Morphology

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Aleksbaron
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248817
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Morphology
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2013-12-14 13:31:48
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ABE Prep
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ABE Prep
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  1. Discuss the types and incidence of lateral / accessory canals?
    • DeDeus – 27% found most often in the apical area
    • Lateral – found in the main body of the root canal
    • Secondary – extends from the main canal to the PDL in the apical region
    • Accessory – from the secondary canal branching off to the PDL
  2. What is the incidence of furcation canals?
    Gutmann – 28%; only 10% extend to the PDL
  3. Discuss canal classification?
    Weine: Type I – one canal; Type II – 2 canals, one foramen; Type III – 2 canals, 2 foramina; Type IV – 1 canal, 2 foramina
  4. Who discussed the anatomy of the pulpal floor?
    • Vigouroux & Bossan – discussed subpulpal grooves & dentinal cornice
    • Krasner & Rankow –
    • Law of Centricity: pulpal floor is located in the tooth center at the CEJ level
    • Law of Concentricity: walls of the pulp chamber are concentric to external suface
    • Law of CEJ: landmark pulp chamber location

    • Law of Symmetry: Except Max molars, orifi are equidistant & perpendicular from M-D line drawn through center of pulpal floor;
    • Law of Color Change: pulpal floor is darker than walls
    • Law of Orifice Location: orifi are located at the junction of the floor and walls
  5. Discuss the apical constriction?
    • Stein & Corcoran – Width of the CEJ was avg. .189mm (size 20 file)
    • Dummer – 4 types of apical constriction: single constriction 46%; tapering 30%; multiconstricted 19%; parallel 5%; 6% were completely blocked
  6. Discuss Abnomalities of the Teeth:
    • MICRODONTIA
    • TEETH SMALLER THAN THEY SHOULD BE
  7. MACRODONTIA
    TEETH LARGER THAN THEY SHOULD BE
  8. AMELOGENESIS IMPERFECTA
    • HERIDITARY DISORDER OF ENAMEL FORMATION IN BOTH DENTITIONS
    • 1. HYPOPLASTIC – INSUFFICIENT AMOUNT OF ENAMEL
    • 2. HYPOCALCIFIED – QUANTITY OF ENAMEL IS NORMAL BUT SOFT AND FRIABLE
    • 3. HYPOMATURATION

    • • COLOR RANGE FROM WHITE OPAQUE TO YELLOW TO BROWN
    • • RADIOGRAPHICALLY DENTIN THIN ROOTS NORMAL
  9. DENTINOGENESIS IMPERFECTA (HEREDITARY) OPALESCENT DENTIN
    AUTOSOMAL DOMINANT

    • 1. TYPE 1 – OCCURS IN PATIENTS WITH OSTEOGENESIS IMPERFECTA
    • 2. TYPE 2 – PATIENTS HAVE ONLY DENTAL ABNORMALITIES NO BONE DISEASE
    • 3. TYPE 3 – OR BRANDYWINE TYPE SIMILAR TO TYPE 2 BUT INCLUDE FEATURES SUCH AS MULTIPLE PULP EXPOSURES AND PERIAPICAL RADIOLUCIENCIES

    • CLINICALLY ALL THREE TYPES SHARE NUMEROUS FEATURES
    • 1. TEETH EXHIBIT AN UNUSUAL TRANSLUCENT, OPALESCENT APPEARANCE
    • 2. COLOR RANGES FROM YELLOW – BROWN TO GRAY
    • 3. ENAMEL NORMAL BUT FRACTURES EASILY
    • 4. ABNORMAL MORPHOLOGY TEETH TULIP OR BELL SHAPED DUE TO CONSTRICTION OF CEJ
    • 5. ROOTS ARE SHORT AND BLUNTED

    • • RADIOGRAPHICALLY
    • 1. TYPES 1 AND 2 PULP SPACE OPACIFIED
    • 2. TYPE 3 PULP CHAMBERS AND ROOT CANALS EXTREEMLY LARGE
  10. DENTIN DYSPLASIA
    • AUTOSOMAL DOMINANT TRAIT
    • • TYPE 1 RADICULAR
    • 1. CROWNS NORMAL
    • 2. TEETH SHOW GREATER RESISTANCE TO CARIES
    • 3. ROOTS EXTREMELY SHORT
    • 4. PULPS OBLITERATED
    • 5. PERIAPICAL LEUCENCIES

