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Managing Canal Anatomies in the Context of Shaping for Cleaning Proposal

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Shaping for Cleaning the Root Canals

Abstract

One of the fundamental basis of the endodontic specialty is the knowledge of root canal anatomy. Over the last century, the internal and external anatomies of teeth were well documented by different methods. Recently, technological advancements in three-dimensional computed tomographic imaging have given rise to more accurate methods for clinical and laboratory evaluations of the root canal morphology. Essentially, it has been demonstrated that the root canal is a complex system usually composed of the main root canal and important lateral components such as isthmuses, fins, accessory canals (furcation, lateral, and secondary canals), and apical ramifications. These anatomical complexities are undoubtedly the main obstacles for shaping, cleaning, and disinfecting the root canal system. This chapter is focused not only on the description of the current studies on root and root canal anatomy using CBCT and micro-CT imaging technologies, but also on the discussion of diagnostic approaches, treatment techniques, and management strategies to successfully deal with anatomical complexities.

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References

  1. Morgan HW. Anatomy—the foundation. JADA. 1919;6:801–5.

    Google Scholar 

  2. Martins JNR, Marques D, Silva E, Carames J, Versiani MA. Prevalence studies on root canal anatomy using cone-beam computed tomographic imaging: a systematic review. J Endod. 2019;45:372–86.e4.

    PubMed  Google Scholar 

  3. Perrini N, Versiani MA. Historical overview of the studies on root canal anatomy. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 3–16.

    Google Scholar 

  4. Reveron RR. Herophilus and Erasistratus, pioneers of human anatomical dissection. Vesalius. 2014;20:55–8.

    PubMed  Google Scholar 

  5. Vesalius A. De Humani Corporis Fabrica Basilea: Libri Septem; 1543.

    Google Scholar 

  6. Black GV. Descriptive anatomy of the human teeth. Philadelphia: The Wilmington Dental Manufacturing Co.; 1890.

    Google Scholar 

  7. Fraenkel M. De penitiori dentium humanorum structura observations. Bratislava; 1835.

    Google Scholar 

  8. Mühlreiter E. Anatomie des menschlichen Gebisses von med. Th. E. de Jonge Cohen. Leipzig: Arthur Felix; 1870.

    Google Scholar 

  9. Witzel A. Compendium der pathologie und therapie der pulpakrankheiten des zahnes. Hagen: Risel & Co.; 1886.

    Google Scholar 

  10. Fischer G. Über die feinere Anatomie der Wurzelkanäle Menschlicher Zähne. Deutsche Monatschrift fur Zahnheilkunde. 1907.

    Google Scholar 

  11. Fischer G. Beitrage zur Behandlung Erkrankter Zahne mit besonderer Berucksichtigung der Anatomie und Pathologie der Wurzelkanale. Deutsche Zahnheilkunde in Vortragen. 1908:4–5.

    Google Scholar 

  12. Fischer G. Bau und Entwickelung der Mundhohle des Menschen. Leipzig: Verlag von Werner Klinkhardt; 1909.

    Google Scholar 

  13. Preiswerk G. Leherbuch und Atlas der Zahnheilkunde mit Einschluβ der Mund-Krankheiten. Munich: J. F. Lehmann; 1903.

    Google Scholar 

  14. Kishen A. Foreword I. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. vii.

    Google Scholar 

  15. Versiani MA, Keles A. Applications of micro-CT technology in endodontics. In: Orhan K, editor. Micro-computed tomography (micro-CT) in medicine and engineering. Cham: Springer; 2020. p. 183–211.

    Google Scholar 

  16. Martins JN, Versiani MA. CBCT and micro-CT on the study of root canal anatomy. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 89–180.

    Google Scholar 

  17. Tjäderhane L. Dentin basic structure, composition, and function. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 17–30.

    Google Scholar 

  18. Ordinola-Zapata R, Versiani MA, Bramante CM. Root canal components. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 31–46.

    Google Scholar 

  19. Hess W. Die pulpaamputation als selbstandige wurzelbehandlungsmethod. Leipzig: Georg Thiéme; 1917.

    Google Scholar 

  20. Hess W, Zürcher E. The anatomy of the root canals of the teeth of the permanent and deciduous dentitions. London: John Bale, Sons & Danielsson, Ltd.; 1925.

    Google Scholar 

  21. Zürcher E. Zur Anatomie der Wurzelkanale des menschliches Milchgebisses und der 6 Jahr-Molaren. Zurich; 1922.

    Google Scholar 

  22. Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. Oral Surg Oral Med Oral Pathol. 1969;28:419–25.

    PubMed  Google Scholar 

  23. Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol. 1972;33:101–10.

    PubMed  Google Scholar 

  24. Vertucci F, Seelig A, Gillis R. Root canal morphology of the human maxillary second premolar. Oral Surg Oral Med Oral Pathol. 1974;38:456–64.

    PubMed  Google Scholar 

  25. Versiani MA, Ordinola-Zapata R. Root canal anatomy: implications in biofilm disinfection. In: Chavez de Paz L, Sedgley C, Kishen A, editors. Root canal biofilms. Toronto: Springer; 2015.

    Google Scholar 

  26. Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod. 2004;30:846–50.

    PubMed  Google Scholar 

  27. Versiani MA, Pereira MR, Pécora JD, Sousa Neto MD. Root canal anatomy of maxillary and mandibular teeth. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 181–240.

    Google Scholar 

  28. Martins JNR, Marques D, Leal Silva EJN, Carames J, Mata A, Versiani MA. Influence of demographic factors on the prevalence of a second root canal in mandibular anterior teeth—a systematic review and meta-analysis of cross-sectional studies using cone beam computed tomography. Arch Oral Biol. 2020;116:104749.

    PubMed  Google Scholar 

  29. Versiani MA, Pécora JD, Sousa-Neto MD. The anatomy of two-rooted mandibular canines determined using micro-computed tomography. Int Endod J. 2011;44:682–7.

    PubMed  Google Scholar 

  30. Chan R, Versiani MA, Friedman S, Malkhassian G, Sousa-Neto MD, Leoni GB, et al. Efficacy of 3 supplementary irrigation protocols in the removal of hard tissue debris from the mesial root canal system of mandibular molars. J Endod. 2019;45:923–9.

