Root and Root Canal Morphology: Study Methods and Classifications
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Abstract
Data: Only electronic published papers were searched within this review. Sources: “PubMed” website was the only source used to search for data by using the following keywords "root", "canal", "morphology", "classification".
Study selection: 153 most relevant papers to the topic were selected, especially the original articles and review papers, from 1970 till the 28th of July 2021.
Conclusions: This review divided the root canal analysis methods into two approaches; clinical and in vitro techniques. The latter has shown more precise non-subjective readings, on the other hand; the clinical methods provide direct chair side diagnosis for the clinical cases. The classification systems reviewed in the present study, started with the oldest trials that simply presented the root canal systems, according to the degree of angulation, or by coded Latin numbers or English letters. Then, the most recent systems were also presented that were persisted with continuous editions up to date. These new systems could briefly describe the root and root canal’s internal and external details in a small formulation, without confusion and in an easily communicated manner, highly recommended specially for students, teachers, and researchers
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References
Shrestha A, Marla V, Shrestha S, Maharjan IK. Developmental anomalies affecting the morphology of teeth–a review. RSBO. 2015;12(1):68-78. DOI: https://doi.org/10.21726/rsbo.v12i1.732
Luder HU. Malformations of the tooth root in humans. Front. Physiol.. 2015;6:307. DOI: https://doi.org/10.3389/fphys.2015.00307
Jafarzadeh H, Abbott PV. Dilaceration: review of an endodontic challenge. J Endod. 2007;33(9):1025-30. DOI: https://doi.org/10.1016/j.joen.2007.04.013
Kremeier K, Hülsmann M. Fusion and gemination of teeth: review of the literature, treatment considerations, and report of cases. ENDO. 2007;1(2).
Alani A, Bishop K. Dens invaginatus. Part 1: classification, prevalence and aetiology. Int Endod J. 2008;41(12):1123-36. DOI: https://doi.org/10.1111/j.1365-2591.2008.01468.x
Jafarzadeh H, Azarpazhooh A, Mayhall J. Taurodontism: a review of the condition and endodontic treatment challenges. Int Endod J. 2008;41(5):375-88. DOI: https://doi.org/10.1111/j.1365-2591.2008.01388.x
Kato A, Ziegler A, Higuchi N, Nakata K, Nakamura H, Ohno N. Aetiology, incidence and morphology of the C‐shaped root canal system and its impact on clinical endodontics. Int Endod J. 2014;47(11):1012-33. DOI: https://doi.org/10.1111/iej.12256
Kim H-J, Choi Y, Yu M-K, Lee K-W, Min K-S. Recognition and management of palatogingival groove for tooth survival: a literature review. JRDE. 2017;42(2):77-86. DOI: https://doi.org/10.5395/rde.2017.42.2.77
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod. topics. 2005;10(1):3-29. DOI: https://doi.org/10.1111/j.1601-1546.2005.00129.x
Cantatore G, Berutti E, Castellucci A. Missed anatomy: frequency and clinical impact. Endod. topics. 2006;15(1):3-31. DOI: https://doi.org/10.1111/j.1601-1546.2009.00240.x
Ahmed H, Versiani M, De‐Deus G, Dummer P. A new system for classifying root and root canal morphology. Int Endod J. 2017;50(8):761-70. DOI: https://doi.org/10.1111/iej.12685
Ahmed HMA, Dummer PM. A new system for classifying tooth, root and canal anomalies. Int Endod J. 2018;51(4):389-404. DOI: https://doi.org/10.1111/iej.12867
Ahmed HMA, Dummer PMH. Advantages and applications of a new system for classifying roots and canal systems in research and clinical practice. Eur Endod J. 2018;3(1):9. DOI: https://doi.org/10.5152/eej.2017.17064
