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A comprehensive understanding of the root structure is important for the successful outcome of endodontic procedures. Lack of knowledge of the anatomic variations in root canal morphology can contribute to the failure of root canal therapy. One of the most anatomically diverse tooth groups is the upper first premolar. The incidence of two root canals is the most predominant anatomy observed for maxillary first premolar however some anatomical variations are also observed. The most frequent anatomical variation in these teeth is the existence of three roots with three canals. The objective of this study is to report a similar case of maxillary first premolar having three roots with separate 3 canals. Endodontic success requires a thorough understanding of root canal anatomy. The variation in the number of roots, canals, root direction, longitudinal depressions of the roots, the various shapes of the pulp cavity and the problems in visualizing the apical limit by radiographs make the endodontic procedure of these teeth quite challenging. [ABSTRACT FROM AUTHOR]

Introduction The primary aim of the study is to evaluate the morphological form of the maxillary first premolar using 2D geomorphometry and evaluate the sexually dimorphic characteristics. Methods The present study was carried out on standardized photographs of right Maxillary first premolar from 120 dental casts (60 male and 60 females). Twenty landmarks (based on geometric and anatomic evidence) were marked on the tooth using TPSdig software and analysed using Morpho J applying procrustes analysis and discriminant function analysis. Results The results showed similar centroid sizes between gender (p = 0.541). Procrustes ANOVA for shape analysis showed a greater dimorphism between sexs (f value of 1.35; p value=0.0793). Discriminant function analysis based on the procrustes coordinates showed an overall accuracy of 74.2 % in classifying sex based on the landmark coordinates with correct classification of 48/60 (80.00%) females and 41/60 (68.33) males. Conclusion Shape of the tooth can be measured objectively using geometric morphometric methods which can be utilized to identify the sex of an individual. The enamel is derived from ectoderm and once formed does not change during the life. The tooth’s structure and shape are determined by the sex chromosomes, which is well represented as sexual dimorphism. The study evaluates the occlusal and contact area morphology of premolars. These are important parameters considered during restorative treatment, functional rehabilitation and forensic investigations.

Introduction The primary aim of the study is to evaluate the morphological form of the maxillary first premolar using 2D geomorphometry and evaluate the sexually dimorphic characteristics. Methods The present study was carried out on standardized photographs of right Maxillary first premolar from 120 dental casts (60 male and 60 females). Twenty landmarks (based on geometric and anatomic evidence) were marked on the tooth using TPSdig software and analysed using Morpho J applying procrustes analysis and discriminant function analysis. Results The results showed similar centroid sizes between gender (p = 0.541). Procrustes ANOVA for shape analysis showed a greater dimorphism between sexs (f value of 1.35; p value=0.0793). Discriminant function analysis based on the procrustes coordinates showed an overall accuracy of 74.2 % in classifying sex based on the landmark coordinates with correct classification of 48/60 (80.00%) females and 41/60 (68.33) males. Conclusion Shape of the tooth can be measured objectively using geometric morphometric methods which can be utilized to identify the sex of an individual. The enamel is derived from ectoderm and once formed does not change during the life. The tooth’s structure and shape are determined by the sex chromosomes, which is well represented as sexual dimorphism. The study evaluates the occlusal and contact area morphology of premolars. These are important parameters considered during restorative treatment, functional rehabilitation and forensic investigations.

Introduction The primary aim of the study is to evaluate the morphological form of the maxillary first premolar using 2D geomorphometry and evaluate the sexually dimorphic characteristics. Methods The present study was carried out on standardized photographs of right Maxillary first premolar from 55 dental casts (33 male and 22 females). Nineteen landmarks (based on geometric and anatomic evidence) were marked on the tooth using TPSdig software and analysed using Morpho J applying procrustes analysis and discriminant function analysis Results The results showed similar centroid sizes between gender (p = 0.606). Procrustes ANOVA for shape analysis showed a greater dimorphism between sexs (f value of 1.4; p value=0.0624). Discriminant function analysis based on the procrustes coordinates showed an overall accuracy of 90.91 % in classifying sex based on the landmark coordinates with correct classification of 20/22 (90.99%) females and 30/33 (90.91) males. Conclusion Shape of the tooth can be measured objectively using geometric morphometric methods which can be utilized to identify the sex of an individual. Enamel covering the crown of the teeth is biologically stable resisting climatic, physical and chemical insults. The enamel is derived from ectoderm and once formed does not change during the life. The tooth’s structure and shape are determined by the sex chromosomes, which is well represented as sexual dimorphism. The study evaluates the occlusal and contact area morphology of premolars. These are important parameters considered during restorative treatment, functional rehabilitation and forensic investigations.

Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned, bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems.

Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned, bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems. [ABSTRACT FROM AUTHOR]

Introduction: The understanding of canal morphology helps the clinician to conduct endodontic procedures effectively. The aim of the study was to assess the morphological variations in canals of maxillary premolars, and categorize them in accordance with Vertucci's classification. Materials and Methods: Cone-beam computerized tomography (CBCT) images were taken from the archives of Islamabad Diagnostic Center. Investigations were carried out by employing CBCT images of 120 individuals. The images of maxillary first (n = 203) and second premolars (n = 205) were analyzed in the axial, sagittal, and coronal planes. The number of canals, roots, and categorization as per the Vertucci's classification was recorded. Data were statistically analyzed by using SPSS 23. Results: The 88.7% maxillary first premolars were found to have two roots and 78% of second premolars were single rooted. The most common Vertucci configuration among first premolars was Type IV (55.3%) and second premolars were Type I (66.8%). The gender-wise difference in the frequency of one- and two-rooted second maxillary premolars was statistically significant (P = 0.01). The gender-wise difference in the frequency of different Vertucci subclassifications for the second maxillary premolars teeth was statistically significant (P = 0.01). Conclusion: The maxillary premolars showed configuration variations in the Pakistani subpopulation.

Aim: The presence of a furcation groove on the palatal aspect of bifurcated maxillary first premolars (MFPs) leaves the dentine cementum wall (DCW) thickness critically thin in this region of the root. The purpose of this study was to evaluate the morphology of the furcation groove and the DCW thickness along the groove before and after root canal instrumentation, utilising cone beam computed tomography (CBCT). Materials and methods: Twenty-five human MFPs with bifurcated roots and furcation groove were divided into three groups according to one of three file systems: Hyflex CM, ProTaper Next (PTN) and Self-Adjusting File (SAF). Pre-instrumentation CBCT analysis was performed for the location, length, beginning and end of groove, and measurement of the minimum DCW thickness along the length of the groove. Post-instrumentation CBCT scans were analysed again for residual DCW thickness. The amount and percentage of cut dentine were calculated. Results: The groove began at a mean distance of 1.88 ± 0.13 mm above the bifurcation in 16 out of 25 samples, with a mean length of 5.61 ± 0.38 mm and a mean maximum depth of 0.7 ± 0.15 mm, located at a mean distance of 4.92 ± 0.15 mm above the apex. Preoperatively, the mean DCW thickness was 0.73 ± 0.07 mm. Post-instrumentation, statistically significant reductions in DCW thickness were observed with Hyflex 40/4% (P value = 0.0002), PTN X3 and X4 (P = 0.0002 and <0.0001) and SAF (P = 0.0002). Conclusions: Instrumentation of buccal canals of MFPs with furcation grooves should be performed using files with smaller tip sizes and minimum taper. [ABSTRACT FROM AUTHOR]

Introduction The primary aim of the study is to evaluate the morphological form of the maxillary first premolar using 2D geomorphometry and evaluate the sexually dimorphic characteristics. Methods The present study was carried out on standardized photographs of right Maxillary first premolar from 55 dental casts (33 male and 22 females). Nineteen landmarks (based on geometric and anatomic evidence) were marked on the tooth using TPSdig software and analysed using Morpho J applying procrustes analysis and discriminant function analysis Results The results showed similar centroid sizes between gender (p = 0.606). Procrustes ANOVA for shape analysis showed a greater dimorphism between sexs (f value of 1.4 ; p value=0.0624). Discriminant function analysis based on the procrustes coordinates showed an overall accuracy of 90.91 % in classifying sex based on the landmark coordinates with correct classification of 20/22 (90.99%) females and 30/33 (90.91) males. Conclusion Shape of the tooth can be measured objectively using geometric morphometric methods which can be utilized to identify the sex of an individual. Enamel covering the crown of the teeth is biologically stable resisting climatic, physical and chemical insults. The enamel is derived from ectoderm and once formed does not change during the life. The tooth's structure and shape are determined by the sex chromosomes, which is well represented as sexual dimorphism. The study evaluates the occlusal and contact area morphology of premolars. These are important parameters considered during restorative treatment, functional rehabilitation and forensic investigations.