    PubMed  Google Scholar 

  31. Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera JF, Pécora JD, Sousa-Neto MD. Ex vivo evaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root canal system of mandibular first molars. Int Endod J. 2017;50:398–406.

    PubMed  Google Scholar 

  32. Versiani MA, Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Provenzano JC, Rocas IN, et al. Micro-CT evaluation of the efficacy of hard-tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J. 2016;49:1079–87.

    PubMed  Google Scholar 

  33. Keleş A, Alcin H, Sousa-Neto MD, Versiani MA. Supplementary steps for removing hard tissue debris from isthmus-containing canal systems. J Endod. 2016;42:1677–82.

    PubMed  Google Scholar 

  34. von Arx T. Frequency and type of canal isthmuses in first molars detected by endoscopic inspection during periradicular surgery. Int Endod J. 2005;38:160–8.

    Google Scholar 

  35. von Arx T, Steiner RG, Tay FR. Apical surgery: endoscopic findings at the resection level of 168 consecutively treated roots. Int Endod J. 2011;44:290–302.

    Google Scholar 

  36. Tronstad L. Clinical endodontics: a textbook. 3rd rev. ed. Stuttgart. New York: Thieme; 2009.

    Google Scholar 

  37. Siqueira JF Jr, Roças IN, Ricucci D. Internal tooth anatomy and root canal instrumentation. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 277–302.

    Google Scholar 

  38. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics. 2005;10:3–29.

    Google Scholar 

  39. Morfis A, Sylaras SN, Georgopoulou M, Kernani M, Prountzos F. Study of the apices of human permanent teeth with the use of a scanning electron microscope. Oral Surg Oral Med Oral Pathol. 1994;77:172–6.

    PubMed  Google Scholar 

  40. Gutierrez JH, Aguayo P. Apical foraminal openings in human teeth. Number and location. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:769–77.

    PubMed  Google Scholar 

  41. Versiani MA, Ahmed HM, Sousa-Neto MD, De-Deus G, Dummer PM. Unusual deviation of the main foramen from the root apex. Braz Dent J. 2016;27:589–91.

    PubMed  Google Scholar 

  42. Burch JG, Hulen S. The relationship of the apical foramen to the anatomic apex of the tooth root. Oral Surg Oral Med Oral Pathol. 1972;34:262–8.

    PubMed  Google Scholar 

  43. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58:589–99.

    PubMed  Google Scholar 

  44. Green D. A stereomicroscopic study of the root apices of 400 maxillary and mandibular anterior teeth. Oral Surg Oral Med Oral Pathol. 1956;9:1224–32.

    PubMed  Google Scholar 

  45. Piñeda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol. 1972;33:101–10.

    PubMed  Google Scholar 

  46. Mizutani T, Ohno N, Nakamura H. Anatomical study of the root apex in the maxillary anterior teeth. J Endod. 1992;18:344–7.

    PubMed  Google Scholar 

  47. Ricucci D, Siqueira JF Jr. Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. J Endod. 2010;36:1–15.

    PubMed  Google Scholar 

  48. Gao X, Tay FR, Gutmann JL, Fan W, Xu T, Fan B. Micro-CT evaluation of apical delta morphologies in human teeth. Sci Rep. 2016;6:36501.

    PubMed  PubMed Central  Google Scholar 

  49. Chugal NM, Lin ML, Kahler B. Introduction: endodontic prognosis and outcome. In: Chugal NM, Lin ML, editors. Endodontic prognosis—clinical guide for optimal treatment outcome. Cham: Springer; 2017. p. 1–12.

    Google Scholar 

  50. Kvist T. Apical periodontitis in root-filled teeth. 1st ed. Cham: Springer; 2018.

    Google Scholar 

  51. Rosen E, Russell P, Tsesis I. Evidence-based decision making in dentistry: the endodontic perspective. In: Rosen E, Nemcovsky CE, Tsesis I, editors. Evidence-based decision making in dentistry: multidisciplinary management of the natural dentition. Cham: Springer; 2017. p. 19–38.

    Google Scholar 

  52. Friedman S. Prognosis of healing in treated teeth with endodontic infections. In: Fouad AF, editor. Endodontic microbiology. Ames, IA: Wiley; 2017. p. 341–84.

    Google Scholar 

  53. Chugal NM, Clive JM, Spangberg LS. A prognostic model for assessment of the outcome of endodontic treatment: effect of biologic and diagnostic variables. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:342–52.

    PubMed  Google Scholar 

  54. Karabucak B, Bunes A, Chehoud C, Kohli M, Setzer F. Prevalence of apical periodontitis in endodontically treated premolars and molars with untreated canal: a cone-beam computed tomography study. J Endod. 2016;42:538–41.

    PubMed  Google Scholar 

  55. Costa FFNP, Pacheco-Yanes J, Siqueira JF Jr, Oliveira ACS, Gazzaneo I, Amorim CA, et al. Association between missed canals and apical periodontitis. Int Endod J. 2019;52:400–6.

    PubMed  Google Scholar 

  56. Versiani MA, Martins JN, Basrani B. 3D visual glossary of terminology in root and root canal anatomy. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 391–422.

    Google Scholar 

  57. Barnett F. Anatomy, access, and length determination. In: Chugal NM, Lin ML, editors. Endodontic prognosis—clinical guide for optimal treatment outcome. Cham: Springer; 2017. p. 115–30.

    Google Scholar 

  58. Fayad M, Johnson BR. 3D imaging in endodontics: a new era in diagnosis and treatment. Cham: Springer; 2016.

    Google Scholar 

  59. Al-Nahlawi T, Doumani M, Alalo HA, Habib A. Dentists’ knowledge, attitude and practice of root canal treatment procedure: survey-based research. J Contemp Dent Pract. 2019;20:347–54.

    PubMed  Google Scholar 

  60. Madarati AA. Why dentists don’t use rubber dam during endodontics and how to promote its usage? BMC Oral Health. 2016;16:24.

    PubMed  PubMed Central  Google Scholar 

  61. Kapitan M, Hodacova L, Jagelska J, Kaplan J, Ivancakova R, Sustova Z. The attitude of Czech dental patients to the use of rubber dam. Health Expect. 2015;18:1282–90.

    PubMed  Google Scholar 

  62. Gaikwad A, Jain D, Rane P, Bhondwe S, Taur S, Doshi S. Attitude of general dental practitioners toward root canal treatment procedures in India. J Contemp Dent Pract. 2013;14:528–31.

