Influence of anatomical features in the endodontic treatment planning of maxillary anterior teeth

MAZZI-CHAVES, Jardel Francisco; LEONI, Graziela Bianchi; OLIVEIRA, Juliana Santos; SILVA-SOUSA, Yara Terezinha Corrêa; SILVA, Ricardo Gariba; PAUWELS, Ruben; SOUSA-NETO, Manoel Damião

doi:10.1590/1807-3107BOR-2022.vol36.0005

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Original research, Endodontics • Braz. oral. res. 36 • 2022 • https://doi.org/10.1590/1807-3107BOR-2022.vol36.0005 copy

Influence of anatomical features in the endodontic treatment planning of maxillary anterior teeth

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study evaluate the maxillary anterior teeth anatomy by micro-computed tomography (μCT), about relevant characteristic for endodontic treatment planning. Fifty maxillary central incisors (MCI), lateral incisors (MLI) and maxillary canines (MC) were scanned using a μCT device. Two and three-dimensional parameters at 1 to 5mm distance to the apical foramen, external anatomic characteristics of the teeth and qualitative analysis of the internal anatomy was performed. The roundness and form factor values revealed a circular canal in the apical third in the MCI and MC, whereas MLI showed flattening in the apical third. The linear regression test indicated a progressive increase in the major/minor diameters in the five mm assessed (p < 0.001). The 3D analysis revealed the greatest volume and surface area in MC. The SMI showed a cylindrical geometry of root canals. All teeth presented Vertucci’s type I root canal configuration. A mild curvature was prevalent in the MCI (45%) and a moderate one in the MLI (50%) and MC (50%). Palatal shoulder volume was smaller in the MLI (11.46 ± 3.09) than in the MCI (14.15 ± 3.85) and MC (13.95 ± 2.55). The most common exit of main apical foramen was in a central (22%), distolingual (30%) and mesiobuccal position (28%) for MCI, MLI and MC, respectively. Radicular grooves were observed in 2% of MCI and 4% of MLI. Two and three-dimensional data obtained by μCT allowed to observe morphological characteristics of internal/external anatomy of the maxillary anterior teeth. These characteristics may affect the endodontic treatment planning.

Endodontics; X-Ray Microtomography; Dental Pulp Cavity; Root Canal Therapy; Tooth

Tooth	Distance from apical foramen	Area (mm²)	Perimeter (mm)	Roundness	Form factor	Major diameter (mm)	Minor diameter (mm)	Volume (mm³)	Surface area (mm²)	SMI
MCI	1 mm	0.16 ± 0.07^a	1.49 ± 0.38^a	0.77 ± 0.06^a	0.87 ± 0.05^a	0.50 ± 0.13^ab	0.41 ± 0.10^a	8.40 ± 4.62^a	42.29 ± 13.28^a	2.51 ± 0.91^a
	2 mm	0.20 ± 0.11^a	1.68 ± 0.46^a	0.75 ± 0.10^a	0.86 ± 0.06^a	0.57 ± 0.17^b	0.46 ± 0.11^a
	3 mm	0.31 ± 0.20^a	2.00 ± 0.57^ab	0.76 ± 0.12^a	0.85 ± 0.07^a	0.68 ± 0.21^ab	0.52 ± 0.13^a
	4 mm	0.37 ± 0.19^a	2.27 ± 0.61^ab	0.76 ± 0.11^a	0.84 ± 0.07^a	0.77 ± 0.21^b	0.60 ± 0.17^a
	5 mm	0.47 ± 0.25^a	2.55 ± 0.69^ab	0.75 ± 0.10^a	0.85 ± 0.07^a	0.87 ± 0.24^b	0.67 ± 0.17^a
MLI	1 mm	0.16 ± 0.11a	1.53 ± 0.57^a	0.64 ± 0.15^b	0.81 ± 0.10^b	0.56 ± 0.24^a	0.36 ± 0.11^b	7.93 ± 3.57^a	39.95 ± 8.50^a	2.60 ± 0.41^a
	2 mm	0.22 ± 0.16^a	1.76 ± 0.65^a	0.61 ± 0.13^b	0.79 ± 0.08^b	0.65 ± 0.25^a	0.40 ± 0.14^a
	3 mm	0.31 ± 0.21^a	2.11 ± 0.70^b	0.63 ± 0.13^b	0.80 ± 0.08^b	0.77 ± 0.27^a	0.48 ± 0.15^a
	4 mm	0.43 ± 0.27^a	2.53 ± 0.81^b	0.62 ± 0.14^c	0.78 ± 0.09^b	0.91 ± 0.30^a	0.56 ± 0.17^a
	5 mm	0.54 ± 0.31^a	2.90 ± 0.79^a	0.63 ± 0.16^b	0.76 ± 0.12^c	1.04 ± 0.30^a	0.65 ± 0.20^a
MC	1 mm	0.14 ± 0.08^a	1.35 ± 0.39^a	0.73 ± 0.10^a	0.87 ± 0.05^a	0.47 ± 0.13^b	0.37 ± 0.10^b	14.46 ± 5.27^b	66.20 ± 18.82^b	2.28 ± 0.81^a
	2 mm	0.18 ± 0.11^a	1.60 ± 0.49^a	0.74 ± 0.11^a	0.86 ± 0.06^a	0.55 ± 0.18^b	0.43 ± 0.13^a
	3 mm	0.24 ± 0.15^a	1.81 ± 0.63^a	0.74 ± 0.12^a	0.86 ± 0.07^a	0.63 ± 0.24^b	0.49 ± 0.15^a
	4 mm	0.33 ± 0.22^a	2.15 ± 0.77^a	0.70 ± 0.11^b	0.84 ± 0.07^a	0.75 ± 0.29^b	0.55 ± 0.18^a
	5 mm	0.44 ± 0.27^a	2.52 ± 0.83^b	0.67 ± 0.13^b	0.81 ± 0.08^b	0.89 ± 0.32^b	0.60 ± 0.19^a

Variable	MCI (mm³)	MLI (mm³)	MC (mm³)
Cervical shoulder	14.15 ± 3.85^a	11.46 ± 3.09^b	13.95 ± 2.55^a

Variable	Apical constriction	Apical foramen
MCI
Roundness	0.77 ± 0.06^a	0.67 ± 0.12^b
Major diameter (mm)	0.50 ± 0.13^a	0.51 ± 0.15^a
Minor diameter (mm)	0.41 ± 0.10^a	0.37 ± 0.11^a
MLI
Roundness	0.64 ± 0.15^a	0.65 ± 0.13^a
Major diameter (mm)	0.56 ± 0.24^a	0.54 ± 0.23^a
Minor diameter (mm)	0.36 ± 0.11^a	0.36 ± 0.12^a
MC
Roundness	0.73 ± 0.10^a	0.65 ± 0.14^b
Major diameter (mm)	0.47 ± 0.13^a	0.54 ± 0.19^b
Minor diameter (mm)	0.37 ± 0.10^a	0.36 ± 0.09^a

Teeth	Radicular grooves

	Landmarks	Depth (mm)	Length (mm)
MCI	M-2	0.13 ± 0.01	4.38 ± 0.53
	M-1	0.21 ± 0.00
	M	0.28 ± 0.04
	M+1	0.26 ± 0.10
	M+2	0.26 ± 0.08
MLI	M-2	0.22 ± 0.07	4.80 ± 0.12
	M-1	0.22 ± 0.07
	M	0.22 ± 0.09
	M+1	0.24 ± 0.11
	M+2	0.27 ± 0.08
MC	No grooves

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[1] Corresponding Author: Manoel D. Sousa Neto E-mail: sousanet@forp.usp.br