Root anatomy and root canal configuration of human permanent mandibular premolars: a systematic review.
Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24%) while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.
Department of Conservative Dentistry and Endodontics, Mar Baselios Dental College, Kothamangalam, Ernakulam, Kerala 686691, India.
Jojo
J
Kottoor
Endodontic Speciality Practice, Dental Expert, Orlem, Malad, Mumbai 400064, India.
Denzil
D
Albuquerque
Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai 600 095, Tamil Nadu, India.
Natanasabapathy
N
Velmurugan
Department of Public Health Dentistry, Mar Baselios Dental College, Kothamangalam, Ernakulam, Kerala 686691, India.
Jacob
J
Kuruvilla