Pulp Space Morphology PDF

Pulp Space Morphology By: Dr. Mohamed Samir Associate Professor of Endodontics OBJECTIVES 1- Pulp ( Contents & Compartments) 2- Pulp space morphology: → a. Root canal system → b. Pulp space morphology of anterior teeth → c. Pulp Space morphology of premolars → d. Pulp Space...

Pulp Space Morphology By: Dr. Mohamed Samir Associate Professor of Endodontics OBJECTIVES 1- Pulp ( Contents & Compartments) 2- Pulp space morphology: → a. Root canal system → b. Pulp space morphology of anterior teeth → c. Pulp Space morphology of premolars → d. Pulp Space morphology of molars  RATIONAL  A successful endodontic treatment depends mainly on proper diagnosis, thorough cleaning and shaping and 3D obturation.  The gate to successful cleaning and shaping is a properly designed access cavity which in turn is very much dependable on the macroscopic anatomy of the tooth.  The pulp space is the central cavity within a tooth that is entirely enclosed by dentin except at the apical foramen. 1-THE PULP SPACE IS DIVIDED INTO :  1)Coronal pulp space a- Pulp chamber b- Pulp horns  2)Radicular pulp space a- Root canal b- Accessory canals The apical foramen  PULP SPACE Pulp horn Pulp chamber Root canal Root canal orifice Lateral canal Apical foramen Accessory foramina 1) CORONAL PULP SPACE Def: It is the space occupied by the pulp tissue within the crown.  a- Pulp chamber: - It is the pulp space that lies within the crown of the tooth. The shape of the pulp chamber usually reflects the external form of the crown.  b- Pulp horns: - These are accentuations in the roof of the pulp chamber that lie directly below cusps. 2) RADICULAR PULP SPACE:  Def: It is the space occupied by the pulp tissue within the root. a- Root canal: It is the part of the pulp space that lies within the root of the tooth. It starts by an orifice and ends by an apical foramen. The root canal tapers till it reaches its narrowest diameter at the apical constriction.  b- Accessory canals: -These are lateral branches of the main root canal communicating the pulp space with the periodontium and ending with accessory foramina. -Although they could exist at any level along the length of the root canal, they are mainly detected at the apical third of the canal as well as at the furcation area in multirooted teeth. ACCESSORY CANALS  THE APICAL FORAMEN:  It is an aperture at or near the apex of the root through which the blood vessels and nerves of the pulp would enter or leave the pulp cavity.  Anatomical studies had demonstrated that the apical foramen could be located within the anatomical apex in only 17-46% of the cases. It could also exist on the mesial, distal, labial or lingual sufaces at an average of 0.4-0.7 mm away from the anatomical apex. The average size of the apical foramen is varies from 0.3 to 0.6mm LOCATION OF THE APICAL FORAMEN THE APICAL FORAMEN Minor apical diameter Major apical diameter  ROOT CANAL CLASSES:  Root canals can be classified according to maturity of the canals (completion of root canal formation) and curvature as follows: Class I : Mature, straight root canals Class II : Mature, curved root canals that could be:  Slightly curved  Severely curved  Dilacerated  Bayonet Class III : Immature with open apex that could be:  Blunderbuss  Tubular ❖ANOTHER CLASSIFICATION (WEINE)  Types of Root Canal Configurations (Systems):  Type I : Single root canal with one orifice and one apical foramen  Type II : Two root canals with two orifices and one apical foramen  Type III : Two root canals with two orifices and two apical foramina WEINE CLASSIFICATION  Type IV: Single root canal with one orifice and two apical foramina forming an apical delta.  Type V: Single root canal with one orifice that divides into two canals within the body of the root forming a dentin island then reunite to exit with one apical foramen.  Type VI: Two root canals with two orifices that unite within the root into one canal then divide again at the apical third into two canals with two apical foramina WEINE CLASSIFICATION Type IV Type V Type VI  Type I Type II Type III Type IV Type V Type VI Orifice single Two Two Single Single Two 2 Canals Branching in unite at middle 1/3 cervical 1/3 Root Canal single Two Two Single surrounding a then divide dentin island at apical 1/3 Apical single single Two Two single Two Foramen Weine Type I Root canal system Type II Type III Type IV Type V Type VI  PULP SPACE MORPHOLOGY OF ANTERIOR TEETH Maxillary Central Incisor:  Average Length: 23mm  Root Number and Form: One and bulky --- - Canal Type: Type I  Outline form: Triangular in the middle one third of the palatal surface with base incisally and apex cervically. MAXILLARY CENTRAL INCISOR THE ACCESS CAVITY  MAXILLARY LATERAL INCISOR:  Average Length: 22.5mm  Root Number and Form :One slender root frequently with an apical distal and/or a palatal curvature Canal Type: Type I  Outline form: Triangular in the middle one third of palatal surface. MAXILLARY LATERAL INCISOR THE ACCESS CAVITY(DOP)  MAXILLARY CANINE:  Average Length:26 mm; the longest root in the oral cavity.  Root Number and Form: One root, slender mesio-distally and bulky labio-lingually.  