Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations.
BACKGROUND
Sound knowledge of the external and internal morphology of the different teeth groups is essential to ensure a successful outcome of root canal treatment. The aims of this study were to review the available literature with respect to the root and root canal morphology of maxillary first premolars and discuss the clinical considerations of this morphology on the various dental procedures.


METHODS
The MEDLINE/PubMed and Scopus databases were searched for relevant literature. The identified publications were classified into anatomic studies and clinical case reports. The data extracted from anatomic studies were tabulated, and weighted averages for certain internal and external morphologic features were calculated. The anatomic and developmental variations in the clinical case reports were summarized.


RESULTS
A total of 92 studies (45 anatomic studies and 47 case reports) including a total of 11,299 teeth were identified. The majority of maxillary first premolars had 1 root (41.7%) or 2 roots (56.6%). Regardless of the number of roots, the vast majority (86.6%) had 2 root canals, with type IV (2-2) being the most common canal configuration (64.8%). The majority of the apical foramina (66.6%) did not coincide with the apical root tip. About 38% of the teeth had lateral canals, 12.3% had apical deltas, and 16.0% had isthmi. The clinical case reports showed that the 3-rooted variant was the most common anatomic variation, and developmental anomalies were rarely reported.


CONCLUSIONS
The maxillary first premolars are predominantly 2-rooted teeth with 2 root canals. However, the clinician should be aware about the possible anatomic variations of these teeth and their relationship with the adjacent anatomic structures while planning and performing endodontic, restorative, periodontal, and surgical procedures.
Dentistry Department, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar. Electronic address: ibrahimali79@yahoo.com.
Ibrahim Ali
IA
Ahmad
Ministry of Health, Kuwait City, Kuwait; Restorative Dentistry Department, College of Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Kingdom of Saudi Arabia.
Mohammad Ahmad
MA
Alenezi
D063405:Anatomic Variation; D001641:Bicuspid / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D003786:Dental Pulp Cavity / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016239:MEDLINE; D008297:Male; D008437:Maxilla; D039781:PubMed; D012390:Root Canal Therapy; D019227:Tooth Apex / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000033:anatomy & histology* / Q000000981:diagnostic imaging
3-rooted premolars; Anatomic variations; furcation grooves; maxillary first premolars; root canal morphology