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Molar Access

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The Guidebook to Molar Endodontics

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Abstract

The preparation of an endodontic access is a key step during root canal therapy, in particular for molar teeth. This chapter describes design and preparation of molar access cavities to facilitate successful endodontic therapy and to identify, avoid, and overcome potential complications that may arise during treatment. Procedural errors during access significantly reduce the expected outcome for root canal treatment; therefore detailed knowledge of canal and tooth anatomy and a conscientious instrumentation strategy is required for this step in molar endodontics.

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References

  1. Nattress BR, Martin DM. Predictability of radiographic diagnosis of variations in root canal anatomy in mandibular incisor and premolar teeth. Int Endod J. 1991;24:58–62.

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  3. Schäch 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.

    Article  Google Scholar 

  4. Slowey RR. Radiographic aids in the detection of extra root canals. Oral Surg Oral Med Oral Pathol. 1974;37:762–72.

    Article  PubMed  Google Scholar 

  5. Benye B. Identification of dental root canals and their medial line from micro-CT and cone-beam CT records. Biomed Eng Online. 2012;11:81.

    Article  Google Scholar 

  6. Abbott PV. Assessing restored teeth with pulp and periapical diseases for the presence of cracks, caries and marginal breakdown. Aust Dent J. 2004;49:33–9.

    Article  PubMed  Google Scholar 

  7. Pecora JD, Woelfel JB, Sousa Neto MD. Morphologic study of the maxillary molars. 1. External anatomy. Braz Dent J. 1991;2:45–50.

    PubMed  Google Scholar 

  8. Gani O, Visvisian C. Apical canal diameter in the first upper molar at various ages. J Endod. 1999;25:689–91:68.

    Article  PubMed  Google Scholar 

  9. Foreman PC, Soames JV. Structure and composition of tubular and non-tubular deposits in root canal systems of human permanent teeth. Int Endod J. 1988;21:27–36.

    Article  PubMed  Google Scholar 

  10. Le May O, Kaqueler JC. Scanning electron microscopic study of pulp stones in human permanent teeth. Scanning Microsc. 1991;5:257–67.

    PubMed  Google Scholar 

  11. Smith AJ. Ch 3. Dentine formation and repair. In: Hargreaves KM, Goodis HE, editors. Seltzer and Bender’s dental pulp. Berlin: Quintessence; 2002.

    Google Scholar 

  12. Allen PF, Whitworth JM. Endodontic considerations in the elderly. Gerodontology. 2004;21:185–94.

    Article  PubMed  Google Scholar 

  13. Acosta Vigouroux SA, Trugeda Bosaans SA. Anatomy of the pulp chamber floor of the permanent maxillary first molar. J Endod. 1978;4:214–9.

    Article  PubMed  Google Scholar 

  14. Leeb J. Canal orifice enlargement as related to biomechanical preparation. J Endod. 1983;9:463–70.

    Article  PubMed  Google Scholar 

  15. Weller RN, Hartwell GR. The impact of improved access and searching techniques on detection of the mesiolingual canal in maxillary molars. J Endod. 1989;15:82–3.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. Bonessio N, Arias A, Lomiento G, Peters OA. Effect of root canal treatment procedures with a novel rotary nickel titanium instrument (TRUShape) on stress in mandibular molars: a comparative finite element analysis. Odontology. 2016. [Epub ahead of print] PubMed PMID: 26847080.

    Google Scholar 

  19. Barbizam JV, Ribeiro RG, Tanomaru Filho M. Unusual anatomy of permanent maxillary molars. J Endod. 2004;30:668–71.

    Article  PubMed  Google Scholar 

  20. Caliskan MK, Pehlivan Y, Sepetcioglu F, Turkun M, Tuncer SS. Root canal morphology of human permanent teeth in a Turkish population. J Endod. 1995;21:200–21.

    Article  PubMed  Google Scholar 

  21. al Shalabi RM, Omer OE, Glennon J, Jennings M, Claffey NM. Root canal anatomy of maxillary first and second permanent molars. Int Endod J. 2000;33:405–14.

    Article  PubMed  Google Scholar 

  22. Skidmore AE, Bjorndal AM. Root canal anatomy of the human mandibular first molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1971;32:778–84.

