population Ampofo P Nyako EA Blankson P and Konadu A University of Ghana School of Medicine and Dentistry Accra Ghana Korle Bu Teaching Hospital Accra Ghana ID: 779923 Download
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Radiographic In-Vivo Determination of the number of Canals in maxillary premolars of a Ghanaian population
of Ghana School of Medicine and Dentistry, Accra, Ghana
Teaching Hospital, Accra, Ghana
Materials and Methods
Meet Mr. Kpodzro…Slide4
presented at the Emergency Unit with a 4-day history of swelling in the right maxillary region which gradually increased in size.
He was subsequently referred to the Dental department where thorough investigation was done.
; WBC- 10.30 x 109
/L; Vitals and other results were grossly normalHe had apparently been seen by a Dentist 3-months prior to presentation where a root-canal was done on the second upper premolar which was confirmed on X-ray.Slide5
X-RAY OF MR. KPODZRO’S TOOTHSlide6
INTRODUCTIONBack to BasicsThe Concept of Reversible
WHAT IS ROOT CANAL THERAPYA sequence of treatment for the infected pulp of a tooth which results in the elimination of infection and the protection of the decontaminated tooth from future
It is evident
that the root canal varies with size, shape and number of roots in different teeth,
it is a known pertinent consideration in
. Successful General dental procedures and Root canal therapy in particular requires a thorough knowledge of tooth anatomy and root canal morphology
With a variation in the number of canals
, the maxillary premolars remain one of the challenging teeth to treat
lso because of the direction and longitudinal depressions of the roots, the various pulp cavity configurations, and the difficulties in visualizing the apical limit by radiographs
The Objective?Many factors contribute to differences in canal morphology4
but largely influenced by ethnic background, age and gender of the populations studied
copious data on several populations worldwide, data is scarce for Ghana.
This study thus describes a clinical survey by use of radiographs to determine the number of canals in maxillary premolars in a Ghanaian population.Slide11
Materials And MethodsFour hundred and two (402) participants were selected from patients who had opted for, and were referred to the Restorative Dentistry Department of the University Ghana School of Medicine and Dentistry for endodontic treatment of maxillary premolar from January 2012 till December 2015
Preoperative radiographs were taken for evaluation (root morphology, number of canals, and
The teeth that were included in this study were those teeth that required nonsurgical endodontic treatment. The
included teeth were free of root
, had no calcifications or open apices and no retreatment cases were included in the study, patients who defaulted treatment at any point were also excluded.
was sought from each patient.Slide13
The teeth included were both clinically and radiographically examined by three specialists with more than 10 years of experience in
and all patients operated on by the same certified Dental
The endodontic procedures undertaken were as follows: local anesthesia consisting of 2%
in 1:100,000 adrenaline was administered by infiltration.Slide14
After the contents of the pulp chamber were removed, a sharp endodontic explorer was used to explore the developmental grooves carefully to locate the orifices of the canals. Copious amount of 2.5% sodium hypochlorite irrigation was used.
tissue was extirpated using barbed broaches and the canals were flared with gates
of the floor of the pulp chamber to locate canals orifices was done using 3.5 high resolution magnification loupes (
Azdent). The number of root canals in the maxillary first and second premolars was recorded with correlated folder numbers, age and gender. The data was analyzedSlide15
RESULTSA total of 402 patients were used in the study. 239 of these were females and 163 males, representing 59.45% and 40.55% respectively. Of the total number of teeth used, 160 were maxillary
first premolars while 242 were maxillary second premolars.
The age ranged from 16yrs to 82yrs with a mean age of 40yrs.Slide16Slide17Slide18
DISCUSSIONDetermination of pulp anatomy generally fall within In-vivo (Clinical) or In-vitro studies.
in-vitro methods encompass teeth sectioning of extracted or cadaveric teeth, to apply dyes, contrasting media or scanning electron microscopy for analysis,
methods on the other hand uses Anatomy studies, exploration, high resolution CT, Visualization endogram,
Fibreoptic endoscopy, magnetic resonance imaging and radiographs, which our study employs6,8Slide19
While Maxillary first premolars are considered to have two canals, Maxillary second premolar are generally considered to have one canal.
In the present study, the latter had one canal in 24.7% of cases. This is at variance with the studies of Green
et al. 10 in which the maxillary second premolars was reported to have one canal in 72% and 75% of cases respectively.Slide20
Like other anatomical features, it is natural to assume racial and ethnology influences on dental morphology differences. It
has been observed that different populations show distinctive variations of tooth morphology.
study’s 95.4% and 75.3% finding for the first and second maxillary premolars respectively
much higher than reported in Asian studies in Singapore 20
and Sichuan province, China 21Slide21
In 1969, Weine et al.22,23 provided the first classification of more than one canal system in a single root and used the
root of the maxillary first molar as the type specimen.
further studied the canal anatomy extensively establishing eight different classification of pulp anatomy.
