Hess anatomy

One of the first studies in the world about dental anatomy described with great details. Prof. Walter Hess 1885-1980

iBook available at iTunes.

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Finally, we have released our IBook version of the Internal Anatomy of human teeth. An interactive atlas of the internal dental anatomy – Free lite version- from the Bauru School of Dentistry, University of São Paulo, Brazil, made possible by the use of microcomputed tomography. This book is available for download on your iPad with iBooks 2 or on your computer with iTunes. To read this book, you must be using an iPad with iBooks 2.

Thanks for visit us!

http://itunes.apple.com/us/book/internal-anatomy-human-teeth./id534097316?mt=11

Maxillary Molars

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Maxillary first molars usually present 3 roots. The presence of an additional canal in the mesial root (MB2) has been the subject of several studies that includes the use of histological techniques, microcomputed tomography or by clinical observation through the use of magnifications during the root canal treatment. It is accepted that the use of the operative microscope has resulted in an increase of the detection rate of the MB2 system. Failure to treat and fill this additional canal can lead to failure of the root canal treatment.

Recommended papers

Root and Root Canal Morphology of the Human Permanent Maxillary First Molar: A Literature Review

Canal Morphology of Maxillary Molars: Clinical Observations of Canal Configurations

Root canal morphology of the mesiobuccal root of maxillary first molars: a micro-computed tomographic analysis

Apical delta

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The root canal space is an arborizational, anastomotic, labyrinthine complexity, morphologically comparable to the pathways of a maze. While primary canals exist, the tributaries, accessory branches and lumina of the dentinal tubuli harbor extensive tissue and microflora.  The existence of these vast, capacious passages has been demonstrated throughout the past century beginning with the work of Hess and continues to this day with the use of micro computed tomography.
Presence of multiple foramina, additional canals, fins, deltas, intercanal connections, loops, C-shaped canals and accessory canals are an integral part of the pulpal anatomy. Morphology of the apical portion of the root varies tremendously, including numerous accessory canals formed as a result of entrapment of periodontal vessels in Hertwig’s epithelial root sheath during calcification, areas of resorption and its repair, attached, embedded and free pulp stones, varying amounts of irregular dentin, intercanal connection that may become exposed and single foramen may become multiple.Adding to these is the root curvature especially in the apical portion, which makes the endodontic treatment all the more complex.

Maxillary premolar

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The maxillary first premolar is located in the upper jaw. At least 55% of maxillary first premolar present a single root, 41% present 2 roots and 3% presents 3 roots (Pecora et al. 1991). This roots presents deep longitudinal depressions , enlargement of the root canal system for post placement should be performed with caution to avoid accidents.

Recommended papers

Root form and canal anatomy of maxillary first premolars. Pecora et al. 1991

Root canal treatment of three-rooted maxillary first and second premolars:  a case report 

Maxillary first premolars with three root canals: an anatomic evidence of clinical relevance 

Furcation Groove of Maxillary First Premolar, Thickness, and Dentin Structures 

Access preparation for premolar

Maxillary Lateral Incisor

The maxillary lateral incisor is narrower mesio-distally than the  central incisor. This tooth can be variable. Often the tooth is narrow, conical, or peg-shaped. Dental anomalies include the presence of talon cusp, palatogingival groove, dens invaginatus, conical crown or peg-shaped

Dens Invaginatus is an uncommon anomaly of teeth probably resulting from an infolding of the dental papilla during tooth development. The most widely used classification of dens invaginatus has been proposed by Oehlers (1957), who’s described the malformation in three forms:

Type I: an enamel-lined minor form occurring within the confines of the crown not extending beyond the amelocemental junction.

Type II: an enamel-lined form, which invades the root but remains confined as a blind sac. It may or may not communicate with the dental pulp.

Type III: a form which penetrates through the root perforating at the apical area showing a ‘second foramen’ in the apical or in the periodontal area. There is no immediate communication with the pulp. The invagination may be completely lined by enamel, but frequently cementum will be found lining the invagination.

According Ridell et al. (2001) the Type I is the most prevalent (79%), in sequence Type II (15%) and Type III (5%).

Recommended lectures:

Clinical management of palatogingival groove

Palatogingival groove: An enigma

Multiple dens invaginatus affecting maxillary lateral incisors

Freqüência do sulco palatogengival e morfologia dos canais de dentes portadores antes e depois do preparo biomecânico (In Portuguese)

Maxillary Central Incisor

The maxillary central incisor presents commonly one root canal. However, the occurrence of additional canals has been reported. Traumatic injury of the maxillary central incisor is not uncommon in children and adolescents. In 50-70% of trauma cases the maxillary central incisor is affected by fractures that can involve the dental pulp. Common pathological complications after trauma include pulp necrosis, pulp obliteration, dental ankylosis, internal resorption and external cervical resorption.

Recommended lectures:

Epidemiology of Dental Trauma. A review of literature

Dental Trauma guide

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