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Preparation of the lingual canal in mandibular first premolar with canal bifurcation

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Abstract

The aim of this study was to establish an effective method of locating and negotiating the lingual canal in mandibular first premolars with two canals during root canal preparation. A total of 125 mandibular first premolars with radicular grooves were collected, and after micro-computed tomography scanning, 50 mandibular first premolars with a Vertucci V/III canal form were selected based on the inclusion criteria. Access cavities were prepared, and the lingual canals (LCs) were searched in four following steps: step 1 direct vision and a straight K-file; step 2 stereomicroscopy and a straight K-file; step 3 stereomicroscopy and a pre-curved K-file; and step 4 a long-neck bur. After localization, the LCs were instrumented. In most cases, access to the LC was achieved by step 2 (19/50, 38%) or step 3 (22/50, 44%). In three cases (6%), step 1 alone was enough to achieve access to the orifice, and in six cases (12%), access to the lingual canal was not achieved until step 4. Overall, 43 of the 50 mandibular first premolars (86%) were successfully instrumented, and the remaining seven failed. Two cases failed in the process of negotiating the canal to full length and five cases failed due to procedural errors (ledge formation, canal perforation, vertical fracture, or instrument separation). The LC in mandibular first premolars is a major endodontic challenge. A stereomicroscope and a pre-curved K file are suggested to be valuable tools for detecting and accessing the extra LC.

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Acknowledgements

The authors thank Professors Chengfei Zhang from HKU Faculty Dentistry and Yingyip Chui from Centralized Research Laboratory of HKU Faculty Dentistry, for their guidance and help in the experiment. The authors thank Helen Jeays, BDSc AE, from Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study was funded by Carder Health Care Research of Jiangsu Province. (Grant number: BJ15030. Recipient: Jin Li).

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Author notes

  1. Jin Li and Yongchun Gu contributed eqaully to this work.

Authors and Affiliations

  1. Jiangsu Key Laboratory of Oral Disease, Department of Endodontics, Nanjing Medical University, the Affiliated Stomatological Hospital of Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, People’s Republic of China

    Yaqian Lu, Yawen Liu, Yuhua Xiong, Nan Geng, Feng He & Jin Li

  2. Sunshine Dental Haishu Clinic, 8 Lengjing Street, Ningbo, 315000, People’s Republic of China

    Chao Sun

  3. Departments of Dentistry, Department of Central Laboratory, The Ninth People’s Hospital of Suzhou, 2666 Ludang Road, Suzhou, 215200, People’s Republic of China

    Yongchun Gu

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  1. Yaqian Lu
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  2. Yawen Liu
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  3. Yuhua Xiong
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  4. Nan Geng
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  5. Feng He
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  6. Chao Sun
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  7. Jin Li
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  8. Yongchun Gu
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Correspondence to Jin Li or Yongchun Gu.

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Lu, Y., Liu, Y., Xiong, Y. et al. Preparation of the lingual canal in mandibular first premolar with canal bifurcation. Odontology 109, 231–238 (2021). https://doi.org/10.1007/s10266-020-00525-9

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  • DOI: https://doi.org/10.1007/s10266-020-00525-9

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