    PubMed  Google Scholar 

  63. Kapitan M, Sustova Z. The use of rubber dam among Czech dental practitioners. Acta Medica (Hradec Kralove). 2011;54:144–8.

    Google Scholar 

  64. Slaus G, Bottenberg P. A survey of endodontic practice amongst Flemish dentists. Int Endod J. 2002;35:759–67.

    PubMed  Google Scholar 

  65. Whitworth JM, Seccombe GV, Shoker K, Steele JG. Use of rubber dam and irrigant selection in UK general dental practice. Int Endod J. 2000;33:435–41.

    PubMed  Google Scholar 

  66. Gluskin AH, Peters CI, Peters OA. Minimally invasive endodontics: challenging prevailing paradigms. Br Dent J. 2014;216:347–53.

    PubMed  Google Scholar 

  67. Levin HJ. Access cavities. Dent Clin North Am. 1967:701–10.

    Google Scholar 

  68. Clark D, Khademi J. Modern molar endodontic access and directed dentin conservation. Dent Clin North Am. 2010;54:249–73.

    PubMed  Google Scholar 

  69. Bóveda C, Kishen A. Contracted endodontic cavities: the foundation for less invasive alternatives in the management of apical periodontitis. Endod Topics. 2015;33:169–86.

    Google Scholar 

  70. Silva EJNL, Rover G, Belladonna FG, De-Deus G, Teixeira CS, FIdalgo TKS. Impact of contracted endodontic cavities on fracture resistance of endodontically treated teeth: a systematic review of in vitro studies. Clin Oral Investig. 2017;22:109–18.

    PubMed  Google Scholar 

  71. Krishan R, Paqué F, Ossareh A, Kishen A, Dao T, Friedman S. Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars. J Endod. 2014;40:1160–6.

    PubMed  Google Scholar 

  72. Neelakantan P, Khan K, Hei Ng GP, Yip CY, Zhang C, Pan Cheung GS. Does the orifice-directed dentin conservation access design debride pulp chamber and mesial root canal systems of mandibular molars similar to a traditional access design? J Endod. 2018;44:274–9.

    PubMed  Google Scholar 

  73. Correia LC. O Princípio da Assimetria: uso de máscaras e aquecimento global. http://medicinabaseadaemevidencias.blogspot.com/2011/03/. Accessed 24 Mar 2011.

  74. Bürklein S, Hinschitza K, Dammaschke T, Schäfer E. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J. 2012;45:449–61.

    PubMed  Google Scholar 

  75. Paqué F, Musch U, Hülsmann M. Comparison of root canal preparation using RaCe and ProTaper rotary Ni-Ti instruments. Int Endod J. 2005;38:8–16.

    PubMed  Google Scholar 

  76. Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A. Effect of different apical preparation sizes on outcome of primary endodontic treatment: a randomized controlled trial. J Endod. 2012;38:1309–15.

    PubMed  Google Scholar 

  77. Garcia-Guerrero C, Parra-Junco C, Quijano-Guauque S, Molano N, Pineda GA, Marin-Zuluaga DJ. Vertical root fractures in endodontically-treated teeth: a retrospective analysis of possible risk factors. J Investig Clin Dent. 2018;9.

    Google Scholar 

  78. Haueisen H, Gartner K, Kaiser L, Trohorsch D, Heidemann D. Vertical root fracture: prevalence, etiology, and diagnosis. Quintessence Int. 2013;44:467–74.

    PubMed  Google Scholar 

  79. Yoshino K, Ito K, Kuroda M, Sugihara N. Prevalence of vertical root fracture as the reason for tooth extraction in dental clinics. Clin Oral Investig. 2015;19:1405–9.

    PubMed  Google Scholar 

  80. Bürklein S, Schäfer E. Minimally invasive endodontics. Quintessence Int. 2015;46:119–24.

    PubMed  Google Scholar 

  81. Ruddle CJ. FOCUS on: minimally invasive endodontics. Dent Today. 2014;33:14.

    PubMed  Google Scholar 

  82. Augusto CM, Barbosa AFA, Guimaraes CC, Lima CO, Ferreira CM, Sassone LM, et al. A laboratory study of the impact of ultraconservative access cavities and minimal root canal tapers on the ability to shape canals in extracted mandibular molars and their fracture resistance. Int Endod J. 2020;53(11):1516–29. https://doi.org/10.1111/iej.13369.

    Article  PubMed  Google Scholar 

  83. Barbosa AFA, Lima CO, Coelho BP, Ferreira CM, Sassone LM, Silva E. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars. Int Endod J. 2020;53(12):1666–79. https://doi.org/10.1111/iej.13383.

    Article  PubMed  Google Scholar 

  84. Corsentino G, Pedulla E, Castelli L, Liguori M, Spicciarelli V, Martignoni M, et al. Influence of access cavity preparation and remaining tooth substance on fracture strength of endodontically treated teeth. J Endod. 2018;44:1416–21.

    PubMed  Google Scholar 

  85. Moore B, Verdelis K, Kishen A, Dao T, Friedman S. Impacts of contracted endodontic cavities on instrumentation efficacy and biomechanical responses in maxillary molars. J Endod. 2016;42:1779–83.

    PubMed  Google Scholar 

  86. Özyürek T, Ülker Ö, Demiryürek EÖ, Yilmaz F. The effects of endodontic access cavity preparation design on the fracture strength of endodontically treated teeth: traditional versus conservative preparation. J Endod. 2018;44:800–5.

    PubMed  Google Scholar 

  87. Sabeti M, Kazem M, Dianat O, Bahrololumi N, Beglou A, Rahimipour K, et al. Impact of access cavity design and root canal taper on fracture resistance of endodontically treated teeth: an ex vivo investigation. J Endod. 2018;44:1402–6.

    PubMed  Google Scholar 

  88. Vieira GCS, Perez AR, Alves FRF, Provenzano JC, Mdala I, Siqueira JF Jr, et al. Impact of contracted endodontic cavities on root canal disinfection and shaping. J Endod. 2020;46:655–61.

    PubMed  Google Scholar 

  89. Montgomery DC. Design and analysis of experiments. 10th ed. New York: Wiley; 2019.

    Google Scholar 

  90. Silva E, Pinto KP, Ferreira CM, Belladonna FG, De-Deus G, Dummer PMH, et al. Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature. Int Endod J. 2020;53:1618–35.