Ahmed H, Neelakantan P, Dummer P. A new system for classifying accessory canal morphology. Int Endod J. 2018;51(2):164-76. DOI: https://doi.org/10.1111/iej.12800
Omer O, Al Shalabi R, Jennings M, Glennon J, Claffey N. A comparison between clearing and radiographic techniques in the study of the root‐canal anatomy of maxillary first and second molars. Int Endod J. 2004;37(5):291-6. DOI: https://doi.org/10.1111/j.0143-2885.2004.00731.x
Weng X-L, Yu S-B, Zhao S-L, Wang H-G, Mu T, Tang R-Y, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: a new modified root canal staining technique. J Endod. 2009;35(5):651-6. DOI: https://doi.org/10.1016/j.joen.2009.02.010
Robertson D, Leeb IJ, Mckee M, Brewer E. A clearing technique for the study of root canal systems. J Endod. 1980;6(1):421-4. DOI: https://doi.org/10.1016/S0099-2399(80)80218-4
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 Endod. 2010;36(9):1547-51. DOI: https://doi.org/10.1016/j.joen.2010.05.008
Fan B, Gao Y, Fan W, Gutmann JL. Identification of a C-shaped canal system in mandibular second molars—part ii: the effect of bone image superimposition and intraradicular contrast medium on radiograph interpretation. J Endod. 2008;34(2):160-5. DOI: https://doi.org/10.1016/j.joen.2007.10.010
Naoum H, Love R, Chandler N, Herbison P. Effect of X-ray beam angulation and intraradicular contrast medium on radiographic interpretation of lower first molar root canal anatomy. Int Endod J. 2003;36(1):12-9. DOI: https://doi.org/10.1046/j.0143-2885.2003.00604.x
Lacerda MF, Marceliano-Alves MF, Pérez AR, Provenzano JC, Neves MA, Pires FR, et al. Cleaning and shaping oval canals with 3 instrumentation systems: a correlative micro–computed tomographic and histologic study. J Endod. 2017;43(11):1878-84. DOI: https://doi.org/10.1016/j.joen.2017.06.032
Plotino G, Grande NM, Pecci R, Bedini R, Pameijer CH, Somma F. Three-dimensional imaging using microcomputed tomography for studying tooth macromorphology. J Am Dent Assoc. 2006;137(11):1555-61. DOI: https://doi.org/10.14219/jada.archive.2006.0091
Tseng Y-H, Tsai Y-L, Tsai TW, Lin C-P, Huang S-H, Mou C-Y, et al. Double-quantum filtered heteronuclear correlation spectroscopy under magic angle spinning. Solid State Nucl Magn Reson. 2007;31(1):55-61. DOI: https://doi.org/10.1016/j.ssnmr.2007.01.001
Baumann MA, Doll GM, Zick K. Stray-field imaging (STRAFI) of teeth. Oral Surg Oral Med Oral Pathol. 1993;75(4):517-22. DOI: https://doi.org/10.1016/0030-4220(93)90181-3
Appel TR, Baumann MA. Solid-state nuclear magnetic resonance microscopy demonstrating human dental anatomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(2):256-61. DOI: https://doi.org/10.1067/moe.2002.126019
Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT. Int Endod J. 2003;36(2):86-92. DOI: https://doi.org/10.1046/j.1365-2591.2003.00626.x
Bjørndal L, Carlsen O, Thuesen G, Darvann T, Kreiborg S. External and internal macromorphology in 3D‐reconstructed maxillary molars using computerized X‐ray microtomography. Int Endod J. 1999;32(1):3-9. DOI: https://doi.org/10.1046/j.1365-2591.1999.00172.x
Dowker S. Nondestructive three-dimensional imaging for in vitro endodontic studies. Oral Surg Oral Med Oral Pathol. 1997;83:510-6. DOI: https://doi.org/10.1016/S1079-2104(97)90155-4
Gantt DG, Kappleman J, Ketcham RA, Alder ME, Deahl TH. Three‐dimensional reconstruction of enamel thickness and volume in humans and hominoids. Eur J Oral Sci. 2006;114:360-4. DOI: https://doi.org/10.1111/j.1600-0722.2006.00337.x
Heidrich G, Hassepass F, Dullin C, Attin T, Grabbe E, Hannig C, editors. Non-destructive preclinical evaluation of the root canal anatomy of human teeth using area detector volume CT (FD-VCT). RöFo advances in the field of X-rays and imaging techniques; 2005: © Georg Thieme Verlag KG Stuttgart· New York.
