- Email: [email protected]
Mandibular premolar with two roots
0099-2399/97/2303-0187503.00/0 JOURNALOF ENDODONTICS Copyright © 1997 by The American Association of Endodontists
Printed in U.S.A.
VOL. 23, No. 3, MARCH1997
Mandibular Premolar with Two Roots Mousumi Goswami, BDS, Satish Chandra, BDS(Lko), MDS(Bom), Shaleen Chandra, BDS, and Sanjay Singh, BDS(Lko), MDS(Lko)
This case report illustrates the relatively uncommon anomaly of a mandibular second premolar with two roots branching in a mesiodistal direction.
Detailed knowledge of the root canal anatomy and awareness of the configuration of the pulp canal is essential and basic to the procedure of endodontic therapy. Root canals are left untreated because the dentist fails to identify their presence, particularly in teeth that have anatomical variations or additional root canals. Brescia (1) considered that the first mandibular premolar was the most variable in the entire dentition. Vertucci (2) elaborated that 25.5% of the mandibular first premolars had two canals at the apex, and only 0.5% had three canals at the apex. Among mandibular second premolars, 2.5% had two canals and none with three canals at the apex. Various authors have stressed clues on radiographs that point to the presence of multiple root canals in the lower premolars. Pineda and Kutler (3) reported 0.9%, Zillich and Dowson (4) found 0.4%, and Kerekes and Tronstad (5) reported 5.0% of the mandibular first premolars to have three root canals. Racial differences in the root canal morphology has been well established (6, 7). Multirooted posterior teeth offer better periodontal support for fixed prosthodontics than similar teeth with roots that converge or present a conical configuration (8). The purpose of this case report is to increase awareness as to the likelihood of mesial and distal roots in the lower second premolar teeth that would serve as an excellent bridge abutment.
FIG. 1. Mandibular second premolar with t w o roots and canals.
significant and rare. It is advantageous for bridge fabrication, but disadvantageous while extracting because one has to be very careful. Dr. Goswami is a postgraduate student and Dr. Satish Chandra is head, Department of Pedodontics with Preventive Dentistry; and Dr. Singh is affiliated with the Department of Oral and Maxillofacial Surgery, King George's Medical College, Lucknow, India. Dr. Shaleen Chandra is a postgraduate student, Department of oral pathology, S. D. M. College of Dental Sciences, Dharwad (Karnataka), India. Address requests for reprints to Dr. Mousumi Goswami, c/o Professor Satish Chandra, 250/4-6, "Had Sadan" Rajendra Najar, Lucknow, India.
CASE REPORT
References 1. Brescia NJ. Applied dental anatomy. St. Louis: CV Mosby, 1961:46-8. 2. Vertucci FJ. Root canal anatomy of human permanent teeth. Oral Surg 1984;58:589 -99. 3. Pineda F, Kuttler Y. Mesiodista~ and buccolingual roentgenographic investigation of 7275 root canals. Oral Surg Oral Med Oral Pathol 1972;33: 101-10. 4. Zillich R, Dowson J. Root canal morphology of mandibular first and second premolars. Oral Surg Oral Med Oral Pathol 1973;36:738-44. 5. Keresk K, Tronstad L. Morphometric observations on roots of human premolars. J Endodon 1977;3:74-9. 6. Trope M, Elfenbein L, Tronstad L. Mandibular premolars with more than one root canal in different race groups. J Endodon 1986;12:343-5. 7. Walker RT. Root canal anatomy of mandibular first premolars in a southern Chinese population. Endod Dent Traumatol 1988;4:226-8. 8. Serman NJ, Hasselgren G. The radiographic incidence of multiple roots and canals in human mandibular premolars. Int Endod J 1992;25:234-7.
A 16-yr-old girl sought treatment for the chief complaint of pain in left lower molar region. Routine radiographic examination showed aberrant morphology of the lower premolars (Fig. l). Curiosity led to taking bilateral periapical radiographs that revealed that both right and left lower first premolars had the appearance of extra canals.
