual system with balanced force technique. We worked with 52 mesial canals of 26 first and second maxillary and mandibular molars, which were divided into two groups. The first group (n = 28) was instrumented with rotary Protaper Universal and the second group (n = 24) was instrumented with manual technique with balanced force. The mesial roots of molars were immersed in a matrix of acrylic, which allowed manipulating the preparations with transversal cuts and comparing the wear of the root canals before and after the instrument to set the differences were observed in the apical transport. The images obtained were photographed with a stereoscopic microscope and analyzed with the Autodesk AutoCAD 2007. Finally, the data were tabulated and analy
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