ROOT CANAL ANATOMY AND

MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

PREREQUISITES FOR TREATMENT  furcation canal - result from

1. Thorough knowledge of the RC entrapment of periodontal ligament
morphology during the fusion of the diaphragm
2. Careful interpretation of the angled  Apical delta - root canal break up
radiographs into multiple canal
3. Adequate access to and exploration  Apical foramina - Neurovascular
of the tooth's interior bundle enters through the apical
foramen.
ROOT CANAL MORPHOLOGY AND ITS
SIGNIFICANCE
1. Diagnosis- To know the case
selection and indication for root
canal
2. Treatment-To guide us in all
treatment procedures
3. Prognosis- To predict the outcome
of the treatment

ROOT CANAL SYSTEM

 Entire space in the dentin where the
pulp is housed
 It is very unique

DIVISION OF THE ROOT CANAL

SYSTEM
1. Pulp chamber - found in anatomic
crown
a. pulp horn
b. Roof
c. floor of the pulp chamber

2. Root canal - found in the anatomic

root
a. Accessory, lateral and
furcation canals
b. Apical foramen
c. Apical delta
 accessory canal - formed by the
entrapment of periodontal vessels in
Hertwig's epithelial root sheath
during calcification
ANATOMY OF THE APICAL ROOT
1. Apical Constriction (AC)
- Minor constriction
- smallest diameter
- reference point used as the apical
termination for shaping, cleaning
and obturation
2. Cementodentinal junction (CDJ)
- point where cementum meets
dentin

ENDODONTICS 1 – L.G.G.C 1
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023
- point where pulp tissue ends and
periodontal tissues begin
3. Apical foramen
- circumference or rounded edge,
like a funnel or crater, that
differentiates the termination of the
cemental canal from the exterior
surface of the root
IMPORTANT AIDS IN DIAGNOSING
1. Pretreatment radiographs
2. Examining with sharp explorer
3. Troughing grooves with ultrasonic
tips
4. Staining the chamber floor with 1%
methylene blue
5. Sodium hypochlorite champagne
bubble
6. Visualizing canal bleeding points
7. Dental operating microscope
ANOTHER WAY OF STUDYING RC
SYSTEMS
Ground section
 Done by thinning down the tooth
longitudinally or cross sectionally
with a carborundum
 Disadvantage: Might destroy the real
features of the
Histologic
 The tooth is decalcified using
hydrochloric acid and thinned down
using microtome
 Can be stained further
 Disadvantage: might destroy the true
features of the tooth during
processing
Radiographic
 A two dimensional picture of a three
dimensional object
 Disadvantage: Only dimension is
seen but not the depth
Clearing technique
 The tooth is decalcified with 10%
HCI and the canal is injected with
methylene blue and cleared them
with methyl methacrylate (oil of
wintergreen, making the tooth
transparent
Acrylic cast/silicone injection
 The tooth is decalcified and injected
with fast setting fluid acrylic and the
tooth is split to exposed the
hardened impression of the internal
anatomy
Computed tomography (CT)
 New image reconstruction
techniques provide information of
ENDODONTICS 1 – L.G.G.C 2
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

the root canal anatomy in three CALCIFIC METAMORPHOSIS

dimension  Result of trauma to a recently
 With high resolution digital images erupted tooth
 No need to reexpose patient for  Deposition of hard tissue within the
potential retakes root canal space

FACTORS AFFECTING RC CALCIFICATIONS

MORPHOLOGY
1. Age
2. Caries
3. Developmental anomalies
4. Irritants
5. Attrition
6. Abrasion
7. Erosion
8. Trauma
9. Clinical procedures

AGE
 Physiologic deposition of dentin as
long as the pulp is vital
 Regression in shape and size of the
pulp
RESORPTION
a. Internal resorption may occur
treatment thermoplastic gutta percha
- wider radicular area
b. External resorption
- extraction