DISCUSSION Bifurcation of roots among lower premolars'usually occurs buccolingually. In this case, the mesiodistal branching is quite 187
Printed in U.S.A.
VOL. 23, No. 3, MARCH1997
Mandibular Premolar with Two Roots Mousumi Goswami, BDS, Satish Chandra, BDS(Lko), MDS(Bom), Shaleen Chandra, BDS, and Sanjay Singh, BDS(Lko), MDS(Lko)
This case report illustrates the relatively uncommon anomaly of a mandibular second premolar with two roots branching in a mesiodistal direction.
Detailed knowledge of the root canal anatomy and awareness of the configuration of the pulp canal is essential and basic to the procedure of endodontic therapy. Root canals are left untreated because the dentist fails to identify their presence, particularly in teeth that have anatomical variations or additional root canals. Brescia (1) considered that the first mandibular premolar was the most variable in the entire dentition. Vertucci (2) elaborated that 25.5% of the mandibular first premolars had two canals at the apex, and only 0.5% had three canals at the apex. Among mandibular second premolars, 2.5% had two canals and none with three canals at the apex. Various authors have stressed clues on radiographs that point to the presence of multiple root canals in the lower premolars. Pineda and Kutler (3) reported 0.9%, Zillich and Dowson (4) found 0.4%, and Kerekes and Tronstad (5) reported 5.0% of the mandibular first premolars to have three root canals. Racial differences in the root canal morphology has been well established (6, 7). Multirooted posterior teeth offer better periodontal support for fixed prosthodontics than similar teeth with roots that converge or present a conical configuration (8). The purpose of this case report is to increase awareness as to the likelihood of mesial and distal roots in the lower second premolar teeth that would serve as an excellent bridge abutment.
FIG. 1. Mandibular second premolar with t w o roots and canals.
significant and rare. It is advantageous for bridge fabrication, but disadvantageous while extracting because one has to be very careful. Dr. Goswami is a postgraduate student and Dr. Satish Chandra is head, Department of Pedodontics with Preventive Dentistry; and Dr. Singh is affiliated with the Department of Oral and Maxillofacial Surgery, King George's Medical College, Lucknow, India. Dr. Shaleen Chandra is a postgraduate student, Department of oral pathology, S. D. M. College of Dental Sciences, Dharwad (Karnataka), India. Address requests for reprints to Dr. Mousumi Goswami, c/o Professor Satish Chandra, 250/4-6, "Had Sadan" Rajendra Najar, Lucknow, India.
CASE REPORT
References 1. Brescia NJ. Applied dental anatomy. St. Louis: CV Mosby, 1961:46-8. 2. Vertucci FJ. Root canal anatomy of human permanent teeth. Oral Surg 1984;58:589 -99. 3. Pineda F, Kuttler Y. Mesiodista~ and buccolingual roentgenographic investigation of 7275 root canals. Oral Surg Oral Med Oral Pathol 1972;33: 101-10. 4. Zillich R, Dowson J. Root canal morphology of mandibular first and second premolars. Oral Surg Oral Med Oral Pathol 1973;36:738-44. 5. Keresk K, Tronstad L. Morphometric observations on roots of human premolars. J Endodon 1977;3:74-9. 6. Trope M, Elfenbein L, Tronstad L. Mandibular premolars with more than one root canal in different race groups. J Endodon 1986;12:343-5. 7. Walker RT. Root canal anatomy of mandibular first premolars in a southern Chinese population. Endod Dent Traumatol 1988;4:226-8. 8. Serman NJ, Hasselgren G. The radiographic incidence of multiple roots and canals in human mandibular premolars. Int Endod J 1992;25:234-7.
A 16-yr-old girl sought treatment for the chief complaint of pain in left lower molar region. Routine radiographic examination showed aberrant morphology of the lower premolars (Fig. l). Curiosity led to taking bilateral periapical radiographs that revealed that both right and left lower first premolars had the appearance of extra canals.
DISCUSSION Bifurcation of roots among lower premolars'usually occurs buccolingually. In this case, the mesiodistal branching is quite 187