The maxillary first premolar (MFP) presents a highly variable and complex root morphology; it is also one of the teeth most likely to suffer vertical root fractures. The aim of this study was to describe the morphology of the root and root canal system of the MFP in a Chilean population using Cone-Beam Computed Tomography (CBCT). One hundred and twenty-one MFP were evaluated (60 left and 61 right), belonging to subjects of both sexes. Descriptive and statiscal analysis of the data was carried out, with a value of P < 0.05 being statistically significant. One root was observed in 71 % of teeth and two roots in 29 %; statistically significant differences were observed in the number of roots by sex (p<0.05). Two root canals were found in 69.5 % of teeth and one canal in 30.5 %. In terms of morphological classification, 41.3 % of cases were Vertucci Type IV. The proximal cementodentinal walls were the thinnest. The MFP presented a high degree of morphological variation in a Chilean subpopulation. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to investigate the root canal anatomy of maxillary premolars in a North Indian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 101 extracted maxillary first and second premolars were analyzed, and data were recorded to determine length of the tooth, number of roots, bifurcation level in double rooted teeth, number of apical foramina, and anatomy of the root canal system. Results: Most maxillary first premolars were double rooted (57.7%), while maxillary second premolars were predominantly single rooted (83.6%). The average length of the maxillary first premolar was 21.6 mm and second premolar was 21.3 mm. All double-rooted maxillary premolars had two canals. Single canal (at apex) was more prevalent in single-rooted maxillary premolars (86% in first premolar and 73% in second premolar). In double-rooted maxillary first premolar, the most prevalent canal type was Type IV (34.6%), followed by Type I (23.1%) and Type V (17.3%), and in maxillary second premolars, the dominant canal morphology was Type II (32.6%), followed by Type IV (22.4%) and Type I (20.4%). Conclusion: In North Indian subpopulation, most maxillary first premolars have double roots with two root canals, while second premolars are predominantly single rooted with single canals. Maxillary premolars can show all types of Vertucci's root canal anatomy with most prevalent being Type IV in double-rooted maxillary first premolars, Type I in single rooted maxillary first premolars, and Type II in maxillary second premolars.

A variety of shapes has been reported for the roots and root canals of maxillary first premolars. The purposes of the present study were to determine branching and shapes of the roots of maxillary first premolars, as well as age-related changes using slice images obtained with cone-beam computed tomography (CBCT) for dental use. CBCT-reconstructed images of 125 cases that included maxillary first premolars were used as subjects. Slice images at the cervical one-third, center, and apical one-third positions of the root were prepared. Root branching and number of root canals was determined at each measurement position in the images. The subjects were divided into three groups: younger than 30 years, 30 to 50 years, and over 50 years. The root canal morphology was compared among these age groups. Single-rooted premolars were the most frequent. As for number of root canals, a single-canal premolar was observed at the position of the cervical one-third in 33.6%, at the center in 35.2%, and at the apical one-third in 56.0%. Thereafter the subjects were divided into groups by age, namely, younger than 30 years, 30 to 50 years, and over 50 years old, and it was revealed that the ratio of the two-canal type increased with age. In regard to tooth morphology, it was confirmed that the two-canal type shows more frequent occurrence with aging in maxillary first premolar. Based on our findings, we consider that CBCT can be useful for determining the root canal morphology with complicated shapes. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyze root form and morphology of human maxillary first permanent premolars of an Indo-Dravidian population from southern India. Materials and Methods: Eight hundred and twenty-two maxillary first permanent premolars were cleansed and stored appropriately. Morphology and root form analysed, segregated into Groups (Gps): Gp I, Gp II, and Gp III, and later divided into subgroups (SGs) based on specific criteria. Gp I was divided into two SGs: SG A (minimal or absence of grooving in the root) (n = 252) and SG B (clear and defined longitudinal groove in the root) (n = 104), and Gp II was divided into SG C (roots dividing in coronal one-third) (n = 154), SG D (roots dividing in the middle one-third) (n = 158), and SG E (roots dividing in the apical one third) (n = 138). Gp III consisted of only one SG F (teeth with three roots) (n = 16). The groups were analyzed separately, their external root form and morphology were recorded. Root form was analyzed, and results were tabulated. This study was compared with other studies and statistically analyzed. Results: Gp II was common with an incidence of 54.74%. Gp I was the next most common with an incidence of 43.3%. Gp III was the least common with an incidence of 1.94%. The number and distribution of roots was also computed. Six types of root form were identified (Type [Ty] A = 30.65%, Ty B = 12.65%, Ty C = 18.73%, Ty D = 19.22%, Ty E = 16.78%, and Ty F = 1.94%). Conclusion: Awareness and assessment of root form, number preoperatively with regard to specific populations before initiation will pave way for successful outcome of therapy.

This study aims to report the endodontic management of the maxillary first premolar with three roots, using cone-beam computed tomography (CBCT) and an operating microscope. Most maxillary first premolars have two roots, buccal and palatal but it may rarely have three. The incidence of three separate roots in maxillary first premolars ranges between 0.5% and 6%. Variation in root anatomy makes root canal treatment challenging necessitating improved technology. CBCT imaging provides precise location and visualization of root morphology, and canal anatomy. Operating microscope provides better lighting, magnification, and visualization of the operative field that helps to recognize and locate additional roots canals. This article reports the endodontic management of a maxillary right first premolar with three separate roots.