    PubMed  Google Scholar 

  91. Pache B, Hubner M, Jurt J, Demartines N, Grass F. Minimally invasive surgery and enhanced recovery after surgery: the ideal combination? J Surg Oncol. 2017;116:613–6.

    PubMed  Google Scholar 

  92. AlAsseri N, Swennen G. Minimally invasive orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg. 2018;47:1299–310.

    PubMed  Google Scholar 

  93. Cloyd JM. Minimally invasive surgery for palliation. Surg Oncol Clin N Am. 2019;28:79–88.

    PubMed  Google Scholar 

  94. Costantino CL, Mullen JT. Minimally invasive gastric cancer surgery. Surg Oncol Clin N Am. 2019;28:201–13.

    PubMed  Google Scholar 

  95. Garmpis N, Dimitroulis D, Garmpi A, Diamantis E, Spartalis E, Schizas D, et al. Enhanced recovery after surgery: is it time to change our strategy regarding laparoscopic colectomy? In Vivo. 2019;33:669–74.

    PubMed  PubMed Central  Google Scholar 

  96. McGurkin-Smith R, Trope M, Caplan D, Sigurdsson A. Reduction of intracanal bacteria using GT rotary instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2. J Endod. 2005;31:359–63.

    PubMed  Google Scholar 

  97. Shuping GB, Ørstavik D, Sigurdsson A, Trope M. Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod. 2000;26:751–5.

    PubMed  Google Scholar 

  98. Sakamoto M, Siqueira JF Jr, Rôças IN, Benno Y. Bacterial reduction and persistence after endodontic treatment procedures. Oral Microbiol Immunol. 2007;22:19–23.

    PubMed  Google Scholar 

  99. Siqueira JF Jr, Paiva SS, Rôças IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod. 2007;33:541–7.

    PubMed  Google Scholar 

  100. Neves MA, Rôças IN, Siqueira JF Jr. Clinical antibacterial effectiveness of the self-adjusting file system. Int Endod J. 2014;47:356–65.

    PubMed  Google Scholar 

  101. Rôças IN, Lima KC, Siqueira JF Jr. Reduction in bacterial counts in infected root canals after rotary or hand nickel-titanium instrumentation—a clinical study. Int Endod J. 2013;46:681–7.

    PubMed  Google Scholar 

  102. Zandi H, Rodrigues RC, Kristoffersen AK, Enersen M, Mdala I, Orstavik D, et al. Antibacterial effectiveness of 2 root canal irrigants in root-filled teeth with infection: a randomized clinical trial. J Endod. 2016;42:1307–13.

    PubMed  Google Scholar 

  103. Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, et al. Influence of the apical preparation size and the irrigant type on bacterial reduction in root canal–treated teeth with apical periodontitis. J Endod. 2017;43(7):1058–63.

    PubMed  Google Scholar 

  104. Siqueira JF Jr, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod. 2000;26:331–4.

    PubMed  Google Scholar 

  105. Siqueira JF Jr, Rôças IN, Santos SR, Lima KC, Magalhães FA, de Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002;28:181–4.

    PubMed  Google Scholar 

  106. Brito PR, Souza LC, Machado de Oliveira JC, Alves FR, De-Deus G, Lopes HP, et al. Comparison of the effectiveness of three irrigation techniques in reducing intracanal Enterococcus faecalis populations: an in vitro study. J Endod. 2009;35:1422–7.

    PubMed  Google Scholar 

  107. Neves MA, Provenzano JC, Rôças IN, Siqueira JF Jr. Clinical antibacterial effectiveness of root canal preparation with reciprocating single-instrument or continuously rotating multi-instrument systems. J Endod. 2016;42:25–9.

    PubMed  Google Scholar 

  108. Rôças IN, Provenzano JC, Neves MA, Siqueira JF Jr. Disinfecting effects of rotary instrumentation with either 2.5% sodium hypochlorite or 2% chlorhexidine as the main irrigant: a randomized clinical study. J Endod. 2016;42:943–7.

    PubMed  Google Scholar 

  109. Siqueira JF Jr, Guimarães-Pinto T, Rôças IN. Effects of chemomechanical preparation with 2.5% sodium hypochlorite and intracanal medication with calcium hydroxide on cultivable bacteria in infected root canals. J Endod. 2007;33:800–5.

    PubMed  Google Scholar 

  110. Boutsioukis C. Internal tooth anatomy and root canal irrigation. In: Versiani MA, Basrani B, Sousa Neto MD, editors. The root canal anatomy in permanent dentition. Cham: Springer; 2018. p. 303–22.

    Google Scholar 

  111. Garberoglio R, Brännström M. Scanning electron microscopic investigation of human dentinal tubules. Arch Oral Biol. 1976;21:355–62.

    PubMed  Google Scholar 

  112. Siqueira JF Jr, Araujo MC, Garcia PF, Fraga RC, Dantas CJ. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod. 1997;23:499–502.

    PubMed  Google Scholar 

  113. Walton RE. Histologic evaluation of different methods of enlarging the pulp canal space. J Endod. 1976;2:304–11.

    PubMed  Google Scholar 

  114. Nair PN, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:231–52.

    PubMed  Google Scholar 

  115. Ricucci D, Siqueira JF Jr, Bate AL, Pitt Ford TR. Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients. J Endod. 2009;35:493–502.

    PubMed  Google Scholar 

  116. Vera J, Siqueira JF Jr, Ricucci D, Loghin S, Fernandez N, Flores B, et al. One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study. J Endod. 2012;38:1040–52.

    PubMed  Google Scholar 

  117. Peters OA, Schönenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J. 2001;34:221–30.

    PubMed  Google Scholar 

  118. Siqueira JF Jr, Alves FR, Versiani MA, Rôças IN, Almeida BM, Neves MA, et al. Correlative bacteriologic and micro-computed tomographic analysis of mandibular molar mesial canals prepared by self-adjusting file, Reciproc, and Twisted File systems. J Endod. 2013;39:1044–50.

    PubMed  Google Scholar 

  119. Paqué F, Balmer M, Attin T, Peters OA. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. J Endod. 2010;36:703–7.

    PubMed  Google Scholar 

  120. Ricucci D, Siqueira JF Jr. Apical actinomycosis as a continuum of intraradicular and extraradicular infection: case report and critical review on its involvement with treatment failure. J Endod. 2008;34:1124–9.

