Clinically relevant dimensions of 3-rooted maxillary premolars obtained via high-resolution computed tomography

This study aimed to characterize the dimensions of a selection of 3-rooted maxillary premolars through high-resolution computed tomographic analysis considering measures of clinical interest for root canal treatment, such as root wall thickness, canal diameters, and distances between 2 canals in fused roots and between the root apex and foramen.

Fifteen 3-rooted human maxillary premolars extracted for therapeutic reasons were individually scanned using a high-resolution desktop high-resolution computed tomographic system. Starting from the apical foramen, the selected cross-sectional images corresponding to each millimeter of the roots were evaluated. Measures of clinical interest were determined using Image J software (version 1.41; National Institutes of Health, Bethesda, MD).

Root wall thickness as thin as 0.4 and 0.6 mm was detected in the apical portion of buccal and palatal roots, respectively. In the cervical portion, buccal roots had narrower root walls (0.817-1.670 mm) compared with palatal roots (1.361-2.720 mm). In all thirds, the palatal canal was wider compared with the mesiobuccal and distobuccal canals. In the buccopalatal direction, all roots had thicker root walls toward the furcation, whereas in the mesiodistal direction the mesiobuccal and distobuccal roots had the thinnest walls along their distal and mesial aspects, respectively. Both buccal canals revealed dentin apposition 2 mm from the canal orifice, resulting in cervical constriction. Generally, the distance between the root apex and the foramen was greater in distobuccal roots in comparison with the others with a tendency for foramina to be eccentric.

Three-rooted premolars are a clinical challenge not just because of their low frequency and difficulties regarding diagnosis and root canals access but also because of their fragile roots. These phenomena are critical in terms of the amount of dentin removed during the preparation of root canals and during post space preparation.