Objective: To determine the frequency of the number of roots and root canals in a sample of 250 extracted maxillary first premolar teeth of patients visiting Peshawar Dental College and Hospital Khyber Pakhtunkhwa. Study Design: Cross Sectional. Setting: Department of Oral Biology, Peshawar Dental College and Hospital Khyber Pakhtunkhwa. Period: April 2016 to December 2016. Material & Methods: A total of 250 extracted human maxillary first premolars were collected from the Department of Oral & Maxillofacial Surgery, Peshawar Dental College, and Hospital Khyber Pakhtunkhwa. All teeth were visually inspected to count the number of roots. Subsequently, the access cavity was prepared, and pulp extirpated from each tooth. Endodontic explorer was used to locate the canal orifice(s) at the pulp chamber floor. Later the root canal orifices were injected with India ink to stain the canals. After that roots of teeth were sectioned at different levels to note down the number of canals. Data were analyzed using SPSS version 19. The statistical significance of the variations from mean values was considered significant if the p-value was less than 0.05. Results: Out of 250 maxillary first premolar teeth, 44.8% had one root, 40.4% had two separate and 12.8% had two fused roots. Three roots were seen in 2.0% teeth. Two root canals were present in the vast majority (70.4%), whereas one and three root canals were seen in 27.6% and 2.0% teeth, respectively. The correlation between the number of roots and root canals of maxillary first premolar teeth was highly significant. Conclusions: There was a high frequency of maxillary first premolars with two roots and two root canals. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyze incidence of three canals in human permanent maxillary first premolar teeth using cone beam tomographic techniques. Materials and Methods: The samples were divided into three groups namely Group (GP) I (single rooted [n = 255]), GP II (two rooted [n = 326]), and GP III (three rooted [n = 8)]. The teeth were processed, mounted in arches, coded, and subjected to cone beam tomographic scanning. Incidence of three canals was evaluated by cone beam tomography, compared, and statistically analyzed. Results: The percentage of incidence of three canals in human permanent maxillary first premolar teeth was 1.7% and there was no statistically significant difference of incidence of three canals between studies using cone beam and non-cone beam methodologies. Conclusion: Clinicians should be aware of the variations they may encounter when endodontically treating a maxillary first permanent premolar and should apply this knowledge in a clinical scenario systematically.

Cone Beam Computed Tomography (CBCT) is a radiographic imaging technique which provides accurate, high-quality, threeDimensional (3D) images of various parts of head and neck. They deliver images with a spatial resolution of teeth required for diagnosis, treatment planning and postoperative evaluation. The aim of this case series is to describe the importance of determining the root canal morphology with the help of CBCT. This case series presents the endodontic management of a three rooted maxillary first premolar, maxillary first molar with single palatal root and three canals and mandibular first molar with five canals using CBCT. The axial images from CBCT show Gulabivwala K Type I (3-1) canal pattern in distal root of mandibular first molar (36) and palatal root of maxillary first molar (26) according to Al-Quadah Awawdeh showed Type XXII (3-2-1) canal configuration. Biomechanical preparations of all the teeth were done with hand as well as rotary file systems and lateral compaction obturation technique was used. With the advancing technology in imaging, there are possibilities to detect and treat a number of variations particularly in posterior teeth leading to successful endodontic treatment.

Cone Beam Computed Tomography (CBCT) is a radiographic imaging technique which provides accurate, high-quality, three- Dimensional (3D) images of various parts of head and neck. They deliver images with a spatial resolution of teeth required for diagnosis, treatment planning and postoperative evaluation. The aim of this case series is to describe the importance of determining the root canal morphology with the help of CBCT. This case series presents the endodontic management of a three rooted maxillary first premolar, maxillary first molar with single palatal root and three canals and mandibular first molar with five canals using CBCT. The axial images from CBCT show Gulabivwala K Type I (3-1) canal pattern in distal root of mandibular first molar (36) and palatal root of maxillary first molar (26) according to Al-Quadah Awawdeh showed Type XXII (3-2-1) canal configuration. Biomechanical preparations of all the teeth were done with hand as well as rotary file systems and lateral compaction obturation technique was used. With the advancing technology in imaging, there are possibilities to detect and treat a number of variations particularly in posterior teeth leading to successful endodontic treatment. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study was to investigate variations in the root canal systems of permanent maxillary first premolars in a Yemeni population using a clearing technique. Methods Two hundred fifty permanent maxillary first premolar teeth extracted from Yemeni individuals were collected. A small hole in the center of the occlusal surface of each tooth was prepared and pulp tissue was removed by immersion in 5.25% sodium hypochlorite. Teeth were stored in 5–10% nitric acid solution for 5–6 days. Next, teeth were rinsed, dried, and dehydrated using ascending concentrations of ethanol (70, 95, and 100%) successively for 12 h each. Waterproof black ink was injected into the dried dehydrated teeth. Stained teeth were then rendered clear by immersion in methyl salicylate solution (98%) until evaluation. Root canal morphology of each tooth was then examined. Results 54.8% of teeth were single-rooted, while 44.4% were double-rooted and only 0.8% had three separated roots. The most common canal system configuration was Vertucci type IV (55.6%). Eight specimens of the single-rooted premolars (3.2%) had new canal configurations that have not been recognized in previous published studies. Accessory canals and inter-canal communications were detected in a total of 52.8 and 34.4% of the specimens, respectively. The apical foramen was located centrally to the apex in 84.9% and apical deltas were found in 13.2% of the studied sample. Conclusions Yemeni permanent maxillary first premolars are mainly single-rooted and predominantly present Vertucci type IV canal morphology. The finding of additional canal configurations in this study is low but should be kept in mind when performing endodontic therapy for these teeth.