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. Ross IF, Evanchik PA. Root fusion in molars: incidence and sex linkage. J Periodontol. 1981;52:663–7.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  27. Christie WH. Canal configuration in the mesiobuccal root of the maxillary first molar: a clinical study. J Endod. 1994;20:135–7.

    Article  PubMed  Google Scholar 

  28. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod. 2006;32:813–21.

    Article  PubMed  Google Scholar 

  29. Fogel HM, Peikoff MD, Christie WH. Canal configuration in the mesiobuccal root of the maxillary first molar: a clinical study. J Endod. 1994;20:135–7.

    Article  PubMed  Google Scholar 

  30. Hartwell G, Bellizzi R. Clinical investigation of in vivo endodontically treated mandibular and maxillary molars. J Endod. 1982;8:555–8.

    Article  PubMed  Google Scholar 

  31. Neaverth EJ, Kotler LM, Kaltenbach RF. Clinical investigation (in vivo) of endodontically treated maxillary first molars. J Endod. 1987;13:506–12.

    Article  PubMed  Google Scholar 

  32. Nosonowitz DM, Brenner MR. The major canals of the mesiobuccal root of the maxillary 1st and 2nd molars. N Y J Dent. 1973;43:12–5.

    PubMed  Google Scholar 

  33. Sempira HN, Hartwell GR. Frequency of second mesiobuccal canals in maxillary molars as determined by use of an operating microscope: a clinical study. J Endod. 2000;26:673–4.

    Article  PubMed  Google Scholar 

  34. Buhrley LJ, Barrows MJ, BeGole EA, Wenckus CS. Effect of magnification on locating the MB2 canal in maxillary molars. J Endod. 2002;28:324, 28:3.

    Article  PubMed  Google Scholar 

  35. Stropko JJ. Canal morphology of maxillary molars: clinical observations of canal configurations. J Endod. 1999;25:446–50.

    Article  PubMed  Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. Yoshioka T, Kobayashi C, Suda H. Detection rate of root canal entrances with a microscope. J Endod. 2002;28:452–3.

    Article  PubMed  Google Scholar 

  38. Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93:19–26.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Maggiore F, Jou YT, Kim S. A six-canal maxillary first molar: case report. Int Endod J. 2002;35:486–91.

    Article  PubMed  Google Scholar 

  40. Gu Y, Lu Q, Wang P, Ni L. Root canal morphology of permanent three-rooted mandibular first molars: part II – measurement of root canal curvatures. J Endod. 2010;36:1341–6.

    Article  PubMed  Google Scholar 

  41. Jerome CE, Hanlon Jr RJ. Dental anatomical anomalies in Asians and Pacific Islanders. J Calif Dent Assoc. 2007;35:631–5.

    PubMed  Google Scholar 

  42. Jung HJ, Lee SS, Huh KH, Yi WJ, Heo MS, Choi SC. Predicting the configuration of a C-shaped canal system from panoramic radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e37–41.

    Article  PubMed  Google Scholar 

  43. Manning SA. Root canal anatomy of mandibular second molars. Part II C shaped canals. Int Endod J. 1990;23:40–5.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Endodontics, Penn Dental Medicine, 240 South 40th Street, Philadelphia, PA, 19104, USA

    Frank C. Setzer DMD, PhD, MS

  2. Department of Endodontics, Penn Dental Medicine, Philadelphia, PA, 19104, USA

    Helmut Walsch DMD, PhD, MS

  3. Private Practice, Baierbrunnerstr. 25, 81379, Munich, Germany

    Helmut Walsch DMD, PhD, MS

Authors
  1. Frank C. Setzer DMD, PhD, MS
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  2. Helmut Walsch DMD, PhD, MS
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Corresponding author

Correspondence to Frank C. Setzer DMD, PhD, MS .

Editor information

Editors and Affiliations

  1. Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California, USA

    Ove A. Peters

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Setzer, F.C., Walsch, H. (2017). Molar Access. In: Peters, O. (eds) The Guidebook to Molar Endodontics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52901-0_5

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  • DOI: https://doi.org/10.1007/978-3-662-52901-0_5

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  • Online ISBN: 978-3-662-52901-0

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