Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (4): 246-251.doi: 10.12016/j.issn.2096-1456.2020.04.008

• Prevention and Treatment Practice • Previous Articles     Next Articles

A cone-beam computed tomography study of the root and canal morphology of maxillary premolars

KONG Qianying1(),LIANG Lizhong2(),WANG Guangyong3,QIN Shiqi1   

  1. 1. Department of Oral Implantology, Zhuhai Stomatology Hospital, Zhuhai 519000, China
    2. Department of Stomatology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China
    3. Judicial Appraisal Office of the Intermediate People′s Court of Huangshan City, Huangshan 245000, China
  • Received:2019-07-08 Revised:2019-08-25 Online:2020-04-20 Published:2020-03-31
  • Contact: Qianying KONG,Lizhong LIANG E-mail:314833802@qq.com;lianglzh3@mail.sysu.edu.cn

Abstract:

Objective To study root morphology, the incidence of three root canals and the root canal anatomy of maxillary premolars. Methods The cone-beam computed tomography (CBCT) data of 779 maxillary first premolars and 728 maxillary second premolars were collected from 412 patients in Zhuhai Stomatological Hospital. The root and canal morphology, incidence of three canals, bilateral symmetry and location of root canal bifurcation were analyzed. Results The incidence of three canals in the maxillary first premolars was 1.8% and that in the maxillary second premolars was 0.3%. The incidence of three canals in the maxillary first premolars was significantly higher than that in the maxillary second premolars (c 2=8.304, P=0.004). The symmetrical ratio of the three-canal maxillary first premolar was 27.3%. There was no symmetrical three-canal maxillary second premolar. The anatomical morphology of the maxillary premolar can be single root, double root or trident root. Its internal root canal system is complex and diverse. There are seven kinds of Vertucci morphology: the first maxillary premolar is mainly Vertucci IV type, and the second maxillary premolar is mainly Vertucci I type. Most of the root canal bifurcations of the three-canal maxillary premolars were observed in the midthird or the cervical third of the root. All three-canal maxillary premolars had three independent apical foramens. Conclusion The root canal morphology of maxillary premolars is complex and changeable. CBCT plays an important role in the discovery of variation and extra root canals.

Key words: cone beam CT, maxillary, premolar, maxillary first premolar, maxillary second premolar, root morphology, root canal anatomy, three canals, root canal bifurcated position, apical foramen, vertucci classification

CLC Number: 

  • R781.05

Table 1

Incidence of three-canal maxillary premolars in the study sample n(%)"

Three canals Single/double canals Total
Maxillary first premolar
Male 6(1.6) 378(98.4) 384 c2=0.236, P=0.627
Female 8(2.0) 387(98.0) 395
Total 14(1.8) 765(98.2) 779
Maxillary second premolar
Male 0 357(100) 357 Fisher exact test, P=0.499
Female 2(0.5) 369(99.5) 371
Total 2(0.3) 726(99.7) 728

Table 2

Frequency distribution of canal types in the maxillary first and second premolars according to the number of roots n(%)"

Maxillary first premolar Number
of roots
Vertucci types Total
Ⅰ(1-1) Ⅱ(2-1) Ⅲ(1-2-1) Ⅳ(2-2) Ⅴ(1-2) Ⅶ(1-2-1-2) Ⅷ(3-3)
1 69(15.5) 156(35.1) 49(11.0) 160(36.0) 8(1.8) 1(0.2) 1(0.2) 444
2 0 0 0 322(98.2) 0 0 6(1.8) 328
3 0 0 0 0 0 0 7(100) 7
Total 69(8.9) 156(20.0) 49(6.3) 482(61.9) 8(1.0) 1(0.1) 14(1.8) 779
Maxillary second premolar 1 341(48.9) 142(20.3) 162(23.2) 11(1.6) 42(6.0) 0 0 698
2 0 0 0 28(96.6) 0 0 1(3.4) 29
3 0 0 0 0 0 0 1(100) 1
Total 341(46.8) 142(19.5) 162(22.3) 39(5.4) 42(5.8) 0 2(0.3) 728

Figure 1

Sagittal and cross-sectional CBCT images of the maxillary premolars of single, double and triple root canals(as shown by arrows) a: sagittal view of the maxillary premolars with a single root and three canals; b: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure a; c: sagittal view of the maxillary premolars with double roots and three canals; d: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure c; e: sagittal view of the maxillary premolars with three roots and three canals; f: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in the figure e"

Table 3

Root canal bifurcation position of the maxillary premolars with three canals"

Buccal root canal bifurcation Buccal-palatal root canal bifurcation
Cervical third 1/3 Midthird 1/3 Cervical third 1/3 Midthird 1/3
Maxillary first premolar 3 11 14 0
Maxillary second premolar 0 2 2 0
Total 3(18.8%) 13(81.3%) 16(100%) 0