Aim: The current study aimed to investigate the root canal anatomy and their variations associated with premolar teeth in a defined population using tooth-clearing technique. Materials and Methods: Three hundred extracted premolar teeth (maxillary and mandibular) were collected from western Maharashtra (Pune). Access cavities were prepared and samples were placed in 2.5% sodium hypochlorite for 48 h. They were then decalcified with 5% nitric acid, dehydrated, and rendered clear by immersion in methyl salicylate, and methylene blue dye was injected. After staining, cleared teeth were evaluated for (i) number of roots and root canals, (ii) number of apical foramina, (iii) shape of root, (iv) type of root canal based on Vertucci's classification, (v) presence of lateral canals and their locations, and (vi) presence of root curvatures. Results: Vertucci Type I canal configuration represented the highest percentage (72.66%) followed by Type II (11.66%), Type III (6.33%), Type IV (4.66%), Type VI (2.66%), Type V (1.66%), Type VIII (0.66%), and C shaped (2.33%). Accessory canals were detected in 22.8% and intercanal connections were observed in 24.8% while 54% showed apical delta. Conclusion: Such knowledge is clinically useful for localization, negotiation, and subsequent management of premolar teeth in the studied population.

The root canal system of the maxillary first premolar (MFP), present a high rate of variation, especially at apical level. This complicates the action of antiseptic solutions and endodontic instruments at this level. The object of this in vivo study was to analyse by Cone Beam Computed Tomography (CBCT) the radicular and canalicular morphology of MFP in a Chilean sub-population. We carried out a cross sectional, descriptive and observational in vivo study with CBCT examinations of 70 MFP, both left and right. The data were analysed using descriptive statistics (mean (M), standard deviation (SD), with a confidence interval of 95 %), and one-factor ANOVA was used to relate the sections observed. Tooth 1.4 presented one root in 64.86 % of cases and two roots in 35.15 %. Tooth 2.4 presented one root in 66.67 % of cases and two roots in 33.33 %. The frequency of one and two canals was observed to be 30 % and 70 % respectively. The walls with the smallest cementodentinal thickness were the mesial (1.11±0.55) and distal (1.08±0.52). The thickest dentinal wall was the palatine (2.07±1.29), followed by the buccal (1.6±1.0). No statistical differences between males and females were found in the thickness of the root wall, nor in the location of the premolar in the maxilla (p>0.05). In conclusion, the root morphology of the MFP is highly variable. Care must be taken not to over-instrument the proximal walls to avoid perforations or fractures. CBCT has proved to be a useful and effective diagnostic tool for in vivo study of dental morphology. [ABSTRACT FROM AUTHOR]