Distal/ labial apical curvature may be present. Canal Type: Type I  Outline form: Oval inciso-gingivally in the middle third of the palatal surface MAXILLARY CANINE THE ACCESS CAVITY(DOP) MANDIBULAR CENTRAL AND LATERAL INCISOR:  Average Length: 21 mm  Root Number and Form: One root It has distal and /or lingual curvature.  Canal Type: Type I 60%-70% Type II, Type III 30%-40%  Outline form: Triangular in the middle third of the lingual surface. MANDIBULAR CENTRAL AND LATERAL INCISOR THE ACCESS CAVITY(DOP)  MANDIBULAR CANINE:  Average Length: 24mm  Root Number and Form: One root that is narrow mesiodistally, but broad labiolingually.  Canal Type: Type I 94%  Type II, III 6%  Outline form: Oval labiolingually in the middle one third of lingual surface. MANDIBULAR CANINE THE ACCESS CAVITY(DOP)  PULP SPACE MORPHOLOGY OF PREMOLARS  Maxillary First Premolar:  Average Length: 21mm  Root Number and Form: Two roots in 60% of the cases; buccal and palatal.  One root in 38% of the cases  Canal Type: Two roots: Each has Type I One root: Type III most frequent Type II less frequent  Outline form: Oval in buccolingual dimension, in the center of the occlusal surface. MAXILLARY FIRST PREMOLAR THE ACCESS CAVITY(DOP)  MAXILLARY SECOND PREMOLAR:  Average Length: 21 mm  Root Number and Form: One root in 85% of the cases. Two roots in 15% of the cases.  Canal Type: -One root:  Type I most frequent  Type II less frequent  -Two roots: Each has type I; Bayonet curve could be found in 20% of the cases.  Outline form: Oval buccolingual in the center of the occlusal surface MAXILLARY SECOND PREMOLAR THE ACCESS CAVITY(DOP)  MANDIBULAR FIRST PREMOLAR:  Average Length: 22mm  Root Number and Form: One root. Rarely two roots can exist; buccal and lingual.  Canal Type: - One root:  Type I most frequent 75%  Type II or III or IV less frequent - Two roots:  One canal is present in each root (type I).  Outline form: Ovoid buccolingually. The access cavity is located in the occlusal surface slightly towards the buccal cusp MANDIBULAR FIRST PREMOLAR THE ACCESS CAVITY(DOP)  MANDIBULAR SECOND PREMOLAR:  Average Length: 21.5mm  Root Number and Form: One root. Two roots can occur rarely; buccal and lingual.  Canal Type:  One root: Type I most frequent(85%) Type II, III, IV less frequent (15%) Outline form: Ovoid buccolingually in the center of the occlusal surface. MANDIBULAR SECOND PREMOLAR THE ACCESS CAVITY(DOP) OVAL VS OVOID PULP SPACE MORPHOLOGY OF MOLARS Maxillary First Molar:  Average Length: 20.5mm  Root Number and Form: Three roots, two buccal and one palatal. o Canal Type: o -MB root: Type II, III most frequent (over 90%) Type I least frequent o -DB root: Type I, narrow o -P root: Type I, wide and broad  Outline form: Triangular, with base towards the buccal and the apex towards the lingual.  Orifices are positioned at the angles of the triangle.  The orifice of the MB canal is usually located under the MB cusp tip.  DB orifice is 2 mm distal and palatal to the MB orifice.  P orifice is usually found on the same straight line palatal to the DB orifice.  -In case of a fourth canal detected, second mesio- buccal canal (MB2), the outline form would be a quadrilateral.  The cavity is entirely within the mesial half of the tooth. MAXILLARY FIRST MOLAR  THE ACCESS CAVITY MB 1 DB MB 2 P  THE ACCESS CAVITY(DOP) MB2  MANDIBULAR FIRST MOLAR:  Average Length: 21 mm  Root Number and Form: Two roots, one mesial and one distal.  Canal Type: - Mesial root: always has two canals; Type III 90% Type II 10% -Distal root: Type III, II 60%-70% (DB&DL) Type I 30%-40%  The orifices of the mesial and distal canals lie in the mesial 2/3 of the crown.  - Outline form: triangular, with base towards the mesial and the apex towards the distal.  -Orifices are positioned at the angles of the triangle.  The orifice of the MB canal is usually located under the MB cusp tip,  ML orifice is 2 mm lingual to the MB orifice,  D orifice is usually located 1 mm distal to the central fossa.  In case of a fourth canal detected, DB or DL, the outline form would be a quadrilateral. MANDIBULAR FIRST MOLAR  THE ACCESS CAVITY MB D ML  THE ACCESS CAVITY MB MMM LDB MMM LML DL THE ACCESS CAVITY(DOP)  VARIATIONS IN THE INTERNAL ANATOMY OF TEETH  Causes: a-Age b-Calcification c-Irritation d-Resorption 1.Variations in development 2. Variations in shape of pulp cavity 3. Variations in size of tooth  1.VARIATIONS IN DEVELOPMENT i. Gemination - A disturbance during odontogenesis in which partial cleavage of the tooth germ occurs and results in a tooth that has a double or “twin” crown ii. Fusion - A “double” tooth resulting from the union of two adjacent tooth germs. iii. Concrescence - Cemental fusion of two roots. Gemination Fusion Concrescence  2. VARIATIONS IN SHAPE OF PULP CAVITY C-shaped -This type of canal is usually found in mandibular molars. -Pulp chamber in C-shaped molar is single ribbon shaped with 180 degree arc or more.  3. VARIATIONS IN SIZE OF TOOTH i. Macrodontia ii. Microdontia  Q&A  What is the outline form of upper lateral tooth? A- Triangular B- Round C- Square D- Ovoid Thank You