    PubMed  Google Scholar 

  121. Vieira AR, Siqueira JF Jr, Ricucci D, Lopes WS. Dentinal tubule infection as the cause of recurrent disease and late endodontic treatment failure: a case report. J Endod. 2012;38:250–4.

    PubMed  Google Scholar 

  122. Siqueira JF Jr, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008;34:1291–301.e3.

    PubMed  Google Scholar 

  123. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 1974;18:269–96.

    PubMed  Google Scholar 

  124. Barborka BJ, Woodmansey KF, Glickman GN, Schneiderman E, He J. Long-term clinical outcome of teeth obturated with Resilon. J Endod. 2017;43:556–60.

    PubMed  Google Scholar 

  125. Strange KA, Tawil PZ, Phillips C, Walia HD, Fouad AF. Long-term outcomes of endodontic treatment performed with Resilon/Epiphany. J Endod. 2019;45:507–12.

    PubMed  Google Scholar 

  126. Faraj S, Boutsioukis C. Observer variation in the assessment of root canal curvature. Int Endod J. 2017;50:167–76.

    PubMed  Google Scholar 

  127. Hartmann RC, Fensterseifer M, Peters OA, de Figueiredo JAP, Gomes MS, Rossi-Fedele G. Methods for measurement of root canal curvature: a systematic and critical review. Int Endod J. 2019;52:169–80.

    PubMed  Google Scholar 

  128. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32:271–5.

    PubMed  Google Scholar 

  129. Weine F. Endodontic therapy. 3rd ed. St. Louis: Mosby; 1982.

    Google Scholar 

  130. Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod. 1997;23:77–85.

    PubMed  Google Scholar 

  131. Gunday M, Sazak H, Garip Y. A comparative study of three different root canal curvature measurement techniques and measuring the canal access angle in curved canals. J Endod. 2005;31:796–8.

    PubMed  Google Scholar 

  132. Schäfer E, Diez C, Hoppe W, Tepel J. Roentgenographic investigation of frequency and degree of canal curvatures in human permanent teeth. J Endod. 2002;28:211–6.

    PubMed  Google Scholar 

  133. Cvek M, Granath L, Lundberg M. Failures and healing in endodontically treated non-vital anterior teeth with posttraumatically reduced pulpal lumen. Acta Odontol Scand. 1982;40:223–8.

    PubMed  Google Scholar 

  134. Tamse A, Fuss Z, Lustig J, Kaplavi J. An evaluation of endodontically treated vertically fractured teeth. J Endod. 1999;25:506–8.

    PubMed  Google Scholar 

  135. Tamse A. Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management. Endod Topics. 2006;13:84–94.

    Google Scholar 

  136. Gutmann JL. The dentin-root complex: anatomic and biologic considerations in restoring endodontically treated teeth. J Prosthet Dent. 1992;67:458–67.

    PubMed  Google Scholar 

  137. Rundquist BD, Versluis A. How does canal taper affect root stresses? Int Endod J. 2006;39:226–37.

    PubMed  Google Scholar 

  138. Gher ME Jr, Dunlap RM, Anderson MH, Kuhl LV. Clinical survey of fractured teeth. J Am Dent Assoc. 1987;114:174–7.

    PubMed  Google Scholar 

  139. Keleş A, Keskin C, Karataslioglu E, Kishen A, Versiani MA. Middle mesial canal preparation enhances the risk of fracture in mesial root of mandibular molars. J Endod. 2020;46(9):1323–9. https://doi.org/10.1016/j.joen.2020.05.019.

    Article  PubMed  Google Scholar 

  140. De-Deus G, Rodrigues EA, Belladonna FG, Simoes-Carvalho M, Cavalcante DM, Oliveira DS, et al. Anatomical danger zone reconsidered: a micro-CT study on dentine thickness in mandibular molars. Int Endod J. 2019;52:1501–7.

    PubMed  Google Scholar 

  141. Versiani MA, Ordinola-Zapata R, Keleş A, Alcin H, Bramante CM, Pécora JD, et al. Middle mesial canals in mandibular first molars: a micro-CT study in different populations. Arch Oral Biol. 2016;61:130–7.

    PubMed  Google Scholar 

  142. Keleş A, Keskin C, Alqawasmi R, Versiani MA. Evaluation of dentine thickness of middle mesial canals of mandibular molars prepared with rotary instruments: a micro-CT study. Int Endod J. 2019;53(4):519–28.

    PubMed  Google Scholar 

  143. Lertchirakarn V, Palamara JEA, Messer HH. Patterns of vertical root fracture: factors affecting stress distribution in the root canal. J Endod. 2003;29:523–8.

    PubMed  Google Scholar 

  144. Lim SS, Stock CJ. The risk of perforation in the curved canal: anticurvature filing compared with the stepback technique. Int Endod J. 1987;20:33–9.

    PubMed  Google Scholar 

  145. Russell AA, Chris He LH, Chandler NP. Investigation of dentin hardness in roots exhibiting the butterfly effect. J Endod. 2014;40:842–4.

    PubMed  Google Scholar 

  146. Russell AA, Chandler NP, Hauman C, Siddiqui AY, Tompkins GR. The butterfly effect: an investigation of sectioned roots. J Endod. 2013;39:208–10.

    PubMed  Google Scholar 

  147. Vasiliadis L, Darling AI, Levers BG. The amount and distribution of sclerotic human root dentine. Arch Oral Biol. 1983;28:645–9.

    PubMed  Google Scholar 

  148. Cooke HG 3rd, Cox FL. C-shaped canal configurations in mandibular molars. J Am Dent Assoc. 1979;99:836–9.

    PubMed  Google Scholar 

  149. Malpighi M. Observationes de dentibus: Manoscritto 936 Busta II D; 1690.

    Google Scholar 

  150. Martins JNR, Marques D, Silva E, Carames J, Mata A, Versiani MA. Prevalence of C-shaped canal morphology using cone beam computed tomography—a systematic review with meta-analysis. Int Endod J. 2019;52:1556–72.

    PubMed  Google Scholar 

  151. Solomonov M, Paque F, Fan B, Eilat Y, Berman LH. The challenge of C-shaped canal systems: a comparative study of the Self-Adjusting File and ProTaper. J Endod. 2012;38:209–14.