This study aims to report the endodontic management of the maxillary first premolar with three roots, using cone-beam computed tomography (CBCT) and an operating microscope. Most maxillary first premolars have two roots, buccal and palatal but it may rarely have three. The incidence of three separate roots in maxillary first premolars ranges between 0.5% and 6%. Variation in root anatomy makes root canal treatment challenging necessitating improved technology. CBCT imaging provides precise location and visualization of root morphology, and canal anatomy. Operating microscope provides better lighting, magnification, and visualization of the operative field that helps to recognize and locate additional roots canals. This article reports the endodontic management of a maxillary right first premolar with three separate roots. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyze root form and morphology of human maxillary first permanent premolars of an Indo-Dravidian population from southern India. Materials and Methods: Eight hundred and twenty-two maxillary first permanent premolars were cleansed and stored appropriately. Morphology and root form analysed, segregated into Groups (Gps): Gp I, Gp II, and Gp III, and later divided into subgroups (SGs) based on specific criteria. Gp I was divided into two SGs: SG A (minimal or absence of grooving in the root) (n = 252) and SG B (clear and defined longitudinal groove in the root) (n = 104), and Gp II was divided into SG C (roots dividing in coronal one-third) (n = 154), SG D (roots dividing in the middle one-third) (n = 158), and SG E (roots dividing in the apical one third) (n = 138). Gp III consisted of only one SG F (teeth with three roots) (n = 16). The groups were analyzed separately, their external root form and morphology were recorded. Root form was analyzed, and results were tabulated. This study was compared with other studies and statistically analyzed. Results: Gp II was common with an incidence of 54.74%. Gp I was the next most common with an incidence of 43.3%. Gp III was the least common with an incidence of 1.94%. The number and distribution of roots was also computed. Six types of root form were identified (Type [Ty] A = 30.65%, Ty B = 12.65%, Ty C = 18.73%, Ty D = 19.22%, Ty E = 16.78%, and Ty F = 1.94%). Conclusion: Awareness and assessment of root form, number preoperatively with regard to specific populations before initiation will pave way for successful outcome of therapy. [ABSTRACT FROM AUTHOR]

Aim: To report the root canal treatment performed on a three-rooted maxillary first premolar. Summary: Many of the difficulties found in endodontic therapy are caused by variations in root canal anatomy. Most commonly bi-rooted, the maxillary first premolar can also have three roots with three independent canals at the apex. This case report describes the root canal treatment performed on a maxillary first premolar with three independent root canals in three distinct roots. Good knowledge of the endodontic anatomy and good interpretation of the periapical radiographs are very important skills in recognising the unusual morphology of the teeth and performing a predictable endodontic treatment. Special care needs to be taken during clinical examination, refining the access cavity, locating the orifices of the root canals on the pulpal floor and cleaning, shaping and filling all identified root canals [ABSTRACT FROM AUTHOR]

Objective: Endodontically treated maxillary first premolars present a restorative challenge. The objective of the present study was to assess the resistance to fracture of crowned endodontically treated maxillary first premolars under simulated occlusal load, while preserving various degrees of remaining coronal structure. Methods and Materials: The study consisted of 50 intact maxillary first premolars with bifurcated roots and similar root diameter and length, randomly divided into 5 equal experimental groups. All dowels were luted with Flexi-Flow titanium-reinforced composite resin cement. TiCore titanium-reinforced composite resin was used to fabricate the core. Complete cast crowns were fabricated and cemented with zinc phosphate cement. Forces at fracture and mode of failure were recorded. Results: Statistically significant differences (P < .05) were found among mean failure forces for all tested groups in their resistance to fracture under load with the Kruskal-Wallias test and among all combinations of the 5 groups (Z = -1.56/ -2.34; P > .05) with the Mann-Whitney test. This indicates that crowned maxillary first premolars with varying degrees of remaining coronal structure differ significantly in their resistance to fracture under occlusal load. There was increased protection against fracture under occlusal loads with more remaining tooth structure. Conclusions: Within the limitations of this study, remaining coronal structure influenced the fracture resistance of crowned endodontically treated maxillary first premolars. Preservation of tooth structure is important for its protection against fracture under occlusal loads and may influence the tooth prognosis. [ABSTRACT FROM AUTHOR]

Labial mucosal fenestration of the root apex is an uncommon occurrence. An unusual case involving a maxillary right first premolar is described. When presented, the tooth was nonvital with the buccal root apex readily seen through a soft tissue and bone fenestration. Conventional endodontic treatment with gutta percha failed to resolve the problem. Periodontal surgery with a laterally positioned pedicle flap was thus scheduled. At the 1-month recall, complete healing was evident in the surgical site, and the fenestrated area of the maxillary right first premolar was filled with healthy mucosal tissue. One-year postoperatively, the mucosa remained covered, and there was radiographic evidence of bone infilling in the periapical region. [ABSTRACT FROM AUTHOR]

Objective: To determine the root morphology, tooth and root length of maxillary first premolars in Indian and Filipino population. Materials and Methods: A total of 121 maxillary first premolars that were extracted for routine orthodontic procedure were examined in this study. The root forms were identified as one root, two roots, three roots and fused roots. The root length is measured from middle of cemento-enamel junction of buccal aspect and the tooth length is measured from tip of buccal cusp to the root apex using a digital vernier caliper. Root length and tooth length comparisons between gender and two races were done by independent t-test. Results: In our study, 49.22% and 60.7% of the Indian and Filipino samples are found to have single root respectively. In the present study the mean tooth length was 21.97 mm in Indian samples and 21.45 mm in Filipino sample. The mean root lengths were 13.46 mm and 13.39 mm in Indian and Filipino sample respectively. No significant correlation among age and gender was noted. Conclusion: Most the maxillary first premolars in Indian and Filipino were single rooted. The mean tooth length was 21.97 mm in Indian samples and 21.45 mm in Filipino sample and the mean root lengths were 13.46 mm and 13.39 mm in Indian and Filipino sample respectively. [ABSTRACT FROM AUTHOR]

