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"

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