3-Dimensional Analysis and Systematic Review of Root Canal Morphology and Physiological Foramen Geometry of 109 Mandibular First Premolars by Micro-computed Tomography in a Mixed Swiss-German Population.

Wolf, Thomas Gerhard; Kim, Paul; Campus, Guglielmo Giuseppe; Stiebritz, Michael; Siegrist, Mark; Briseño Marroquin, Benjamin (2020). 3-Dimensional Analysis and Systematic Review of Root Canal Morphology and Physiological Foramen Geometry of 109 Mandibular First Premolars by Micro-computed Tomography in a Mixed Swiss-German Population. Journal of endodontics, 46(6), pp. 801-809. Elsevier 10.1016/j.joen.2020.03.002

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INTRODUCTION

The aim of this study was to systematically revise the root canal configuration (RCC) literature and to investigate the root canal morphology of mandibular first premolars (Ma1Ps) of 2 populations by means of micro-computed tomographic imaging.

METHODS

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including RCC randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies. Furthermore, the RCC, physiological foramina, the frequency of accessory and connecting canals, and the physiological foramina morphology of 109 Ma1Ps were investigated by means of micro-computed tomographic imaging. The RCC results are described using a 4-digit system code.

RESULTS

The most frequent RCCs observed were 1-1-1/1 (70.6%), 1-1-2/2 (7.3%), 1-2-2/2 (7.3%), and 1-2-1/1 (5.5%). Accessory canals were observed in 31.2%. Connecting canals were observed in 1-1-2/2 (4.6%), 1-2-2/2 (4.6%), 1-1-2/1 (1.8%), and 1-2-1/1 (1.8%) RCCs. Accessory foramina were observed in 52.3%; 30.3% of the Ma1Ps had 1 accessory foramen, 12.8% had 2, 2.8% had 3, 2.8% had 4, 2.8% had 5, and 0.92% had 6. The narrow and wide diameter mean of 136 physiological foramina was 0.28 mm (±0.9) and 0.37 mm (±0.11) when only 1 physiological foramen was present.

CONCLUSIONS

This study provides detailed root canal morphology of Ma1Ps in a Swiss-German population. Within the limitations of the study, the authors recommend a final physiological foramen preparation size of instrument tip sizes 30-40; yet, such a decision should be carefully considered on an individual basis.

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