Introduction: The primary aim of the study is to evaluate the morphological form of the maxillary first premolar using 2D geomorphometry and evaluate the sexually dimorphic characteristics., Methods: The present study was carried out on standardized photographs of right Maxillary first premolar from 120 dental casts (60 male and 60 females). Twenty landmarks (based on geometric and anatomic evidence) were marked on the tooth using TPSdig software and analysed using Morpho J applying procrustes analysis and discriminant function analysis., Results: The results showed similar centroid sizes between gender (p = 0.541). Procrustes ANOVA for shape analysis showed a greater dimorphism between sexs (f value of 1.35; p value=0.0793).  Discriminant function analysis based on the procrustes coordinates showed an overall accuracy of 74.2 % in classifying sex based on the landmark coordinates with correct classification of  48/60 (80.00%) females and 41/60 (68.33) males., Conclusion: Shape of the tooth can be measured objectively using geometric morphometric methods which can be utilized to identify the sex of an individual. The enamel is derived from ectoderm and once formed does not change during the life. The tooth's structure and shape are determined by the sex chromosomes, which is well represented as sexual dimorphism. The study evaluates the occlusal and contact area morphology of premolars. These are important parameters considered during restorative treatment, functional rehabilitation and forensic investigations., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Natarajan S et al.)

Aim: This study aimed to analyze incidence of three canals in human permanent maxillary first premolar teeth using cone beam tomographic techniques. Materials and Methods: The samples were divided into three groups namely Group (GP) I (single rooted [n = 255]), GP II (two rooted [n = 326]), and GP III (three rooted [n = 8)]. The teeth were processed, mounted in arches, coded, and subjected to cone beam tomographic scanning. Incidence of three canals was evaluated by cone beam tomography, compared, and statistically analyzed. Results: The percentage of incidence of three canals in human permanent maxillary first premolar teeth was 1.7% and there was no statistically significant difference of incidence of three canals between studies using cone beam and non-cone beam methodologies. Conclusion: Clinicians should be aware of the variations they may encounter when endodontically treating a maxillary first permanent premolar and should apply this knowledge in a clinical scenario systematically. [ABSTRACT FROM AUTHOR]

A deep knowledge of the internal and external anatomy of various human teeth is a backbone for a successful outcome of endodontic therapy. Usually, maxillary first premolar tooth has two roots, buccal and palatal. Three-rooted maxillary first premolar is scarce. The clinician has to expect any variation in root canal system and use the best diagnostic tools to manage the cases. The aim of this case report was to illustrate bilateral three-rooted maxillary first premolars and to describe the endodontic implication in preoperative assessment and during operative procedures.

By means of a finite element method (FEM), the present study evaluated the effect of fiber post (FP) placement on the stress distribution occurring in endodontically treated upper first premolars (UFPs) with mesial–occlusal–distal (MOD) nanohybrid composite restorations under subcritical static load. FEM models were created to simulate four different clinical situations involving endodontically treated UFPs with MOD cavities restored with one of the following: composite resin; composite and one FP in the palatal root; composite and one FP in the buccal root; or composite and two FPs. As control, the model of an intact UFP was included. A simulated load of 150 N was applied. Stress distribution was observed on each model surface, on the mid buccal–palatal plane, and on two horizontal planes (at cervical and root-furcation levels); the maximum Von Mises stress values were calculated. All analyses were replicated three times, using the mechanical parameters from three different nanohybrid resin composite restorative materials. In the presence of FPs, the maximum stress values recorded on dentin (in cervical and root-furcation areas) appeared slightly reduced, compared to the endodontically treated tooth restored with no post; in the same areas, the overall Von Mises maps revealed more favorable stress distributions. FPs in maxillary premolars with MOD cavities can lead to a positive redistribution of potentially dangerous stress concentrations away from the cervical and the root-furcation dentin.

This case study reviewed conventional root canal treatment of a maxillary root canal treatment which unexpectedly had a single canal with two foramens. This tooth was recognized as the last frequent tooth appeared neither with additional canal nor unusual root anatomy. Retreatment for this case was successful through widening of the access cavity and the root canal. While trying the master cone, it revealed that the canal splitted and had two foraments. A thorough knowledge of the root canal anatomy as well as careful radiograph interpretations were essential in enhancing the root-cleaning procedure.