    PubMed  Google Scholar 

  152. Yin X, Cheung GS, Zhang C, Masuda YM, Kimura Y, Matsumoto K. Micro-computed tomographic comparison of nickel-titanium rotary versus traditional instruments in C-shaped root canal system. J Endod. 2010;36:708–12.

    PubMed  Google Scholar 

  153. Fan B, Min Y, Lu G, Yang J, Cheung GS, Gutmann JL. Negotiation of C-shaped canal systems in mandibular second molars. J Endod. 2009;35:1003–8.

    PubMed  Google Scholar 

  154. Melton DC, Krell KV, Fuller MW. Anatomical and histological features of C-shaped canals in mandibular second molars. J Endod. 1991;17:384–8.

    PubMed  Google Scholar 

  155. Fan B, Cheung GS, Fan M, Gutmann JL, Bian Z. C-shaped canal system in mandibular second molars: part I—anatomical features. J Endod. 2004;30:899–903.

    PubMed  Google Scholar 

  156. Ordinola-Zapata R, Martins JN, Bramante CM, Villas-Boas MH, Duarte MH, Versiani MA. Morphological evaluation of maxillary second molars with fused roots: a micro-CT study. Int Endod J. 2017;50:1192–200.

    PubMed  Google Scholar 

  157. Boschetti E, Silva-Sousa YTC, Mazzi-Chaves JF, Leoni GB, Versiani MA, Pecora JD, et al. Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves. Braz Dent J. 2017;28:597–603.

    PubMed  Google Scholar 

  158. Ordinola-Zapata R, Monteiro Bramante C, Gagliardi Minotti P, Cavalini Cavenago B, Gutmann JL, Moldauer BI, et al. Micro-CT evaluation of C-shaped mandibular first premolars in a Brazilian subpopulation. Int Endod J. 2015;48:807–13.

    PubMed  Google Scholar 

  159. Ordinola-Zapata R, Bramante CM, Villas-Boas MH, Cavenago BC, Duarte MH, Versiani MA. Morphologic micro-computed tomography analysis of mandibular premolars with three root canals. J Endod. 2013;39:1130–5.

    PubMed  Google Scholar 

  160. Keith A. Problems relating to the teeth of the earlier forms of prehistoric man. Proc R Soc Med. 1913;6:103–24.

    PubMed  PubMed Central  Google Scholar 

  161. Shaw JC. Taurodont teeth in South African races. J Anat. 1928;62:476–98.

    PubMed  PubMed Central  Google Scholar 

  162. Carlsen O, Alexandersen V. Radix mesiolingualis and radix distolingualis in a collection of permanent maxillary molars. Acta Odontol Scand. 2000;58:229–36.

    PubMed  Google Scholar 

  163. AAE. Glossary of endodontics terms. 9th ed. Chicago: American Association of Endodontists; 2016.

    Google Scholar 

  164. Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod. 2007;33:58–63.

    PubMed  Google Scholar 

  165. De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004;37:789–99.

    PubMed  Google Scholar 

  166. Turner CG. Three-rooted mandibular first permanent molars and the question of American Indian origins. Am J Phys Anthropol. 1971;34:229–41.

    PubMed  Google Scholar 

  167. Oehlers FA. Dens invaginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol. 1957;10:1204–18 contd.

    PubMed  Google Scholar 

  168. Hülsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. Int Endod J. 1997;30:79–90.

    PubMed  Google Scholar 

  169. Oehlers FA. Dens invaginatus (dilated composite odontome). II. Associated posterior crown forms and pathogenesis. Oral Surg Oral Med Oral Pathol. 1957;10:1302–16.

    PubMed  Google Scholar 

  170. Martins JNR, Marques D, Silva E, Carames J, Mata A, Versiani MA. Second mesiobuccal root canal in maxillary molars—a systematic review and meta-analysis of prevalence studies using cone beam computed tomography. Arch Oral Biol. 2020;113:104589.

    PubMed  Google Scholar 

  171. Huumonen S, Kvist T, Grondahl K, Molander A. Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars. Int Endod J. 2006;39:827–33.

    PubMed  Google Scholar 

  172. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S. Clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. J Endod. 2002;28:477–9.

    PubMed  Google Scholar 

  173. Ordinola-Zapata R, Martins JNR, Plascencia H, Versiani MA, Bramante CM. The MB3 canal in maxillary molars: a micro-CT study. Clin Oral Investig. 2020;24(11):4109–21. https://doi.org/10.1007/s00784-020-3284-7.

    Article  PubMed  Google Scholar 

  174. Tomaszewska IM, Skinningsrud B, Jarzebska A, Pekala JR, Tarasiuk J, Iwanaga J. Internal and external morphology of mandibular molars: an original micro-CT study and meta-analysis with review of implications for endodontic therapy. Clin Anat. 2018;31:797–811.

    PubMed  Google Scholar 

  175. Gonzalez-Plata RR, Gonzalez-Plata EW. Conventional and surgical treatment of a two-rooted maxillary central incisor. J Endod. 2003;29:422–4.

    Google Scholar 

  176. Lambruschini GM, Camps J. A two-rooted maxillary central incisor with a normal clinical crown. J Endod. 1993;19:95–6.

    PubMed  Google Scholar 

  177. Lin WC, Yang SF, Pai SF. Nonsurgical endodontic treatment of a two-rooted maxillary central incisor. J Endod. 2006;32:478–81.

    PubMed  Google Scholar 

  178. Gondim E Jr, Setzer F, Zingg P, Karabucak B. A maxillary central incisor with three root canals: a case report. J Endod. 2009;35:1445–7.

    PubMed  Google Scholar 

  179. Mangani F, Ruddle CJ. Endodontic treatment of a “very particular” maxillary central incisor. J Endod. 1994;20:560–1.

    PubMed  Google Scholar 

  180. Pécora JD, da Cruz Filho AM. Study of the incidence of radicular grooves in maxillary incisors. Braz Dent J. 1992;3:11–6.

    PubMed  Google Scholar 

  181. Libfeld H, Stabholz A, Friedman S. Endodontic therapy of bilaterally geminated permanent maxillary central incisors. J Endod. 1986;12:214–6.