Hannig C, Krieger E, Dullin C, Merten H-A, Attin T, Grabbe E, et al. Volumetry of human molars with flat panel-based volume CT in vitro. Clin. Oral Investig. 2006;10(3):253-7. DOI: https://doi.org/10.1007/s00784-006-0051-6
Jiang H, Robinson D, Yates C, Lee P, Wark J. Peripheral quantitative computed tomography (pQCT)–based finite element analysis provides enhanced diagnostic performance in identifying non-vertebral fracture patients compared with dual-energy X-ray absorptiometry. Osteoporos Int. 2020;31(1):141-51. DOI: https://doi.org/10.1007/s00198-019-05213-1
Sousa TO, Hassan B, Mirmohammadi H, Shemesh H, Haiter-Neto F. Feasibility of cone-beam computed tomography in detecting lateral canals before and after root canal treatment: an ex vivo study. J Endod. 2017;43(6):1014-7. DOI: https://doi.org/10.1016/j.joen.2017.01.025
Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J. 2007;40(10):818-30. DOI: https://doi.org/10.1111/j.1365-2591.2007.01299.x
Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. Dent J. 2006;72(1):75.
Somma F, Leoni D, Plotino G, Grande N, Plasschaert A. Root canal morphology of the mesiobuccal root of maxillary first molars: a micro‐computed tomographic analysis. Int Endod J. 2009;42(2):165-74. DOI: https://doi.org/10.1111/j.1365-2591.2008.01472.x
Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-5. DOI: https://doi.org/10.1016/0030-4220(71)90230-1
Backman CA, Oswald RJ, Pitts DL. A radiographic comparison of two root canal instrumentation techniques. J Endod. 1992;18(1):19-24. DOI: https://doi.org/10.1016/S0099-2399(06)81137-4
Dobo NC, Bernath, M. and Szabó, J., . A comparative study of six methods of shaping the root canal in vitro. . Int Endod J 1992: p.29.
Southard DW, Oswald RJ, Natkin E. Instrumentation of curved molar root canals with the roane technique. J Endod. 1987;13(10):479-89. DOI: https://doi.org/10.1016/S0099-2399(87)80015-8
Nagy CD, Szabó J, Szabó J. A mathematically based classification of root canal curvatures on natural human teeth. J Endod. 1995;21(11):557-60. DOI: https://doi.org/10.1016/S0099-2399(06)80985-4
Gupta SK, Saxena P. Proposal for a simple and effective diagrammatic representation of root canal configuration for better communication amongst oral radiologists and clinicians. J Oral Biol Craniofac Res. 2016;6(1):60-6. DOI: https://doi.org/10.1016/j.jobcr.2015.09.005
Weine F. Endodontic Therapy 3rd ed St. Louis: CV Mosby, 176, 2. 1982;19.
Vertucci F, Williams R. Root canal anatomy of the mandibular first molar. J N J Dent Assoc. 1974;45(3):27.
Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004;30(6):391-8. DOI: https://doi.org/10.1097/00004770-200406000-00004
Arnold M, Ricucci D, Siqueira JF. Infection in a Complex Network of Apical Ramifications as the Cause of Persistent Apical Periodontitis: A Case Report. J Endod. 2013;39(9):1179-84. DOI: https://doi.org/10.1016/j.joen.2013.04.036
Iqbal MK, Gartenberg J, Kratchman SI, Karabucak B, Bui B. The clinical significance and management of apical accessory canals in maxillary central incisors. J Am Dent Assoc. 2005;136(3):331-5. DOI: https://doi.org/10.14219/jada.archive.2005.0173
Kim S, Kratchman S. Modern Endodontic Surgery Concepts and Practice: A Review. J Endod. 2006;32(7):601-23. DOI: https://doi.org/10.1016/j.joen.2005.12.010
Cheung GSP, Yang J, Fan B. Morphometric study of the apical anatomy of C-shaped root canal systems in mandibular second molars. Int Endod J. 2007;40(4):239-46. DOI: https://doi.org/10.1111/j.1365-2591.2007.01193.x
De Deus QD. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod. 1975;1(11):361-6. DOI: https://doi.org/10.1016/S0099-2399(75)80211-1
American Association of Endodontics (2016) Glossary of terms.