COMMONLY SEEN ANOMALIES OF

PULP
CAVITIES
1. Lingual groove
IRRITANTS 2. High pulp horns
 Caries 3. C -shaped canals
 Periodontal disease 4. Presence of extra canals
 Attrition 5. Dilacerations
 Abrasion 6. Den en dente
 Erosion 7. Dens invaginatus
 cavity preparation 8. Taurodontism
 other operative procedures
LINGUAL GROOVE
 Associated with deep narrow
periodontal pocket which often
communicates with pulp causing
endodontic-periodontal relationship

ENDODONTICS 1 – L.G.G.C 3
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

 Frequently seen in maxillary lateral PRESENCE OF EXTRA CANALS

incisor  maxillary first molar - occurrence of
second mesiobuccal canal
o MB1
o MB2
 Mandibular molars - second distal
canal
 Mandibular incisors - labial, lingual
 Mandibular premolars - may have
extra canals
 Man first premolar - most difficult to
treat
HIGH PULP HORNS
 Common in recently erupted teeth
where chance of pulp exposure is
high

DILACERATIONS
 a severe bends or distortion of the
root and crown 45 – 90 degrees

C-SHAPED CANALS
 Single ribbon shaped with 180
degree arc or more
 Usually found in mandibular molars

DENS EN DENTE (DENS

INVAGINATUS
 tooth within the tooth appears in the
coronal third of the tooth

ENDODONTICS 1 – L.G.G.C 4
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

TAURODONTISM (BULL OR PRISM METHODS OF DETERMINING

TEETH) ANATOMIC DATA
 has exaggerated long pulp chamber 1. radiograph shows that the canal
and long crown suddenly stops in the radicular
 bifurcation of root is lower toward the region
apical

2. radiograph also reveals many clues

to anatomic "aberrations"

3. endodontic pathfinder inserted into

the orifice openings will reveal the
direction that the canals take in
leaving the main chamber

4. Digital perception with a hand

Importance of Studying RC Morphology instrument
 To be able to get familiar with the
route in getting to the apex

ENDODONTICS 1 – L.G.G.C 5
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

5. Fiberoptic illumination can reveal Type II

calcifications, orifice location, and  two separate canals leaving the
fractures chamber but exiting as one canal
 21

Type Ill
6. Knowledge of root canal anatomy  two separate canals leaving the
will prompt the clinician always to chamber and exiting as two separate
search for additional canal orifices foramina
where they are known to  22
7. Further knowledge of root formation
can save the clinician difficulties with
instrumentation
8. Ethnic characteristics as well as
other physical differences can be
manifested in tooth morphology,

ROOT CANAL CONFIGURATION Type IV

 one canal leaving the chamber but
dividing into two separate canals
and exiting in two separate foramina
 12

Type I
 single canal from pulp chamber to
apex
 11

ENDODONTICS 1 – L.G.G.C 6
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023
ROOT CANAL ANATOMY
Maxillary Central Incisor
 Eruption: 7 to 8 years
 Age of calcification: 10 years
 Average length: 22.5 mm
 Newly erupted has 3 pulp horns
 Pulp chamber is wider mesiodistally
than buccolingually
 Rectangular from labial aspect
 Shovel shape from the proximal
 Lateral and accessory canals are
common
Maxillary Lateral Incisor
 AE: 8 to 9 vrs
 AC: 11 yrs
 AL: 22 mm
 Two or no pulp horns may be
present
 PC at the center, shape maybe
triangular, round or ovoid
 Root is slightly conical
 Apex curve toward distal
Maxillary Canine
 AE: 10 to 12
 AC: 13 to 15
 AL: 26.5 mm
 Longest tooth
 PC is wider labiolingually than
mesiodistally
 No pulp horns
 Radicular canal is straight and quite
long
 Apex often curves in the last 2 to 3
mm and it can turn direction
 Apical foramen usually close to the
anatomic apex but may be laterally
positioned
 Less accessory and lateral canals
Maxillary first premolar
 AE: 10 to 11
 AC: 12 to 13
 AL: 20.6 m][
 Commonly two rooted (buccal and
palatal); OR three (mesiobuccal,
distobuccal and palatal)
 Canal orifices lie below and slightly
central to the cusp tips
 Mesial concavity which make the
area below the pulp chamber
laterally thin
 Palatal orifice is slightly larger than
the buccal
ENDODONTICS 1 – L.G.G.C 7
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