    PubMed  Google Scholar 

  182. Pécora JD, Santana SV. Maxillary lateral incisor with two roots—case report. Braz Dent J. 1992;2:151–3.

    PubMed  Google Scholar 

  183. Peix-Sanchez M, Minana-Laliga R. A case of unusual anatomy: a maxillary lateral incisor with three canals. Int Endod J. 1999;32:236–40.

    PubMed  Google Scholar 

  184. Kottoor J, Murugesan R, Albuquerque DV. A maxillary lateral incisor with four root canals. Int Endod J. 2012;45:393–7.

    PubMed  Google Scholar 

  185. Fried IL, Winter AA. Diagnosis and treatment of a two-rooted maxillary lateral incisor. Periodontal Case Rep. 1984;6:40–4.

    PubMed  Google Scholar 

  186. Wong M. Treatment considerations in a geminated maxillary lateral incisor. J Endod. 1991;17:179–81.

    PubMed  Google Scholar 

  187. Pécora JD, Saquy PC, de Souza JE, Sousa-Neto MD. Endodontic treatment of a maxillary lateral incisor presenting dens invaginatus and transposition to the region of the canine—case report. Braz Dent J. 1991;2:5–8.

    PubMed  Google Scholar 

  188. Mupparapu M, Singer SR, Goodchild JH. Dens evaginatus and dens invaginatus in a maxillary lateral incisor: report of a rare occurrence and review of literature. Aust Dent J. 2004;49:201–3.

    PubMed  Google Scholar 

  189. Boveda C, Fajardo M, Millan B. Root canal treatment of an invaginated maxillary lateral incisor with a C-shaped canal. Quintessence Int. 1999;30:707–11.

    PubMed  Google Scholar 

  190. Leoni GB, Versiani MA, Pécora JD, Sousa-Neto MD. Micro–computed tomographic analysis of the root canal morphology of mandibular incisors. J Endod. 2013;40:710–6.

    PubMed  Google Scholar 

  191. Sachdeva GS, Malhotra D, Sachdeva LT, Sharma N, Negi A. Endodontic management of mandibular central incisor fused to a supernumerary tooth associated with a talon cusp: a case report. Int Endod J. 2012;45:590–6.

    PubMed  Google Scholar 

  192. Khabbaz MG, Konstantaki MN, Sykaras SN. Dens invaginatus in a mandibular lateral incisor. Int Endod J. 1995;28:303–5.

    PubMed  Google Scholar 

  193. Loushine RJ, Jurcak JJ, Jeffalone DM. A two-rooted mandibular incisor. J Endod. 1993;19:250–1.

    PubMed  Google Scholar 

  194. Barkhordar RA, Nguyen NT. Maxillary canine with two roots. J Endod. 1985;11:224–7.

    PubMed  Google Scholar 

  195. Sousa Neto MD, Zuccolotto WG, Saquy PC, Grandini SA, Pécora JD. Treatment of dens invaginatus in a maxillary canine case report. Braz Dent J. 1992;2:147–50.

    PubMed  Google Scholar 

  196. Orguneser A, Kartal N. Three canals and two foramina in a mandibular canine. J Endod. 1998;24:444–5.

    PubMed  Google Scholar 

  197. Soares JA, Leonardo RT. Root canal treatment of three-rooted maxillary first and second premolars—a case report. Int Endod J. 2003;36:705–10.

    PubMed  Google Scholar 

  198. Lammertyn PA, Rodrigo SB, Brunotto M, Crosa M. Furcation groove of maxillary first premolar, thickness, and dentin structures. J Endod. 2009;35:814–7.

    PubMed  Google Scholar 

  199. Nahmias Y, Rampado ME. Root-canal treatment of a trifid crown premolar. Int Endod J. 2002;35:390–4.

    PubMed  Google Scholar 

  200. Colak H, Aylikci BU, Keklik H. Dens evaginatus on maxillary first premolar: report of a rare clinical case. J Nat Sci Biol Med. 2012;3:192–4.

    PubMed  PubMed Central  Google Scholar 

  201. Rotstein I, Stabholz A, Friedman S. Endodontic therapy for dens invaginatus in a maxillary second premolar. Oral Surg Oral Med Oral Pathol. 1987;63:237–40.

    PubMed  Google Scholar 

  202. Vaghela DJ, Sinha AA. Endodontic management of four rooted mandibular first premolar. J Conserv Dent. 2013;16:87–9.

    PubMed  PubMed Central  Google Scholar 

  203. Gu Y, Zhang Y, Liao Z. Root and canal morphology of mandibular first premolars with radicular grooves. Arch Oral Biol. 2013;58:1609–17.

    PubMed  Google Scholar 

  204. Fan B, Yang J, Gutmann JL, Fan M. Root canal systems in mandibular first premolars with C-shaped root configurations. Part I: microcomputed tomography mapping of the radicular groove and associated root canal cross-sections. J Endod. 2008;34:1337–41.

    PubMed  Google Scholar 

  205. Stecker S, DiAngelis AJ. Dens evaginatus: a diagnostic and treatment challenge. J Am Dent Assoc. 2002;133:190–3.

    PubMed  Google Scholar 

  206. Tavano SM, de Sousa SM, Bramante CM. Dens invaginatus in first mandibular premolar. Endod Dent Traumatol. 1994;10:27–9.

    PubMed  Google Scholar 

  207. Aryanpour S, Bercy P, Van Nieuwenhuysen JP. Endodontic and periodontal treatments of a geminated mandibular first premolar. Int Endod J. 2002;35:209–14.

    PubMed  Google Scholar 

  208. De Moor RJ, Calberson FL. Root canal treatment in a mandibular second premolar with three root canals. J Endod. 2005;31:310–3.

    PubMed  Google Scholar 

  209. Farmakis ET. Four-rooted mandibular second premolar. Aust Endod J. 2008;34:126–8.

    PubMed  Google Scholar 

  210. Demiryürek EO, Gönülol N, Bulucu B. Endodontic treatment of a taurodontic premolar with five canals. Aust Endod J. 2013;39:81–4.

    PubMed  Google Scholar 

  211. Goswami M, Chandra S, Chandra S, Singh S. Mandibular premolar with two roots. J Endod. 1997;23:187.

    PubMed  Google Scholar 

  212. Cleghorn BM, Christie WH, Dong CC. Anomalous mandibular premolars: a mandibular first premolar with three roots and a mandibular second premolar with a C-shaped canal system. Int Endod J. 2008;41:1005–14.