Al‐Qudah A, Awawdeh L. Root canal morphology of mandibular incisors in a Jordanian population. Int Endod J. 2006;39(11):873-7. DOI: https://doi.org/10.1111/j.1365-2591.2006.01159.x
Çalişkan MK, Pehlivan Y, Sepetçioğlu F, Türkün M, Tuncer SŞ. Root canal morphology of human permanent teeth in a Turkish population. J Endod. 1995;21(4):200-4. DOI: https://doi.org/10.1016/S0099-2399(06)80566-2
Green D. A stereo-binocular microscopic study of the root apices and surrounding areas of 100 mandibular molars: Preliminary study. Oral Surg Oral Med Oral Pathol. 1955;8(12):1298-304. DOI: https://doi.org/10.1016/0030-4220(55)90434-5
Yoshiuchi Y., Yokochi K. Studies on the anatomical forms of the pulp cavities with new method of vaccum inje ction,. Shika Kiso Igakkai zasshi. 1972;14(2):156-85. DOI: https://doi.org/10.2330/joralbiosci1965.14.156
Yoshida H, Yakushiji M, Sugihara A, Tanaka K, Taguchi M. [Accesory canals at floor of the pulp chamber of primary molars (author's transl)]. Shikwa Gakuho. 1975;75(3):580-5.
Versiani M.A. O-ZR. Root Canal Anatomy: Implications in Biofilm Disinfection. Springer Series on Biofilms ed. Chávez de Paz L. SC, Kishen A., editor. Berlin, Heidelberg.: Springer; 2015. DOI: https://doi.org/10.1007/978-3-662-47415-0_7
Satoru Matsunaga YS, Hideaki Kinoshita, Masashi Yamada, Akinobu Usami, Yuichi Tamatsu, Shinichi Abe. Morphologic Classification of Root Canals and Incidence of Accessory Canals in Maxillary First Molar Palatal Roots: Three-Dimensional Observation and Measurements using Micro-CT. J Hard Tissue Biol. 2014;23(3):329-34. DOI: https://doi.org/10.2485/jhtb.23.329
Ozcan G, Sekerci A, Kocoglu F. C-shaped mandibular primary first molar diagnosed with cone beam computed tomography: A novel case report and literature review of primary molars' root canal systems. J Indian Soc Pedod Prev Dent. 2016;34(4):397-404. DOI: https://doi.org/10.4103/0970-4388.191438
Neboda C, Anthonappa RP, King NM. Preliminary investigation of the variations in root canal morphology of hypomineralised second primary molars. Int J Paediatr Dent. 2018;28(3):310-8. DOI: https://doi.org/10.1111/ipd.12356
Ahmed H. Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth. Int Endod J. 2013;46(11):1011-22. DOI: https://doi.org/10.1111/iej.12134
El Hachem C, Kaloustian M, Nehme W, Ghosn N, Abou Chedid J. Three-dimensional modeling and measurements of root canal anatomy in second primary mandibular molars: a case series micro CT study. Eur Arch Paediatr Dent. 2019;20(5):457-65. DOI: https://doi.org/10.1007/s40368-019-00426-8
Reddy NV, Daneswari V, Patil R, Meghana B, Reddy A, Niharika P. Three-dimensional assessment of root canal morphology of human deciduous molars using cone beam computed tomography: An In vitro Study. Int. J. Pedod.Rehabil. 2018;3(1):36. DOI: https://doi.org/10.4103/ijpr.ijpr_21_17
Rimondini L, Baroni C. Morphologic criteria for root canal treatment of primary molars undergoing resorption. Dent Traumatol. 1995;11(3):136-41. DOI: https://doi.org/10.1111/j.1600-9657.1995.tb00475.x
Waterhouse PJ WJ, Camp JH, Fuks AB Pathways of the Pulp 10th ed. Hargreaves K CS, editor: St. Louis, Mosby Elsevier; 2011. 808–57 p. DOI: https://doi.org/10.1016/B978-0-323-06489-7.00023-0
Ahmed HMA, Musale PK, El Shahawy OI, Dummer PMH. Application of a new system for classifying tooth, root and canal morphology in the primary dentition. Int Endod J. 2020;53(1):27-35. DOI: https://doi.org/10.1111/iej.13199
Ahmed HM, Versiani MA, De-Deus G, Dummer PM. New proposal for classifying root and root canal morphology. The Root Canal Anatomy in Permanent Dentition. 2019:47-56. DOI: https://doi.org/10.1007/978-3-319-73444-6_4