2. Distobuccal - conical. Oval and

becomes round as it approaches the
apical 3rd
3. Palatal - longest , has the largest
diameter and easiest to access
- flat, ribbon like and wider in
MD direction
 Cusp of carabelli- Lingual to the ml
Maxillary Second Premolar cusp
 AE: 10 to 12
 AC: 12 to 14
 AL: 21.5 mm
 Usually has one root
o may have two separate
canals, two canals
anastomosing to a single
canal, or two canals with
interconnections or webbing

Maxillary second molar

 AE: 11 to 13
 AC: 14 to 16
 AL: 20 mm
 Three roots are group closer
together and are sometimes fused
 No fourth canal

Maxillary First Molar

 Average tooth length is 21 mm

THREE roots are

1. Mesiobuccal
a. MB1 – MESIOBUCCAL
b. MB2-MESIOLINGUAL -
smallest

ENDODONTICS 1 – L.G.G.C 8
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

Maxillary third molar

 Average time of eruption: 17 to 22
years
 Average age of calcification: 18 to
25 years
 Average length: 17.0 mm
 Some third molars will have only a
single canal, some two, and most
three.
 The orifice openings may be made
in either a triangular arrangement or
a nearly straight-line.

Mandibular Canine
 AE: 9 10 10
 AC: 13 years
 AL: 25.6 mm
 Occasionally two canals and two
Mandibular Central and Lateral Incisor roots
 AE: 6 to 8  If there are two roots, one is always
 AC: 9 to 10 easier to instrument
 AL: 20.7 mm  Ovoid labiolingually
 Wider labiolingually  Anterior teeth that can have 2 roots
 Smallest teeth
 Frequently have two canals
 Apical curvatures and accessory
canals - common
 Labial and lingual canal
 Because canal is broad
labioingually, a dentinal bridge is
present that divides the root into two
canals
 May exit through single foramen or
may persist into two separate canals

ENDODONTICS 1 – L.G.G.C 9
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

Mandibular first premolar  In 1991 case reported with four

 AE: 10 to 12 distinct canals
 AC: 12 to 13  mental foramen: parasthesia
 AL: 21.6 mm
 Can be very easy or very difficult to
treat
 Zillich and Dowson reported that " a
second or third canal exist in at least
23%
 Canals may divide anywhere
 Pulp chamber has two pulp horns
a. Buccal - more prominent Mandibular first molar
b. Lingual  AE: 6 years
 AC: 9 to 10
Studies by VERTUCCI  AL: 25 mm
74% - one canal at the apex  Quadrilateral in cross section a the
25.5% - two canals at the apex level of the pulp floor, wider
0.5% - three canals at the apex mesiodistally
There is also an existence of C-shaped  Roof the PC is rectangular in shape;
canals in 14% acc to Kulild and Weller straight mesial wall and rounded
distal wall
 3-4 canals

Mandibular 2nd Premolar

 AE: 11 to 12
 AC: 13 to 14
 AL: 22.3 mm
 97.5% one canal at the apex acc to
Vertucci, Seelig and Gillis
 2.5 % two canals

ENDODONTICS 1 – L.G.G.C 10
 ROOT CANAL ANATOMY AND
MORPHOLOGY
Lecturer: Dr. Elvie Pesigan
Date of Lecture: 02.20.2023

Mandibular 2nd molar Long root (canine 41 mm, central incisor 30

 AE: 11 to 13 mm)
 AC: 14 to 15  Discovered by Dr. Gary Wilkie of
 AL: 19.8 mm Korumburra, Victoria, Australia. Px is
 Smaller than 1st molar 31 yrs old 5'2" from Netherlands
 Can have 3-4 canals present

THE KEYWORD in understanding the root

Mandibular third molar
 Average time of eruption: 17 to 21
years
 Average age of calcification: 18 to
25 years
 Average length: 18.5 mm
 Common to see c-shaped canal
canal morphology is VARIATION. Once we
know the variation, we an truly grasp and
appreciate the internal anatomy of the root
canal as an important tool in Endodontic
diagnosis, treatment and prognosis

ENDODONTICS 1 – L.G.G.C 11