Accessory roots and root canals in human anterior teeth: a review and clinical considerations

By Ahmed HM, Hashem AA

Date: 01/2017
Journal: JOE

Summary:  

•Purpose: to summarize prevalence and etiology of accessory roots and root canals in anterior teeth, clinical and radiographical detection by conventional and contemporary tools, and treatment modifications and clinical outcome. 

•Materials/Methods: 

•Electronic search for articles published in Jan. 1970 to Nov. 2014 in 5 major endodontic journals; Australian Endodontic Journals, Dental Traumatology; International Endodontic Journal, Journal of Endodontics, and Oral Surgery Oral Medicine Oral Pathology.

•n: 86  Inclusion criteria; exclusion criteria:

Table.1

Highlights:

•Maxillary anterior teeth:

•Most common root canal configuration is type IV (2-2) mostly  in M-D direction

•Mandibular anterior teeth:

•More complex root canal configuration than their maxillary counterparts •Most common root canal configuration is type IV (2-2) and type V (1-2) mostly in labiolingual direction

•Dense invaginatus: 

•invagination of the enamel organ into the dental papilla prior to calcification Prevalence: ranges from<1% to > 26%

•Types:

•1- Type I: Most common; confined enamel form to the crown and do not extend to the CEJ

•2- Type II: Confined enamel form extend to the root as a blind sac ± pulp communication. Radiographic appearance is a RL tear drop shape surrounded by RO border

•3- Type III: The invagination perforate the root showing a second foramen; cementum is frequently found; no immediate communication to the pulp. Radiographic appearance is a  blunderbuss opening to the PDL (pseudo canal)

•Found mostly maxillary lateral > maxillary central > mandibular incisors and canine

Highlights:

•Palato-gingival groove (radicular lingual groove; disto-lingual groove): •Prevalence: ranges from  <1% to >18% •Primary maxillary canine has more prevalence of Double roots than their mandibular counterparts

Strengths: Overview of accessory roots’ prevalence, canal configuration type, radiographic appearance and treatment options.

  Weakness:  Did not state the sample   size directly instead presented it in tables and inter/intra   reviewer  reliability were not mentioned.