Figure 2

CBCT images in the sagittal plane and axial sections revealed different Vertucci types of the maxillary premolars(as shown by arrows) a: sagittal view of a Vertucci type I maxillary premolar; b: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure a; c: sagittal view of a Vertucci type Ⅱ maxillary premolar shows intercanal communication; d: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure c; e: sagittal view of a Vertucci type Ⅲ maxillary premolar; f: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure e; g: sagittal view of a Vertucci type Ⅳ maxillary premolar; h: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure g; i: sagittal view of a Vertucci type V maxillary premolar; j: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure i; k: sagittal view of a Vertucci type Ⅶ maxillary premolar; l: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure k; m: sagittal view of a Vertucci type Ⅷ maxillary premolar; n: from left to right, cross-section from the coronal third to the apical third corresponding to the position of lines 1-4 in figure m"

[1] Ok E, Altunsoy M, Nur BG , et al. A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population[J]. Acta Odontol Scand, 2014,72(8):701-706.
[2] Ahmad IA, Alenezi MA . Root and root canal morphology of maxillary first premolars: a literature review and clinical considerations[J]. J Endod, 2016,42(6):861-872.
[3] Elnour M, Khabeer A, AlShwaimi E . Evaluation of root canal morphology of maxillary second premolars in a Saudi Arabian sub-population: an in vitro microcomputed tomography study[J]. Saudi Dent J, 2016,28(4):162-168.
[4] Saber SEDM, Ahmed MHM, Obeid M , et al. Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study[J]. Int Endod J, 2019,52(3):267-278.
[5] Abella F, Teixidó LM, Patel S , et al. Cone-beam computed tomography analysis of the root canal morphology of maxillary first and second premolars in a spanish population[J]. J Endod, 2015,41(8):1241-1247.
[6] Bürklein S, Heck R, Schäfer E . Evaluation of the root canal anatomy of maxillary and mandibular premolars in a selected german population using cone-beam computed tomographic data[J]. J Endod, 2017,43(9):1448-1452.
[7] Li YH, Bao SJ, Yang XW , et al. Symmetry of root anatomy and root canal morphology in maxillary premolars analyzed using cone-beam computed tomography[J]. Arch Oral Biol, 2018,94:84-92.
[8] Yang L, Chen X, Tian C , et al. Use of cone-beam computed tomography to evaluate root canal morphology and locate root canal orifices of maxillary second premolars in a Chinese subpopulation[J]. J Endod, 2014,40(5):630-634.
[9] Gupta S, Sinha DJ, Gowhar O , et al. Root and canal morphology of maxillary first premolar teeth in north Indian population using clearing technique: an in vitro study[J]. J Conserv Dent, 2015,18(3):232-236.
[10] de Lima CO, de Souza LC, Devito KL , et al. Evaluation of root canal morphology of maxillary premolars: a cone-beam computed tomography study[J]. Aust Endod J, 2019,45(2):196-201.
[11] Elnour M, Khabeer A, AlShwaimi E . Evaluation of root canal morphology of maxillary second premolars in a Saudi Arabian sub-population: an in vitro microcomputed tomography study[J]. Saudi Dent J, 2016,28(4):162-168.
[12] Beltes P, Kalaitzoglou ME, Kantilieraki E , et al. 3-rooted maxillary first premolars: an ex vivo study of external and internal morphologies[J]. J Endod, 2017,43(8):1267-1272.
[13] Peiris R . Root and canal morphology of human permanent teeth in a Sri Lankan and Japanese population[J]. Anthropol Sci, 2008,116(2):123-133.
[14] Garcia GD, Najera RI, Cepeda SE , et al. Endodontic management of a three rooted maxillary premolar: a report of 3 cases[J]. J Clin Diagn Res, 2016, 10(6):ZJ05-6.
[15] Tian YY, Guo B, Zhang R , et al. Root and canal morphology of maxillary first premolars in a Chinese subpopulation evaluated using cone-beam computed tomography[J]. Int Endod J, 2012,45(11):996-1003.
[16] Neelakantan P, Subbarao C, Subbarao CV . Comparative evaluation of modified canal staining and clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral computed tomography, and plain and contrast medium-enhanced digital radiography in studying root canal morphology[J]. J Endod, 2010,36(9):1547-1551.
[1] LIU Li,ZHOU Yan,ZHANG Daling,WANG Yuanyuan. Two methods of treatment for skeletal Class Ⅲ malocclusion on airway changes before and after clinical research [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(8): 541-547.
[2] WANG Ke,PENG Guoguang,HE Shanzhi,TAN Yulian. Retrospective analysis of the treatment of mandibular condylar sagittal fracture with Kirschner wire in 13 cases [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(7): 474-478.