    • • TYPE 2 CORONAL
    • 1. CROWNS NORMAL
    • 2. PULPS LARGE (THISLE TUBE)
    • 3. ROOTS EXTREMELY SHORT
  11. Gutmann
    – about 27-29% of molars have patent canals in furcation region
  12. Krasner & Rankow
    – Anatomy of pulp chamber floor
  13. Deutsch & Musikant
    • – Measurement of anatomic landmarks to pulp chamber
    • o 97-98% of maxillary and mandibular molars
    • o Chamber ceiling matches CEJ
    • o Average distances
    •  Cusp tip to chamber ceiling – 6.0 mm
    •  Floor to furcation – 3.0 mm
    •  Average height of chamber – 1.5 – 2.0 mm
  14. Slowey 1979
    – describes ‘Fast Break’’ = broad canal splits into 2 or more
  15. Cooke
    – 8% of 2nd Md. Molars are ‘C-shaped’ canals; can’t dx by radiograph
  16. Hulsmann 1997
    – Dens invaginatus highest in maxillary laterals / bilateral 43%
  17. Tooth Morphology – describe the possible canal configurations of each tooth in the arch
    • Who Else?
    • Hess 1921, Grove 1931, Kuttler, 1955, Delzangles 1965, Belllizzi 1985
  18. Vertucci 1984,
    Root Canal anatomy of human secondary teeth Examined 2,400 teeth. 24-60% of teeth have lateral canals (highest in 2nd premolars and MB canals of max molars) Sudden narrowing of RC system on radiographic exam is good indication of canal bifurcation. Eight categories
  19. MAXILLARY TEETH:
    • 1st Bicuspid 62% Type IV (2 canals), 18% Type II (2-1 canals), 69% have 2 canals at apex
    • 2nd Bicuspid 48% Type I (1 canal), 22% Type II (2-1 canals), 11% Type IV (2 canals)
    • 1st Molar: MB 45% Type I (1 canal), 37% Type II (2-1 canals), [18% have 2 canals at apex)
  20. MANDIBULAR TEETH:
    • Central 70% Type I (1 canal), 22% Type III (1-2-1 canals)
    • Lateral 75% Type I (1 canal), 18% Type III (1-2-1 canals)
    • Canine 78% Type I (1 canal)
    • 1st Bicuspid 70% Type I (1 canal)
    • 2nd Biscupid 98% Type I (1 canal),
    • 1st Molar: Mesial 12% Type I (1 canal), 22% Type III (1-2-1 canals), 43% Type IV (2 canals)
    • 1st Molar: Distal 70% Type I (1 canal), 15% Type II (2-1 canals), 8% Type V (1-2 canals)

    Younes SA, 1990 – 3-rooted mandibular 1st molars in asian groups in the middle east. 2.33% of Asians have 3 rooted lower 1st molar
  21. Ingle, Bakland 2002 5th Edition, Endodontics
  22. Maxillary Central
    1 Canal 100%
  23. Maxillary Lateral
    1 Canal 99.9%
  24. Maxillary Canine
    1 Canal 100%
  25. Maxillary 1st Bicuspid
    • 1 canal – 1 foramin 9%
    • 2 canals – 1 foramin 13%
    • 2 canals – 2 foramin 72%
    • 3 canals – 3 foramin 6%
  26. Maxillary 2nd Bicuspid
    • 1 canal – 1 foramin 75%
    • 2 canals – 2 foramin 24%
    • 3 canals 1%
  27. Maxillary 1st Molar
    • 3 canals 41.1%
    • 4 canals 56.5%
    • 5 canals 2.4 %
    • MB Root
    • 1 canal – 1 foramin 41.1%
    • 2 canals – 1 foramin 40%
    • 2 canals – 2 foramin 18.9%
  28. Maxillary 2nd Molar
    • 3 Roots 54%
    • Fused 46%
  29. Mandibular Central
    • 1 canal – 1 foramin 70.1%
    • 2 canals – 1 foramin 14.7%
    • 2 canals – 2 foramin 6.5%
  30. Mandibular Lateral
    • 1 canal – 1 foramin 56.9%
    • 2 canals – 1 foramin 14.7%
    • 2 canals – 2 foramin 29.4%
  31. Mandibular Canine
    • 1 canal – 1 foramin 94%
    • 2 canals – 2 foramin 6%
  32. Mandibular 1st Bicuspid
    • 1 canal – 1 foramin 73.5%
    • 2 canals – 1 foramin 6.5%
    • 2 canals – 2 foramin 19.5%
    • 3 canals – 0.5%
  33. Mandibular 2nd Bicuspid
    • 1 canal – 1 foramin 85%
    • 2 canals – 1 foramin 15%
    • 2 canals – 2 foramin 11.5%
    • 3 canals – 0.5%
  34. Mandibular 1st Molar
    • 2 Roots 97.8%
    • 3 Roots 2.2%
    • 2 Canals - 6.7%
    • 3 Canals - 64.4%
    • 4 Canals - 28.9%

    • Mesial Root
    • 2 canals – 1 foramin 40.5%
    • 2 canals – 2 foramin 59.5%
    • Distal Root
    • 1 canal 71%
    • 2 canals 28.9%
    • 2 canals – 1 foramin 61.5%
    • 2 canals – 2 foramin 38.5%
  35. Mandibular 2nd Molar
    • Mesial Root
    • 1 canal – 1 foramin 13%
    • 2 canals – 1 foramin 49%
    • 2 canals – 2 foramin 38%
    • Distal Root
    • 1 canal – 1 foramin 92%
    • 2 canals – 1 foramin 5%
    • 2 canals – 2 foramin 3%
  36. _______

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