    PubMed  Google Scholar 

  213. Koh ET, Ford TR, Kariyawasam SP, Chen NN, Torabinejad M. Prophylactic treatment of dens evaginatus using mineral trioxide aggregate. J Endod. 2001;27:540–2.

    PubMed  Google Scholar 

  214. Muthukumar RS, Arunkumar S, Sadasiva K. Bilateral fusion of mandibular second premolar and supernumerary tooth: a rare case report. J Oral Maxillofac Pathol. 2012;16:128–30.

    PubMed  PubMed Central  Google Scholar 

  215. Gopikrishna V, Bhargavi N, Kandaswamy D. Endodontic management of a maxillary first molar with a single root and a single canal diagnosed with the aid of spiral CT: a case report. J Endod. 2006;32:687–91.

    PubMed  Google Scholar 

  216. Beatty RG. A five-canal maxillary first molar. J Endod. 1984;10:156–7.

    PubMed  Google Scholar 

  217. Albuquerque DV, Kottoor J, Dham S, Velmurugan N, Abarajithan M, Sudha R. Endodontic management of maxillary permanent first molar with 6 root canals: 3 case reports. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:e79–83.

    PubMed  Google Scholar 

  218. Kottoor J, Velmurugan N, Sudha R, Hemamalathi S. Maxillary first molar with seven root canals diagnosed with cone-beam computed tomography scanning: a case report. J Endod. 2010;36:915–21.

    PubMed  Google Scholar 

  219. Kottoor J, Velmurugan N, Surendran S. Endodontic management of a maxillary first molar with eight root canal systems evaluated using cone-beam computed tomography scanning: a case report. J Endod. 2011;37:715–9.

    PubMed  Google Scholar 

  220. De Moor RJ. C-shaped root canal configuration in maxillary first molars. Int Endod J. 2002;35:200–8.

    PubMed  Google Scholar 

  221. Versiani MA, Pécora JD, Sousa-Neto MD. Root and root canal morphology of four-rooted maxillary second molars: a micro-computed tomography study. J Endod. 2012;38:977–82.

    PubMed  Google Scholar 

  222. Sert S, Bayrl G. Taurodontism in six molars: a case report. J Endod. 2004;30:601–2.

    PubMed  Google Scholar 

  223. Peikoff MD, Christie WH, Fogel HM. The maxillary second molar: variations in the number of roots and canals. Int Endod J. 1996;29:365–9.

    PubMed  Google Scholar 

  224. Kottoor J, Hemamalathi S, Sudha R, Velmurugan N. Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e162–5.

    PubMed  Google Scholar 

  225. Koenen DJ, Pahncke D. Gemination or fusion: use of a CT scan to assist in diagnosis and endodontic treatment of a maxillary second molar—a case report. ENDO. 2008;2:145–51.

    Google Scholar 

  226. Radwan A, Kim SG. Treatment of a hypertaurodontic maxillary second molar in a patient with 10 taurodonts: a case report. J Endod. 2013;40:140–4.

    PubMed  Google Scholar 

  227. Friedman S, Moshonov J, Stabholz A. Five root canals in a mandibular first molar. Endod Dent Traumatol. 1986;2:226–8.

    PubMed  Google Scholar 

  228. Ryan JL, Bowles WR, Baisden MK, McClanahan SB. Mandibular first molar with six separate canals. J Endod. 2011;37:878–80.

    PubMed  Google Scholar 

  229. Reeh ES. Seven canals in a lower first molar. J Endod. 1998;24:497–9.

    PubMed  Google Scholar 

  230. Ashwin R, Arathi R. Taurodontism of deciduous and permanent molars: report of two cases. J Indian Soc Pedod Prev Dent. 2006;24:42–4.

    Google Scholar 

  231. Tsesis I, Steinbock N, Rosenberg E, Kaufman AY. Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth—report of two cases. Int Endod J. 2003;36:372–9.

    PubMed  Google Scholar 

  232. Fan B, Pan Y, Gao Y, Fang F, Wu Q, Gutmann JL. Three-dimensional morphologic analysis of isthmuses in the mesial roots of mandibular molars. J Endod. 2010;36:1866–9.

    PubMed  Google Scholar 

  233. Schäfer E, Breuer D, Janzen S. The prevalence of three-rooted mandibular permanent first molars in a German population. J Endod. 2009;35:202–5.

    PubMed  Google Scholar 

  234. Bolger WL, Schindler WG. A mandibular first molar with a C-shaped root configuration. J Endod. 1988;14:515–9.

    PubMed  Google Scholar 

  235. Filpo-Perez C, Bramante CM, Villas-Boas MH, Hungaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod. 2015;41:231–6.

    PubMed  Google Scholar 

  236. Fava LR, Weinfeld I, Fabri FP, Pais CR. Four second molars with single roots and single canals in the same patient. Int Endod J. 2000;33:138–42.

    PubMed  Google Scholar 

  237. Chokshi S, Mehta J, Chokshi P, Vaidya R. Morphological variations in the root canal system of mandibular second molar: a case series. Endodontology. 2013;25:135–8.

    Google Scholar 

  238. Beatty RG, Krell K. Mandibular molars with five canals: report of two cases. J Am Dent Assoc. 1987;114:802–4.

    PubMed  Google Scholar 

  239. Ballal S, Sachdeva G, Kandaswamy D. Endodontic management of a fused mandibular second molar and paramolar with the aid of spiral computed tomography: a case report. J Endod. 2007;33:1247–51.

    PubMed  Google Scholar 

  240. Fuss Z, Lustig J, Tamse A. Prevalence of vertical root fractures in extracted endodontically treated teeth. Int Endod J. 1999;32:283–6.

    PubMed  Google Scholar 

  241. Farzaneh M, Abitbol S, Lawrence HP, Friedman S. Treatment outcome in endodontics-the Toronto Study. Phase II: initial treatment. J Endod. 2004;30:302–9.

    PubMed  Google Scholar 

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Versiani, M.A., Silva, E.J.N.L., Souza, E., De Deus, G., Zuolo, M. (2022). Managing Canal Anatomies in the Context of Shaping for Cleaning Proposal. In: De Deus, G., Silva, E.J.N.L., Souza, E., Versiani, M.A., Zuolo, M. (eds) Shaping for Cleaning the Root Canals. Springer, Cham. https://doi.org/10.1007/978-3-030-84617-6_8

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