[3] ZHANG Weilong,WU Wanqi,LIAO Shanhua,ZOU Junbin,ZHAN Xuzheng,LIN Jie. Fabrication of guide and removal of fiber post by tetrahedron positioning technology at the chair side: a case report and literature review [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(7): 479-484.
[4] MENG Qingyan,LIU Jun. Research progress on factors related to the difficulty of orthodontic tooth movement [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(5): 340-345.
[5] SHU Jingjing,ZENG Feiyue,ZHANG Yanan,XU Qimei,TANG Jialu,XU Bin,SONG Liang. Comparison of diagnosing the relationship between the root of maxillary posterior tooth and maxillary sinus between panoramic radiography and cone beam computer tomography [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(4): 254-259.
[6] WANG Yanlin,SUN Xiaojun. A study of the maxillary sinus lateral wall thickness using cone-beam CT [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(11): 761-765.
[7] MEI Xiaohan,LIU Jin,HONG Tao,YOU Suxia,CHENG Xiaogang,TIAN Yu. Root canal treatment of maxillary second molar with three mesial buccal root canals: a case report and literature review [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(10): 695-700.
[8] LI Yujiao,QIAN Fei,ZHANG Qianxia,WANG Dan,WANG Yirong,TIAN Yu. Research progress on 3D printing in minimally invasive endodontics [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(10): 716-720.
[9] SUN Shuyu,WANG He. Location, incidence and clinical implications of the root canal isthmus [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(1): 11-19.
[10] RONG Mingdeng,ZHOU Tengfei. Clinical guidelines for maxillary sinus floor elevation with sinus membrane lesions [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(9): 551-561.
[11] CHEN Songling,ZHU Shuangxi. The role of the membrane of the maxillary sinus in space osteogenesis under the sinus floor after elevation of the sinus floor [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(8): 477-486.
[12] YANG Yang,YU Zhishuang,DUAN Xiaoyuan,WU Weili,DENG Yi,YAO Ji. Clinical analysis of skeletal malocclusion, axial inclination in patients with short root anomaly of the maxillary central incisors [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(6): 367-371.
[13] ZHANG Sui,HE Dongning. Current status of immediate implant placement in the aesthetic zone of the anterior teeth [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(5): 331-335.
[14] CAO Cong,ZHOU Nan,ZHANG Kai,JIAN Fan,XU Baohua,MAN Yi. Summary of combined orthodontic and implant treatment in the patients with the congenital absence of maxillary lateral incisors [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(4): 241-245.
[15] KONG Qianying,LIANG Lizhong. Cone-beam computed tomography study of C-shaped root canal of mandibular premolars [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(2): 88-92.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] ZHU Song-song, HU Jing. The application of distraction osteogenesis in the temporomandibular joint ankylosis and secondary dentofacial deformities[J]. journal1, 2016, 24(1): 6 -10 .
[2] XU Jing. The influence of the impacted mandibular third molar extraction on the distal periodontal tissue of the mandibular second molar[J]. journal1, 2016, 24(1): 11 -14 .
[3] ZHONG Jiang-long, PAN Ji-yang, CHEN Wei-liang. The evaluation of Eagle syndrome treatment by surgery combined with antidepressant therapy[J]. journal1, 2016, 24(1): 26 -28 .
[4] CHEN Xi, SUN Qin-zhou. The study of colorimetric board of porcelain fused to metal restoration for moderate to severe dental fluorosis[J]. journal1, 2016, 24(1): 33 -36 .
[5] OUYANG Ke-xiong1, LIANG Jun, ZOU Rui, LI Zhi-qiang, BAI Zhi-bao, PIAO Zheng-guo, ZHAO Jian-Jiang.. Ion Torrent RNA-Seq detection and analysis of the long non-coding RNA in tongue squamous cell carcinoma[J]. journal1, 2016, 24(1): 15 -19 .
[6] YU Pei, XUE Jing, ZHANG Xiao-wei, ZHENG Cang-shang. The influence of the roughness of zirconia ceramic surface on microbial attachment[J]. journal1, 2016, 24(1): 20 -25 .
[7] LIU Fang. Clinical assessment of two fissure sealant techniques in children’s dental caries prevention[J]. journal1, 2016, 24(1): 44 -45 .
[8] . [J]. journal1, 2016, 24(1): 49 -52 .
[9] LU Jian-rong, BAN Hua-jie, WANG Dai-you, ZHOU Hui-hui, LONG Ru, QIN Shu-hua. Clinical observation of sternocleidomastoid muscle flaps combined with artificial biological membrane reparing the defects after parotidectomy[J]. journal1, 2016, 24(1): 29 -32 .
[10] LI Bin, HE Xiao-ning, GAO Yuan, HU Yu-ping. Clinical analysis of pain after two kinds of apical stop preparation[J]. journal1, 2016, 24(1): 40 -43 .
This work is licensed under a Creative Commons Attribution 3.0 License.