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Study of the apical foramen location in the extracted first

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سمن غفاری

on 4 March 2014

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Transcript of Study of the apical foramen location in the extracted first

*In order to have a successful RCT, it is necessary to gather complete information on root canal anatomy

*Apical foramina are not always located on the tip of the root

*In radiography, root’s body may cover the Apical Foramen which is placed in Buccal or Lingual position

*Deviations were reported within a domain of
34 to 92 %

*There is no reported research on identifying apical foramen in mandibular first permanent molars
Review of Literature
To determine the apical foramen location in the extracted mandibular first permanent molars
"Evaluation of the apical foramen location in mandibular first permanent molars"

Dr. Nahid Akhlaghi

Dr. Zohre Khalilak

Saman Ghaffari

Materials and Method
Including criteria:

Extracted mandibular first permanent molars from Iranian population
Intact & mature apexes
No previous RCT
No cracks or fractures on the body of the root
No internal or external root resorption
*Morphologic Analysis of the Root Apex in Human Teeth

Martos et al, 2010 J Endod
*Topographical evaluation of the major apical foramen in permanent human teeth

Martos et al, 2009 Int Endod J
*The morphology of the apical foramen in posterior teeth in North Indian population
Arora and Tewari, 2009 Int Endod J
*The distance of the main and auxiliary opening from the top of the mesial and distal root of the first lower permanent molar
Joranovic-Medojeric and Zirkovic, 2005 Serbian Dental J
*Study of foramen openings and their concurrence with root apexes
Sayao et al, 2005 RSBO
*Morphology of the Physiological Foramen Maxillary and Mandibular Molars
Marroquin et al, 2004 J Endod

PA radiography (BL)
Access cavity in 150 remained teeth
Sodium hypochlorite 5.25 %
Washed in running tap water (10 min)
Mandibular first permanent molars have been collected & disinfected (Sodium hypochlorite 5.25 %)
K file (#8 or #10) in canals
Black ink was injected into the canals

5% Nitric acid
/ 4 days
Runing tap water / 3 hours

100% Ethyl alcohol
/ one day

Methyl salicylate
/ one day
Stereo microscope
According to the findings:

Considering AF-Apex distance
Not merely relying on the radiography system
Applying tools such as accurate Apex locator
Problems and Limitations
Collecting 150 teeth that match Including criterias
Loss of the samples in the study
Harsh conditions of purchase and maintenance solutions
Lack of sufficient practical experience in clearing process
Collecting more samples to obtain more precise data
Developing the laboratory site & equipment for further researches in the University
CBCT for evaluating teeth anatomy
for your attention

Numbers of roots
The distance between AF-Apex
AF location
Numbers of primary foramina
Numbers of root canals

(Magnifying glass ×2.5)

MB & ML M > D > C

DB & DL D > C


* Martos et al, 2010/ AF location in MM:
(Optic microscope)
Over ¾


* Martos et al, 2009/ AF location in MM:
(Stereo microscope)
C: 33.4% D: 22.3% B: 20.3%
M: 12% L: 11.7%

Tamse et al, 1988/ AF location in Distal root of MM:
(Stereo microscope)
D: 60% C: 15%

AF-Apex Distance:

(Stereo microscope ×10)

ML: 0.89 mm

DL: 0.87 mm

MB: 0.76 mm


DB: 0.59 mm

DM: 0.15 mm

Marroquin et al, 2004/ AF-Apex Distance in MFPM:
(Stereo microscope ×40)

DL: 0.97mm >
ML: 0.86mm
>DB: 0.84mm >

Sayao et al, 2005/ AF-Apex Distance in MPM:
DL: 1.3mm >
MB: 0.71mm
> DB: 0.67mm >ML:0.64mm

Joranovic et al, 2005/ AF-Apex Distance MFPM:
( Microscope ×40)

18-25: 0.71mm 0.81mm
M 26-50: 0.84mm D 0.89mm
Over51: 0.61mm 0.114mm

Tamse et al, 1988/ AF-Apex Distance in Distal root of MM:
(Stereo microscope)

0.81 mm
99% : 2 canals 2 Foramina: 71.33 %
Mesial Root
0.67% :1 canal 1 Foramen: 28 %

54 % :2 canals 2 Foramina: 22.67%
Distal Root
46 % :1 canal 1 Foramen: 77.33 %

Marroquin et al, 2004:

M 87%
( 2 foramina)

D 60% ( 2 foramina)
Jung et al, 2005:
Mesial root of MFPM
95% (2 canals)
Full transcript