which the authors propose for the curriculum in GhanaSlide22
Type I: A single canal extends from the pulp chamber to the apexType II: Two separate canals leave the pulp chamber and join short of the apex to form one canal
Type III: One canal leaves the pulp chamber and divides into two in the root; the two then merge to exit as one canal
Type IV: Two separate, distinct canals extend from the pulp chamber to the apex
Type V: One canal leaves the pulp chamber and divides short of the apex into two separate, distinct canals with separate apical foramina
Type VI: Two separate canals leave the pulp chamber, merge in the body of the root, and
short of the apex to exit as two distinct canals
Type VII: One canal leaves the pulp chamber, divides and then rejoins in the body of the root, and finally redivides into two distinct canals short of the apex
Type VIII: Three separate, distinct canals extend from the pulp chamber to the apexSlide23
A LOGICAL EXPLANATION FOR MR KPODZROSlide24
This study was done to determine the number of canals in maxillary premolars in a Ghanaian population.
were selected from patients who were referred for endodontic treatment of maxillary premolars. These consisted of 239 females (59%) and 163 males (41%).
teeth included in the study were examined clinically and
radiographically for the number of root canals
using.95.4% of the maxillary first premolars had two canals while 75.3% of the maxillary second premolars also had two canals. There was no significant association between gender and the number of canals in each premolar.Slide25
CONCLUSIONThe incidence of two canals in maxillary premolars of the Ghanaian population is very high.
and Clinicians should be made aware of this extreme variation so that further inspection and careful interpretation of preoperative radiographs is done for success in endodontic therapy, especially of the maxillary second premolar
“…the end? We’re not at the end, we’re nowhere near the end. We are not at the beginning of the end. If anywhere, then perhaps end of the beginning.”Winston ChurchillSlide27
, Leif K & Health Communication Network 2002,
Endodontics, 5th ed, B C Decker, Hamilton, Ont. ; London
D'Souza R. Development of the pulpodentinal complex. In: Hargreaves K, editor. Seltzer and Bender's Dental Pulp. Chicago, Ill, USA: Quintessence Books; 2002.
B, Christie W, Dong C. Root and root canal morphology of the human
first premolar: A literature review. J
. 2007;33:509–16. [
S. Root canal morphology of maxillary second premolars in an Indian population. Journal of Conservative Dentistry : JCD. 2010;13(3):148-151. doi:10.4103/0972-0707.71648.
JB. Root form and canal anatomy of maxillary second premolars.
Dent J. 1992;3:81–5. [
S. Root canal morphology of maxillary second premolars in an Indian population. J
Dent. 2010;13:148–51. [
PMC free article
BG, Ok E,
E. Evaluation of the root and canal morphology of
permanent molars in a south-eastern Turkish population using cone-beam computed tomography.
European Journal of Dentistry
. 2014;8(2):154-159. doi:10.4103/1305-7456.130584
D. Double canals in single roots. Oral
Oral Med Oral
1973; 35: 689-96.
F, Seelig A, Gillis R. Root canal morphology of the human maxillary second premolar. Oral Surg Oral Med Oral Pathol 1974; 58 456-6411. G
, and A.
, “Missed anatomy: frequency and clinical impact,” Endodontic Topics, vol. 15, no. 1, pp. 3–31, 2006.
, M. J. Barrows, E. A.
, and C. S.
, “Effect of magnification on locating the MB2 canal in maxillary molars,” Journal of
, vol. 28,no. 4, pp. 324–327, 2002.
O. Number of root canals of the maxillary second premolar in Nigerians.
1997; 78 : 31-2
JB. In vitro study of root canal anatomy of maxillary second premolars.
Dent J 1993; 3: 81-5.
XL, Yu SB, Zhao SL, Wang HG, Mu T, Tang RY
Root canal morphology of
teeth in the Han nationality in Chinese
area: A new modified root canal staining technique. J
investigations of 7,275 root canals. Oral Surg. 1972;33:101–10. [
W. Root and canal morphology of maxillary first premolar teeth in a Ugandan population. Open J
N. Radiographic investigation of
treated maxillary premolars in a Saudi Arabian sub-population. Saudi
IA. Root and root canal morphology of Saudi Arabian permanent dentition. Saudi
HS. Root morphology of the maxillary first premolar in Singaporeans. Aust
Dent J 1998;43:399-402.21. Deng D, Zhang M, Wu W. The morphology study of root canal system of permanent teeth. Sichuan J Anat 2004;12:226.22. Weine
FS, Healey HJ, Gerstein H,
L. Canal configuration in the
root of the maxillary first molar and its endodontic significance. Oral
Oral Med Oral
. 1969;28:419–25. [
A, Ng YL. Root and canal morphology of Burmese
J. 2001;34:359–70. [
AA. Root form and canal morphology of
premolars in a Jordanian population.
J. 2008;41:240–8. [
FJ. Root canal morphology and its relationship to endodontic procedures.
GS. Evaluation of the root canal configuration of the
and maxillary permanent teeth by gender in the Turkish population. J
. 2004;30:391–8. [