Bu vaka raporu ekstra bir kanal ve meziodistal fraktür hattına sahip üst birinci küçük azı dişinin başarılı bir kök kanal tedavisi yenilemesini sunmaktadır. Üst birinci küçük azı dişe kök kanal tedavisi yaptırmış olan 59 yaşında bayan hasta kliniğimize bu bölgesinden rahatsız olması ve ağız içi fistül nedeniyle başvurmuştur. Radyografik muayenesinde tespit ve tedavi edilememiş bir başka kök kanalından şüphelenilmiştir. Bu nedenle önceki kök kanal dolgusu söküldü (1 distobukkal kanal ve 1 palatinal kanal) ardından 2 bukkal ve 1 palatinal olmak üzere 3 kanala kök kanal dolgusu yapıldı. Tedavi sırasında kavitede meziodistal yönde seyreden fraktür hattı tespit edildi. Kanal dolgusu sonrasında kaviteye direk rezin restorasyon uygulandı. Devam eden takiplerde fistülün iyileştiği ve hastanın ağrılarının geçtiği görüldü. Hastanın 2 yıllık takibinde radyografik ve klinik açıdan asemptomatik olduğu izlendi. Başarılı bir endodontik tedavi için klinisyen kök kanalı morfolojik değişikliklerin farkında olmalıdır. Başarısız kök kanal tedavilerinde en önemli etkenlerden birisi fark edilemeyen ve tedavi edilemeyen ekstra kanallardır. Farklı açıdan alınan radyograflarla dişlerin kök yapılarının, sayılarının fark edilmesi ve fraktür hattının teşhis edilmesi tedavinin başarısı açısından önemlidir.

This study was to compare the influence of glass fiber post placement and crown restoration on endodontically treated maxillary first premolars with severe NCCLs using three-dimensional finite element analysis and fracture resistance testing. G1, intact teeth. G2, teeth with artificial defect. G3, composite resin (CR). G4, CR and fiber post in buccal canal (FPB). G5, CR and fiber post in palatal canal (FPP). G6, CR and fiber posts in buccal and palatal canals (FPBP). G7, CR and crown (C). G8, CR, FPB, C. G9, CR, FPP, C. G10, CR, FPBP, C. Teeth in G2, G3, and G5 showed a similar stress concentration at the tip of the defect. The fracture resistance of G2 did not differ significantly from G3 and G5 (p>0.05) but differed significantly from that in other groups (p<0.05). The fractures in G4 were more favorable, and the difference of those in G1 from those in G7, G8, G9, and G10 was statistically significant (p<0.05). Restoration of root-filled maxillary premolars with severe NCCLs using fiber post in the buccal canal may be more efficacious than other restoration methods. [ABSTRACT FROM AUTHOR]

Understanding the root anatomy and apical canal morphology of maxillary premolars is a key prerequisite for successful surgical and endodontic treatment. The aim of this study was to assess the root anatomy and apical canal morphology of maxillary first premolars. To achieve the set task, 30 maxillary first premolars were extracted. After thorough rinse visual assessment of root anatomy was made. Each root was transversally sectioned six millimeters from apex with a straight hand piece. The apical samples were decalcificated in 7.5% trichloroacetic acid, transversal sections were made, stored in 10% formalin then dyed in hematoxylin and eosin and numerated from I to VI. Apical canal morphology was evaluated with an optical microscope. Majority of maxillary first premolars had double roots (63.0%; n=19) that were mostly separated (50.0%; n=15) containing a single root canal. Minority had double roots that were fused (13.0%; n=4) with two root canals. Single root with almost equal occurrence of two, as well as variable root canal configuration were found in (30.0%; n=9). A very rare occurrence of maxillary first premolars with three roots (7.0%; n=2) was detected, two vestibular and one palatal, each containing a single canal configuration. Accessory lateral canals were detected in 20% of maxillary first premolars. Transversal communications were detected in maxillary premolars with one root and double fused roots (26.6%; n=8). A single apical foramen was detected in majority of maxillary first premolars (50.0%; n=15). Two apical foramina were detected in (33.4%; n=10), three in (10.0%; n=3) and four in (6.6%; n=2) maxillary premolars. [ABSTRACT FROM AUTHOR]

Background: Successful endodontic treatment requires effective biomechanical preparation of the root canals and three-dimensional obturation of the root canal system. This can be achieved only by knowing and identifying the variations in the root canal system of the endodontically treated teeth. The Aim: The aim of this article is to present cases of endodontic treatment of maxillary first premolar with three root canals – different types. Material and Methods: Five clinical cases of successful endodontic treatment of patients with maxillary first premolar and three root canals are described. Result and Discussion: It is noted that good endodontic practice requires good knowledge of dental anatomy and possible variations, accurate X-ray images, as well as use of magnifying equipment. Conclusion: Knowledge of dental anatomy is fundamental for good endodontic practice.